I'm not convinced I am diabetic!

[laura130310]

I am definitely pre diabetic but I am not convinced I am diabetic.

A bit of background...I had a hba1c of 48 a couple of years ago. The doctor at the time said they wouldnt diagnose as my fasting glucose levels are normal (and still are - they can be pre diabetic levels but have never been diabetic levels). I also went through 3 pregnancies and had GTT and they always came back normal. Last year, I was diagnosed as asthmatic and randomly the nurse said she would test for diabetes. The hba1c was 48 so I was diagnosed (I kick myself because had I have sorted my eating out, I could have dropped the hba1c level and skipped diagnosis).

My Mum is diabetic and every so often, checks my blood sugars - it's usually 5. Today I have had lots of sugar (pancakes for breakfast, birthday cake and a chocolate covered rice cake an hour ago) - my Mum has just tested my sugar levels and its 5. I haven't done much exercise today. I have read the letter that's linked to a lot here and I am going to do what she suggests and record my blood sugar levels throughout the day.

Has anyone been in the same position - just in the hba1c threshold for diagnosis but blood glucose levels throughout the day are normal or pre diabetic?

I still need to overhaul my lifestyle and eating habits. Even if I am more pre diabetic, I need to do something about it but the more I read, the more it confuses me as to why I have been diagnosed.

 

[Ralph-YK]

One off finger prick tests don't always provide a good guide. A HbA1c of 48 is the line for a diagnoses. It's quite possible for a diabetic with a HbA1c of 46-48 to get some readings in the 5's.
On the little bit of self testing I did, I got some 5's and a lot of 6's before eating. After I'd usually get 8's. Except for my old breakfast, which gave me 11 - 12.

 

[Neens]

Hi and welcome @laura130310 - I am not in the best position to advise as recently diagnosed. However, like you say 48 is diabetic and if you are only just or very (mine was 118) it is important that you manage your intake of carbs and monitor your BG.

It would have taken a while for my BG to come down - I am on metaformin and control with Low Carb eating plan. I didn't have a monitor until the 2nd month and often my BG is under 5 (4.7 - 5.3) with just a few readings of 6 - 6.9 which were after chocolate/ banana.

Generally my readings are below 5.5 so you can have the levels of a 'normal'/not diabetic reading and be diabetic.


The forum is informative and supportive. It is hard to accept the diagnosis initially and it must be doubly so when you are so close to not being diabetic. You are in the right place for knowledge and advice.

 

[rebrascora]

Hi and welcome

I think the fact that you have had more than one HbA1c indicating diabetes over the past couple of years suggests that you need to take action whether that be as a diabetic or pre diabetic. The level of 48 is a bit arbitrary anyway but clearly you are showing a higher than normal HbA1c and therefore you need to cut back on carbs.
Have you considered that your mother's meter may be reading slightly low? They are not totally accurate and many people find a significant difference in reading between two meters used on the same spot of blood from their finger, so the 5s you are seeing could possibly be 6s.

My advice would be to get your diet back under control as those HbA1c readings are certainly warning signs that your body is becoming less able to deal with carbs and in the meantime take advantage of the additional health checks which are available to us diabetics.

 

[laura130310]

Hi and welcome @laura130310 - I am not in the best position to advise as recently diagnosed. However, like you say 48 is diabetic and if you are only just or very (mine was 118) it is important that you manage your intake of carbs and monitor your BG.

It would have taken a while for my BG to come down - I am on metaformin and control with Low Carb eating plan. I didn't have a monitor until the 2nd month and often my BG is under 5 (4.7 - 5.3) with just a few readings of 6 - 6.9 which were after chocolate/ banana.

Generally my readings are below 5.5 so you can have the levels of a 'normal'/not diabetic reading and be diabetic.


The forum is informative and supportive. It is hard to accept the diagnosis initially and it must be doubly so when you are so close to not being diabetic. You are in the right place for knowledge and advice.

It's more confusing than hard to accept. I read a post yesterday where someone had a hba1c of 61, they did the right thing (unlike me) and changed their eating habits straight away and brought it down to 45 - their diagnoses is pre diabetic not diabetic.

I hope my post isn't coming across the wrong way - I'm not looking for an excuse to continue eating the way I have been. Diabetic, Pre diabetic or not, I need a lifestyle change. I just find diabetes very strange in how they diagnose etc. I suppose it doesnt help that hba1c is an average and an average can be misleading.

 

[emmgeo]

I am not sure how it all works, but my last two hba1c results have been 31 and 32 and no one has told me that I am not Diabetic.
The only medication I take is two metformin tablets a day.

 

[Ralph-YK]

I am not sure how it all works, but my last two hba1c results have been 31 and 32 and no one has told me that I am not Diabetic.

Your HbA1c is at the lower end of "normal". It might be an idea to ask the Dr about reducing your medication.
Once someone has been dianosed as diabetic, they're down as diabetic, even if they get their levels down as low as yours. However, they can be classed as in 'remission'.

 

[emmgeo]

I only saw the Diabetic nurse last Monday, she said well done we will check it in Six months. I just checked back on my results for last year and they go 34,31, latest 32
I was only diagnosed as a Diabetic last Feb whilst in hospital with Pancreatitis and some other complications.think I was in the 70s in hospital but didnt realy know what was going on at the time.

 

[emmgeo]

Just checked my bloods before eating my Sunday roast 4.2

 

[laura130310]

I am not sure how it all works, but my last two hba1c results have been 31 and 32 and no one has told me that I am not Diabetic.
The only medication I take is two metformin tablets a day.

Once diagnosed, you are always diabetic. Some surgeries will put you into remission but not all will.

 

[Lucylemonpip]

I might be wrong, but I think that when you drop below an HbA1c of 48 and enter pre-diabetic and remission figures, you have to be below 48, for a period of time e.g. ? 2 years, before you can be classed as being officially in remission?

 

[Andy HB]

I only saw the Diabetic nurse last Monday, she said well done we will check it in Six months. I just checked back on my results for last year and they go 34,31, latest 32
I was only diagnosed as a Diabetic last Feb whilst in hospital with Pancreatitis and some other complications.think I was in the 70s in hospital but didnt realy know what was going on at the time.

You've probably already asked them this, but with your pancreatitis, couldn't it have been that which caused your initial symptoms? Are you definitely type 2? I'm with @Ralph-YK, it maybe that you can reduce or even, perhaps, do without the medication all together? But only maybe!

 

[emmgeo]

You've probably already asked them this, but with your pancreatitis, couldn't it have been that which caused your initial symptoms? Are you definitely type 2? I'm with @Ralph-YK, it maybe that you can reduce or even, perhaps, do without the medication all together? But only maybe!

I think I am type 2 but at first they thought my pancreas had stopped producing or producing very little insulin, then they tested me thinking I might be type 3c, but aftet some test to see how much insulin my pancreas is producing they decided I am type 2.
I was on insulin for the first 4 months then taken off insulin and put on 2000 Metformin, since November my Metformin has been reduced to 1000.
Its a big tangled web in my case.

 

[emmgeo]

Two hours after eating roast dinner, two roast potatoes, chicken, carrots, broccolli, gravey and an apple for after. 2.3 rise in bg

 

[laura130310]

I think I am type 2 but at first they thought my pancreas had stopped producing or producing very little insulin, then they tested me thinking I might be type 3c, but aftet some test to see how much insulin my pancreas is producing they decided I am type 2.
I was on insulin for the first 4 months then taken off insulin and put on 2000 Metformin, since November my Metformin has been reduced to 1000.
Its a big tangled web in my case.

I can sympathise with the pancreatitis - I had it twice in the space of 3 weeks a couple of years ago.

 

[everydayupsanddowns]

Welcome to the forum @laura130310

Your random and fasting results do sound excellent, and you say you’ve previously been checked with a GTT, which is odd, because your HbA1c is slightly elevated, which suggests either your BG is now spiking after foods (but not when you are spot-checking), or perhaps something about your biochemistry which is producing a higher than expected HbA1c than might be expected from your BGs.

It might be worth checking BG an hour and then 2 hours after eating, (though it sounds like your birthday cake experiment might have been a version of that?).

If you have anaemia can effect HBA1c, giving a higher reading. Additionally, I believe some people are ‘high glycators’ while others are ‘low glycators’ and can produce higher or lower A1cs than regular people.

It might be worth asking your surgery about those options, though with your Mum already having a diagnosis, it does automatically make it more likely that you might be affected at some point.

 

[laura130310]

Welcome to the forum @laura130310

Your random and fasting results do sound excellent, and you say you’ve previously been checked with a GTT, which is odd, because your HbA1c is slightly elevated, which suggests either your BG is now spiking after foods (but not when you are spot-checking), or perhaps something about your biochemistry which is producing a higher than expected HbA1c than might be expected from your BGs.

It might be worth checking BG an hour and then 2 hours after eating, (though it sounds like your birthday cake experiment might have been a version of that?).

If you have anaemia can effect HBA1c, giving a higher reading. Additionally, I believe some people are ‘high glycators’ while others are ‘low glycators’ and can produce higher or lower A1cs than regular people.

It might be worth asking your surgery about those options, though with your Mum already having a diagnosis, it does automatically make it more likely that you might be affected at some point.

I have been aneamic from time to time (actually I would have been the time they did my second hba1c) so its definitely something to consider.

I am also morbidly obese and I am definitely pre diabetic, if not diabetic. Definitely time to give myself a kick.

I have had 3 GTTs in total (one for each pregnancy). They were all normal and they were after my first hba1c.

It will be interesting to see what readings I get when I record daily throughout the day. Definitely going to discuss with my GP. I had a hba1c done last week so will see what that is as well.

 

[Eddy Edson]

I think it's worth remembering that the HbA1c => estimated average blood glucose (EAG) relationship isn't precise. It was worked out by taking a bunch of people, measuring their blood glucose over time, measuring their HbA1c, and finding the "best fit" between the measures.

The formula they came up with has a "standard deviation" of about 0.8 mmol/L. For an HbA1c of 48 mmol/mol, that means for about two-thirds of people, average BG over the last few weeks was somewhere in the range 7.0 mmol/L to 8.6 mmol/L. And for about one-third of people, the possible range is even wider.

The middle of that range is 7.8 mmol/L, which is seen as the "diabetic" cut-off point - hence 48 mmol/mol is taken as the "diabetic" cut-off in HbA1c terms. But it's quite possible for somebody to have an HbA1c of 48 with actual BG at "pre-diabetic" levels.

(That's before any consideration of anemia etc etc. The main source of variability is average age of yr red blood cells, slightly different for everybody.)

I think the main points are: your excess risk of diabetes related complications with an HbA1c of 48 are hardly-anything; but it is a flag that putting some work into getting BG better controlled makes sense - just as you're doing.

 

[laura130310]

I managed to get my blood results today (although dont see the GP until Thursday).

Hba1c is 42, cholesterol is 4.8 which while on the higher end is considered normal (under 5) so not sure why I had a letter saying I would benefit from a statin. Will see what she says on Thursday.

My BG going to bed last night was 6.2 and this morning after 8hrs fasting was 5.2

 

[Eddy Edson]

Great!