I’m type 2 and I’ve just recently had my hba1c which is averaging 9.1 mmol. But when I test myself usually 3-4 hours after eating my readings are really high about 20 mmol. I mentioned this to the nurse who tested me this morning and it was 18.4 and I’d not even eaten since the night before. She didn’t seem concerned and increased one of my tablets. I’m just concerned about my very high readings.
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Low hba1c high monitor readings
- Thread starter Kaz84
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Docb
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- Type 2
Hi @Kaz84 and welcome to the forum.
I wonder if we have a confusion of units somewhere. 9.1 mmol does not sound like an HbA1c to me. It is normally quoted in mmol/mol and is somewhere between 30 and 100+. Could it be that your HbA1c is 91mmol/mol? Your spot readings in the high teens and twenties would be consistent with this.
I wonder if we have a confusion of units somewhere. 9.1 mmol does not sound like an HbA1c to me. It is normally quoted in mmol/mol and is somewhere between 30 and 100+. Could it be that your HbA1c is 91mmol/mol? Your spot readings in the high teens and twenties would be consistent with this.
Hi thanks for your reply.
my reading was 71 but I asked for it converted to same as my test monitor so I could understand it better.
To be honest I’m not too happy with the nurse I saw. A friend told me to mention ketones and she just said she didn’t have a monitor for it. But she tested my sugar at 18.4. She has increased a tablet but I’ve been having readings like this over 6 months now. She has given me a book to write readings in and said come back in a month. I’m on alogliptin and gliclazide.
Il admit I don’t have the best diet but I’m underweight I weigh about 6stone and a half. So I don’t eat a lot. I don’t eat breakfast just dinner and tea. yesterday I ate
Dinner: toasted tea cake cup of tea
Slice of cake and cup of tea in afternoon
tea: Birdseye chicken dinner
Mint aero a bit later on
I don’t usually eat chocolate and cake in same day but my tea wasn’t huge so had an extra treat.
Docb
Moderator
- Relationship to Diabetes
- Type 2
@Anitram is asking all the right questions.
I would add that I am a little amazed that you were told that an HbA1c of 72 equated to 9.1 on your meter. If anything it is more consistent with spot readings being in double figures for most of the time with highs over twenty. In any case the idea that your HbA1c can be equated to a single reading on your meter is, quite frankly, nonsense.
Looking at your weight and diet it would seem that you do not fit easily into the T2 box and because of that I also find the attitude of the nurse very difficult to understand. Is it possible for you to bypass the nurse and ask to speak directly to your GP because, at least in my non medical opinion, your concern is justified.
I would add that I am a little amazed that you were told that an HbA1c of 72 equated to 9.1 on your meter. If anything it is more consistent with spot readings being in double figures for most of the time with highs over twenty. In any case the idea that your HbA1c can be equated to a single reading on your meter is, quite frankly, nonsense.
Looking at your weight and diet it would seem that you do not fit easily into the T2 box and because of that I also find the attitude of the nurse very difficult to understand. Is it possible for you to bypass the nurse and ask to speak directly to your GP because, at least in my non medical opinion, your concern is justified.
rebrascora
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- She/Her
I will go so far as to say that I think you are likely a misdiagnosed Type 1 diabetic (possibly LADA) taking into account you are underweight and have these very high readings despite taking Gliclazide.
Those consistently high readings are potentially harmful and they should be taken seriously by your health care professionals and you should have a means of testing for ketones.... You can buy Ketostix over the counter at a pharmacy for about £5 if you can't get them from your surgery.
I think you should be pushing for Type 1 testing or at least a a referral to the specialist clinic. Ask them why they think you are Type 2 bearing in mind you don't fit the profile at all and you are clearly not responding to Type 2 medication.
I agree with @Anitram that your diet isn't great and you clearly know that but with levels that high despite taking Gliclazide and being under weight, I would say that your pancreas' insulin production is grinding to a halt and you need insulin therapy sooner rather than later..... just my opinion.
Those consistently high readings are potentially harmful and they should be taken seriously by your health care professionals and you should have a means of testing for ketones.... You can buy Ketostix over the counter at a pharmacy for about £5 if you can't get them from your surgery.
I think you should be pushing for Type 1 testing or at least a a referral to the specialist clinic. Ask them why they think you are Type 2 bearing in mind you don't fit the profile at all and you are clearly not responding to Type 2 medication.
I agree with @Anitram that your diet isn't great and you clearly know that but with levels that high despite taking Gliclazide and being under weight, I would say that your pancreas' insulin production is grinding to a halt and you need insulin therapy sooner rather than later..... just my opinion.
Thank you everyone for the advice and extra information I really appreciate it. I’m glad I have a reason for concern. I think il take the new dose for 3 weeks and keep testing. then make an appointment with the diabetes dr instead. I really don’t want to be on insulin I don’t think anyone does, the last dr mentioned a weekly injection but was concerned about my weight and I had read it can cause thyroid cancer so I really don’t want that.
rebrascora
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- Type 1
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- She/Her
Have they increased the gliclazide dose? If I am right and you are a slow developing Type 1 the Gliclazide could bring about a sudden demise of your beta cells which produce insulin. It is the equivalent of flogging a dying horse!... The only possible result is that it will die quicker. If you start to feel unwell with stomach pain or respiratory trouble get yourself to A&E pronto and please push for a means of testing for ketones or buy some yourself. You should be testing for ketones when your BG levels are consistently mid teens or above. Many GPs have no idea that Type 1 can exhibit at any age and assume that it only happens to children or young adults and assume if you are older that it must be Type 2, but that is not the case. Many of us here were diagnosed with Type 1 much later in life and some of us, misdiagnosed as Type 2 to start with, myself included. There is no specific testing which shows you are Type 2, so it is an assumption unless you are tested for the other rarer types of diabetes. In your case, with you not fitting the profile and being under weight, that should be ringing alarm bells with them and at the very least referring you to a consultant.
I appreciate you don't want to inject insulin, nobody does but when it is essential to survive, as it is for Type 1 diabetics, you learn to live with it. I cried when I was told I would need insulin but now it is just a part of my daily routine like cleaning my teeth.... except it takes a bit more thought.
I appreciate you don't want to inject insulin, nobody does but when it is essential to survive, as it is for Type 1 diabetics, you learn to live with it. I cried when I was told I would need insulin but now it is just a part of my daily routine like cleaning my teeth.... except it takes a bit more thought.
6 months ago I was on 80mg gliclizide and 12.5 alogliptin
last 3 months
Dinner 80mg gliclazide
Tea 80mg glicllazide
12.5 mg algogliptn
Now
Dinner 80mg gliclazide 25 mg alogliptin
Tea 80 mg gliclazide
Dad is type 2 medication and insulin
Ljc
Well-Known Member
- Relationship to Diabetes
- Type 1.5 LADA
Hi. I have just come across this thread and before I got to @Docb post saying
I would add that I am a little amazed that you were told that an HbA1c of 72 equated to 9.1 on your meter. If anything it is more consistent with spot readings being in double figures for most of the time with highs over twenty. In any case Looking at your weight and diet it would seem that you do not fit easily into the T2 box and because of that I also find the attitude of the nurse very difficult to understand. Is it possible for you to bypass the nurse and ask to speak directly to your GP because, at least in my non medical opinion, your concern is justified.
[/QUOTE]
I too as thinking LADA. and then you posted about your mum has T1. LADA is like a slow onset T1 , that often responds to T2 meds but after a time they may not work as the beta cells in the pancreas are not able to produce enough insulin , this happened with me .
Their are tests that can determine what type of diabetes you have and imo think you need an urgent referral to the hospitals diabetes clinic as they are the real specialists.
In the meantime if you start to feel really unwell call an ambulance .
What is it that worries you about going onto insulin.
I agree with the rest of docb post too
I would add that I am a little amazed that you were told that an HbA1c of 72 equated to 9.1 on your meter. If anything it is more consistent with spot readings being in double figures for most of the time with highs over twenty. In any case Looking at your weight and diet it would seem that you do not fit easily into the T2 box and because of that I also find the attitude of the nurse very difficult to understand. Is it possible for you to bypass the nurse and ask to speak directly to your GP because, at least in my non medical opinion, your concern is justified.
[/QUOTE]
I too as thinking LADA. and then you posted about your mum has T1. LADA is like a slow onset T1 , that often responds to T2 meds but after a time they may not work as the beta cells in the pancreas are not able to produce enough insulin , this happened with me .
Their are tests that can determine what type of diabetes you have and imo think you need an urgent referral to the hospitals diabetes clinic as they are the real specialists.
In the meantime if you start to feel really unwell call an ambulance .
What is it that worries you about going onto insulin.
I agree with the rest of docb post too
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I think maybe I got confused with the nurses conversion. My hba1c was 72 and I asked her what that meant in the old style and she said 9.1.
I feel like insulin is just a little more inconvenient and also I think it’s harder to accept it’s got worse. Like I could have prevented it somehow.
I do feel ok in general I do feel tired a lot and get blurred vision the odd time but not much.
I feel like insulin is just a little more inconvenient and also I think it’s harder to accept it’s got worse. Like I could have prevented it somehow.
I do feel ok in general I do feel tired a lot and get blurred vision the odd time but not much.
mikeydt1
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- Relationship to Diabetes
- Other Type
i mentioned this quite a few times but many are just been rubber stamped t2 the easy way out when people should be offered further tests to determine the type of diabetes but alas this doesn't seem to be happening they just dish out medication in the sake of hoping it will work and you will go away and when it doesn't work or you don't fit the type then what?
Ljc
Well-Known Member
- Relationship to Diabetes
- Type 1.5 LADA
Here is a conversation chart between the old style % Hb1ac and the Hb1ac that’s been in use for several years .
I can sure understand this . Though T2 and LADA are well known fir being progressive , some with T2 try very hard to control it but end up sadly needing more and more meds then need insulin, it is most definitely not their or your fault.
This regime often called MDI ( multiple daily injections). I find this is very flexible , it means I don’t have to eat if I don’t want to nor do I have to eat a fixed amount of carbohydrates. .
Of course their are a couple of downsides, but for me the improved control,and feeling human again is more than worth it
My last Hb1ac was 42.
I can sure understand this . Though T2 and LADA are well known fir being progressive , some with T2 try very hard to control it but end up sadly needing more and more meds then need insulin, it is most definitely not their or your fault.
But to be honest going onto insulin has been the best thing for me as it has improved my control no end and I feel oh so much better in myself. I went into,a Basal (long acting insulin) which is normally given once or twice daily and a rapid insulin that I inject for meals..
This regime often called MDI ( multiple daily injections). I find this is very flexible , it means I don’t have to eat if I don’t want to nor do I have to eat a fixed amount of carbohydrates. .
Of course their are a couple of downsides, but for me the improved control,and feeling human again is more than worth it
My last Hb1ac was 42.
Those two are roughly equivalent HbA1c readings.
72 mmol/mol is 8.7%
9.1% is 76 mmol/mol
I was in a sort of similar position, I was taking Gliclazide but my fasting levels went up into double figures, and my surgery were uninterested.
So I experimented by gradually increasing my Gliclazide dose, not wanting to cause a hypo by taking too much. But after a a couple of increases with no difference, I went straight to a maximum safe dose of 320 mg. Taken as 160 mg in morning and evening. It still had not effect, so I stopped completely and still nothing changed.
Knowing that, I was able to ask my G.P. (the only reason I am staying with that surgery) to order a C-peptide blood test which he did. It confirmed I was no longer producing enough insulin so he referred my care to the diabetes clinic. Although even with them it was still awkward and difficult process to get to the point of finally being prescribed insulin. Initially they ignored the blood result (their doctor suggesting I restart Gliclazide!) and prescribed a medication which only reduced my HbA1c from 9.3% to 8.8% / 78 to 73 mmol/mol.
Mind, as far as I can tell my diagnosis is still type 2, as the DSN told me that it is normal for the pancreas to do that after five years. Which I am pretty sure is not true, otherwise most type 2s on here would be far worse off. So I am still rather sceptical of what I am told, but the main thing is I am on insulin now, although only a long-acting insulin taken once a day along with a ton of oral meds.
As much as I did not want to be on insulin — in the first few years Gliclaizde was great and I got my HbA1c down to 5.0% / 31 mmol/mol — it was want that or the damage of prolonged high levels. So I would have preferred to be fully on insulin, with a basal-bolus regimen, so I could have proper control. Instead I feel there are times I need to either force eat to keep my levels up or just skip insulin completely and then not eat much in the following 24 hours.
I did tell the nurse, who only said I could adjust my insulin dose to suit. Although I need to adjust based on the past, but can only decide on how I will feel tomorrow which I rarely know in advance. ARGH! And I am pretty sure at least one of the oral meds does nothing. But presumably my pancreas' output will keep reducing and it will happen eventually.
But it has brought my fasting levels down from being around 13–15 mmol/L to around 7 mmol/L. I never tested after eating, but I would certainly have been in the 20s. I was occasionally that high or more for a fasting reading.
So it sounds to me like you are in exactly the same situation I was, including the terrible health care offered. But you definitely need to ask for a C-peptide test as that is vital to getting proper help, even if you still then need to fight for it.
72 mmol/mol is 8.7%
9.1% is 76 mmol/mol
I was in a sort of similar position, I was taking Gliclazide but my fasting levels went up into double figures, and my surgery were uninterested.
So I experimented by gradually increasing my Gliclazide dose, not wanting to cause a hypo by taking too much. But after a a couple of increases with no difference, I went straight to a maximum safe dose of 320 mg. Taken as 160 mg in morning and evening. It still had not effect, so I stopped completely and still nothing changed.
Knowing that, I was able to ask my G.P. (the only reason I am staying with that surgery) to order a C-peptide blood test which he did. It confirmed I was no longer producing enough insulin so he referred my care to the diabetes clinic. Although even with them it was still awkward and difficult process to get to the point of finally being prescribed insulin. Initially they ignored the blood result (their doctor suggesting I restart Gliclazide!) and prescribed a medication which only reduced my HbA1c from 9.3% to 8.8% / 78 to 73 mmol/mol.
Mind, as far as I can tell my diagnosis is still type 2, as the DSN told me that it is normal for the pancreas to do that after five years. Which I am pretty sure is not true, otherwise most type 2s on here would be far worse off. So I am still rather sceptical of what I am told, but the main thing is I am on insulin now, although only a long-acting insulin taken once a day along with a ton of oral meds.
As much as I did not want to be on insulin — in the first few years Gliclaizde was great and I got my HbA1c down to 5.0% / 31 mmol/mol — it was want that or the damage of prolonged high levels. So I would have preferred to be fully on insulin, with a basal-bolus regimen, so I could have proper control. Instead I feel there are times I need to either force eat to keep my levels up or just skip insulin completely and then not eat much in the following 24 hours.
I did tell the nurse, who only said I could adjust my insulin dose to suit. Although I need to adjust based on the past, but can only decide on how I will feel tomorrow which I rarely know in advance. ARGH! And I am pretty sure at least one of the oral meds does nothing. But presumably my pancreas' output will keep reducing and it will happen eventually.
But it has brought my fasting levels down from being around 13–15 mmol/L to around 7 mmol/L. I never tested after eating, but I would certainly have been in the 20s. I was occasionally that high or more for a fasting reading.
So it sounds to me like you are in exactly the same situation I was, including the terrible health care offered. But you definitely need to ask for a C-peptide test as that is vital to getting proper help, even if you still then need to fight for it.
- Relationship to Diabetes
- Type 1
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- He/Him
I wondered that, but the DUK converter suggests 71mmol/mol equates to 8.7% - so perhaps the nurse was using some sort of ‘ready reckoner’?
What is HbA1c?
HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%).
Unfortunately there isnt really a way to directly convert average glucose into A1c, though there are a few formulae which give an approximate idea
eAG/A1C Conversion Calculator | American Diabetes Association
However none seem to match the values that you are seeing.
You aren’t anaemic by any chance?
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
As @rebrascora has said, I’d be pushing hard for a second opinion about your Type 2 diagnosis. Far too many adults are just assumed to be Type 2 when, in fact, they’re Type 1. Type 1 can develop at any age.
Gliclazide isn’t good if you’re Type 1 and might make things worse. A proper diagnosis is crucial. While you might think insulin is bad or a nuisance, if you are Type 1 it’s a lifesaver - literally.
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