Need some advice

[Librose]

Hello
I got a call from my GP today, following a routine blood test requested by rheumatology (I have arthritis); they have referred me to see the diabetes nurse because apparently my Hba1c was 48. I had gestational diabetes in one of my pregnancies and there is type 2 in the family so I wouldn’t be surprised…. My appointment isn’t for another 3 weeks tho and they didn’t really explain to me what the process was and how likely it is that I am diabetic. I wondered if you can get random high readings like that which are just an anomaly or if it is likely an indicator of diabetes? Also wondering whether I should check my blood glucose to get a better idea myself what’s going on before the appointment but not sure how many times a day/when to test? Hoping there’s people on here with experience who can give me some advice

 

[rebrascora]

Hi and welcome.

It sounds like you have a testing kit.... perhaps left over from your GD? If so, you will probably need to buy some new test strips for it as the ones you have will likely be out of date. If it was a prescribed meter and they are no longer on your repeat, then it might be cheaper to buy a low cost meter like the Gluco Navii if you are going to be self funding test strips.

As regards your diagnosis, 48 is right on the diabetes diagnosis red line. At that level I would expect them to do a second test in a few weeks to confirm it so you have those few weeks to possible make some dietary changes and maybe push your levels back enough to avoid the diagnosis. The sooner you start that the better because the HbA1c is a measure of the amount of glucose stuck to your red blood cells and they have a life span of about 3 months so the HbA1c kind of gives you a picture of your glucose levels over the past 3 months but weighted slightly more towards the present. If you can reduce your BG levels enough over the next 3 weeks you could dip below the line. Of course there are some advantages to getting a diabetes diagnosis like the regular health checks, but best avoided if you can.

The options are reducing your carb intake or following a very low Calorie (approx. 800calorie) weight loss program and upping your activity levels with a daily walk perhaps, are things which can help to lower your BG levels and therefore your HbA1c.

 

[everydayupsanddowns]

Welcome to the forum @Librose

As @rebrascora says, the HbA1c is a measure of glucose levels over the past 120 days or so, so a reading of 48 will be the result of elevated BG levels over a fairly extended period, rather than an isolated one-off reading I’m afraid

One of the biggest questions when trying to get to grips with being at risk of diabetes is often ‘what can I eat’ and while there are obvious things like cakes, biscuits, sweets and sugary drinks that you will want to cut out straight away, you might be surprised how much *all* carbohydrate affects your BG levels, including rice, pasta, potatoes, bread, pastry, grains, cereals and many fruits. That’s not to say you have to avoid those things entirely, but a little moderation and portion control can really help your metabolism cope with the food you are eating.

Many new members find it can be really helpful to keep a food diary for a week or two. Be brutally honest! Note down everything you eat and drink. Along with a reasonable estimate of the amount of total carbohydrate (not just ‘of which sugars’) in the meals and snacks you are eating. This will give you an idea of which foods, meals and combinations are the most significant sources of carbs in your menu, and where there might be some easy tweaks or swaps.

Good luck, and let us know how you get on over the next few weeks 🙂

 

[Kopiert]

Welcome @Librose to the forum.

The good new is you are only just "on the line". It is quite likely that small amounts of change could have a big impact. The advice in this thread is good, and certainly where I started.

Good luck, and please ask loads of questions

 

[Librose]

Hi everyone thanks for your input

I’ve been monitoring blood sugars for the past week, before and after meals/snacks. My readings are all between 4.1 and 6.2. Which are perhaps a bit on the low side? Not sure what that means.

it’s a bit odd as I don’t really fit the bill for type 2, I have a normal BMI, plenty of exercise and active lifestyle, and I watch what I’m eating, I drink alcohol but not a lot and well within guidelines. When I was diagnosed with gestational diabetes the doctors were a bit confused for the same reasons that it didn’t really fit.

so I’m wondering firstly if there is a problem with those blood sugar readings and if there is what it means; is it possible it’s actually type 1?

 

[rebrascora]

Those readings are ideal. Have you adjusted your diet to get those readings or are you following the diet you had been for the past 3 months prior to the HbA1c result?

It is possible that you might be a slow onset Type 1 but you often find that there is a tipping point where the pancreas can no longer manage and HbA1c suddenly goes up dramatically and 3 figures is not uncommon. Of course your healthy diet and exercise may be keeping a lid on it and it hasn't quite reached that tipping point yet.

Another possibility is that you might have anaemia, which can artificially raise the HbA1c. So if you haven't changed your diet and are getting those readings, then the HbA1c may be artificially inflated due to you having less red blood cells. HbA1c is a measure of the amount of glucose molecules stuck to your haemoglobin cells, so less of those and more glucose molecules have to be carried on them. It would certainly be worth asking about possible anaemia. There is a fructosamine test for diabetes for people with anaemia to clarify the diabetes situation without the haemoglobin level having an impact.

 

[Librose]

Those readings are ideal. Have you adjusted your diet to get those readings or are you following the diet you had been for the past 3 months prior to the HbA1c result?

It is possible that you might be a slow onset Type 1 but you often find that there is a tipping point where the pancreas can no longer manage and HbA1c suddenly goes up dramatically and 3 figures is not uncommon. Of course your healthy diet and exercise may be keeping a lid on it and it hasn't quite reached that tipping point yet.

Another possibility is that you might have anaemia, which can artificially raise the HbA1c. So if you haven't changed your diet and are getting those readings, then the HbA1c may be artificially inflated due to you having less red blood cells. HbA1c is a measure of the amount of glucose molecules stuck to your haemoglobin cells, so less of those and more glucose molecules have to be carried on them. It would certainly be worth asking about possible anaemia. There is a fructosamine test for diabetes for people with anaemia to clarify the diabetes situation without the haemoglobin level having an impact.

I haven’t changed anything to my diet. I will definitely ask about anaemia, thanks so much for your help

 

[Librose]

Just to give an update on this…. The diabetes nurse decided to re run the blood test done by the hospital as she couldn’t actually find the dodgy result they were referring to. She suspected the hospital had mixed me up with someone else. Results from the re-run my hba1c came back as 32, so normal. So basically the whole thing was an admin error!

 

[Leadinglights]

Just to give an update on this…. The diabetes nurse decided to re run the blood test done by the hospital as she couldn’t actually find the dodgy result they were referring to. She suspected the hospital had mixed me up with someone else. Results from the re-run my hba1c came back as 32, so normal. So basically the whole thing was an admin error!

I'm just glad they put a big arrow on my leg when I had my knee surgery.
Good news anyway.