New fasting requirement for hbA1c test?

[trophywench]

Our GP surgery opens at 8.30am - but they no longer do blood tests anyway! Coventry has a sort of choose & book system now for tests, and the nearest convenient place to us is a pharmacy we don't use, we use the one literally in the same building as the GP surgery but neither shop opens until 9am and the surgery one don't offer blood tests. None of them offer appts after lunch because the transport to the Path Lab for the vials doesn't operate after lunch, end of story. Used to be able to either book or drop in on spec to any of the 3 hospitals in the local area, but not allowed to do that these days. ONLY do tests ordered or booked emanating from the hospital itself.

 

[StephanieMLW]

Thanks all for your thoughts!!
I had the test yesterday and asked the nurse doing it why I’d have to fast, and she said ‘I have no idea, you’re already diabetic so it’s not like we care about testing your glucose levels!’
I actually dropped to 3.6 in the fasting period so had to drink some apple juice, and the nurse was totally unconcerned. So the mystery remains as to why I was instructed to do this in the first place!
Awaiting hbA1c results so hope it was at least worth skipping my breakfast for 🙂
I have been told I have to have another test in 4 weeks as my white blood cell count is slightly low (trying not to panic about that…) so I will ask my GP directly about the fasting next time. Will share if I find out anything interesting.

 

[Burylancs]

Thanks all for your thoughts!!
I had the test yesterday and asked the nurse doing it why I’d have to fast, and she said ‘I have no idea, you’re already diabetic so it’s not like we care about testing your glucose levels!’
I actually dropped to 3.6 in the fasting period so had to drink some apple juice, and the nurse was totally unconcerned. So the mystery remains as to why I was instructed to do this in the first place!
Awaiting hbA1c results so hope it was at least worth skipping my breakfast for 🙂
I have been told I have to have another test in 4 weeks as my white blood cell count is slightly low (trying not to panic about that…) so I will ask my GP directly about the fasting next time. Will share if I find out anything interesting.

The HbA1c is not static and its skewed towards the last ten days ( which is one of the reasons that dramatic drops can be achieved in a comparatively short time ). Presumably it will change with every morsel of carbs eaten. Perhaps we should have tests on consecutive days, one fasting and one eating and split the difference ?

 

[Bruce Stephens]

I had the test yesterday and asked the nurse doing it why I’d have to fast, and she said ‘I have no idea, you’re already diabetic so it’s not like we care about testing your glucose levels!’

I think the lab my GP surgery uses used to want fasting blood for the cholesterol test but I'm not sure they ever did for HbA1c. Anyway, I thought there was some general agreement that for people with T1 fasting tests shouldn't be required (except in unusual cases). I think sometimes blood plasma glucose is ticked just because it's there, but as you say it's irrelevant for us. It's worth querying it next time just in case they've done that and can easily make it a non-fasting test.

 

[Dragonheart]

I was told the reasoning behind dropping the fasting requirement for lipids was because people failed to show for later appointments as a result or ate but didn’t disclose this. Now they don’t bother to make it “easier” and if results are high they redo them fasted before treatment (or should - as it really can make a difference depending what and when you ate).

The advice might depend on who decided to advise on fasting and in relation to what test. Did they actually know what they were talking about or were they playing it safe, eg perhaps it was reception staff not medical