New T2 - BG and HbAc1 queries

[Ciao Belly]

I was diagnosed as T2 in November and been lurking on this forum to educate myself but now need help understanding numbers around BG readings and HbAc1 results.
I find it incredibly difficult to compare numbers. I get what the ranges should be but the variation I get leave me confused and unable to understand if it’s small/big/good/normal/bad/fast/slow. it’s like the numbers mean nothing to me. To compare it with weight loss, I know that a 0.5 lb loss in a week is small and 4lbs is big (but would be small if over a year). However, when I get a BG reading of 5.1 and then another one of 4.2, I don’t understand if it’s important/normal/little. Ditto with HbAc1 results.
Could someone help me make sense of my results please?

HbAc1 - 15/Oct = 100 mmol/mol || 25/Nov = 77mmol/mol
I understand that both results are in the high range but is it a fast/slow drop given the 5 week difference? If it makes a difference, I started taking meds on 9 November (1 metformin x2/day + 1/2 gliclazide x2/day). Upon second results GP changed it to 2 metformin x2/day + 1/2 gliclazide x2/day).

BG average this week 5.1
started measuring on 9/11 with average of 7.1 and been going down 5.1 which is in range. I understand that my food intake will affect the number but I don’t understand how the numbers relate between the green range (4 -7 mmol/L). I often get readings like 5.3 fasting in morning and 4.3 before bed and then the exact opposite, 4.3 in the morning and 5.3 before bed.

T2 max BG post meal
I read that the range should be below 8.5 for T2 but my doctor told me that anything under 10 is good. Did he say that because he wants to gently ease me or is it just wrong?

 

[janw]

Hi and welcome
Your HbAc1 blood tests cover the previous 3 months, whereas your BG meter tells you what your reading is at that precise moment - it will go up and down according to when you eat and what you eat. The meds would have helped to bring your numbers down, that is their job, and is why you are getting the great readings now - it is not usual for the readings to be the same every morning or night, there are many other factors that influence our BG other than sugar and carbs, so as long as they are within the "normal" range there is nothing to worry about.
I think your Dr may have been talking about your BG reading after eating, it is hoped it won't go too high and will be back to below 8 after 2 hours, which is why some will test their BG before eating and again after 2 hours, if it is above 8 then it could be classed as a spike and that gives you the chance to see which carbs you have eaten, then you can reduce the portion size or find an alternative for the next time. It is test, trial, test in the early stages.
I'm not on meds so cannot advise you on the effects of those, but there are others who will be able to pass on their knowledge if need be.

 

[Docb]

Hi @Ciao Belly and welcome to the forum

Getting a perspective on the numbers can be quite difficult and it will get easier with time as you gain experience.

To take your three questions.....

HbA1c results.

Yes HbA1c readings of 100 and 77 are in what I like to refer to as the red zone which means that action is needed. The important thing about the drop from 100 to 77 is that you are heading in the right direction. Whatever you are doing is having the desired effect so keep it up. Some members have reported that rapid drops in HbA1c have resulted in some physical symptoms, mostly affecting vision, but if you are not getting anything, then carry on. Chances are that you should get down to around diagnosis level (HbA1c under 48) sometime in 2022. You might think that I am being a bit vague, but that is the nature of the beast. The fact that things are heading in the right direction is the most important thing.

Blood glucose on waking

When it comes to blood glucose readings from a meter, it is all too easy to get obsessed by the numbers and what they mean. The first thing you need to appreciate is that the number after the decimal place really has no meaning. Being of a scientific mind I did 10 tests one after another one morning and got 10 different readings! What it showed me was that If my meter gave a reading of say, 5.2, what it was really telling me was that my blood glucose was probably somewhere between 4 and 6. So, your comments about your morning and bed time readings are what you might expect. When you tested and got a 4.3 you could quite easily do a repeat and get a reading over 5. If you are getting 4's, 5's and 6's on waking and at bed time, then to my mind you are doing very well. Don't be surprised if you see the odd reading higher than 6, you only need to put your thinking cap on if you get 7's and 8's on a regular basis.

Blood Glucose after eating

This is quite difficult to get your brain round if nothing else because although there are general principles, quite how they apply depends very much on the individual.

The general principle is straightforward, when you eat carbohydrate your body turns it into glucose and the glucose ends up in your blood. The tricky bit is trying to relate the rise you get to the amount of carbohydrate eaten. It is tricky because there is so much going on pulling the blood glucose level one way or the other and quite what is happening will depend on lots of factors which will change both within an individual and between individuals. In general what happens is that after you have eaten your blood glucose goes up and then comes down again. You cannot stop it! What you want to do is to get into a position where it comes down to something like where it started before you eat again and start another cycle. Working on the basis that most people eat meals more than 4 hours apart, you come up with the idea that if your blood glucose is well on the way down after 2 hours then things are OK. That way you finish up with the general guideline that if testing 2 hours after eating gives a blood glucose of no more than 8 and at most a couple of units over your pre-meal reading then you are on the right tack. Your system will not be struggling to deal with the last lot of food when you have your next meal and you will not be heading for the prolonged higher levels which push your HbA1c up.

If you do some tests at less than two hours (say half hour or 1 hour) after eating you might get readings over 10 if your system is producing glucose faster than it can process it. They don't last long unless your system is really struggling and then it is a good idea to look to reduce your carb intake.

Overall

My take is that it is best to treat the numbers you see quoted as sensible guidance rather than absolute targets. If you can keep your average blood glucose decently below 8 and the peaks after eating in single figures then you will have cracked it. If your waking/bedtime readings are 4-6 and your 2 hours post meal are under 8 and no more than 2 units above the pre-meal level then the chances are that your HbA1c will be around what normal people have.

PS.. People with T2 are not abnormal, they are special!

PPS... My standard caveat. Comments only relevant to T2. T1 is a whole different ball game.

 

[Leadinglights]

Hi @Ciao Belly and welcome to the forum

Getting a perspective on the numbers can be quite difficult and it will get easier with time as you gain experience.

To take your three questions.....

HbA1c results.

Yes HbA1c readings of 100 and 77 are in what I like to refer to as the red zone which means that action is needed. The important thing about the drop from 100 to 77 is that you are heading in the right direction. Whatever you are doing is having the desired effect so keep it up. Some members have reported that rapid drops in HbA1c have resulted in some physical symptoms, mostly affecting vision, but if you are not getting anything, then carry on. Chances are that you should get down to around diagnosis level (HbA1c under 48) sometime in 2022. You might think that I am being a bit vague, but that is the nature of the beast. The fact that things are heading in the right direction is the most important thing.

Blood glucose on waking

When it comes to blood glucose readings from a meter, it is all too easy to get obsessed by the numbers and what they mean. The first thing you need to appreciate is that the number after the decimal place really has no meaning. Being of a scientific mind I did 10 tests one after another one morning and got 10 different readings! What it showed me was that If my meter gave a reading of say, 5.2, what it was really telling me was that my blood glucose was probably somewhere between 4 and 6. So, your comments about your morning and bed time readings are what you might expect. When you tested and got a 4.3 you could quite easily do a repeat and get a reading over 5. If you are getting 4's, 5's and 6's on waking and at bed time, then to my mind you are doing very well. Don't be surprised if you see the odd reading higher than 6, you only need to put your thinking cap on if you get 7's and 8's on a regular basis.

Blood Glucose after eating

This is quite difficult to get your brain round if nothing else because although there are general principles, quite how they apply depends very much on the individual.

The general principle is straightforward, when you eat carbohydrate your body turns it into glucose and the glucose ends up in your blood. The tricky bit is trying to relate the rise you get to the amount of carbohydrate eaten. It is tricky because there is so much going on pulling the blood glucose level one way or the other and quite what is happening will depend on lots of factors which will change both within an individual and between individuals. In general what happens is that after you have eaten your blood glucose goes up and then comes down again. You cannot stop it! What you want to do is to get into a position where it comes down to something like where it started before you eat again and start another cycle. Working on the basis that most people eat meals more than 4 hours apart, you come up with the idea that if your blood glucose is well on the way down after 2 hours then things are OK. That way you finish up with the general guideline that if testing 2 hours after eating gives a blood glucose of no more than 8 and at most a couple of units over your pre-meal reading then you are on the right tack. Your system will not be struggling to deal with the last lot of food when you have your next meal and you will not be heading for the prolonged higher levels which push your HbA1c up.

If you do some tests at less than two hours (say half hour or 1 hour) after eating you might get readings over 10 if your system is producing glucose faster than it can process it. They don't last long unless your system is really struggling and then it is a good idea to look to reduce your carb intake.

Overall

My take is that it is best to treat the numbers you see quoted as sensible guidance rather than absolute targets. If you can keep your average blood glucose decently below 8 and the peaks after eating in single figures then you will have cracked it. If your waking/bedtime readings are 4-6 and your 2 hours post meal are under 8 and no more than 2 units above the pre-meal level then the chances are that your HbA1c will be around what normal people have.

PS.. People with T2 are not abnormal, they are special!

PPS... My standard caveat. Comments only relevant to T2. T1 is a whole different ball game.

I gave you a star for the very clear explanation, if it was Strictly it would be a 10.