Numbers confusion

[jackymax]

After a blood test a couple of weeks ago, the GP rang and said I was 176 when I should be around 40. But when i got taken to hospittal a few days later they said I was 29 instead of 4-7.

Is this just the same thing using a different scale or something totally different?

 

[Eddy Edson]

After a blood test a couple of weeks ago, the GP rang and said I was 176 when I should be around 40. But when i got taken to hospittal a few days later they said I was 29 instead of 4-7.

Is this just the same thing using a different scale or something totally different?

They're different things.

The smaller 29 number is your blood glucose (BG) level at a point in time, measured in "mmol/l". BG goes up and down a lot over the course of day and night. The "4-7 mmol/l" range you always see quoted is typical for a non-diabetic during the day who hasn't eaten or drunk anything in the last few hours, but it can be misleading without that context: non-diabetics can certainly go below 4 (eg overnight or after exercise) and above 10 (eg soon after eating).

The big 176 number is your "HbA1c", which measures how much glucose your red blood cells (RBC's) have picked up over their lifetime. RBC's last for 3-4 months before being recycled, so HbA1c roughly correlates with your average blood glucose levels over that period. It's only useful because most people don't have a detailed record of what their BG has been doing in recent weeks, and the HbA1c measure is a reasonably good (but not precise) hack for estimating the average over time. It's measured in "mmol/mol", different to the "mmol/l" for the BG test.

I found this pic useful when I was getting a handle on things:



BG levels down the bottom (corresponding to your 29 mmol/l); HbA1c up the top (corresponding to your 176 mmol/mol). The pic makes the correspondence more exact than it actually is, but it's good enough for a rough idea.

The important thing right now is that your numbers seem to be way high, which isn't a reason to panic but is surely reason enough to take the thing very seriously. With proper treatment from your HCP's etc I'd guess that you will see some large improvements pretty quickly.

Ideally the goal is to get things down into the green zone - so as you were told, an HbA1c of 40 mmol/mol is "normal" and very roughly corresponds to average BG levels around 7 mmol/l. However you will probably also be advised not to push for bringing things down too fast, because this can cause some issues with small blood vessels in the eyes etc.

Good luck! Let us know how you get on.

 

[jackymax]

They're different things.

The smaller 29 number is your blood glucose (BG) level at a point in time, measured in "mmol/l". BG goes up and down a lot over the course of day and night. The "4-7 mmol/l" range you always see quoted is typical for a non-diabetic during the day who hasn't eaten or drunk anything in the last few hours, but it can be misleading without that context: non-diabetics can certainly go below 4 (eg overnight or after exercise) and above 10 (eg soon after eating).

The big 176 number is your "HbA1c", which measures how much glucose your red blood cells (RBC's) have picked up over their lifetime. RBC's last for 3-4 months before being recycled, so HbA1c roughly correlates with your average blood glucose levels over that period. It's only useful because most people don't have a detailed record of what their BG has been doing in recent weeks, and the HbA1c measure is a reasonably good (but not precise) hack for estimating the average over time. It's measured in "mmol/mol", different to the "mmol/l" for the BG test.

I found this pic useful when I was getting a handle on things:

View attachment 21850

BG levels down the bottom (corresponding to your 29 mmol/l); HbA1c up the top (corresponding to your 176 mmol/mol). The pic makes the correspondence more exact than it actually is, but it's good enough for a rough idea.

The important thing right now is that your numbers seem to be way high, which isn't a reason to panic but is surely reason enough to take the thing very seriously. With proper treatment from your HCP's etc I'd guess that you will see some large improvements pretty quickly.

Ideally the goal is to get things down into the green zone - so as you were told, an HbA1c of 40 mmol/mol is "normal" and very roughly corresponds to average BG levels around 7 mmol/l. However you will probably also be advised not to push for bringing things down too fast, because this can cause some issues with small blood vessels in the eyes etc.

Good luck! Let us know how you get on.

Thank you so much for the explanation. Seems I was literally off the chart! I've obviously got a ton to learn but I haven't panicked or stressed much about it at all, which is a bit strange. Even not being able to check my blood for the last few days as the hospital only gave me a limited supply. I'm on Metformin and insulin, the latter being 24 clicks in the morning and 20 at night. Handling that ok as I can't feel the needles, but I usually forget to shake it.

My Fibromyalgia take up most of my headspace as I'm bedbound with pain. My inside voice is always screaming. Also started getting hot flushes 2 years ago, around the same time I was told I had diabetes. My lifelong great eyesight is shot. New varifocals arriving in the next few days.

Was going to say/ask more but I've forgotten what. I do that a lot. 🙄

 

[everydayupsanddowns]

Sorry to hear about your diagnosis @jackymax and your fibromyalgia - very difficult to live with.

Do press them for a more appropriate supply of test strips to support you with your diabetes management. As an insulin user your Dr should put them on repeat.

Is it a cloudy insulin that you are using? Most of them are clear these days. Do you know if it’s a mixed or a long acting?

Oh, and WAIT before you get a new prescription for glasses - the optician should refuse to give you new glasses until your BG levels have stabilised. Elevated glucose levels change the shape of your eyeballs and can give you blurry vision. Blurriness can also happen when your average BGs are changing.

It can take a few weeks for your eyeballs to settle down once you begin to bring your levels back towards your target range.

 

[jackymax]

Sorry to hear about your diagnosis @jackymax and your fibromyalgia - very difficult to live with.

Do press them for a more appropriate supply of test strips to support you with your diabetes management. As an insulin user your Dr should put them on repeat.

Is it a cloudy insulin that you are using? Most of them are clear these days. Do you know if it’s a mixed or a long acting?

Oh, and WAIT before you get a new prescription for glasses - the optician should refuse to give you new glasses until your BG levels have stabilised. Elevated glucose levels change the shape of your eyeballs and can give you blurry vision. Blurriness can also happen when your average BGs are changing.

It can take a few weeks for your eyeballs to settle down once you begin to bring your levels back towards your target range.

Thank you and yes, it's a pain in the.. everywhere.. to live with. 😱
Spoke to GP today and somebody collected them for me within an hour. 7.1 yippee! My insulin is Novomix and cloudy if I remember to shake it.
Outside Clinic comes to your home and will replace as often as needed. As I'm on benefits I don't have to pay. (taxpayers do though). The glasses had already been ordered before I went into hodpital and discovered all this.