Other reasons for high hba1c results

[rebrascora]

She did wash her hands prior to the test. Just wandering if anything else could have caused the leap. Is the two hour window after a meal always the best time to test?

It is the time that problems are likely to show which is important, otherwise you are just kidding yourself, so testing immediately before eating and then 2 hours after the meal gives you a good idea of how well (or poorly in this case) your wife's body coped with the food eaten. As explained by @adrian1der an increase of more than 2 mmols between the before meal and after meal readings indicates that there were too many carbs in the meal for her body to cope with.

You might try the same meal next time with just the wholegrain rice and perhaps a smaller portion but bulk the plate out with some leafy green veg or just garlic bread, but the rice and garlic bread together are a double whammy of carbs. Add on the satsuma and you add another approx. 10-15g carbs. I usually have cheese (without biscuits) these days rather than dessert, as it is almost carb free.

 

[Felinia]

...I note that your hba1c levels shot up as a result, it would seem, of infection. As I said initially, my wife had a test on the day she was rushed into hospital with pneumonia having been ill for about a week prior to this and the two follow up tests were done within two weeks of discharge while recovering from the pneumonia...

I have been reading your posts, and what strikes me in your wife's diet is the high proportion of carbs, and no vegetables. I have read many posts where people think they will be very hungry without carbs. I have found in my case, that larger portions of protein, and 2/3 plate vegetables (not root veggies like potato or parsnip) does keep me full - and I love my tummy!! I suspect that result of 13.2 was due to the high carb content - rice, bread, satsuma. It may be hard to alter habits of a lifetime, but introducing change slowly might be a way forward.

 

[Inka]

She did wash her hands prior to the test. Just wandering if anything else could have caused the leap. Is the two hour window after a meal always the best time to test?

Yes because that’s the standard to compare results with normal. Here are the Type 2 target blood sugars so you can see what she’s aiming at:

If you have Type 2 diabetes​

• before meals: 4 to 7mmol/l
• two hours after meals: less than 8.5mmol/l

.

 

[Billy boy]

Many thanks everyone, we‘ll keep an eye on the carb content of her meals and see if we can get some more consistent results

 

[Deleted member 21371]

Many thanks everyone, we‘ll keep an eye on the carb content of her meals and see if we can get some more consistent results

That is quite consistent to be honest.
A Hba1c of 76 agrees with a spot reading of around 12.

 

[adrian1der]

I usually have cheese (without biscuits) these days rather than dessert, as it is almost carb free.

I make Flax Seed biscuits from Dopamine Diet. They taste really good. https://larderandlife.com/2017/08/21/flaxseed-biscuits/

 

[PattiEvans]

I note you have bought an Accuchek meter which is one of the meters with the most expensive strips. Around £20 per 50 over the counter in Boots. Search around online, you may get them cheaper. However I know that a lot of members here use the Spirit Tee2 (available online from Spirit Healthcare for around £12 with strips around the same price) or the Gluco Navii around the same price. If you are going to do intensive testing then it can make a lot of difference.

See https://shop.spirit-health.co.uk/collections/tee2. Strips are actually £9.99

 

[Billy boy]

I note you have bought an Accuchek meter which is one of the meters with the most expensive strips. Around £20 per 50 over the counter in Boots. Search around online, you may get them cheaper. However I know that a lot of members here use the Spirit Tee2 (available online from Spirit Healthcare for around £12 with strips around the same price) or the Gluco Navii around the same price. If you are going to do intensive testing then it can make a lot of difference.

See https://shop.spirit-health.co.uk/collections/tee2. Strips are actually £9.99

Thanks for that I’ll have a look..

 

[Billy boy]

Wife tested yesterday morning, fasted, 8.3. Tested this morning, fasted, 7.4, had her usual two slices of toast with cheese spread, been out all day at the seaside walking, climbing steps, had fish and chips and I treated her to an ice cream after, this was about 1230 ish. Got home and at 5 pm did a pre meal test, 13.5!...

 

[Inka]

Fish and chips are pretty high carb @Billy boy as is the ice cream. Whatever the cause of her high blood glucose, it would be wise adjusting meals to reduce the carbs. Hopefully both of you can see things are off now you have the meter.

 

[Billy boy]

Fish and chips are pretty high carb @Billy boy as is the ice cream. Whatever the cause of her high blood glucose, it would be wise adjusting meals to reduce the carbs. Hopefully both of you can see things are off now you have the meter.

Strange thing is, all she had to drink is a cup of tea first thing, a coffee in Costa about 11 this morning, nothing at all with the fish and chips because she wasnt thirsty, she had a sip of water on the way home and half a small bottle of water with her evening meal. She never has what could be called a thirst, one of the signs of diabetes, or any of the other ’classic’ signs of diabetes for that matter.

Today we where in Whitby, North Yorkshire where the abbey is that Dracula frequented when he landed. If you don’t know the place there is a stairway from the main street to the abbey, it is very steep and there are 199 steps to climb, she is 63 and I would hardly describe her as ‘fit’ in an aerobic sense and she has admitted that pre pneumonia (she was in a hospital HD ward for ten days and discharged about four weeks ago) she would have dreaded the climb and would have been out of breath at the thought of it, yet today she says she found the climb “easy” which shocked her. I know her BG and her initial Hba1c readings don’t look good and I know people can be diabetic and not display and symptoms so the whole situation is still perplexing as if she hadn’t had blood tests due to the pneumonia we would have been none the wiser.
She has been on 500mg metformin for a week. We have managed to get registered with a new GP and she is seeing a diabetic nurse in a couple of weeks, so hopefully we can line up the ducks...

 

[AJLang]

A lot of people with Type 2 often don't have symptoms and are then diagnosed with a routine blood test. Unfortunately some are left undiagnosed for years whilst the diabetes is doing the damage. It is very easy to not have symptoms when you are at the levels you're wife is at - I know that I don't. But the HBA1C and BG tests that you're posting definitely indicate Type 2 diabetes. I know that it is difficult to accept (not the best word but all I can think of at the moment) that your wife has got diabetes because of the lack of symptoms but unfortunately, if the BG levels are too high they can quietly cause complications that you don't know about until the damage has been done.
That is why it is so important to get the BG levels under control which can hopefully be done through the combination of reducing carbohydrates and medication. I think that quite a lot of Type 2 diabetics have achieved this through carbohydrate reduction alone but you also need to find a balance between how restricted you want the diet to be and medication.

 

[Felinia]

Fish and chips are pretty high carb @Billy boy as is the ice cream. Whatever the cause of her high blood glucose, it would be wise adjusting meals to reduce the carbs. Hopefully both of you can see things are off now you have the meter.

I second Inka's comments. Whilst your wife continues to eat mainly carbs - bread, potatoes, ice cream - I do not think her glucose levels will reduce. Please - it is sometimes necessary to be firm with diet to be kind. I never had the classic symptoms of diabetes either.

 

[Billy boy]

A lot of people with Type 2 often don't have symptoms and are then diagnosed with a routine blood test. Unfortunately some are left undiagnosed for years whilst the diabetes is doing the damage. It is very easy to not have symptoms when you are at the levels you're wife is at - I know that I don't. But the HBA1C and BG tests that you're posting definitely indicate Type 2 diabetes. I know that it is difficult to accept (not the best word but all I can think of at the moment) that your wife has got diabetes because of the lack of symptoms but unfortunately, if the BG levels are too high they can quietly cause complications that you don't know about until the damage has been done.
That is why it is so important to get the BG levels under control which can hopefully be done through the combination of reducing carbohydrates and medication. I think that quite a lot of Type 2 diabetics have achieved this through carbohydrate reduction alone but you also need to find a balance between how restricted you want the diet to be and medication.

On a more general note, what I find unusual is that nothing is done ‘routinely’ to detect diabetes by the medical profession. I understand that there are over a million people potentially at risk, who, unless they have a blood test for unrelated reasons, from diabetes which must place a huge financial burden on the NHS. You would think that regular checks would be done on everybody and if detected, treated, surely that would be more cost effective (sorry for sounding mercenary) and would possibly reduce the numbers going on to more serious problems and causing further financial burden...

 

[Leadinglights]

You could look at some better options for meals by looking in the thread What did you eat Yesterday in the food/recipes forum.
Cutting down of some of those high carb foods and replacing with more vegetables and meat or fish should help reduce the high glucose levels she is getting. Even though she may not feel thirsty keeping hydrated helps to flush excess glucose out of the system.
The after effects of an illness could still be affecting the body's ability to cope with the carbs.

 

[Billy boy]

I second Inka's comments. Whilst your wife continues to eat mainly carbs - bread, potatoes, ice cream - I do not think her glucose levels will reduce. Please - it is sometimes necessary to be firm with diet to be kind. I never had the classic symptoms of diabetes either.

Well at just after 5 pm her BG was 13.5, she had five cream crackers with spread and slices of cheese an apple and a slack handful of grapes, just checked her BG and it’s 12.3...

 

[Molly M]

@Billy boy Please read up on foods that are high in carbs as everything your wife is having is high in carbs or sugar.

My stats are below in my signature - I was very very strict with what I ate and in 3 months my HBA1C readings went from 77 to 30 which is now 'normal'. It takes work but it is really worthwhile.

 

[Billy boy]

You could look at some better options for meals by looking in the thread What did you eat Yesterday in the food/recipes forum.
Cutting down of some of those high carb foods and replacing with more vegetables and meat or fish should help reduce the high glucose levels she is getting. Even though she may not feel thirsty keeping hydrated helps to flush excess glucose out of the system.
The after effects of an illness could still be affecting the body's ability to cope with the carbs.

...regarding the illness, she was ill for a week before getting to a point where she was struggling to breath, hence the rush to hospital and the diagnosis of pneumonia which put her in a high dependency unit for ten days on antibiotics intravenously then by mouth, morphine, and steroids. She was discharged after ten days and has spent the last four weeks recuperating, she is improving to the point were she is returning to work tomorrow (she works part time five days a week in an office type environment) because she is “getting stare crazy” which is a good sign, but she still has her breathless moments and we are under no illusions that her recovery is still ongoing. I have read that serious illness and certain medications can affect with BG levels but have no idea if this has affected my wife...

 

[Billy boy]

@Billy boy Please read up on foods that are high in carbs as everything your wife is having is high in carbs or sugar.

My stats are below in my signature - I was very very strict with what I ate and in 3 months my HBA1C readings went from 77 to 30 which is now 'normal'. It takes work but it is really worthwhile.

Thanks, that’s really encouraging, the wife’s hba1c‘s were 67 fasted 76 after a meal about three weeks ago..

 

[Leadinglights]

...regarding the illness, she was ill for a week before getting to a point where she was struggling to breath, hence the rush to hospital and the diagnosis of pneumonia which put her in a high dependency unit for ten days on antibiotics intravenously then by mouth, morphine, and steroids. She was discharged after ten days and has spent the last four weeks recuperating, she is improving to the point were she is returning to work tomorrow (she works part time five days a week in an office type environment) because she is “getting stare crazy” which is a good sign, but she still has her breathless moments and we are under no illusions that her recovery is still ongoing. I have read that serious illness and certain medications can affect with BG levels but have no idea if this has affected my wife...

Steroids are well known for raising blood glucose levels, but I think the main problem is the very high carb foods that she is having, cream crackers, grapes, apples after fish and chips and ice cream, toast all in one day.
The only thing low carb is the cheese.