Quarterly Blood Test

[Bernie 2]

I am 87 - male and have always been relatively fit and healthy and was first diagnosed Type 2 about 25 years ago. This has been controlled mostly by eating normal but low in sugar meals and by Metformin SR . My recent Blood Test showed my HbA1C level as 8.6 % over the past three months and this has more or less been my average quarterly level over the years. Unfortunately, you never get a definitive answer from either Diabetic Nurse or Doctor when I ask if that figure is a reasonable or not. All they really tell you is that you should try to get your sugar levels down but don't tell you what figure to aim for. My average fasting figure first thing in the morning is about 8 mmol/l but rises rapidly with food to about 14.

What I really want to know is whether the fasting level of 8 mmol/l and the quarterly figure 8.6% are reasonable ones for my age and how this compares with other long term adult members. I want to know if I can relax a little and overcome this constant niggle about eating the right foods and keeping my sugar levels down!!

 

[DaveB]

Hi. An HBA1C of 8.6% is too high. You should be aiming for less than 7.5% and below 7% if you can. Your morning BS should be between 5 and 7mmol. Is you diet low-carb or just low-sugar? i suspect you may have been told by the GP/DN to just reduce sugar whereas you need to control all carbs of which sugar is just one. You can eat fats and proteins fairly freely

 

[Drummer]

I find the food not niggling at all.
I have bacon and eggs with mushrooms, sweet pepper, courgette perfectly fine, roast chicken with a hefty salad, swede roasted under the bird (or with a joint is just as good) or any other low carb meal is far better than the low fat high carb stuff I was encouraged to eat as 'healthy'.
My Hba1c seems to be glued to 42, which is just at the very top of normal, but having been told that I was a very bad diabetic at diagnosis, and my meter now always shows under 8, and often under 7mmol/l after meals, I am happy enough.

 

[Bernie 2]

Thank you for your replies. As I thought, 8.6% is too high but I cannot understand why my GP/DN have not told me so and prescribed upping or changing my medication. Maybe it is because of my age or longevity of diabetes I don't know but nevertheless they say nothing, so I have always assumed that around 8/8.6% is acceptable. It seems ironical that a year ago one GP prescribed Glicazide combined with Metformin and yet recently I was taken off Glicazide because of the fear that my sugar levels might go too low !!! I will of course be taking this up with them as soon as this Covid 19 situation permits.

Thank you once again

 

[grovesy]

Thank you for your replies. As I thought, 8.6% is too high but I cannot understand why my GP/DN have not told me so and prescribed upping or changing my medication. Maybe it is because of my age or longevity of diabetes I don't know but nevertheless they say nothing, so I have always assumed that around 8/8.6% is acceptable. It seems ironical that a year ago one GP prescribed Glicazide combined with Metformin and yet recently I was taken off Glicazide because of the fear that my sugar levels might go too low !!! I will of course be taking this up with them as soon as this Covid 19 situation permits.

Thank you once again

Your age maybe a factor as some research has suggested that aggressively reducing levels may increase risk of hypos and thus increasing risk of falls, in the older people. As Gliclazide can cause hypos, it could be the reasoning.
Maybe you could make small gradually changes to your diet.

 

[DaveB]

Thank you for your replies. As I thought, 8.6% is too high but I cannot understand why my GP/DN have not told me so and prescribed upping or changing my medication. Maybe it is because of my age or longevity of diabetes I don't know but nevertheless they say nothing, so I have always assumed that around 8/8.6% is acceptable. It seems ironical that a year ago one GP prescribed Glicazide combined with Metformin and yet recently I was taken off Glicazide because of the fear that my sugar levels might go too low !!! I will of course be taking this up with them as soon as this Covid 19 situation permits.

Thank you once again

Hi again. As you have gathered many in the NHS don't understand diabetes but won't admit it. NICE on the web has some good stuff about diabetes and the levels to achieve; pity GPs don't read some of it. Gliclazide can help but only if your beta cells are below par. It stimulates the cells you have left to produce more insulin. It's not a good idea if you are an overweight T2 as you may already have too much insulin. The point about Gliclazide causing hypos is a bit silly really. Yes it will if the dose is too high AND your beta cells are generally not bad. The important thing is to start with a low 40mg dose and increase it gradually. I was on 320mg before insulin and my DNs would ask if I was having hypos. I thought a chance would be a nice thing with my sugars in the teens. So, I would ask to re-start Gliclazide but on a low dose and see how you go.

 

[Piglet]

Hi Bernie,

I'm also old enough to remember % levels for your Hba1c. Having looked at the conversion chart from Southend NHS Trust found here http://www.southend.nhs.uk/media/44653/hba1c_conversion_table.pdf your result of 8.6% is a level of 70 in the new system of measuring and recording the level. A good target is to be in the range of 42-45 or 5.9-6.6%.

Just to quantify, each NHS trust uses slightly different ranges so please use this as a guide and not gospel.

I hope this helps
Piglet