Recent rise in my HbA1C has me alarmed

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TonyL

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Type 2
Hi everyone. I wonder if I can ask for some advice regarding what may have caused my A1C level to have risen on my last test.
I'm lucky that my GP allows me a 3 monthly HbA1C test and has done since my diagnosis in 2020.
Shocked at my diagnosis, I reduced my weight from 14st to my current steady weight of 10st 4lb within 3 months and my A1C levels dropped from 50 to normal levels in the same time frame. So I watch my carbs intake like a hawk, allowing myself a treat once a week and my A1c results have been (going backwards) 35, 36, 38, 38, 39, 36 37.
My latest one, to my concern was 41, which I know isn't horrific but I'm wondering why...
The only significant thing that has happened was that my good lady and I went to Spain on Jan 6th this year for a week and both got awful chest infections, from the flight out we reckon. In my case it lasted a good 2 -3 weeks before I picked up and then I got antibiotics prescribed (2 courses, one after the other) for a nasty abscess that I'll refrain from elaborating on in case anyone is eating as they read this and they appear to have worked thankfully. I've not had antibiotics for a good few years so this new territory with regard to my diabetic inclination.
So, my question after the long winded intro is, do people think that a continuous five week period of infection plus 2 course of antibiotics will have played a part in raising my latest A1c? or am I in bother?
Thanks in anticipation.
 
Yes, i think its the infection, see what happens in 3 months time
 
In a word "Yes" most definitely. Any stress on the body (i.e. illness or mental stress) will push BGs up and your 3 monthly Hba1c test is always skewed towards the last couple of weeks. I was quite ill just prior to Xmas and had bloods taken for an Hba1c on 5 January. It had gone up 5 points, which I completely understood.
 
Pattidevans said:
In a word "Yes" most definitely. Any stress on the body (i.e. illness or mental stress) will push BGs up and your 3 monthly Hba1c test is always skewed towards the last couple of weeks. I was quite ill just prior to Xmas and had bloods taken for an Hba1c on 5 January. It had gone up 5 points, which I completely understood.
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Thank you, that's very reassuring. I hope you have fully recovered.
 
Hi everyone who responded to my tale of woe a few months ago. It appears that my higher than hoped for A1c test in February was highly likely to have been the result of my infection and resultant antibiotic treatment as my latest test was down from 41 in Feb to 34 on the 1st of May.
This was a huge relief and so thanks again for your support
 
JITR said:
I suspect that's so, but I have not seen any explanation. Would you kindly point me to one? Thanks
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This is from the US www.niddk.nih.gov website:-

Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months.
 
Martin.A said:
This is from the US www.niddk.nih.gov website:-

Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months.
Click to expand...
Thank you, a good article. Come to think of it, I read that about 50% of the result is from the last month, 25% from the month before and 25% from previous months. Looks like hemoglobin has a half-life like some isotopes.
 
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JITR said:
Thank you, a good article. Come to think of it, I read that about 50% of the result is from the last month, 25% from the month before and 25% from previous months. Looks like hemoglobin has a half-life like some isotopes.
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Average life span of red blood cells is 120 days, as one ages they tend to have a shorter life. If people have any haemoglobinopathies then that will affect their like span which is why the HbA1C test may not be accurate for those people.
 
Leadinglights said:
Average life span of red blood cells is 120 days, as one ages they tend to have a shorter life. If people have any haemoglobinopathies then that will affect their like span which is why the HbA1C test may not be accurate for those people.
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120 days may be the average but what is the range?
 
JITR said:
120 days may be the average but what is the range?
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From google
In practice there is considerable variation in the lifespan of human RBC. In a normal individual with a mean RBC lifespan of 115 days, this value may vary between 70 and 140 days
It can be as little as 20 days in people with some anaemias
 
Leadinglights said:
From google
In practice there is considerable variation in the lifespan of human RBC. In a normal individual with a mean RBC lifespan of 115 days, this value may vary between 70 and 140 days
It can be as little as 20 days in people with some anaemias
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@Leadinglights Thank you. There is a typo in Dr Google's opinion.

According to an article published in Blood 2008 describing tests on 12 subjects, it might have said:
In normal individuals mean RBC lifespan is between 40 to 60 days, the maximum lifespan may vary between 70 and 140 days. Note: A few RBC may live longer but it is not practical to measure their lifetimes.

See the informative graphs from the Blood 2008 article here. They indicate roughly 1% of today's new RBCs will perish every day over the next two months.
 
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