MikeWeatherley
New Member
- Relationship to Diabetes
- Type 2
Hi,
I was diagnosed a couple of years ago, but put on diet-control. However, my annual 14 hour fasting blood glucose - tested by the local hospital - was always 9-10. My GP and practise diabetic nurse (who was also a diabetic) were not worried about that, though, as they both said that my HbA1C result was 6 or below - so that was okay. I'd always doubted the logic of their complacency, as it makes no sense that a fasting blood glucose can be 9-10 if the 'average over the last 3 mnoths' can be as apparently low as 6.🙄 Anyway, for my last annual check, before Xmas, the diabetic nurse was off on long-term sick-leave, as she'd had a series of bad strokes, and will not now be returning to work. As a result, I was seen by a 'locum' diabetic nurse, who was so concerned about my blood glucose being 9-10, that she gave me a blood glucose monitor to take home (I'd never had one before). I started measuring it myself, and found that it was always a minimum of 9-10, going as high as 14 after meals.
Then I started to wonder: I was born anaemic - it's Spherocytosis, a form of heamolytic anaemia - which means that my blood cells don't last as long as 3 months, as in most people. So I wondered about the validity of the HbA1C test. Surely, if my blood cells don't last 3 months, then they won't accumulate as much glucose, and will be giving a false-low result for my long-term blood glucose? I mentioned this to my GP - who had my medical history - including the anaemia - in front of him, but he insisted the HbA1C was the thing to go on. I also mentioned it to the - by now - new permanent diabetic nurse, who had also not been made aware in her training of any complications involving anaemia. However, she did arrange for an extra blood test with the hospital - Fructosamine - to double-check. This is a non-routine test, and it measures average blood glucose over the last two weeks (where it's attached to blood plasma proteins, rather than red blood cells). The result came back 1.5 times the normal upper reading - equivalent to blood glucose of 9-10, confirming all my actual glucose measurements.
With the nurse's help, I then persuaded my GP that I needed to go onto Metformin tablets (which he was still reluctant to prescribe) and the results were dramatic. I'm now on one tablet three times a day, and my blood glucose is 5-6 before meals and 8-10 after. I would therefore like to urge all Type 2s who are also anaemic to ask their GP for a Fructosamine test, as - otherwise - they may be seriously under-diagnosed, and may be sleep-walking towards blindness. My annual retinal scan had already noticed the first signs of retinal damage the previous year, but my GP had not been concerned, as the HbA1C was okay. But actually, it wasn't.
Regards,
Mike
I was diagnosed a couple of years ago, but put on diet-control. However, my annual 14 hour fasting blood glucose - tested by the local hospital - was always 9-10. My GP and practise diabetic nurse (who was also a diabetic) were not worried about that, though, as they both said that my HbA1C result was 6 or below - so that was okay. I'd always doubted the logic of their complacency, as it makes no sense that a fasting blood glucose can be 9-10 if the 'average over the last 3 mnoths' can be as apparently low as 6.🙄 Anyway, for my last annual check, before Xmas, the diabetic nurse was off on long-term sick-leave, as she'd had a series of bad strokes, and will not now be returning to work. As a result, I was seen by a 'locum' diabetic nurse, who was so concerned about my blood glucose being 9-10, that she gave me a blood glucose monitor to take home (I'd never had one before). I started measuring it myself, and found that it was always a minimum of 9-10, going as high as 14 after meals.
Then I started to wonder: I was born anaemic - it's Spherocytosis, a form of heamolytic anaemia - which means that my blood cells don't last as long as 3 months, as in most people. So I wondered about the validity of the HbA1C test. Surely, if my blood cells don't last 3 months, then they won't accumulate as much glucose, and will be giving a false-low result for my long-term blood glucose? I mentioned this to my GP - who had my medical history - including the anaemia - in front of him, but he insisted the HbA1C was the thing to go on. I also mentioned it to the - by now - new permanent diabetic nurse, who had also not been made aware in her training of any complications involving anaemia. However, she did arrange for an extra blood test with the hospital - Fructosamine - to double-check. This is a non-routine test, and it measures average blood glucose over the last two weeks (where it's attached to blood plasma proteins, rather than red blood cells). The result came back 1.5 times the normal upper reading - equivalent to blood glucose of 9-10, confirming all my actual glucose measurements.
With the nurse's help, I then persuaded my GP that I needed to go onto Metformin tablets (which he was still reluctant to prescribe) and the results were dramatic. I'm now on one tablet three times a day, and my blood glucose is 5-6 before meals and 8-10 after. I would therefore like to urge all Type 2s who are also anaemic to ask their GP for a Fructosamine test, as - otherwise - they may be seriously under-diagnosed, and may be sleep-walking towards blindness. My annual retinal scan had already noticed the first signs of retinal damage the previous year, but my GP had not been concerned, as the HbA1C was okay. But actually, it wasn't.
Regards,
Mike
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