Feeling really fed up. My HbA1c results came in today and they are 41mmol/mol or 5.9% - exactly the same as they were eleven months ago

when I had the NHS health check. They focused at the time on hypertension and the doc never mentioned this HbA1c figure tiIl I accessed my medical notes online and noticed they were almost pre diabetic and he agreed. He added that all they would have done is give some diet advice and sent me away but that the life style changes I'd made anyway should have lowered the BG. Now I don't know what to do: I lost a lot of weight over the past year and LCHF has become a way of life. I feel I've done all the right things and they haven't changed a thing. I just feel really cross about it, shocked too.

Also does anyone know anything about Serum C reactive protein levels? Mine was 4mg/L which I think is a little higher than it should be and I wonder if it is in any way connected to the Hba1c?

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  • Hello,

    You can Google to check the results comparison.

    Relax, you are in the controlled range, please check with your GP and practice nurse, also do a full diabetic check with your practice nurse. good luck.

    In short:

    HbA1c targets Targets for HbA1c are as follows:

    For people without diabetes, the range is 20-41 mmol/mol

    (4-5.9%)

    For people with diabetes, an HbA1c level of 48 mmol/mol

    (6.5%) is considered good control, although some people may prefer their numbers to be closer to that of non-diabetics

    For people at greater risk of hypoglycemia (lower than normal blood sugar), a target HbA1c of 59 mmol/mol (7.5%) to reduce the risk of hypos

  • It must be really disappointing for you after all your efforts, but on the positive side it has remained stable and there is no reason why it shouldn't remain at that level for ever.

    There is a tremendous amount of difference between being at the top end of normal and being diabetic and you may never move into that bracket.

    You don't mention exercise, but I presume you do it because you have lost so much weight and exercise can also have an effect on blood sugar.

    I don't know anything about serum reactive C levels.

  • I think the C reactive levels might be irrelevant, hope so anyway. Yes I do feel disappointed as what started out last March as a weight loss exercise for hypertension and also to reduce future arthritis problems in my knee hasn't made any difference whatsoever. I know the numbers are in the 'normal' range but only just and I can't see much difference between 41mmol/mol and 42mmol/mol. I walk regularly and garden too - and I don't mean messing in a window box! I just feel sickened and the only positive thing is that if I hadn't done all these life style changes then the numbers would have probably just been worse :(

  • It would help if you could explain what those abbreviations mean to a layman such as I.

  • Hi,

    This may help:

    C-reactive protein (CRP) is a protein found in the blood, the levels of which rise in response to inflammation (i.e., C-reactive protein is an acute-phase protein). Its physiological role is to bind to phosphocholine expressed on the surface of dead or dying cells (and some types of bacteria) in order to activate the complement system via the C1Q complex.[1]

    CRP is synthesized by the liver[2] in response to factors released by macrophages and fat cells (adipocytes).[3] It is a member of the pentraxin family of proteins.[2] It is not related to C-peptide or protein C. C-reactive protein was the first pattern recognition receptor (PRR) to be identified.[4]

    You can fine more information on the internet.

  • C reactive protein is a measure of inflammation, so what it tells you if it is elevated is that there is an inflammatory process going on somewhere.

    Omega 3 fats are the best way to reduce inflammation. Make sure you have plenty of oily fish - walnuts and hemp oil are the best vegetable sources.

  • Hi,

    There is discussion on inflammation and Magnesium and how it relates to CVD on top of cholesterol!, Is cholesterol checking necessary?

    May be soon GPs will look at testing Magnesium and Inflammation.

  • sorry, I meant flaxseed oil, not hemp oil. You can buy it from health food shops, though it's expensive, (make sure it's fresh and refrigerated) you can also get ground flax seeds (linseeds) to add to food.

  • I don't know your diet but to get lower HbA1c figures you need to reduce or eliminate the white bread, white rice, white pasta and reduce the sugar content on your foods. If not stay at your levels. You have made sacrifices to get to where you are today BUT maybe you need to go further if the Blood Glucose level bothers you. As you have not been diagnosed diabetic then it is no big deal for you just be aware of it. And talk to your doctor about it.

    To understand the results try this

    rcn.org.uk/__data/assets/pd...

    and

    cllsupport.org.uk/uybresult...

  • Hello,

    Your web links are full of information. Thank you.

    Have found out the refined sugar is the one to reduce.

  • refined sugar is the worst because it spikes your blood sugar fastest - but the key is to eat a low glycaemic load diet - so if you are having carbs, try to choose low GI ones (pulses, wholegrains) and have some fat at the same meal, also meat/fish/eggs if possible.

  • I do know that all sugar is the one to avoid and of course there has been a lot in the press about that in the past week. It is something that I've always been aware of though, mainly through reading stuff on this site and links given on this site. so I add no sugar to anything but of course it is hard to avoid it totally, it creeps in everywhere. I cut out rice, pasta and white bread, all the things we are told we should eat and have never done ready meals, junk food or fizzy drinks - ever! Usually I will eat 1 slice of wholemeal toast with my boiled egg at breakfast - with BUTTER. One thing in particular I did do is not eat any so called low fat [but high sugar] yogurts. They are loaded with sugar.

    My grandmother's generation would always cut out bread, potatoes etc from their diet if they wanted to lose weight. That was before the saturated fat lobby came along and saturated fat became like tobacco and dieters were told to eat loads of carbs. No wonder there is an obesity and diabetes epidemic. I feel the NHS is dishing out the wrong evidence.

  • As a dieter i was never told to eat loads of carbs but i understand others were. Yes sugar is everywhere and in fruit also so cannot be avoided just reduced. Just read labels.

    So you are doing all the right things so maybe this is where you glucose level is. Get on with living.

  • Sounds like you've done a decent job, with your HbA1c being in the normal range. Some fine tuning may help further. Wholemeal bread is a fast-release sugar to your body for example.

  • Hi concerned. Are you saying that it's better to eat white bread rather than wholemeal? Or just avoid bread completely? Thanks

  • Personally, I seldom eat bread, however there are slower release breads such as mixed whole-grain. The main reason I don't eat shop bought bread much though is the additives, especially preservatives, which is why I rarely have sausages or pate too.

    It definitely is not better to eat white bread than wholemeal.

  • The other influence of course is genetics and family history of type 2. I don't know if this applies to you.

  • there are lots of other anti inflammatory foods by the way, turmeric is a great one (so you eat lots of curry, ginger, there's a piece on anti inflammatory diets here webmd.com/food-recipes/feat...

  • I don't have a family history of diabetes save for my grandmother - but does that count? I'm waiting to hear what the doc has to say about this result, if anything. I realise this is not actually a diabetes diagnosis but feel these are still too high for my life style. If they are 'normal' then I have very little leeway before pre-diabetes sets in and type 2 escalates. After all in the past year I changed my eating habits and exercised more but the HbA1c number hasn't altered at all.I was never a couch potato in the first place nor was I overweight or ate junk food.

  • I hope you will get some good news from your doctor. If it does look as though diabetes is a possibility then you may need to think about reducing your carbohydrates to a very low level. Have a look at the discussions on Diabetes Uk or look for Paleo/ketogenic diet.

  • Well bad news really. My dr eventually got back to me and says there are plenty of thin healthy people who contract T2 diabetes and have it to deal with. He says it is a 'disease not a punishment'. Presumably as the number hasn't altered in 12 months, despite my strict life style improvements, he feels that this is pre diabetes. There is little difference between 41mmol/mol and 42 [prediabetic] and 48 is a diagnosis of T2 I think. anyway he generously says he'll "Have the metformin ready for me when the A1c reaches 50 [because it will!!]" -his words :(

  • Sorry to hear your news. My husband was apparently on his way to diabetes a few months ago (sugar in urine) so I persuaded him to cut his carbs, and he no longer has the problem. It may not work for everyone.

    We gave up all bread, pasta etc. We eat eggs and bacon for breakfast, or full fat yoghurt. Veg soup or protein and veg for our other meals, plus a little fruit or some nuts. Our treat is a good coffee with cream.

    This is a link to Dr Briffa and a discussion on diabetes, I hope it may be some use to you.

    drbriffa.com/2012/10/02/dia...

    Good luck Gardengnome.

  • Thanks for the link Penel, I will read it later as I always think Dr. Briffa has something useful to say. Glad the carb cutting worked for your husband but it hasn't worked for me as I've been doing it for almost a year and all the eggs and full fat milk and yogurt [much nicer and less/no sugar than the low fat stuff]. Feels indulgent though! I do have a small slice of wholemeal bread for breakfast and occasionally a potato in the evening, maybe I should ditch those . It's the fact that the dr knows I've done these things and the number hasn't altered that leads him to think the way he does. He was trying to be light about it I think, he's quite a nice guy.

  • Hello,

    The mail is writing about how to reduce "SUGAR" in our food intake. Please take a look, for me there is some thing to learn fro this. Understanding the sugar content in food is very important even in fruit and vegetables.

  • Dairy foods may be inflammatory for some people if they don't have the gene that enables them to digest it. The human race evolved eating meat and has done so for thousands of years, good quality meat is unlikely to be inflammatory.

    authoritynutrition.com/

    7-evidence-based-health-reasons-to-eat-meat/

    Grains are a much recent addition to our diet and are inflammatory for many people.

  • Some organisations assert that preparing grains properly, by soaking for instance, reduces the toxins in grains (by facilitating fermentation), reducing their inflammatory effects.

    The food industry produces food with inadequate preparation, uses solvents too cleanse and/or extract vegetable oils for instance, uses additives such as colourings, preservatives and sweeteners, refines fructose that contributes to fatty-liver and insulin resistance, and refines high-glycaemic foods that raise insulin levels whilst encouraging low-fat. As a result, chronic inflammatory-disease is rampant.

  • Hopefully if the numbers have stayed the same for a year they may stay like that permanently.

  • let's hope so, sadly the doctor didn't think they would :( that's encouraging isn't it !! He said if they hadn't gone down at all with everything I did then I'm looking at T2 diabetes before long. I wonder why they tell you to improve life style if it doesn't make any difference. I suppose it does for lots of people though, your husband included. Perhaps I'll get run over by a bus !!!

  • If you acquire metabolic syndrome you have to be meticulous about watching how much carbohydrate you eat, how fast it is digested, and even to a lesser extent how much protein you consume.

  • How would you know how fast carbs are digested? Metabolic syndrome: I think that always has 3 problems - is that right? high cholesterol, hypertension and waist obesity. My cholesterol was borderline a year ago and will have it tested again in April. Hypertension was stage 2 but is 'OK' now - not brilliant though and I'm not obese. My doc says there are plenty of thin active people with T2 and although people think you have to be obese that is not the case. To test oneself is it a good idea to get one of those blood sugar meters I wonder? I'm almost wondering now if a year ago the hypertension was connected to being pre diabetic/metabolic syndrome.

  • I've got a home glucose monitor and they are easy to use, once you get used to pricking your finger!

    However, I haven't used it for a while as it was always OK (at the top end of normal) and I didn't want to get too obsessional, although husband is nagging.

    Always wash your hands to remove any high sugar grime (!) and always take under same circumstances as blood sugar varies a lot depending on whether you have eaten or not.

    Personally, I think your GP is being a bit pessimistic when he says it will go up or maybe it's his medic's sense of humour.

  • Hi Alliwally, I'm not sure whether to get one or not.12 months ago I was a healthy, never ill and never visiting the doctor sort of person. Stiff upper lip etc! Then a cholesterol test followed by a health check revealed borderline cholesterol and stage 2 hypertension and a host of tests that had me almost living at the drs surgery. All were OK although I'd no idea what they were until recently. That's when I realised the hba1c test was high and nobody had mentioned [or noticed] it. As I'd made lots of changes to lifestyle over the year and the dr knew that, he presumably thought it should have dropped. You could be right though, it might be his warped sense of humour. It was the same guy who said that I wouldn't be able to make enough difference to hypertension levels by life changes. What he actually said then was "You won't be able to make enough difference". I determined to prove him wrong but unfortunately he was right! I've a nasty feeling he might be right on this too but only time will tell.

  • Hello,

    Home testing and glucose monitor I am not sure!

    Today HbA1c is the new way of testing for Type 2.

    You surgery should give you a free glucose monitor.

    Please ask for one.

  • Hi Bala,

    They will only give you a free one if you become diabetic and there is a medical reason for you to check your blood sugar, I think I am right in saying.

    Hopefully Gardengnome will never reach that stage.

  • Hopefully I won't but unfortunately the dr wrote to me just today saying that they don't treat pre diabetes with meds,they just wait for the number to rise! He said they give diet advice [courtesy of the NHS plate no doubt!] and that the diet changes etc that I have made had merely kept the HbA1c numbers where they were. The thing is I'd never have known these numbers had I not seen my notes online, obviously they aren't considered important until they reach a tipping point. Makes you wonder doesn't it?

  • Approximately how much carbohydrate do you eat at each meal? How much fruit do you eat? How many protein portions do you eat in a day?

  • Hi Concerned, I don't know how you measure carbs, I used to be a weight watcher and they had their own system but I doubt it is what you mean. A typical days meals would be:- First thing: 2 large cups of tea with milk. Breakfast: half a grapefruit, boiled or poached egg, 1 slice of wholemeal bread with unsalted butter and probably an actimel drink. No tea or coffee. Mid morning: cup of coffee. Lunch: generous bowl of home made veggy soup; 2 pieces of fruit - apple, orange, pear, grapes and perhaps a few dates, cup of expresso coffee. Mid afternoon: drink of tea with milk and perhaps a banana or apple. Dinner: could be fish or some vegetarian dish. Always made from scratch, but we rarely eat meat. Tonight though we had an oxtail, mashed potato [medium portion] and Brussels sprouts followed by natural full fat Greek yogurt with lemon juice and sweetener. Water to drink. I usually have some chocolate after dinner - dairy milk I'm afraid! I do drink wine [red mostly] but only occasionally. I might have some walnuts as a snack, any time. Do you know the best sort of artificial sweetener to use? I usually use Morrisons own sort and tried Truvia once. Apart from the absurd high price I didn't like the taste. Sorry if this is too long winded !!!

  • All,

    I was trying to bring my HbA1c numbers down, had a lot of problem with NHS food people in understanding what I wanted! I could not measure cab in food!

    In the end had a look for "SUGAR" in food, now days my food intake is green vegetables, twice a week rice and curry, multi seed breed with coconut oil on it for breakfast, some times I do don't have any breakfast, home made milky coffee.

    My next blood test for HbA1c is in two months time.

    Go to the gym for 40 minutes at least five days a week.

    My body is telling me it is getting better compared to three years ago.

    Have not taken any medication for type 2.

  • Hello,

    Thank you. May be I need to discuss your food intake after your blood test via an email as your numbers are coming down. In my house we do not measure our food intake.

    We may have to start on measuring our food intake.

    Reduced from food or no sugar in tea or coffee and no medication. Please give an update once you get your results. Thanks.

  • Big leg, thanks for the interesting reply, definitely worth more than tuppence! I'll comment on your remarks in the order you wrote them.

    You are spot on when you say I've become one of the 'worried well'. A year ago before the health check I only ever visited the surgery for the annual flu jab and an asthma review, if every you weren't well I was brought up that you didn't make a fuss, stiff upper lip etc., happily I never was. Then that check which I wish I'd never had, except that perhaps is silly, as hypertension is both potentially serious and easy to treat. I can still see the nurse's eyes lighting up when she took my the blood pressure [at that point I'd no idea of numbers] giving me a pitying look as though I was going to expire at any moment due to this. Then she said "But you are 70", I told her that No, I wasn't, I was 29! There was something about her attitude that irritated me. Thereafter I seemed to be at the surgery monthly for blood tests and pills plus an ECG and Lord knows what else. I shouldn't be so ungrateful I know, but I was!

    Re. the HbA1c; This was never mentioned to me at the time, either that they were doing it [as part of taking an armful of blood] or later when the myriad results arrived back at the surgery. I don't think I even asked for the results as I knew they would be onto me if they weren't OK. So it's interesting to read that your husband has kept his levels stable for so long. My doc seems to think it is inevitable that mine will rise, probably because I've lost so much weight and exercised more yet the numbers after the most recent test remained the same. He was saying that they would have risen had I not lost the weight and it was inevitable that they would rise in time as I had no more weight to comfortably lose. In the same vein, were I to put any weight back on they would certainly rise. I do wonder why he hadn't mentioned the numbers though a year ago. Of course I shall be 81 in ten years time so probably gaga by then anyway - so who cares!!

    I think the dr I see for the blood pressure checks [a different one and a friend of my daughters] also thinks the same as yours does about cholesterol. She just said not to worry about it. I know it was borderline a year ago hence the hauling in for the health check, but 3 years prior to that it was much higher. On that occasion I had foolishly asked for a cholesterol check as there had been something in the press about it and I'd fallen for the hype. If only I'd known then what I know now I'd never have gone near! I remember at the time being given a diet sheet and a patronising lecture on the NHS way of eating. I binned it as soon as I left the surgery. It makes my blood boil when I read about the cholesterol con and big pharma making millions out of it. Bring back butter I say! It seems that the sugar issue is no different, the people who sit on the quangos that tell us what to eat are financed by the likes of Mars and Coca cola. Wonderful.

    Re. online medical notes. I had an argument with the surgery in 2008 over a smoking issue and wanted to get to the bottom of it. That was my main reason for asking. It was on the Emis website for repeat prescriptions and booking appointments that I first heard about it as there was a box 'click here for your medical notes'. Initially I had to make an appointment to see my dr so he could explain the system and give me a password etc. There was no problem and I believe they are obliged to give you access if you ask. Incidentally as a result I got to the bottom of the smoking issue I'd had with them. Seems there was an incorrect entry written in 1996 when I was diagnosed with asthma and it had been copied over annually ever since. When I saw the error and told the dr he deleted it. I haven't had a cigarette in over 50 yrs yet I had to take a saliva test for an insurance company as the surgery had said I was a smoker when I had filled in a form saying I wasn't !!

    You are right when you talk about having been lucky in experiencing real food before the supermarket explosions, deep freezes and the rest. We ate proper food and prepared it freshly and were happy to do so. Nowadays with both parents out to work there is little time for cooking. Such a shame. What is more I, at any rate,was taught to cook at school and how to balance meals out quite apart from what I learnt at home. How many girls today can do that. They might be able to bake a cake - but plan and cook a meal ....easier to go to the supermarket and buy a ready one. The very idea of a chip butty was unthinkable, it still is to me actually. Quite common in Yorkshire though. We don't do deep fried mars bars though, the credit for that goes to Glasgow I believe!!

  • Hello,

    Your post has given 45 replies on the subject of HbA1c so far most of the time it is statin and cholesterol, well done.

    I agree with you NHS, GP, NHS food plan and making mistake in computer records. A typo in my weight caused a lot of problem, I was never that weight! Eating what we consider is best for us and keeping fit by walking or going to the gym is the best way. We know our body and our body can give us a better indication on medical problems.

    Good luck with your plan.

  • Thank you all, it's been a really interesting conversation.

  • Hi GG

    It may be of of no consolation to you, but apparently it is possible to have a genetic predisposition to Type 2 diabetes. I had always thought that only applied to Type 1. You have done the best you can, so fingers crossed.

  • I confirm what some of the others say about protein. My GP said simply they test for it to see liver function. TBH I don't know if your level is good bad or indifferent. I hope your GP would have said something if there was concern.

    I could not find anything on NHS choices. . .

    I realise you posted this question ages ago.

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