HbA1c Relevance re Pred.

[Nuff1]

OH had request from Health Centre to see GP on Monday as this last HbA1c came through as 69!

Given that it's an average over 3months and Pred can fire off raised spikes of blood glucose levels at random I'm wondering how relevant the reading is - Pred dose at start of period covered was 25mg p.d. - at end of period is 15mg.

He's not keen on the finger pricking however

24/01/19 Prednisalone 15mg

before breakfast 9.7

before lunch 7.1

before dinner 5.5

after dinner 7.2

Average 7.38

(after meal readings not taken during daytime as by the time due he's over half a mile away in workshop with oily mucky fingers)

Trying to reconcile thse readings with blood test result.

Morning readings have invariably been randomly high whereas pre dinner readings have averaged between and 5.5 for the past several weeks.

[SheffieldJane]

Not qualified to interpret these results. I hope one of the clever girls comes through for you.

[SnazzyD]

Your shock comes due from different units. So your finger prick is in mmol/L and the HbA1c is in mmol/mol. There are various conversion calculators online and 69 mmol/mol equates to 10.9 mmol/L. This is still too high but not as bad as 69 mmol/L! Sometimes it is shown as a percentage, in this case 8.5%.

[PMRpro Ambassador]

They aren't the same thing by the way - they are measuring 2 completely different things,

The spikes are part of the problem, they can be pretty high and that obviously shoves the Hba1c reading up. It isn't so much and average but more an indication of how much the haemoglobin was exposed to raised plasma glucose levels. The more often it goes up as well as how high it goes up has an effect. And this

diabetes.org.uk/professiona...

includes this statement:

"Situations where HbA1c is not appropriate for diagnosis of diabetes: ...

patients taking medication that may cause rapid glucose rise e.g. steroids, antipsychotics"

But I do note that most doctors DO seem to think it is!

This is also interesting:

type2diabetes.com/news/new-...

suggesting that 8% is actually an acceptable target for diabetics - even, I imagine, in steroid induced diabetes, If he's at 8.5% now it shouldn't be too difficult to get it down to under 8%. And it should improve as the pred reduces.

[Nuff1 in reply to PMRpro]

Thanks for the links - I'll print the relevent bits for OH

[Nuff1 in reply to PMRpro]

Back from GP and she wants him to take Metformin!!

We're going to print out those URLs and relevent text and drop into surgery (not disclosing source of info)

[PMRpro Ambassador in reply to Nuff1]

Entirely predictable...