HbA1c level

[Phoebenooby]

Hi, been on pred since end of January 24, my blood sugar level was over 7 in April, but no one questioned it, in July it was 5.5 as I had cut my carbs and sugar, in September it was pre diabetic range 6, cut carbs etc again and now at 5.7 which is ‘Normal’ Looking at my results I was 5.9 on January 15th before I even started pred. So my blood sugar before pred was higher than it is now. 5.9 is very close to 6…… so am I tottering on the verge of becoming diabetic?

[PMRpro Ambassador]

Are these all Hba1c levels? What are the units they are quoting?

We usually use the numbers that are around 30 and above - measured in mmol/mol.

The range of HbA1c values for people without diabetes will be 20 to 42 mmol/mol. 42mmol/mol converts to 7 mmol/L so anything under that is normal.

Then there is a range from 42-48 mmol/mol or 7.1-7.7 mmol/L which is called pre-diabetes. Above that, you are into the diabetic range.

So if your results are ranging around 6 nmol/mol, no, you are not tottering on the verge of diabetes. For someone on pred, you are doing very well indeed.

[Phoebenooby in reply to PMRpro]

Oh thank you! That is very reassuring! My dad was diabetic and lost his leg … I also have a brother who has had type 1 for over 50 years!

[Phoebenooby in reply to Phoebenooby]

I can’t seem to add the photo of the other photo, so just copied the numbers:

25 November 2024

39 MMOL/MOL

10 September 2024

42 MMOL/MOL

4 July 2024

37 MMOL/MOL

28 February 2024

40 MMOL/MOL

25 January 2024

37 MMOL/MOL

11 October 2023

37 MMOL/MOL

19 January 2023

41 MMOL/MOL

[Phoebenooby in reply to PMRpro]

Here are the results.

Text

[PMRpro Ambassador in reply to Phoebenooby]

I didn't know they still used %, thought that was dropped ages ago!!! Though it seems strange, this converter won't accept 5,7% as a level!

You can use this

diabetes.co.uk/hba1c-to-blo...

to convert the % figures you have to the other units.

6% is 42,1 - just barely into the pre-diabetic range.

This different one accepts % with a decimal point:

hba1cnet.com/hba1c-calculator/

and your 5.7% level is 39 mmol/mol which is well inside normal range.

[Phoebenooby in reply to PMRpro]

Very reassuring…. The test result in September at 6% had an abnormal alert next to it and I was asked to ring the GP, I will just continue to try and watch my sugar and carbo intake …. shame it’s Christmas soon!

[PMRpro Ambassador in reply to Phoebenooby]

The computer flags anything that is outside the set parameters, even 0.1 that is absolutely within the normal errors. Did the GP say anything about it when you spoke to them?

[Phoebenooby in reply to PMRpro]

When the test was really high in April, I was at the hospital having a PET scan. The trace is sugar based so they test you blood before hand, She got the result and asked if I was diabetic,! The result was on my NHS records but my GP never contacted me or gave me any advice. I reduced my sugar carb intake myself and the next test was normal. I slipped back and then it was 6 and that’s when it was flagged and I was advised to cut back on my fruit by the GP I said I did like bread and she said that’s starch not sugar!

[PMRpro Ambassador in reply to Phoebenooby]

Good lord - I know they don't do much nutrition at med school but I wonder what she thinks amylase in saliva is for ... Doesn't know the difference between complex and simple carbs either. I learned that in school, long before med school! And we are supposed to trust them???

Were you on pred in April? If there had been a random spike of BS due to pred shortly before, yes, could well have been high.

[Phoebenooby in reply to PMRpro]

Yes I had been on pred for 3 months in the April, it shocked me as I had the blood test about 3pm and hadn’t eaten since the evening before, but I didn’t realise it is the sugar level in the last couple of months not just the day before….

[Fatsiajaponica in reply to PMRpro]

Hi PMRPro, just for clarification, my results came in as 42 and 6% (whatever the latter means) down from 45 on the low carb. They seem to give both figures, the 6% they say = top of normal range and my lab saying the 42 = low end of prediabetic?? So I don't really know which one I am!

[PMRpro Ambassador in reply to Fatsiajaponica]

The 6% is SOO out of date. Whatever - you are on the borderline and you have had a really positive result from before low carb. If you continue with low carb it may fall further - it is a reflection of the last 3 months so won't have fallen as far as it could until you have been on the low carb a good 3 months.

[Koalajane]

are these finger prick tests or hba1c test s. It needs a hba1c test to show if you are diabetic and the figures quoted are not ones normally used for that. I am a steroid induced diabetic in remission with a hba1c of 37. Over 41 is prediabetic and over 47 is diabetic

[Phoebenooby in reply to Koalajane]

No it’s the full blood test taken from my arm

[PMRpro Ambassador in reply to Phoebenooby]

Yes, but they do do one-off BS levels as well as Hba1c from a "proper" blood sample, The units are just strange as I said above.

[Phoebenooby in reply to PMRpro]

I have having 2 monthly blood tests only because the rheumatologist requested it for the PMR a levels which are always in normal range 😊 the sugar one just happened to be checked as well as lots of other things with at were all normal

[PMRpro Ambassador in reply to Phoebenooby]

The Hba1c SHOULD be checked every 3 or 6 months. It is an average of the BS levels over the previous 3 months so 6 months is fine unless it starts to rise. Lots of people who aren't as careful as you were might see it shoot up miles because of pred and comfort eating or pred-induced ravenous hunger. And lots of GPs don't check it - and the diabetes appears seemingly out of the blue - even though the sings would have been there had they bothered to look.

[Phoebenooby in reply to PMRpro]

It’s only through reading the posts we learn anything! I have never been offered a dexa scan!

[PMRpro Ambassador in reply to Koalajane]

See my reply just above. I've never seen % used for Hba1c, think it was changed about 13 years ago!!!

[Koalajane in reply to PMRpro]

It really annoys me when doctors use these old measures

[PMRpro Ambassador in reply to Koalajane]

Me too - makes you wonder what else they are years out of date on doesn't it!! But that appears to be the lab being complicit - or is the practice just continuing to use % "because that what it always was"?

[Koalajane]

yes very strange and it can’t be easy for patients to know when they are not the new measure. Oh well maybe they will get there in another 30 years!

[Tappo]

Is that blood glucose or HBa1c?

[Phoebenooby in reply to Tappo]

HBa1c

[ExpatRay]

Hello Phoebenooby the traditional HBa1c(A1c hereafter) tiers are 5.6 and below is normal, 5.7 to 6.4 is prediabetes(commonly referred to as type 2 diabetes) and 6.5 or above is full blown Diabetes(type 1).

Your levels seem to be marginally suggestive of prediabetes.

Many doctors today however push for A1c levels to be 5.4 or below as a practical target level.

Also bear in mind the A1c test is an average reflection of your sugar/glucose levels over the three months prior to your test, so changes in your diet today will not reflect immediately.

I am a non diabetic but also a keen health watcher, with A1c at 5.2, and recently with the now public/pharmacy availability of CGM meters(continuous glucose meters) i tried one for a 14 day test and found i was able to identify serious glucose spikes during the course of my day(and night) from my meals and with a little tweaking/adjustment of my dietary intake was able to reduce my A1c below 5.0. If you are able to get one, you will receive a detailed report over the 14 day period and this can be shown to your Dr who will be able to help with the necessary adjustments if you are not a technophobe yourself.

I found this one time exercise to be very beneficial and gave me a very clear insight of the relationship between my diet, daily glucose levels and my A1C.

The other important matter over and above fasting A1c is your fasting insulin levels and it is worthwhile to get this tested also. Along with your fasting glucose and fasting insulin your level of insulin in your blood can be checked for any irregularities with insulin also.

just a thought.

wish you well.

Expat Ray

[PMRpro Ambassador in reply to ExpatRay]

But are those A1c numbers % or mmol/L - see my discussion above and compare the results from the NHS app, photo of % and a written list of mmol/mol (hope I got those right!!) The mmol/mol results are all in normal range as are the outdated % figures. SOOOO confusing.

[Phoebenooby in reply to PMRpro]

Yes you are right!

Text

[LindyMc]

The US Hb1Ac is measured in % not mmol/l and the prediabetic range is 5.7 to 6.4, slightly different from the UK where our % equivalent is 5.9% to 6.5%. Don't know any light on the situation but as you have seen fixing it is not that hard. There is also research in uk that if you can reduced weight by 10% and keep it off most folks drop out of the prediabetic range permnantly.

[Koalajane in reply to LindyMc]

Yes but Phoebenooby is from UK

[Phoebenooby in reply to LindyMc]

Yes I am in oxford U.K., I’m not overweight and have never had raised blood sugar so hopefully if I just keep my sugar and carbs in check when the steroids are finished I will be good !

[Koalajane]

as has been mentioned I would keep an eye on your hba1c numbers. But well done for getting your numbers down.

I just wonder if your doctor realises that carbs turn to sugar!

[Pixix]

41 isn’t too bad onsteroids in my history,but it is borderline prediabetes ias told last year. I cut my carbs, & this year the result was fine…but they’ve also altered my norm to 47 - 56 as I have many diseases…it says ‘due to personal circumstances’ onthe test results!

[Mewy]

I live in Canada and we use those numbers. My A1C was 6 after taking PRED for a year, and my NP suggested I try to get it lower as she called 6 pre-diabetis. At that point I had tapered off the Pred . I lost 30 lbs by reducing sugar and starches and now at 5.7 A1C and she said that was good. I have continued to maintain my weight and get a blood test for A1C every 6 months. Mewy

[LindyMc]

I am on the point of being skinny and have battling to keep Hb1Ac down from 40 and 41. Have given all refined carbs ie white pretty much anything and refined sugars. Even wholemeal pastas do for me. Tho lentil sparhetti and legume other pasta are OK, together with 50/50 brown rice/ quinoa tho rice on its own is no good. Last test after being v strict was 37, yeh! No doubt after Christmas it will be hovering around 41 or worse.