# Sudden increase in HBA1c



## lucy123 (Apr 5, 2016)

Hi - I haven't been on the boards for a long time now  - the forum looks very different!  But hello everyone.

My control has been really good for a long time now HBA1c at 47.  However I have started feeling really dizzy lately and at my last diabetic appt the nurse did my sugars with a finger prick test to just try out a new meter. I was shocked when my fasting test was 12.2.  They had always been in the 6's and low 7's for over a year now.  I have now had a phone call to say GP wants to see me to discuss change in medication as my HBA1c is 61.  I have been testing regularly and haven't been able to get down below 11.  

What can be going on?  Could the dizziness be associated?  What would the next stage of medication be?  I am already on the maximum slow release metformin?

Also I am on crutches at the moment, but only for the last week due to a knee injury but don't think that would affect HBA1c would it?  maybe the finger prick test but isn't HBA1c over a 3 month period?

Thanks for any advice you can give - I know for some these figures will still be good but for me they are alarming as normally so good.


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## Northerner (Apr 5, 2016)

Hi Lucy, good to hear from you again  Very sorry to hear you are having problems though  That's quite a spike in HbA1c - was this an annual check, or 3/6 months? What sort of a winter have you had - have you been doing any fingerprick tests yourself lately? Any increase in weight/less exercise during the dark cold days?

Has the doctor said anything about the dizziness? Do you test when you feel dizzy? You knew I was going to ask you loads of questions, didn't you? Sorry 

There are a plethora of other medications they can try in addition to metformin - I seem to remember you were on Voctoza for a while? It might also be worth doing a food diary and reviewing your carb intake.


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## lucy123 (Apr 5, 2016)

Thanks Alan - lovely to hear from you again.  The spike was since beginning January!  In early January it was 47.   No change to diet and didn't mention dizziness (not sure why) but sort of felt things were going downhill.  Crawled into a hole of denial a bit over testing - mainly because testing always seemed ok - lesson learnt there!  Have been eating healthy and still working out to the max but having problems dropping my weight - maintaining seems okay but not dropping and already on low carb diet.   Will see what GP says.  I stopped the victoza and byetta as both were making me so sick I couldn't work.  Will see what they suggest this time.  Has anyone heard of a new drug that makes you wee a lot - my neighbour was talking about this the other day.


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## Northerner (Apr 5, 2016)

The medication you are thinking of is dapagliflozin - we do have some other members on it, with varying degrees of success:

http://www.drugs.com/cdi/dapagliflozin.html

That is quite a spike in such a short period!  I'm at a bit of a loss, I suppose there's the possibility that the test got messed up, but your fasting fingerprick would seem to back it up.


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## lucy123 (Apr 5, 2016)

Just tested and I am 15.4  - breakfast was at 7am  wheat and raisins.   I'm quite alarmed at how quickly they are rising.  It seems at the moment each time I test they have risen more.  Hopefully GP will discuss when she rings me today to discuss medication.

I am thinking I need to take a look at a diabetic diet sheet or sheet of yes and no's again just to make sure I haven't slipped into bad eating - I don't think I have though.  Could the knee injury be causing this I wonder?


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## Northerner (Apr 5, 2016)

Stress and the (presumably) reduction in activity might be playing a part, but I would be surprised if it would have such an impact. Re-evaluating your diet might help - perhaps follow a testing schedule as described in Test,Review, Adjust by Alan S . Even better, if you can stretch to it, perhaps a Freestyle Libre might help to pinpoint where the problems might lie? 

https://youcandoit.freestylediabetes.co.uk/?gclid=CNHqwNid98sCFRSNGwody-cFMA


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## lucy123 (Apr 5, 2016)

Oh wow - I am behind the times.   Once you have paid the £150 does that mean no more test strips?  Do you have to buy the sensors?  I see it says wear for 14 days.  I am very interested in this.  If anything it stops the denial by limiting how much you test.   I even just tried a different tester to convince myself all is ok but still said 15.9.  If it is just a one off £150 and no extra cost it might be worth me looking at.


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## grovesy (Apr 5, 2016)

I believe you still need test strips and purchase more sensors. There are few using the Libre sure some will be along soon.


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## Northerner (Apr 5, 2016)

lucy123 said:


> Oh wow - I am behind the times.   Once you have paid the £150 does that mean no more test strips?  Do you have to buy the sensors?  I see it says wear for 14 days.  I am very interested in this.  If anything it stops the denial by limiting how much you test.   I even just tried a different tester to convince myself all is ok but still said 15.9.  If it is just a one off £150 and no extra cost it might be worth me looking at.


You pay for the initial starter pack, which includes a couple of sensors and a reader device. Each sensor lasts 14 days, then you have to put a new one on. It's a bit like a 'poor man's CGM' - similar to devices costing considerably more, but obviously with less functionality. I'm not sure how much the replacement sensors are. You do still have to do some fingerprick tests just to make sure the sensors are working correctly. If you search for 'Libre' you'll find quite a few threads about it - many members use them to great effect


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## lucy123 (Apr 5, 2016)

Wow its £58 for a sensor that lasts 14 £116 per month!  A bit steep really but may be worth a go short term to see what is happening over a month period.
I will speak to GP - I very much doubt they will give me this on NHS.  Thanks for sharing this though - could be useful.


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## Northerner (Apr 5, 2016)

lucy123 said:


> Wow its £58 for a sensor that lasts 14 £116 per month!  A bit steep really but may be worth a go short term to see what is happening over a month period.
> I will speak to GP - I very much doubt they will give me this on NHS.  Thanks for sharing this though - could be useful.


It's being evaluated by the NHS/NICE currently - the hope is that it will be prescribed, but probably limited. Many people have found the results quite revelatory, so it can be very useful for short-term or occasional use when you have hard to spot problems  I've been tempted myself!  By the way, you don't need to pay the VAT on them.


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## Robin (Apr 5, 2016)

lucy123 said:


> Wow its £58 for a sensor that lasts 14 £116 per month!  A bit steep really but may be worth a go short term to see what is happening over a month period.
> I will speak to GP - I very much doubt they will give me this on NHS.  Thanks for sharing this though - could be useful.


Hi Lucy, I use a Libre on and off ( I'd use it full time if I could afford it). You get the VAT off if you tick the box that asks if you're diabetic, when you order, so it comes down to just below £50 per sensor. I used my two starter pack sensors to have a thorough review of my levels, and found it invaluable. I now use one on holiday, I figure £50 as a 'holiday expense' is neither here nor there, and gives me much more peace of mind when I'm away and out of normal routine.


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## lucy123 (Apr 5, 2016)

If my sugars keep rising the way they do - it might be worth it.   I am now thinking in my early days it took a lot to get my nurse to believe I was having hypos (remember this Alan?)  and this would have been invaluable!   Every time I hypod I couldn't get myself to test until sugars had gone back up again.
I cant understand why bs rising so fast - but I have always been different when it comes to my diabetes    No call from GP yet but look forward to hearing her suggestions - and at least she has picked up the sudden rise and is going to call me. She asked me to go see her but because I am on crutches we are going to try and do over the phone .  thank you so much for your replies - really helpful.


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## DeusXM (Apr 5, 2016)

Rather than go the full Libre route, I think in the first instance you need to just get back in the habit of regular testing. Not knowing your full background, I have to say I'm not surprised you're finding your blood sugar rocketing up in the mornings. Wheat and raisins for breakfast is the equivalent of eating a massive bowl of sugar, and I would imagine this probably raises your baseline blood sugar for the entire day. It may be that reducing your carb intake substantially will reduce the overall glycaemic load placed on your body - which then will give you the chance to get your blood sugars back down to a more acceptable baseline.


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## lucy123 (Apr 5, 2016)

Oh dear - have to go back on victoza - and it made me so sick before.  Have asked GP if can give me something this time for sickness.  Anyone else had issues with sickness and how did you solve it/cope with it.  Last time it really did give me projectile vomiting!  Feeling a bit fed up as have just been told its nothing I have done wrong - just its a progressive disease.   I wonder if this could be why despite a really healthy diet I have been struggling to move weight recently?   Diabetes is not my friend today :-(


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## Northerner (Apr 5, 2016)

lucy123 said:


> Oh dear - have to go back on victoza - and it made me so sick before.  Have asked GP if can give me something this time for sickness.  Anyone else had issues with sickness and how did you solve it/cope with it.  Last time it really did give me projectile vomiting!  Feeling a bit fed up as have just been told its nothing I have done wrong - just its a progressive disease.   I wonder if this could be why despite a really healthy diet I have been struggling to move weight recently?   Diabetes is not my friend today :-(


Sorry to hear this  Why Victoza though, if it made you so sick before? Have you ever tried Bydureon, which some people find a bit kinder? It's similar, but you only inject it once a week - it's effectively an extended-release version of Byetta. I find it odd that they are laying the blame at the 'progressive disease' door, given the short timescale of the apparent deterioration. It's a generalism anyway  -some people find a balance and never 'progress', some 'progress' regardless of their efforts. Lazy and blinkered reasoning, in my opinion!


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## DeusXM (Apr 5, 2016)

I'm not personally convinced that T2 is always a progressive disease. What is your diet like? I know you've said 'really healthy'..but what does that specifically entail?


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## trophywench (Apr 5, 2016)

Hi Lucy - I dunno whether I was around much when you were here before so basically all I know about you started 5 minutes ago - so if I suggest anything that 'you've been there done that!' - you'll have to excuse me!

Couple of things have jumped out and bitten me - first is - why are you on crutches? - because any sort of injury (or stress or any 'trauma') can cause our BG to shoot up - someone (a T1 but still a diabetic LOL) on here had an operation - all planned and went well - and commented that just after the op - when he knew he'd need more insulin because you just do with anything like that - he needed THREE times as much, to do the same thing, except he wasn't doing ANYTHING - just stuck in bed.

Second is 'wheat and raisins' for brekkie ????  HUGE carb count for ALL dried fruit - and the carbs in the wheat on TOP of the raisins!  Paired with the fact that 99x out of 100, most diabetics are less carb tolerant first thing in a morning.  I really think you ought to look to change your choice in a morning for something a lot lower carb, that will hit your bloodstream a bit slower than your current selection!  Grilled bacon and a tomato?  Lump of cheese and a crispbread?  - all sorts of things you could try instead.


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## lucy123 (Apr 5, 2016)

Hi - the wheat and raisin I have been having for a year now and always remained stable - back to 6's within 2 hrs - never going above 7's in the two hour gap.  Only have 8 little wheats or a small bowl of porridge. So If it was okay before, the question really for me is why not now - but I have already decided to look at this.  I generally eat a low carb 'clean' diet with the exception of breakfast - lots of chicken spinach egg tomato,fish etc.  No bread and not much pasta or rice and if rice long grain brown.  I haven't changed how I am eating.  I wondered about the leg and asked but the leg injury is only a week old and the HBA1c tests and high bs go back to January.  Both Byetta and Victoza made me sick Alan, but going to try with an anti sickness drug to see. I will see if I can find a 7 day diabetics diet sheet to compare to what I eat - but seems funny that all was good sugars wise before January and not now.


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## lucy123 (Apr 5, 2016)

Is there a 7 day plan anywhere for diabetics menu?  Its worth looking at I suppose to give it 100%?


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## lucy123 (Apr 5, 2016)

Well I am beginning to think I may be going bananas!  I have just found a post I put on here in reply to a question in 2012.
This suggested that I had switched from Byetta (which did make me very sick!) to Victoza and that other than a headache for 3 days I was finding it much better and only injecting once a day.   So maybe it wasn't the victoza that made me sick - but now I am thinking why did I stop then? 

Thank you all so much for your help today - it is much appreciated. I am going to post again separately re victoza.

I am now going to take the bull by the horns and test away and see if I can find a diet sheet for diabetes somewhere to follow for a few weeks.  If anyone can help with this it would be most appreciated.

Also has anyone heard of cyclizide  as a drug for diabetes - I have probably spelt this completely wrong but the GP mentioned this too - she said it was a giicazide (I think) that wouldn't make me put weight on!


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## grovesy (Apr 5, 2016)

I and many others are on Gliclzide . My weight has been more stable since I have been on it. Though I have reduced my carbohydrate and potion sizes too!


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## lucy123 (Apr 5, 2016)

Ah  I now think it might have been sitagliptin that was suggested  - GP mentioned the only one that doesn't cause weight gain?  Anyone any experience of this?


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## grovesy (Apr 5, 2016)

I am also on sitagliptin too.


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## lucy123 (Apr 5, 2016)

How are you finding it?  I think I am to switch to this and Victoza and come off Metformin.


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## grovesy (Apr 5, 2016)

I find it ok i have been on it for a few years, take aswell as gliclazide and metformin.


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## KookyCat (Apr 6, 2016)

Hi Lucy 
Did they do a second hba1c test, just to check?  It seems like one heck of an increase in a very short time without much change to food or exercise or well anything.  I know you've been experiencing high blood sugars when testing but it just seems a little odd and I think I'd want a bit more reassurance before they changed a regime that had been working so well previously.  If it had changed that much in a year well I would be less taken aback but in three months that's quite the change.  My friends doctor was trying to get her to take insulin on the basis of a big increase in hba1c because of progression, but he didn't realise that the steroids she was taking for a chest infection increased blood sugar, once she came off them they hba1c returned to her normal level.  There's definitely nothing else, like a change in meds (steroids, statins other culprits) that could have caused a temporary spike?


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## lucy123 (Apr 6, 2016)

2nd hba1c was done and came back yesterday the same.  But thanks for the thoughts.  I thought the knee but only injured a week ago and although this would affect finger prick test it wouldn't affect hba1c as much apparently.  The good news is I now get passed to the 'real' diabetic nurse who I have always wanted to see but as my diabetes was okay I didn't get an opportunity.  I shall be asking just that question - why so quickly.  The only difference was I was training for a half marathon which I ran in October - and although since then I am still training 5 days a week its a diferent activity but the level is still quite high.  So that shouldn't make a difference - unless the half marathon training did a flipping good job at keeping levels low. I would start the training again to see but knee is shot at the moment


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## DeusXM (Apr 6, 2016)

> So that shouldn't make a difference - unless the half marathon training did a flipping good job at keeping levels low.



Ummm....that could well be your answer. I'm hard pushed to think of any diabetes treatment that reduces your insulin resistance as much as marathon training.


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