# Hba1 result - non diabetic but something going on



## B17Fan (Mar 9, 2016)

Hello all. Just a quick bit of background info. I have pcos and am overweight. I get shaky if i need something to eat and i feel sleepy sometimes after a meal. I know i have insulin resistance because i find it very hard to lose weight and the only time i did, was when the doc gave me metformin.

anyway, that was 6 years ago. 

My mum is type 1 diabetic and let me test my sugar levels for the past few days.
2 hours after eating dinner in the evening, my blood sugar has been 10.3, 8.3 and last night was 9.6
I told my doctor that today and he said they allow up to 11.0 for a non diabetic. But the Nice guidelines say that is prediabetic levels.

My hba1 result was 35. Which is kind of disappointing because i know something isn't right.
the only thing that come up in my blood test result was that i'm a bit anemic. 

What i want to know is your opinions on this. Do you think my sugar levels are normal for a non diabetic?

Would so appreciate any replies


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## Amberzak (Mar 9, 2016)

What was it you ate for dinner? Just out of curiousity.


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## Ralph-YK (Mar 9, 2016)

You should insist that your doctor talks to you.


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## Mini-Vicki (Mar 9, 2016)

I would say those levels are high for a non diabetic, maybe make a note of them and take them back to your doctor. Have you tested your blood glucose first thing in the morning to see what your fasting level is? 
I seem to have in my memory, than anaemia can make a HbA1c result inaccurate, at least I was told that a few years ago... Anyone else heard this?


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## B17Fan (Mar 9, 2016)

Amberzak said:


> What was it you ate for dinner? Just out of curiousity.



Hi. When it was 10.3 we had chips from the chip shop as a treat.  When it was 9.6, I'd had potato, chicken in breadcrumbs and spaghetti. Know it's all high carb.

My doctor said that it's something we could do an annual check on.
Don't have much faith in him. Not the best Doctor.

That's interesting about anemia. I'll have to Google that. 

Feel like I should go back to the docs and ask for maybe a fasting test or glucose loading test.
I'm going to check my blood sugar at 9pm and I'll do it first thing in morning. I shall report back to you all


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## Amberzak (Mar 9, 2016)

High in carbs yes, but not particularly sugary. Very interesting. Definitely worth seeing another doctors.


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## Northerner (Mar 9, 2016)

Hi, welcome to the forum  I'd suggest doing some fasting tests - test first thing in the morning as soon as you get up (not after you've had your first cup of coffee etc.! )  A couple of fasting tests above 7.0 mmol/l can be used for a diagnosis of diabetes.


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## Amigo (Mar 9, 2016)

Anaemia can apparently affect Hba1c levels;


http://www.nature.com/nutd/journal/v5/n6/full/nutd201516a.html

It's a long, complex study. This conclusion may help;

*Conclusions:*
These findings suggest potential misclassification of diabetes using HbA1c in areas of endemic ID/anemia. Estimating diabetes prevalence using HbA1c may result in under-diagnosis in women with ID and over-diagnosis in men with anemia.


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## AlisonM (Mar 9, 2016)

Hi @B17Fan, welcome. If I were you I'd consider getting a second opinion, your symptoms shouldn't be brushed aside like that. Could you call the surgery and ask to see a different doctor?

ETA, I'm permanently anaemic and had been told that my BG readings might be affected by this. They can be erratic, but don't seem to be that far off on the whole, at least my HbA results indicate a fairly close correlation between the two (I don't know if the HbA is affected as well).


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## Copepod (Mar 9, 2016)

Amigo's link is good for one  study of anaemia and HbA1c in a Chinese population, with consideration of other populations in the Discussion at the end. There are several possible caused of anaemia eg "simple" iron deficiency, sickle cell or thalassaemia, vitamin B12 deficiency ot folate deficiency. A person with "ordinary" anaemia, cause by "simple" iron deficiency may be falsely diagnosed with diabetes when they don't actually have diabetes. Anaemia from other causes can have the opposite effect on diabetes diagnosis. I have added the words in "quotation marks" - I have not used not technical terms. 
As others have suggested, testing your fasting blood glucose level, on rising, would be sensible. That should be 3.5 to 5.5mmol/l in a non diabetic person (and the levels aimed for by people with diabetes). At least two readings above 7.0mmol/l are needed to diagnose diabetes. 
Metformin is used to treat PCOS (poly cystic ovary syndrome), whether or not diabetes is also present. 
What did your GP suggest about treating your anaemia? Did they suggest changing you diet, taking iron supplements etc? I wouldn't write off yur GP as useless at this stage - they are best placed to deal with all your conditions together.


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## B17Fan (Mar 9, 2016)

Just took my blood sugar and it's 10.5. That's the highest it's been. The doctor has given me a prescription for iron tablets which he said to take for 2 months. 
My doctor is totally useless. 3 weeks ago he said he'd refer me to Gynaecology (because he won't prescribe metformin!) And you know, I phoned the surgery today only to be told that he hasn't sent the letter yet. Totally incompetent!


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## AndBreathe (Mar 9, 2016)

B17Fan said:


> Hello all. Just a quick bit of background info. I have pcos and am overweight. I get shaky if i need something to eat and i feel sleepy sometimes after a meal. I know i have insulin resistance because i find it very hard to lose weight and the only time i did, was when the doc gave me metformin.
> 
> anyway, that was 6 years ago.
> 
> ...



OK.  Leaving aside the anaemia, with the potential to impact HbA1c, which you are having treated, that you have an HbA1c of 35 in the face of some high post meal readings makes me wonder if in fact you are having some quite big swings, and some lower than usual periods too going into the mix.

When you say you get shaky when you need something to eat, is that after many hours without food, or just before your next meal is due, and have you noticed if it's worse at any time, or after you have eaten anything in particular, or a large meal.

Have you ever tested for longer than just the two hours after eating to see what happens to your sugars then?

I would be curious to know what sort of pre meal readings you have, what it is at 1 hour, 2 hours, then 2.5 hours, and maybe even three hours, depending on the numbers.

I know I ask a lot of questions.  And don't call me Sherlock.


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## B17Fan (Mar 9, 2016)

AndBreathe said:


> OK.  Leaving aside the anaemia, with the potential to impact HbA1c, which you are having treated, that you have an HbA1c of 35 in the face of some high post meal readings makes me wonder if in fact you are having some quite big swings, and some lower than usual periods too going into the mix.
> 
> When you say you get shaky when you need something to eat, is that after many hours without food, or just before your next meal is due, and have you noticed if it's worse at any time, or after you have eaten anything in particular, or a large meal.
> 
> ...




Hi. I don't mind the questions at all! Glad I'm getting some insight.

If I've been busy, like doing exercise or going round town and I've left about 5 hours between breakfast and lunch, then I'll get shaky and feel a bit clammy. 
It is then, when I've had a sandwich and maybe a chocolate bar, that I start feeling sleepy after.
Sometimes if I have a roast dinner on a Sunday, I will feel sleepy about an hour or so later. 

I haven't tested longer than 2 hours.
Before meals it will be between 4.5 and 5.5


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## AndBreathe (Mar 10, 2016)

B17Fan said:


> Hi. I don't mind the questions at all! Glad I'm getting some insight.
> 
> If I've been busy, like doing exercise or going round town and I've left about 5 hours between breakfast and lunch, then I'll get shaky and feel a bit clammy.
> It is then, when I've had a sandwich and maybe a chocolate bar, that I start feeling sleepy after.
> ...



Can I suggest you test is you have one of those clammy sensations too?  I'm not expecting anything too dramatic, as after 5 hours of walking around you might well be justifiably hungry.

What does your sleep inducing Sunday dinner usually have in it, and have you tested after that meal at all?

I think you're probably gathering I like factual data.


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## B17Fan (Mar 10, 2016)

AndBreathe said:


> Can I suggest you test is you have one of those clammy sensations too?  I'm not expecting anything too dramatic, as after 5 hours of walking around you might well be justifiably hungry.
> 
> What does your sleep inducing Sunday dinner usually have in it, and have you tested after that meal at all?
> 
> I think you're probably gathering I like factual data.



My blood sugar this morning was 5.0. 
Usually in a roast dinner it's roast potatoes, chicken, vegetables, Yorkshire puddings. Might have a yogurt or mousse for dessert.

I have tested before when I've felt shaky and clammy and it's usually between 4 and 5


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## AndBreathe (Mar 10, 2016)

B17Fan said:


> My blood sugar this morning was 5.0.
> Usually in a roast dinner it's roast potatoes, chicken, vegetables, Yorkshire puddings. Might have a yogurt or mousse for dessert.
> 
> I have tested before when I've felt shaky and clammy and it's usually between 4 and 5



I guess I'm wondering if your bloods go up and down pretty quickly, which could account for some of the things you feel, and to an extent (notwithstanding your anaemia) your seemingly mismatched finger prick tests versus HbA1c.  Only more testing, or perhaps an OGTT would tell.  

Many folks like a snooze after a carb heavy meal, so could you just be a little hyper-sensitised to that, as you have it in your head there's something untoward afoot?

I'm not rubbishing anything you say; just asking you to challenge your own conclusions to an extent.


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## B17Fan (Mar 10, 2016)

I just know there's something going on, because I ate the same meal as my sister over the weekend and her sugar level was 6.0. Whereas mine was high. It all makes sense that anemia could affect the result. I think once I get my iron levels back up over the next 2 months, then I'll ask them to check the glucose levels again.


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## AndBreathe (Mar 10, 2016)

B17Fan said:


> I just know there's something going on, because I ate the same meal as my sister over the weekend and her sugar level was 6.0. Whereas mine was high. It all makes sense that anemia could affect the result. I think once I get my iron levels back up over the next 2 months, then I'll ask them to check the glucose levels again.



Of course it makes sense to be checked again after a suitable period, but just because you and a family member ate the same foods, I would not necessarily expect the same blood results.  Factors influencing it can be:  individual (normal, where appropriate) metabolisms, stress, exercise, or lack of it, general health (infections can raise numbers), fatigue, dehydration (even very minor dehydration), just off the top of my head.

I suggest you take your iron tablets, make a concerted effort to drink plenty of water - a couple of litres a day, in addition to your usual intake, but maybe consider having the extra earlier in the day, so as not to disturb your sleep patterns, then see how you go.  Your concern and mental certainty something is going wrong won't necessarily be helping the numbers the meter displays.


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## B17Fan (Mar 10, 2016)

I'm not overly concerned about it. It's just something I've always been suspicious about and bit annoyed that it seems anemia can alter the blood test result. Think I will see a different doctor eventually to get a second opinion about it


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