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-   -   A1c eAG higher than expected (https://www.diabetesforum.com/diabetes/46514-a1c-eag-higher-than-expected.html)

bignick 07-08-2014 15:41

A1c eAG higher than expected
 
In Nov '13 I realized I may have a BG problem as my fasting BG on blood tests had been showing up in the 103-115 range for over a decade. I found this forum and adopted a LCHF WOE which I have adhered to faithfully since Christmas.

Since the first of the year my highest FBG level has been 98, which I have seen 3-4 times since. My average is about 84 according to my meter. Most all PP testing is below 105, I've seen over 120 less than half a dozen times and after eating something higher in carbs.

I got results from my first A1c test a few days ago and it was 5.8 with a eAG of 120. This is puzzling because what I see on my meter I was expecting much lower results. I'm thinking my meter is reading much lower than my actual BG or during times I don't test my BG levels are extremely high.

Again my fasting testing averages are 84 and Estimated Average Glucose (eAG) from the lab is 120.

My meter is an inexpensive True2go made by Nipro Diagnostics from Walgreens. Any thoughts on this?

John.in.France 07-08-2014 16:24

Nick,

I've got to repeat something that you'll find all over the forum. Meters - even the pricey ones - have an error tolerance of up to 20%. Most do better than that but....

Now the next point to consider is when you did your tests. Even with some post prandial numbers in the mix you don't have a true 'metered' average. For that you need a continuous monitoring system.

For instance my fasting average on my meter (Accu-chek) is 85. My HbA1c is 5% - so that suggests that my overall average is about 97. As it's largely statistics there'll be a standard deviation factor - that I don't know - that might mean my true average is a bit lower or a bit higher. Finally, how well do we fit the population from whom that formula was derived?

What was your pre LCHF HbA1c? Was it higher than 5.8%? (and that's comfortably a 5% club member number:)). Yes, it could come down a bit more and I'd suggest another hard look at what carbs have been left in you meals. Grain products for instance?

Well done on your 5.8% .:clap2:

VeeJay 07-08-2014 16:24

5.8 is great.

the lab's eAG may be somewhat high (and the model can vary from lab to lab)

AND, meters are not 100% accurate at best of times and you are not catching absolutely every rise in BG on your meter to factor into its average.

So... be happy with the 5.8. And know that it never exactly matches your meter average since they are measuring different things.

MichaelCort 07-08-2014 16:32

I have three different meters and they all come up with different readings, so I guess I'd also be happy with your latest A1C even though it's a bit higher than what your meter said it should be.

bignick 07-08-2014 16:44

Quote:

Originally Posted by John.in.France (Post 634818)
Nick,

I've got to repeat something that you'll find all over the forum. Meters - even the pricey ones - have an error tolerance of up to 20%. Most do better than that but....

Now the next point to consider is when you did your tests. Even with some post prandial numbers in the mix you don't have a true 'metered' average. For that you need a continuous monitoring system.

For instance my fasting average on my meter (Accu-chek) is 85. My HbA1c is 5% - so that suggests that my overall average is about 97. As it's largely statistics there'll be a standard deviation factor - that I don't know - that might mean my true average is a bit lower or a bit higher. Finally, how well do we fit the population from whom that formula was derived?

What was your pre LCHF HbA1c? Was it higher than 5.8%? (and that's comfortably a 5% club member number:)). Yes, it could come down a bit more and I'd suggest another hard look at what carbs have been left in you meals. Grain products for instance?

Well done on your 5.8% .:clap2:

Thanks for your reply.
A bit more: I tested myself at 83 before the lab drew blood. They reported my FBG at 96.

As far as carbs, it is generally broccoli, cauliflower, nuts, avocado, bell peppers, peanut butter. I have dumped all grain products. I will rarely have a piece of fruit or tortilla with cheese or peanut butter while hiking or expending a great amount of energy.

This is my first A1c test ever.

I understand about the averages. Assuming my meter is accurate I must have an awful lot of times where my BG is over 140 and up to 155 or so. I've never seen it even approaching those numbers.

Thanks!

John.in.France 07-08-2014 17:09

Quote:

Originally Posted by bignick (Post 634850)
Thanks for your reply.
A bit more: I tested myself at 83 before the lab drew blood. They reported my FBG at 96.

As far as carbs, it is generally broccoli, cauliflower, nuts, avocado, bell peppers, peanut butter. I have dumped all grain products. I will rarely have a piece of fruit or tortilla with cheese or peanut butter while hiking or expending a great amount of energy.

This is my first A1c test ever.

I understand about the averages. Assuming my meter is accurate I must have an awful lot of times where my BG is over 140 and up to 155 or so. I've never seen it even approaching those numbers.

Thanks!

Nick,

On the lab fasting figure, join the club. In May I measured my fasting as 88, they gave me 104. The stress of the test perhaps or my liver helping out since my breakfast was delayed? Don't know.

Now on food, sorry but peanut butter can be suspect as can bell peppers. I suggest sticking to snacks (if you absolutely must have them) that are totally innocent. Stick to old fashioned, non processed cheese, non processed meats, nuts (but not peanuts). If you're burning fats for energy, the last thing you want is to reintroduce sugar - even in small quantities.

ShottleBop 07-08-2014 17:11

The other thing you should know is that, depending on a number of other factors, your A1c CAN be higher or lower than would otherwise be expected: "A1c: Does One Size Fit All?".

My A1c bounces between 5.3 and 5.7; my meter averages (low-to-mid 90s; for a run of a year and half, 89/90) would put me below 5. I have blown through 100 strips over six days, testing 16 times a day to see if I might be having highs that somehow drove my average as high as my A1c indicated they must be. Didn't find any such highs; decided I must simply be a high glycator.

Mary, 07-08-2014 21:44

Nick, for what it's worth, I had to scrap my True2 meter. It constantly read in the 80's when I was actually anywhere from 110-120, when tested on other meters. I took my True2 as a backup when we went to Florida and it read low (from what it was supposed to be) the entire time.

I started looking around online (just through a simple Google search) and found that many other people also have True2's that consistently read low. Just something to consider. If you have a Prime or another brand, you may want to switch back. :)

tgrmuskego 07-09-2014 00:13

Nick,

My numbers and diet is very similar to yours, according to my meter my 90 day average was in the low 90's and I to ended up with a 5.8 a1c.

I have 3 meters, 2 accu-check nano and a relion prime, The 2 accu-check are always with in 2 points, the relion prime is within 5 points when under low 90's but above 100 it's 20 to 25 points higher.

5.8 is not bad, not what I expected, but hey, I started at 12.

You're doing great!

Tom

Rahul_Boston 07-09-2014 01:31

My take on it is like this.

Its just a number after all.
There are so many variables in its computation and its meaning may differ from person to person.

Overall you should see if you have succeeded in your efforts to improve your health in last 6 months. Do you feel better or not.
And if you would like to change anything about what you currently do.Diet or exercise wise.

Looks like from all your posts so far, you are pretty happy about your progress. All you need to change at this point is your meter.:)


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