A1c eAG higher than expected

bignick · Jul 8, 2014

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 · Jul 8, 2014

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:

bignick · Jul 8, 2014

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!

VeeJay · Jul 8, 2014

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 · Jul 8, 2014

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.

ShottleBop · Jul 8, 2014

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 · Jul 8, 2014

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 · Jul 8, 2014

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 · Jul 9, 2014

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.

bignick · Jul 9, 2014

Yup, I'm pretty happy about my progress the last 6 months, but I feel my meter has been displaying false numbers the whole time. What I've seen number wise does not at all jive with my lab results. From a BG stand point, my numbers are great, but from my hundreds of tests and results according to my meter thay are pretty disappointing.

I'm about 45 minutes PP after dinner, I had a salad with BC dressing, olives, a few hot Greek peppers, 1/2 med tomato. A 1/3 beef patty, 1 grilled Jalapeno, orange pepper, some red onion and broccoli. I just tested and got 78 with my True2go. I tested with 3 yr outdated strips on a Bayer Contour and got 109.

I think 109 is more believable than 78 for someone who is slightly glucose intolerant.

gotsomeold · Jul 9, 2014

bignick said:
Y..... I think 109 is more believable than 78 for someone who is slightly glucose intolerant.

That does make sense.

Interesting, and a bit depressing. Thanks for sharing this.

vrbalthezr · Jul 9, 2014

My wife and I are both diabetic (she is type 1, me type 2) and she is on kidney dialysis. They always use blood from the access line for the glucometer and consistently read 15 points lower than with a finger stick, yet still make her eat something if they deem the reading too low from the line. Her access is in her upper arm, BTW.

We also have used five different meters in the last few years and I check each new one against the old one (I'm an engineer and that's what we do...) I have noticed up to 15-20 points difference between meters on the blood from one stick point and then the next day, same test, they agree. The lesson is not to expect reproduceable results from meters selling for under $30. I wonder if there is any place to send glucometers to check their calibration??

skb · Jul 9, 2014

IMHO Shottlebop has hit the nail on the head. Your meter/s may/may not be in error. A1c just by itself can be affected by several factors. If your CBC was also carried out, the answers may lie in your RBC & hemoglobin counts. RBCs do have an approximate 3-4 month shelf life but there are no absolutes even the life cycle is estimated. So if your RBC lasts longer (it is good) it will affect the A1c in the way that you have observed.

If you ask me, I'd rather have a higher A1c than (based on my own meter estimated average) lower.

Shanny · Jul 9, 2014

vrbalthezr? Please click over to our Introductions board, start a new thread and tell us about yourself. How are you managing your diabetes?

Mary · Jul 9, 2014

I stopped using the True after reading too many online complaints about it. I had the same problem that Nick's having. I knew I was higher than my True readings, based on measuring it against other meters and my A1C, which went from 6.0 to 5.9 over many months. According to my True, it should have been much lower than that.

Current - True: 114
Accu-Chek Nano: 145

The 145 is more realistic and what I'd expect. I always go up after playing basketball, and we just got in from playing for a good 40 minutes. It usually stays around 130-155 post-basketball.

I was actually thinking of contacting the True manufacturer since I bought several boxes of True strips to see what they can do about refunding my money. I've noticed readings like this, much lower than they are, too many times now.

A1c eAG higher than expected

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