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Observations / Concerns/ Your comments requested

3. How the heck is my HbA1C 5.9 ? That is a mean blood sugar level of 122. I've hardly had a reading over 120 for a long time. I have been averaging 103 for the last three months and I test 5-6 times a day. There is no way in the world my average BG can be 122 over the last 3 months. (can the 4th month make an impact ?)
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Good control. Congratulations.
As for the numbers:

ISO 15197 requires a blood glucose meter's test result to fall within +/- 15 mg/dl of the lab test for glucose values under 75 mg/dl and +/- 20% of the lab reference results for levels above 75mg/dl.

So expect those variations if comparing values of self tests with lab reports.
 

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Discussion Starter · #23 ·
I cant expect my meter reading to be 15% - 20% wrong every time. Each time ( 5-6 occasions) my lab numbers have been lower than my meter numbers

I have a feeling that even though it is said that HbA1C values depend on blood sugars of last 2-3 months it maybe possible that the previous 4th month may also have some impact.

A 4%-5% contribution from that (4th) month also explains my slightly higher HbA1C.

But all said and done I am not going to bother a lot about this

It will come down for sure
 
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I cant expect my meter reading to be 15% - 20% wrong every time. Each time ( 5-6 occasions) my lab numbers have been lower than my meter numbers

I have a feeling that even though it is said that HbA1C values depend on blood sugars of last 2-3 months it maybe possible that the previous 4th month may also have some impact.

A 4%-5% contribution from that (4th) month also explains my slightly higher HbA1C.

But all said and done I am not going to bother a lot about this

It will come down for sure
The main thing is that your own meter produces consistent results so you can follow your trend. The fact that the readings are out of step with the lab isn't very important. For instance, my lab figures seem to be around 10% higher than my meter figures.

The HbA1c result depends on the life span of your red blood cells. So for instance, someone with anemia will get a lower HbA1c than they "deserve" whilst someone who has particularly long lived cells will show higher than they "deserve".

The various formulae to calculate a value from fasting are statistical and work for groups rather than individuals, so hitting an exact match is fluke.

You've done a great job so far, just stay with it and as you say, your numbers will come down.

John
 

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Discussion Starter · #25 ·
The main thing is that your own meter produces consistent results so you can follow your trend. The fact that the readings are out of step with the lab isn't very important. For instance, my lab figures seem to be around 10% higher than my meter figures.

The HbA1c result depends on the life span of your red blood cells. So for instance, someone with anemia will get a lower HbA1c than they "deserve" whilst someone who has particularly long lived cells will show higher than they "deserve".

The various formulae to calculate a value from fasting are statistical and work for groups rather than individuals, so hitting an exact match is fluke.

You've done a great job so far, just stay with it and as you say, your numbers will come down.

John
John I am not really worried about this but I do have a doubt. I've heard and read about this explanation of the RBC life span

My doubt is that is this only valid for the first time post diagnosis HbA1c or is it for every time one gets a HbA1C ?

I mean if hypothetically if someone who has a longer RBC life span of 5 months (compared to 4 months of others) and maintains average BG of 100 for 4 months will his HBA1C ultimately fall in line (~ 5.1) or will it always run high ?

Similar the person with a long RBC lifespan would also see his HbA1c rise at a lower pace compared to others, right ? (when on a rising trend)

Maybe this discussion is too academic. I probably eat my doctor's head tomorrow (my low carb lunch :))

Tony
 

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Tony,

Each HbA1c is a snapshot of the current red blood cell state, so someone with a genetic disposition to long life cells will always be high in the absence of a short term problem such as anaemia.

Whether that pre-disposes him to diabetic complications or not is not something on which I'd care to express a view.

John
 

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Discussion Starter · #27 ·
I'm quite sure the condition is more rare than we assume it is. I am not expecting to be in that group :)

This question was mostly academic in nature.

Thanks (as always :)) for your great answers
 

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I'm following this discussion because I have a condition which requires me to have phlebotomies done every month or so to keep my hemoglobin under 14 because apparently I had a stroke(mild) because my red blood cells clumped. I've wondered what this does to my A1C, but since nothing can be done, it's purely academic.
 

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I'm following this discussion because I have a condition which requires me to have phlebotomies done every month or so to keep my hemoglobin under 14 because apparently I had a stroke(mild) because my red blood cells clumped. I've wondered what this does to my A1C, but since nothing can be done, it's purely academic.
My guess, it will mean that your test will report slightly better values than it should. Sorry - hope I'm wrong :eek:

John
 

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kudos to you Tony.

You are really lucky that you got all the information you needed at a early stage and have bought all your numbers in control, that too in 3 months.

Sadly for me, due to lack of funds, arrogant public sector doctors and the lack of information regards to diabetes. I have spent a whole year seeing BG between 150 to 250 everyday. (At one day even 325)

I think it's the duty of a doctor even if he is a public doc and has to attend to a crowd, that he should at-least tell a newly diabetic guy what he needs to do or something. They just write the medication on a paper, have this in the morning / night and bye bye.

Frankly, for a normal guy who has never been to a doc for 10 years, hows he supposed to know whats H1Abc or ketones and many things like that, its like all Greek to him.

It's when i started experiencing problems with my vision, especially when reading a newspaper or reading something on white background, where I am experiencing small tiny dots in my vision. That's when i found out its a complication from diabetes and I got scared I'm getting blind, I joined the forum from searching google to find some way to help myself on my own, get the blood sugar in control.

Before joining this place, i thought diabetes means i have to pop a pill morning/night and stay away from sugar, I didn't know there are many many more things I should be careful about what I'm eating, exercise.

No wonders they say people in India are dying from diabetes and losing the limbs, It's because most people don't have or rather haven't been provided the required knowledge to keep their numbers in control. Majority of people cannot afford to pay a premium to a private doc who can pamper and sit and explain personally about controlling.

Anyways, I am beginning to feel safe now that I know how to keep BG in control.. Just got to keep the pace and see my H1ABc results too, maybe in Jan end will do that test.

For now I know from a recent blood test for malaria that i had done 4-5 weeks back. It says Glycoslated Hemoglobin 11.5% , I think this is the H1Ac what needs to go low.

Congrats,
I'm next in line to the "I'm in Control" throne. Hehe .. hopefully.
 

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kudos to you Tony.

You are really lucky that you got all the information you needed at a early stage and have bought all your numbers in control, that too in 3 months.

Sadly for me, due to lack of funds, arrogant public sector doctors and the lack of information regards to diabetes. I have spent a whole year seeing BG between 150 to 250 everyday. (At one day even 325)

I think it's the duty of a doctor even if he is a public doc and has to attend to a crowd, that he should at-least tell a newly diabetic guy what he needs to do or something. They just write the medication on a paper, have this in the morning / night and bye bye.

Frankly, for a normal guy who has never been to a doc for 10 years, hows he supposed to know whats H1Abc or ketones and many things like that, its like all Greek to him.

It's when i started experiencing problems with my vision, especially when reading a newspaper or reading something on white background, where I am experiencing small tiny dots in my vision. That's when i found out its a complication from diabetes and I got scared I'm getting blind, I joined the forum from searching google to find some way to help myself on my own, get the blood sugar in control.

Before joining this place, i thought diabetes means i have to pop a pill morning/night and stay away from sugar, I didn't know there are many many more things I should be careful about what I'm eating, exercise.

No wonders they say people in India are dying from diabetes and losing the limbs, It's because most people don't have or rather haven't been provided the required knowledge to keep their numbers in control. Majority of people cannot afford to pay a premium to a private doc who can pamper and sit and explain personally about controlling.

Anyways, I am beginning to feel safe now that I know how to keep BG in control.. Just got to keep the pace and see my H1ABc results too, maybe in Jan end will do that test.

For now I know from a recent blood test for malaria that i had done 4-5 weeks back. It says Glycoslated Hemoglobin 11.5% , I think this is the H1Ac what needs to go low.

Congrats,
I'm next in line to the "I'm in Control" throne. Hehe .. hopefully.
I wish I could say that medical assistance and advice in France was better - but no! Like you we had to do our own homework and learn what a "Hémoglobine Glyquée" (see it's even worse in French! :)) meant.

And yes, whilst a value of 11.5% is way too high, your approach is exactly what it should be. Take control of your diet and cut back as much as you can on carbohydrates - despite the official guidance to the contrary.

A quick word of warning on two things.

First, your body will take time to adjust to a change in diet away from carbohydrates. That means you will probably have a few days of "carb flu" - Your muscles will ache and you will feel just like you have flu. I promise, it will pass but stick with it. Give up a few days into it and the symptoms will go - but you end up back at square one.

Second, if your body is used to a high blood sugar, as you come down with your new diet you may get some of the symptoms of a hypo. If you do, test before you treat it - make sure you really are hypo or, again, you destroy the benefits of the hard work you've done up to that point.

Eat to the meter - and good luck.

John
 

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Unfortunately Nicku it is not just the Indian population who are not given enough information at diagnosis it seems to be world spread, if not for this site I'm sure more of us would still be battling high numbers & wondering where we were going wrong as after all we were following the docs advise in regard to carbs at each meal etc, & then having the doc at our 3 monthly admonish us for not doing better & trying harder.
I'm glad you are beginning more confident about keeping your BG under control it will pay dividends in the long run
 
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Discussion Starter · #33 ·
You know when I was in school we were taught that we should visit our doctor once every 12 months and get regular tests done. The Health practitioner in the school took us to the dentist every 6 months

Had we continued this good habit that we could have caught our diabetes at the prediabetes stages. We could have realised our cholestrols/BP were rising. Unfortunately the day I left school I forgot everything

I'm not making the same mistake with my kids
 
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You know when I was in school we were taught that we should visit our doctor once every 12 months and get regular tests done. The Health practitioner in the school took us to the dentist every 6 months

Had we continued this good habit that we could have caught our diabetes at the prediabetes stages. We could have realised our cholestrols/BP were rising. Unfortunately the day I left school I forgot everything

I'm not making the same mistake with my kids
I agree with the concept but....

In the UK and France (and I suspect elsewhere) the old concept of the family doctor has died. When I was a child our doctor knew our names and our medical history - he treated a person.

Now, you get a 10 minute slot to describe a few symptoms and the doctor writes a slip for a few pills - and bye, bye! He doesn't know you except as a cash cow (with apologies to our Hindu friends).

So, your idea, whilst sound would probably turn into a simple superficial check - at your cost - and the only information you'd receive on cholesterol would be to follow the official low fat diet and we all know how effective that is in reducing triglicerides, don't we? :rolleyes::rolleyes:

John
 

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Discussion Starter · #35 · (Edited)

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I'm a management consultant :D
Hey Tony, Just came to my mind you asked me which company I work. I work as a Senior Tech Support guy for DELL USA.
I'm over the phone all night fixing the computers of people from the US.
Very sedentary job you know sitting all night and then I'm sleeping all day.

I guess your a free bird, self-employed. Dream Life!
 
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