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Discussion Starter · #1 ·
OK, so my doctor's office test for my A1C was 7. That means my blood sugar was averaging 154 or some such over the last two to three months.

So I've been monitoring my blood sugar (despite my doctor's request that I don't test at all) fasting, one hour after meals, two hours after meals, and before meals. The highest number I've gotten so far is 128 after one meal of almost all carbs.

So, if my blood sugar isn't spiking after meals, when is it spiking?
 

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The correlation between A1C and average serum glucose is only a statistical correlation. There is no actual direct physiological relation which can translate from one to the other.

Although statistical studies have been done with pretty large groups of subjects, I have never seen mention of what the standard deviations were, only the much-touted "averages". Also, studies done in different countries have gotten pretty different results causing some scientist to insist on only using their "local" numbers.

There are known conditions which can cause the A1C to be very much off this "average" such as conditions where red blood cells live unusually long (gives higher A1C) or unusually short (gives lower A1C).

There could be spikes somewhere that you don't know about, or you could just be one of these statistical outlyers. If your monitoring that carefully and results look good, I wouldn't worry about it too much.
 
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Chris Kressor has a good article that discusses why A1c is not terribly accurate for individuals (instead of for entire populations).

I was testing blood sugar in three different ways for all new patients: fasting blood glucose, post-meal blood sugar (with a glucometer) and A1c. And I was surprised to see people with completely normal fasting and post-meal blood sugars, and A1c levels of >5.4%.

In fact this is not abnormal, when we understand that people with normal blood sugar often have longer-lived red blood cells – which gives those cells time to accumulate more sugar.
 

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As Salim said, there are high glycators, low glycators and average glycators. That means 3 people with the exact same bg numbers may have very different HbA1c's, differering by as much as a full point up or down. I would guess you may be spiking in the wee hours of the morning because of adrenaline, cortisol or even growth hormone production. Some people will do basal insulin tests where they test every hour for 24 hours to see where they spike. Also the other thing is all meters are inaccurate. No meter is 100% accurate. They can be 10-20% off. So your meter may not tell the whole story. It would be nice if your doctor could outfit you with a Continuous Glucose Monitor for a few weeks to see where your spikes are.
 
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Discussion Starter · #5 ·
Mystery solved! My actual A1C is 5.6 and not 7.0. It would seem like I wouldn't have gotten a diagnosis as full-blown type two diabetic and immediately put on medication with that A1C.
 

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Discussion Starter · #7 ·
Sweet! That's a great A1c. How come you originally thought it was 7?
Because that's the number I recalled the doctor saying. But yesterday, I got to bring home actual copies of the test results. Is it odd that I got diagnosed with full-blown type two diabetes and put on meds with a 5.6?

Now that I know the number, it seems like overkill, especially since the pain meds I've recently been put on are allowing me to be more active. I would think that diet and exercise would be enough for a technically "normal" A1C.
 

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Could you share with me what you are on for pain and what for? I'm in severe pain in my back and leg and haven't yet found a good pain med for it that doesn't put my mind to sleep. I'm going to Scott & White's spine center as soon as they will see me for a total look at what is going on and what they think can be done. I'm sick and tired of seeing specialists in my area for over 10 years and getting progressively worse. It's quite a distance and I will need someone with me so I've resisted, but I've got to do something!
 

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Discussion Starter · #9 ·
Could you share with me what you are on for pain and what for? I'm in severe pain in my back and leg and haven't yet found a good pain med for it that doesn't put my mind to sleep. I'm going to Scott & White's spine center as soon as they will see me for a total look at what is going on and what they think can be done. I'm sick and tired of seeing specialists in my area for over 10 years and getting progressively worse. It's quite a distance and I will need someone with me so I've resisted, but I've got to do something!
I'm on Vicodin 500/5 3x daily plus soma 350 1x daily at bedtime.

I'm on them for muscle/skeletal pain and cramping and headaches, the cause of which could be my lupus, fibromyalgia, vitamin D deficiency, or whatever is causing my FUO (Fevers of Unknown Origin) that we're still hunting for.

I was on zero pain medication beyond OTC Tylenol prior to going on them so any improvement was something amazing. I'm more clear headed because I'm not being distracted by high levels of pain but I'm a little less clear headed because my short term memory seems a tiny bit compromised and I'm a wee bit more emotional. So, I guess, in my case, it's a wash and, all things being equal, the side with less pain wins. Wait, I'm also sleeping through the night so that's a huge one on the plus side.

I wish you luck in your quest for less pain.
 
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