My HbA1c

What is the hba1c test?

HbA1cThe HbA1c test is the hemoglobin A1c test, or glycated haemoglobin test. What that means is it’s a test of your red blood cells that have chemically combined with sugar (glucose). In other words, the build up of glucose in your system has attached itself to a red blood cell, and glycated it. So the more sugar in your system, the more glycated red blood cells you carry, and in turn, the higher your HbA1c result will be.

So the test reflects on your blood sugar over the last 2-3 months, with the last month or so having more dominance over your result, because you’re red blood cells regenerate. It’s basically a quality control test for diabetes to assess a diabetics control over their blood sugar levels from the previous 2-3 months. Because blood glucose levels fluctuate from minute to minute, hour to hour, and day to day, this is the best method doctors have for assessing control.

Everyone, whether non-diabetic, pre-diabetic, type 1 diabetic, or type 2 diabetic has some degree of sugar in their blood.

What is a normal HbA1c?

HbA1c

That chart is from Diabetes UK. Along with this more visual one:

HbA1c chart

Any HbA1c result of over 6.5%, ie, a diabetic, is automatically at risk of several health complications. The NHS website states that ‘Even a mildly raised glucose level that doesn’t cause any symptoms can have damaging effects in the long term.’

This means, in short, as a diabetic you are up to five times more likely to develop heart disease or have a stroke. High blood glucose levels can also damage the tiny blood vessels of your nerves, which causes a tingling or burning pain that spreads from your fingers and toes up through your limbs. The nerves in your digestive system may also be affected, causing vomitting, diarrhoea or constipation. Retinopathy is also damaged, which may damage your vision. The blood vessels in your kidneys may become blocked, causing your kidneys to work less efficiently, and in severe cases can lead to kidney failure. There are also a lot of foot problems with diabetics, as damage to the nerves can means that small cuts aren’t noticed, which can lead to a foot ulcer developing, and about 1 in 10 diabetics get a foot ulcer. Sexual dysfunction is another problem caused by high blood glucose levels, as is miscarriage and stillbirth. Still with me? Good.

So why are diabetics encouraged to have a HbA1c of at least 6.5%? This is was Dr. Bernstein discovered:

‘From different doctors, I’ve gotten the same answers. They’ll say ‘Look, my specialty is diabetes. I treat maybe 3,000 patients. If all of these patients were to either die young, go blind, develop painful neoroptahy in their feet, if they wer to lose their ability to copulate or reproduce, or if they lost their legs…these are all natural consequences of diabetes’, these dotors tell me, ‘but if one patient out of my 3,000 dies of hypoglycaemia  I get sued. So I’m gonna make sure that there’s not the remotest possibility of any of my patients dying of hypoglycaemia.  I’m gonna keep their blood sugars so high so it’s not a possiblity.’ That’s the story. That’s the true story. ‘ (1. Dr. Richard Bernstein)

None of these diabetic complications have to be a part of a diabetics future. None of them. They only occur when blood glucose levels are elevated for a prolonged period of time. This is why it’s so important that blood glucose levels being aimed for are as near to normal as possible, ie, in the range of a person who does not have diabetes.

These are:

4-5.5mmol/l before meals, and less than 8mmol/l, postprandial (two hours after meals). 

When I was diagnosed with Type 1 diabetes in September 2014, I had a HbA1c of 12.5%, which equates to an average blood glucose level of 17.3 mmol/L for the previous 2-3 months. I was already showing signs of nerve damage, my fingers and toes would tingle regularly, and I didn’t know why. I thought maybe just poor circulation. But no, it was high blood sugar. Had I ignored my symptoms and suspicions, I’d have ended up in a coma in hospital before I could’ve hoped to have being diagnosed. Otherwise, death would have soon followed.

Screen Shot 2015-12-28 at 10.02.26 PMSince diagnosis, I’ve had 3 HbA1c results. I ignored the diabetes target – instead, I take every day as it comes and try to have tight control over my diabetes. As a result, my HbA1c result came back at 4.8%. I have a HbA1c result that would match a non-diabetic. If I had another medical examination now for a visa, I wouldn’t even flag up as being medically unsound in any way. I would pass with flying colours. So for any diabetic out there who wants to achieve a normal HbA1c, it’s completely achievable, and should not be discouraged. I have been told that my HBA1c is too low for a diabetic, and that I should aim for 6.5-8.2%.  However…

if a normal, non-diabetic HbA1c result is achievable for me, as a diabetic, then why don’t I deserve a normal level, free from the risk of diabetic complications?

 

 

 

1. Dr. Richard Bernstein in ‘Note 2. An HbA1c of 6.5% – Dr Bernstein’s Diabetes University

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One thought on “My HbA1c

  1. Sandra says:

    Hi, we have a daughter with diabetes type 1, and we had so many problems with her blood glucose levels because of the basal insulin we were forced to use (insulatard 12 hous basal) the reason beeing that it spiked after 4 hours. During the day this would not be problematic as we would just set lunchtime for the spike and give little to no bolus. But when this would happen during the night we would have hypo all over the place and would have to give her lots of sugar to keep her alive, keep in mind she was only 2 years at the time so it would be a constant struggle to get her to drink and flush with water after. And absolutely NO way we could get her to brush her teeth in the middle of the night in that state. Crying, tired and angry. It was a complete nightmare. And at the hospital checkups we were met with disbelief and absolutely no answers or help, besides from that they stood strong on the fact that her growth hormones should raise her glucose levels during her sleep so it should counteract the basal spike (wich never happend for us, but anyhow). No change in basal medicine or anything, no advice, just tough it out. So we ended up with karies in 8 teeth as a result… We had to fight and beg to try different basals, levemir and lantus, and now we have a pump, wich is the only thing that really works for us. Our daughter is now 8, and since I am on a low carb diet and she would much rather have greens and bacon instead of toast I have noticed an even greater improvement in how much her basal has been decreased. Not that she doesnt love her sweets, because, maaan she does, but a little goes a long way when it comes to cutting back on the carbs, the results are very noticeable. I think you have a great blog and you are very good at highlighting problems one does run into with diabetes be it the surroundings or the illness itself☺ I would very much like to hear your story of how you learned to maintain your diabetes during your first months, ups and downs and other realizations. I hope my daughter will be as responsible as you when she grows older.
    With regards Mother of diabetic T1

    Like

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