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Can the hemoglobin A1C test be faulty?
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An_240534 posted:
I just got back my blood work results today, which said that I have high levels of blood sugar (6.3) and am therefore prediabetic.

What confuses me is that I'm an athlete, training 4-6 days a week for at least 2 hours a time and am vegetarian--and make sure I "eat a rainbow" and am getting all the nutrients I need. My diet is pretty healthy: next to no processed foods, fried/sugary/fatty foods, no sodas, just water 90% of the time...etc. Pretty much everything I eat I make myself and it's usually just vegetables, tofu, beans, almost always whole grain/multigrain bread, brown rice and the only "sugary" drink I have is soymilk, and even that's unsweetened. Desserts are far and few in between. Though I do admit I eat sugary cereals sometimes, but usually that's less than 1/4 cup (since I mix different cereals together).

The only things I can come up with for my pre-diabetes diagnosis is 1) that I have INCREDIBLY poor sleep--always waking up exhausted, troubles falling and staying asleep, waking up automatically at ungodly hours (4:30am at worst), and I've heard sleeping problems affect blood sugar levels--and 2) that I eat way too much fruit (since fruits are really high in sugar??): about 5 servings a day. E.g. for breakfast sometimes I'll have 1/4 cup raspberries, a banana, a small apple, maybe half a papaya and later after dinner 1/2 cup of watermelon or something.

So my question is, am I actually pre-diabetic, or is this just a small symptom of different problem, rather than being the problem itself? And if I fix that other problem, my A1C levels will be fixed too?
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phototaker responded:
Welcome! First of all, I'm just another diabetic on here and not a doctor, but I'll throw some ideas out to you.

You ABSOLUTELY do take care of yourself. Kudos for that!

Diabetics can do all the right things and still become a diabetic.
You've probably kept yourself from becoming a full blown diabetic with "some" of this great eating.

I'm not on medicine for my diabetes. Eating right and exercising helps a lot IF your pancreatic function is working correctly.

Do you have a family history of diabetes? My mom, aunt, and grandmother had diabetes. Some people can eat incorrectly and not exercise, and NEVER get diabetes.

I would agree that sleepless nights can bring up your bs levels. That happened to me two nights ago. I slept 2 hours, and my numbers were way up first thing in the morning. Being sick, getting a cortisone shot, using allergy breathing meds, etc. will also raise bs levels.

So...go to Calorie King.Com and check out the number of carbs in fruit. You will be surprised. For me, I can only eat melons(not those tainted ones), berries, like strawberries and blueberries, a "small" apple, AND if I do, I have to have some nuts with it for a snack. If you do just the drink alone with all the fruits, it could send up your bs numbers. Multigrain bread and brown rice are okay, but not a lot of it...one slice, a small bit of rice. Try to have the fruit with some protein, if you're eating it for a meal. Check out how much cottage cheese is for carb levels. Grab a piece of cheese with the fruit.

My mom used to tell me that fruit and bread are full of sugar.
She's right. I LOVE fruit and bread, so I have to be very careful what I eat and HOW I eat it. Other people on here will tell you that they don't have problems with it. You have to test yourself two hours after you eat to see how high you get eating this. That will help you decide what you can eat, and what you can't.

I hope this helps a little.

Yes, your A1c will most likely go down if you don't spike up high in your bs after fruit. My numbers have been higher lately because of my bread use. I try to keep it to two slices a day or less. I also lose more if I do that, too.
 
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nutrijoy responded:
I, too, was largely vegetarian when I became a full blown diabetic (self-diagnosed initially but confirmed with a huge battery of tests by one of the best endos in the county). Your lack of "good" sleep can be a significant factor in elevated blood sugar levels as can stress and high blood pressure. You could just be developing insulin resistance which can often be countered with natural supplements and fine tuning your diet (exercise is also an important part of the equation but as an athlete, this is probably not an issue in your particular case). Tropical fruits (bananas, mangos, pineapple, etc.) tend to spike blood glucose levels more than their Northern Hemisphere counterparts (such as apples, berries, pears, etc). Also, it is a persistent myth that whole grains and brown rice are significantly better than their white counterparts. Both ARE better from a nutritional standpoint in that the former still has some fiber (bran, mostly) and nutrients (e.g., polyphenols) that their more processed cousins have had removed. However, from the standpoint of their impact on blood glucose levels, both pack the same starch load and virtually all starches convert to glucose eventually in the digestive system.

To assist in reducing stress and getting truly restful sleep, meditation and/or yoga can be a means of improving same. You didn't mention your age but as one ages, the amount of melatonin produced in the brain begins to decline markedly, especially after age 50. Many people find it helpful to add a 3 mg dose of melatonin about 30 minutes before bedtime to improve their quality of sleep. More elderly seniors may repeat the dose once or twice during the night if they should awaken. Melatonin is a natural hormone so it will not work miracles (i.e., it is NOT a "sleeping" pill). If your mind is cluttered with distracting thoughts and worries, the melatonin will do nothing to ease them nor will it help you sleep any better. You will have to deal with those issues yourself (i.e., internally) before melatonin can exert a beneficial effect.
 
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mlin11 replied to phototaker's response:
Hi! Thanks for replying so quickly.

To answer whether I have a family history of diabetes--NOPE! No one except my grandmother on my mom's side has diabetes. Strange, right? And because I'm Type 2, my doctor said genetics factors very little into how I got diabetes.

And thanks for the link. Sigh, like you, I really really love fruit and bread. This is gonna be tough.
 
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mlin11 replied to nutrijoy's response:
Thanks for replying! That bit about distinguishing tropical fruits and non-tropical is really helpful, since tropical fruits are actually my favorite, haha.

I'm only 19, which makes this all the more confusing/annoying. I'll definitely try the melatonin; I was also wondering--you brought up natural supplements that can counter insulin resistance, so what kind of things could I take?
 
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nutrijoy replied to mlin11's response:
Type 2 diabetes in adults usually represents a metabolic imbalance of both insulin secretion and insulin action at the cellular level. The beta cells of the pancreas in most type 2 diabetics still produce plenty of insulin as opposed to the absolute deficiency of insulin production in type 1 and type 1.5 diabetes. In type 2 diabetes, a host of different factors lead to a poor response to insulin in muscle tissue, fat, and the liver. In other words, your cells simply become less responsive to insulin. This then triggers the pancreas to overcompensate by producing even greater amounts of insulin and levels can easily double, triple, and even quadruple normal levels as the pancreas struggles to overpower the body's poor responsive to insulin. That's the condition defined as "insulin resistance."

Nutritional supplements that are effective in reducing insulin resistance include fish oil, chromium, DHEA, vitamin D, lipoic acid, magnesium, cinnamon (aqueous extracts), resveratrol, grape seed extract, and polyphenols found in cocoa, green tea, and apples (a large percentage of the nutrients in apples is in the skin so if an apple is included in your diet, make sure that you eat it with the skin). For someone that is as young as you are, DHEA should probably not be an issue but a blood test can easily determine your DHEA status. The only supplements that I would personally consider if I were in your shoes is a high quality fish oil supplement, chromium, vitamin D3, lipoic acid, cinnamon, magnesium (approximately 90% of the adult population in the U.S. is deficient in magnesium), and grape seed extract. Vitamin D and fish oil have been linked to reducing risk factors for metabolic syndrome and diabetes but all of the studies have been done with an older population group. Do a little research on your own using online resources and make your own conclusions/decisions as to whether any of the foregoing will be helpful to you.

Just one word of caution: be very leery of the many supplement vendors who make false promises and charge exorbitant prices for their "proprietary blends" of supplements that are "virtually guaranteed" to resolve your insulin resistance problems. While I do purchase many of my needs from a few trusted online vendors, I also purchase some of the more common supplements from Costco under their Kirkland and TruNature labels (particularly vitamin D3, fish oil, and grape seed extract; cinnamon has not been useful to me personally since I am a type 1.5 but Costco also sells the Cinsulin brand of cinnamon extract which has a pretty solid reputation).

One more thing: Always take supplements with food (your meals) and if taking multiple items, spread it out during the course of the day among all three meals instead of ingesting them all at one sitting. Then make a periodic evaluation to determine if you are deriving any benefit. If not, go ahead and finish the bottle but do not repurchase because not all supplements will help everyone. Our bodies are all different to some extent and can respond differently to both medications as well as nutritional supplements. And, by all means, concentrate on improving your sleep and sleep cycles. That could be the biggest factor in your elevated blood glucose levels.
 
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nutrijoy replied to mlin11's response:
Here's a short article on the value of Omega-3 fatty acids in helping to reduce/lower insulin resistance. The article was initially published in Cell but has been reproduced in lots of other sites devoted to health & fitness. Click here (or the link above) to view the article.
 
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Laurie Anderson, MSN, RNP, CDOE responded:
Hi,

You have received some great replies. I would like to add one point to their suggestions. The lower your HgA1c is, the more important it is to control blood glucose after meals. In my opinion a pattern of blood glucose testing will give you the most important information that you need; this pattern involves testing twice a day. On day one, test a fasting glucose and 1 hour after eating your morning meal. On day two, test just before lunch and 1 hour afterwards. On day three test before and after your evening meal. You glucose goals would be 70-100 (110) fasting and less than 160 (180) in the time 1 to 2 hours after eating a meal (numbers in parens represent a range for different people and goals should be individualized with your health care provider). Controlling the blood glucose to this degree will help to lower your A1C to a lower range. It will also help you to see how individual foods affect your blood glucose. As an example you can specifically test for the impact of 1/2 cup of brown rice versus 1/4 cup of the same, or any other food you think might be impacting your glucose. These lessons will assist you to make the best choices for your health. Kind regards, Laurie Anderson, MSN, RNP, CDOE
 
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mlin11 replied to Laurie Anderson, MSN, RNP, CDOE's response:
Thanks for the help!

But I'm just a little bit skeptical of my test results because I did not fast before the blood testing was done (never had a blood test done before, so I didn't know, and my doctor didn't mention that I needed to fast). My doctor did say, though, that my not fasting wouldn't affect the results of the hgA1C. Is that true?

And is it better to have a low sugar or low GI diet? Because some things, like bananas, are pretty high in sugar but are low in GI.

Thanks!!
 
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Anon_4858 replied to mlin11's response:
A1c tests do not have to be fasting...but a lot of doctors do other blood tests at the same time that do need fasting (like cholesterol).

Because an A1c is an average over the last 3 months, what you at the morning of the test will not alter the results. Now your total cholesterol or TSH may be off because you ate beforehand.

It's good to have both low sugar and low glycemic index foods, like whole grains. Bananas are OK if you eat maybe 1/2 of one at a time, that way you wont be overloaded with sugar. Fruits like blueberries or apples have lower sugar content and are better on the index. Everything in moderation though.
 
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auriga1 responded:
An A1C of 6.3 means your blood glucose readings before that test was taken are running an average of 147. Too high for someone without diabetes. A non-diabetic's average is around 85.

You need to do a little research and get yourself a glucose meter. Laurie gave you some very good advice as did the others.

Everything we eat has carbs in it, except for your proteins and fats. That includes your veggies. We all know fruit, some more than others, have natural sugars in them and can raise your blood glucose rapidly.

Get yourself a carb counter. From the average blood glucose you are running, you need to watch your carb intake. You are eating a lot of fruit, which is naturally going to raise your blood sugar. In diabetics, this causes a problem when that blood sugar doesn't come down to where it should be one to two hours after you have consumed it.

If you're sleep problem can be fixed, it may lower your glucose levels. Lack of sleep causes a lot of stress in the body.

You should watch your blood sugars with purchasing a meter or you may be able to find one for free through promos from various different companies.
 
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xylitol replied to nutrijoy's response:
MY BLOOD READ HEMOGLOBIN WAS 5.9. GLUCOSE WAS
65. HDL CHOL.,DIRECT WAS 39. LDL CHOLESTEROLWAS
125.TRIGLYCERIDES WAS 114.CHOLESTROL WAS 187.
FORGOT TO TELL THE DOCTOR I HAD 2 DANNON YOGURT CHERRY AND STRAWBERRY EARLY THAT MORNING. IS THAT WHAT SPIKED MY A1C. WAS THINKING TO CHANGE MY DIET FOR ALL VEGGIES AND
FISH AND LEAVE THE MEATS ALONG. SOME ADVICE
THANKS. XYLITOL
 
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Laurie Anderson, MSN, RNP, CDOE replied to xylitol's response:
Hi, A1C is based on a 3 month average and was not affected by our morning yogurt. Your random glucose of 65 mg/dl was influenced by your AM yogurt and it looks like it was a good thing that you ate it! Kind regards, Laurie
 
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brunosbud replied to xylitol's response:
Xylitol,

I think your idea is a good one. Depending on how its prepared and what's added to them, veggies and fish can provide excellent nutrition and be diabetes safe, too. In fact they are considered some of the most safe foods to eat. I'm careful with really sweet fruit, especially over-ripened fruit, because if it tastes really sweet, its not the safest.

Another idea that you may consider is something I do...

I like all kinds of food. Some are compatible with diabetes; some are not compatible with diabetes, at all. So, in order that I don't deprive myself of anything, yet, keep my body reasonably safe from developing harmful insulin resistance, I emphasize these two helpful strategies: (1.) daily exercise, and (2.) eat a lot of raw, diabetes-friendly superfoods...avocados, beans, spinach, lettuce, cabbage, grapefruit, oranges, strawberries, bell peppers, tomatoes, sweet potatoes, mushrooms and nuts.

(Hint: There's one dish that you can prepare in minutes that can incorporate everyone of these superfoods...raw)

Finally, I do one other thing that helps me stay on top of not just diabetes but all disease: I get my blood tested, twice a year. CMP and CBC. Remember the movie, All the President's Men..."Follow the money"?

I follow the "vitals"...
 
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winnie_the_pooh17 replied to mlin11's response:
Hi there

Just saw your post today. I see that you posted this message 12 months ago.. How is your a1c levels now?

I also have terrible sleep problems for the past 6 years and am working on it coz I am scared of getting diabetes. Even though my blood works came back normal, I still experience some symptoms. But one thing I can vow is that I definitely have insulin resistance because of sleep deprivation.


If you can share your progress on reversing your insomnia and pre-diabetes, it will definitely be helpful to me and others out there Plus, I am also in your age-range(23yrs old).


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