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A1C Number and Daily BG Readings In Conflict......Why?
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labbydog posted:
Hi, I am new here. I just came from my annual physical and my A1C was 6.6. It was 6.5 three months ago, so fairly stable. When I was diagnosed with Type 2, one year ago, the diabetes educator/nurse I was sent to told me that my A1C needed to be below 7, and my daily BG readings were to be under 140 two hours after a meal. They also told me my FBG should be 100 or less. They started me on the regular Metformin 500mg twice daily and soon increased me to 1000 twice daily. I was able to maintain good numbers until the last 2 months. I am maybe exercising a little less, but my diet is good and I have not changed anything. Now, I wake up and my FBG is 170, 156, 132, etc......nowhere near 100. Also, my FBG two hours after meals has skyrocketed: 155,171, 219, etc. All over the place. My regular primary care physician said she is not worried about the daily numbers.....the A1C is what counts. I am suspect about this conclusion. I have an appointment with an endocrinologist the end of March, so I will get a second opinion. Does anyone else have this discrepany problem and, if so, how did you fix it?

Age: 58
Weight: 137
Diagnosed March, 2012
1000 mg Metformin twice per day
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brunosbud responded:
When I hear about high fasting blood sugar readings, the first thing that comes to mind is "daily activity".

From my own experience, when I'm sick and I don't walk my normal 6 miles per day, I can always count on my FBG reading to be high the next morning. I think the reason for this is my body "anticipates" a certain level of activity and metabolizes fat reserves in preparation for the next day. When I suddenly go sedentary, for whatever reason, it "confuses" my liver and as a result, "dawn phenom".

The sophistication of the human body is amazing; it's the ultimate "smart" machine doing millions of intricate adjustments and operations outside our consciousness. And, it's regulation and control are intimately tied to activity and movement, ie, exercise. So, when I don't exercise, its "messin with sasquatch"; I've confused my body..."Hey, you walked 6 miles the day before, and, then, you decide to park your butt on the couch all day...How's I suppose to know?"

This is why, when I hear diabetics say, "I workout 3 days a week!", the first thought that comes to mind is "Well...Good Luck."
 
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auriga1 responded:
I disagree with your doctor. You can have very high numbers and then very low numbers. Your A1C will reflect this average. Having either very high or very low is not good on the body.

Have you seen a dietician? The foods you eat will reflect in your BG readings. I realize you are on metformin, but you need to know how many carbs you need to eat in order for your blood sugar numbers to remain where they should be. If your numbers have climbed since reducing your physical activiy, you will have to lower your carb intake. Physical activity is what burns those carbs.

You are eating the same, but your physical activity is less. Doesn't matter what you do, just keep moving every single day. You don't say if you are exercising less because of physical limitations.

Your numbers should remain steady rather than climbing if you have good control.

You may have to experiment a bit with foods and exercise to see if your numbers come down.

IMHO (in my humble opinion) your numbers are much higher than they should be. My doctor said the same thing as yours did regarding the fasting number (100 or less) and the PP two hours later (140 and under.)

I use two insulins, but I have to be very careful with what I eat and my physical activity. The more active I am, the less insulin I need to use.

So...if it were me, I would fix this by eating less carbs and being more physically active. No matter what types of meds or insulin you are on, less carbs and more physical activity can work magic.

Keep us up to date on your endo visit. Hope you gather some enlightening information. I have been seeing one for nearly 7 years now. Has been very helpful for me.
 
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brunosbud replied to auriga1's response:
auriga1, Do you think reversing your advanced state of diabetes is possible? Are you seeing any signs that suggest that possibility? Would you say you've optimized your diet from a nutrition and carb control standpoint or do you still have considerable room for improvement? Thx.
 
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auriga1 replied to brunosbud's response:
To put it bluntly, no, I do not think reversal is possible.

For me, exercise (physical activity) and eating less carbs has been a huge improvement.

My doctor believes that I had diabetes for 10 years before being diagnosed, if not longer. I started with higher than normal blood sugars in my 30's. Always have been on the lean side and exercised. Ate right, too. I had schooling in the health field and know nutrition is very important along with physical activity.

At diagnosis, my diabetes was totally out of control. I stand 5'9" and weighed 128 lbs. when diagnosed. Wacky. Too thin, but diabetic. Even though I have not been tested, my doctor believes my pancreas has no working beta cells that produce insulin. My mother and her side of the family were the exact same way.

I was diagnosed as a Type 2 because of my age. My fasting blood sugar readings without eating and without using insulin are 250 and beyond. I could weigh 100 lbs. and still have high blood sugar.

If my body produces no insulin, I don't see a reversal in my future.
 
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nutrijoy responded:
Does anyone else have this discrepancy problem and, if so, how did you fix it? ... Labbydog

There is no question that there is a discrepancy between the recommended fasting level of 100 and the statement that an A1c of 7.0 is "in control." A FBG level of 100 if maintained 24/7 is quite healthy but it translates to an A1c value of 5.0, not 7.0. Of course, after meal spikes and other surges will raise the bar somewhat and the average will increase above 5.0. The conversion chart below reflects the latest research studies that show diabetics should try to get their A1c level down to 5.4 or lower in order to prevent or avoid serious diabetic complications.

Color-coding of chart values is based on actual diabetes statistics and outcomes (and the color codes are also a moving target, depending on new studies that might be published in the future). What did I do to fix the discrepancy? After implementing major lifestyle modifications that included very low carb meal plans and lots of exercise/activity, I elected (voluntarily) to go on insulin and eliminate a lot of the oral meds that were not working for me (except for metformin which I continue to take for its anti-cancer properties but not for any blood glucose lowering value). Did it work? My last A1c was 4.8 and my average FBG is in the eighties. Although my endo was reluctant to give my regimen his blessing initially, I now have his full support and he has been impressed with my results.
 
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brunosbud replied to auriga1's response:
Thx for sharing. I read, recently, that our bones fracture, dissolve and regrow, frequently, throughout our lives; adults replace their thigh bones 2-3 times/yr. Sure, this process slows with age, but imagine how little we understand the awesome capabilities of the human body and it's ability to self monitor, maintain and, when called upon, repair, itself. Personally, I believe advanced type 2 diabetes reversal is within our grasp. We just haven't figured out, yet, what we're doing (or eating) that's keeping this from happening.
 
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An_250197 responded:
I have a problem with my FBG. They're not terribly high, but higher than I'd like. For example, last night before bed my reading was 99, so not bad...this morning I woke up and it was 134. Sometimes if I wake up during the night, I'll take my blood sugar - and at 3:19 this morning, it was 99. So it's frustrating to wake up with a little higher reading. It's called "dawn phenomenon", but I wish I could find a way to solve it forever. My nutritionist thinks that it's hormones. (At this point, I am on insulin for type 2, and I am followed closed by an endocrinologist and his nurse practitioner, and a nutritionist. I eat healthy and exercise.)
 
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peiglaws replied to An_250197's response:
When I wake up at 3AM and take a BG reading, I add 10 to the reading: for instance, if I get 98, I count that as 108, which is what it will be after 7AM. Since I do not want a reading above 100, I take a Metformin 500MG. That will stop the Dawn Phenomon from happening and my 7AM reading will be 98 or less.
 
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Georgiaboy responded:
I agree with auriga1 about watching what you eat. I too count the carbs. Dietitian told me 45 a meal. Gave me a list of things I can choose from to make a meal, how many carbs each count etc. Doing this and walking has helped me to lose weight and also try to get a handle on the reads. The past couple of weeks have been a havoc though with the wife's operation and different stresses going on. But I still try to do the count. Certain things on the list are counted such as 15(and I mean 15) baked potatoe chips, 17 grapes, a cup of milk. So, when the list says to count and measure I do. Wife used to tease me about it and offer things that's not on the list to see if I'd grab and run or turn it down. Shocked her. Haven't done a grab and run yet.
But carbs can and do come into a big play on this along with the exercise. Plus the managing of stress. This runs in my family and after all these years it decided to raise up and show me it's here. Now I know I've got it I also know that it's going to be a life time thing to manage. This is one thing I keep having to tell the wife. That no matter how the doctor says I'm looking good or doing good I will still need to do this or it will gain control of me and take me for a ride that I don't want to go on.
 
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Georgiaboy replied to peiglaws's response:
Interesting. Would never had thought of doing something like this. Unless on the weekends I usually take mine between 4:30am and 5:10am. On the weekends it can be between 7 and 8 am depending on what the better half has in mind for me to do. Had readings in the mid seventies a few times. Most average in the nineties to low & mid hundreds. Although a couple days ago it was about 120. But like I said earlier had some stress past couple of weeks too. Probably came into play on this. Found some good yogurt this weekend. It's a Kroger's brand. Called Carb Master. Has 4 carbs and 3g sugar. Not bad. Very tastey, at least it was to me. Nice pieces of fruit in them. At least you can tell you have some in there not a little smear of something that you think is fruit but couldn't just be sure on it. Might check and see if you can find that or another brand that has something similar to it.
 
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auriga1 replied to Georgiaboy's response:
Absolutely right, Georgiaboy. Lifetime change. I'm doing really well watching those carbs. Using insulin does not give me the green-light to OD on carbs. Some do, because the insulin will bring those BS readings down. If you don't use up those carbs you eat, it stays in your body. This is how many insulin users gain weight. Not going there.

Keep up the good work.
 
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labbydog replied to auriga1's response:
Thanks for all the great information. I really do watch my carb intake, but I have found since cutting way back I am tired all the time. I think my FBG is a combo of Dawn phenomenon, stress, and hormones. It doesn't take much for me to get super stressed. I am already on a anti-anxiety drug, but I think I need to learn Tai Chi or meditation! I am going to try the FBG test at 3 AM. Interestingly, I usually wake up during the night about this time. I have sleep apnea and wear a mask at night, so the quality of my sleep probably is not top notch, which could also be contributing. I recently started taking a drink recommended by a nutritionist that is supposed to "cleanse" your liver. It is a combo of unsweetened cranberry juice, lemon juice, apple cider vinegar and water. I try to remember to take this first thing in the morning. Don't know whether it is coincidence or not, but, since I've been doing it, ALL of my numbers have been a lot lower.
 
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september_gurl replied to labbydog's response:
Hi--I was just wondering what the recipe is for your cran/lemon/apple cider vinegar/water drink? I have been wanting to start taking Apple Cider Vinegar but the taste is so awful, I just can't get (or keep!) it down.

Thanks a lot!
 
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betatoo replied to labbydog's response:
Vinegar in water is a staple of my day. It does lower BG!


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