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Old 11-28-2012, 10:10 PM   #1
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A1C vs. fasting glucose

I have not been diagnosed as diabetic but I have PCOS and have been on Metformin ER 1500 mg/day for several years to control my high insulin levels. I get tested for fasting insulin and fasting blood glucose once a year. My fasting insulin is now in the normal range (though high end of normal, I think) and my fasting blood glucose has come out a 88 consistently. Last year my doc wanted to do A1C at my visit (non-fasting) but I opted to return to get the fasting glucose and insulin done. Not sure why she didn't have them do A1C then but she didn't. DH was just diagnosed with Type II (via A1C) and I have been reading up more, and I'm wondering if I should get an A1C. My next doctor visit isn't until May. I've just (re)started low carb since DH's diagnosis, so perhaps it would be best to wait and see what the level is after I've been low-carbing a while. Any thoughts?
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Old 11-29-2012, 12:02 PM   #2
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I don't see any reason to think your A1c would be high. Just as an aside, there is no need to fast for an A1c, so the office test is fine. Get it if it would reassure you.

It's only relevant to test things while you are low carbing if you plan to keep low carbing. Otherwise they are optimistic numbers. It would be interesting though to compare your A1c now to what it is after several months low carbing.
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Old 11-29-2012, 07:38 PM   #3
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Thanks for your reply. I don't need to be convinced I should stick with low carb, so I guess I will wait and request it at my next visit along with any other tests I need. Maybe if I go in earlier for something else I will ask for it to be done then.
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Old 12-01-2012, 06:47 AM   #4
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If you're curious about your A1C and want to check it yourself, you can buy a home test. There's 2 of them: Bayer's A1C Now, which is an instant-read test, and Walmart's ReliOn mail-away test.

The general consensus seems to be that the mail-away test is a little more accurate, as that is read by a lab. The instant-read test seems to be a little less accurate (but would still give you a good idea).

Just FYI, in case you want to try it.
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Old 12-03-2012, 09:04 PM   #5
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Originally Posted by Vilya View Post
If you're curious about your A1C and want to check it yourself, you can buy a home test. There's 2 of them: Bayer's A1C Now, which is an instant-read test, and Walmart's ReliOn mail-away test.

The general consensus seems to be that the mail-away test is a little more accurate, as that is read by a lab. The instant-read test seems to be a little less accurate (but would still give you a good idea).

Just FYI, in case you want to try it.
Thanks for the info. My insurance is really good, so the test is either free or very cheap if I go to the doctor...I'll probably just wait for now.
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Old 12-14-2012, 06:13 AM   #6
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Over on the Hyperlipid blog there is a little discusion about LC and your A1c. They
bring up that someone on LC with a A1c of 5 may have a fasting blood sugar a lot
higher than someone eating a lot of carbs with a A1c of 5.
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Old 12-16-2012, 03:09 PM   #7
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Quote:
Originally Posted by E.W. View Post
Over on the Hyperlipid blog there is a little discusion about LC and your A1c. They
bring up that someone on LC with a A1c of 5 may have a fasting blood sugar a lot
higher than someone eating a lot of carbs with a A1c of 5.
Good to know thanks. Sounds like it might be best to get the A1C next time, since by then I hopefully will have been LC for 7 months.
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Old 12-21-2012, 02:08 PM   #8
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Or another option is to go to one of the pay it yourself labs. I saw one lab that will do
it for $32.50 that's go in have it drawn and they email the results in 2 to 3 days.
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Old 12-23-2012, 10:07 AM   #9
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Quote:
Originally Posted by E.W. View Post
Over on the Hyperlipid blog there is a little discusion about LC and your A1c. They
bring up that someone on LC with a A1c of 5 may have a fasting blood sugar a lot
higher than someone eating a lot of carbs with a A1c of 5.
That sounds a bit strange to me, and I'm wondering how that would work. Since the A1c is an average of what your blood sugar levels are over a period of time (60 days, I think), then why would it be relevant that you're low carbing? Your A1c is what it is no matter how you've been eating. If your blood sugar averages are higher, then your A1c reading is going to be higher, wouldn't it? My last A1c was 5.1, and I was not low carbing at the time. I expect my next one to be lower, since I am low carbing and will continue to do so. My blood sugar levels are consistently lower when I'm low carbing.
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Old 12-26-2012, 05:13 AM   #10
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Terry it does seem crazey at first so I hunted that post for up.

Hyperlipid: Physiological insulin resistance (1)
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Old 12-26-2012, 08:21 AM   #11
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Quote:
Originally Posted by Magicsmom View Post
That sounds a bit strange to me, and I'm wondering how that would work. Since the A1c is an average of what your blood sugar levels are over a period of time (60 days, I think), then why would it be relevant that you're low carbing? Your A1c is what it is no matter how you've been eating. If your blood sugar averages are higher, then your A1c reading is going to be higher, wouldn't it? My last A1c was 5.1, and I was not low carbing at the time. I expect my next one to be lower, since I am low carbing and will continue to do so. My blood sugar levels are consistently lower when I'm low carbing.
This was my thought exactly. My last A1C (taken a week ago) was 6.7; 4 months ago it was 12+. My overall eating has changed dramatically and my overall glucose results show that - regardless of what my fasting glucose readings may be.

Last edited by AllisonB; 12-26-2012 at 08:25 AM..
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Old 12-27-2012, 05:16 PM   #12
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My endo confirmed what I read on Hyperlipid. I've always been concerned that my fasting BG is higher than I'd expect since I eat very low carb. My doctor told me that's why he goes by my A1c and doesn't worry about my 93-95 fasting numbers.

The way it's explained on Hyperlipid, I can't quite follow the science, but apparently regular low carbers experience something like the Dawn Phenomenon of diabetics where the liver will dump glucose to keep the blood sugar from going too low--and that results in fasting numbers that are deceptively high.
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Old 12-28-2012, 09:11 PM   #13
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Thanks for the info, Leo. I will read more on this. I saw my bariatric surgeon yesterday and my PCP today, both told me they are only concerned with my A1C and not individual readings, but I need to continue to use the post-meal readings to refine my post-surgery food choices. When I mentioned going back on a low dose of Lantus at night, my PCP said no, that my A1C is coming down fast and she expects that to continue w/o the further need for insulin. Yay
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