A1c and Blood Sugar Readings

I went to my endo yesterday for my quarterly checkup. I am working on getting the CGMS, but I haven’t yet. My last A1c was 6.7. The one before that was 6.6. Yesterday the doctor didn’t do regular blood work. He did an in-office A1c w/ something that looked kind of like a regular meter. When it came back it was 5.6. There is NO WAY that’s what my real A1c is. My blood sugars have actually been running higher than normal for the past couple of months and we did some major adjustments on my insulin to carb ratios and to my basals yesterday. My average accoring to my personal records is around 136. Which is really much closer to a high 6 or low 7 A1c.
Has anyone else had an A1c you just knew wasn’t right? Someone told me I should be happy with the right number. I would be overjoyed…if I thought it was right. Any suggestions on what to do?

Those in office A1cs can be off by 1% in either direction. So your 5.6% might easily be a 6.6%. My endo told me she tried one but it was a random number generator.

Running their own test is a great way for the docs to earn more money from the insurers but it isn’t as accurate a test. Tell your doc to order you a lab A1c test. If you get a hard time about it, find a new doctor who cares more about patient health than profit.

The funny thing is that he usually does order a lab A1c for me. I always requested one. This last time he and I both forgot to get orders for me to have a lab test done for this appointment. So he just said they’d to it there. I’ve already gotten the lab orders for my next appointment, so I won’t have to worry about that for my next appointment.

Jenny’s right. Those in office A1C’s are about as accurate as our glucometers. You’ll find variations of +/- 20%. While they’re nice for a quick check, you really need a lab to get more precise results.

Hey Cara,

Each lab (or device) is different in calculating A1cs. All of them weigh different red blood cells differently. For instance - each test divides the red blood cells (hemoglobin) into age categories. 30, 60, 90 amd 120 days old. The last group (oldest) is usually thrown-out. The remaing groups are assigned a “percentage” of importance – 20% (say 90 days old), 30% (say 60 days old), and 50% (say 30 days old).

When one lab gets an HbA1c of 5.6 another lab can get an HbA1c of 6.7 – all depending on which age group of hemoglobin has the highest percentage in their lab algorithms. The “in house” A1c testers are no different. They just work A LOT faster :slight_smile:

So, all in all, your friend who said not to freak about it was just being a good friend and giving you good advice. It is what it is :wink: Diabetes is so easy to peg with numbers – but isn’t it most important how we feel?

Best always,

Allison Love Beatty - Founder of “Allies Voice”
Making the World Safer for People with Diabetes

Yes, the last two in a row. I always felt really secure in that I could accurately predict my Alc based on my logbok. I keep a log of 7 test per day. I’d agree that if my total average was about 140, I’d be just below 7 for A1C. So, 6 months ago I was averaging pretty high and concluded that my results would be 8 - 8.5, and I rung in at 7.5. Well, I didn’t think much about it. I had my next appt this last Monday and was thinking that I’d be around 7.5-8 and the results were 6.7. The doc knows I fret a lot about the db and complications and he said “Kathy, can’t you accept good news just this once?”, which made me feel even more like a freak of nature. Then he looked at my numbers and said he thought they corresponded appropriately. So, I left the clinic feeling that once again db has thrown me a curve ball that I hadn’t anticipated and went across the street to McDonalds and had pancakes, eggs and sausage (well, I had been fasting for my cholesterol test and was duly famished). Of course, I was relieved that the doc was pleased with the number, but, I know it is incorrect. What to do now? I haven’t a clue. (Maybe eat that chocolate Santa that’s in my cupboard.)

PS - Mine have always been done in the lab, and I have been going to the same clinic for 7 years.
But, another thing, sometimes anemia can distort the AlC. The doc and I went over this earlier in the year, and I had a complete blood count and there’s nothing wrong.

It’s so frustrating, isn’t it? I don’t know if I trust my meter completely, but I know that it isn’t that far off. I kind of felt like a freak of nature too. My doctor called me “motivated”. I took it as a complement. I wondered somewhere if that wasn’t his nice way of saying I annoyed the living daylights out of him. Oh well, I figure I have to live with diabetes, so they can put up with my obsessive compulsiveness when it comes to my diabetes.