A1C Mystery Will not Come Down

Thank you. This is very helpful. I have been tested for some hemoglobin variants but I will check these and make sure these were not missed. Thanks again. It’s very appreciated.

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I will check. Thanks.

Thanks Gary. Anemia has been ruled out but I will check on the others.

@zack are you in canada??

The A1C scale is different than US units, so 10.5 canada would be a slightly high US 8ish.
This may explain your doctor’s response.

Stemwinder_Gary is right…there are those factors too. Those are more “common” issues and I figured an endo may consider those things. As the article mentioned,
“boronate affinity method” may give you real results. Another two possible tests are either fructosamine or glycated albumin. The first one I have seen done but the second I’ve not heard of.

Do mind telling us what has been ruled out?

@MM1 - the A1C scale used in Canada is the same as the one used in USA

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I did have my fructosamine checked just recently. It was good. I’ll check this - glycated albumin.

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Mine is the opposite low , very low. I have dealt with similar issues though.I have been to all the doctors and specialists. Some docs ( usually specialist do very little for very high cost). I heard someone say diabetes but my A1c was never high.( probably because I have issues with hemoglobin dysfunction).

U do have to keep looking for a doctor who will give some help.drinking plenty of water helps just dont over do it.( not saying it will fix u) just give some relief.i even drink water after /with orange juice. If my blood sugar goes up this helps. Mine never goes super high that I notice 200 max that I catch.
Probably because my lows make me feel so bad. An endocrinologist said 60 is not low!( that was just 2 weeks they reviewed)
It has dipped so much lower,before scary.

When I started an inhaled cortico it actually helped with some symptoms of mine. I may have had adrenal insufficiency or developed on the medication. Either way doctors not much help. Some cases are too complicated Believe it or not.

Wonder if a university would help?
Also check allergies,medication,protein to carb ratio.vitamins/ minerals… kidneys.
you could have more than one issue going on.try balance; your body does need some carbs try low glycemic. Definitely try and start with the basics. I had multiple nutritional deficiencies due to malabsorption. No one checked them until probably now that it’s done damage. I think all doctors should do a panel when someone has symptoms.
It makes me want to run when a doctor says something about my diet. I have been to nutritionists and I was missing 1 serving of vegetables. I probably eat better than many doctors. It’s easier to blame the patient when something is wrong when they can’t figure it out.

I had an endocrinologist diagnosing with something. then turn around and say they couldn’t help it’s not endo( all because I had concern and questions).kind of criminal?
I feel some in Medical fields take advantage.

Must be thinking about bg uom for canada being different. Thanks!

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You should see your endo or GP again and ask them to explain why they think you don’t have diabetes when you have such a high A1c. We can’t offer useful information when we don’t have all the facts.

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Sounds like you have diabetes. Welcome to the club.
Sounds like you are a diabetic who they have decided to put into the grave instead of providing medical treatment. They do that sometimes.
Your gonna have to find help. I’m sorry about this.
I’m afraid that I don’t think you can wait until after covid ends.

I don’t think now is the time to bother about fixing your GP. Save that for later. You gotta save yourself, now. If a1c = 8, I’m more OK with that, although they should still be providing treatment. 10 is not ok.

Schedule with an endocrinologist, not a GP. They had their chance. They blew it.

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CGM readings are more valuable than an A1c when it comes to diagnosing diabetes. If your CGM readings are consistently in range, then I agree with folks that the A1cs are like not accurately representing glucose readings for you, which warrants more detective work but not necessarily diabetic treatment. Because A1cs typically reflect approximately a weighted average across the last three months, if your CGM values are only recent, I might repeat a run of that and the A1c in a couple of months to make sure that blood glucose numbers continue look good around the clock and that the A1c continues not to reflect that.

Good luck!

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CGM data is not used to diagnose diabetes. That is false.

I am following up on some of this today and have reached out to the authors of these papers as well. Thanks.

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Thanks. I’m on it now. Unfortunatley, with our Canadian system (despite all it’s great features that I can attest to) seeing a specialist can take months and only after a referral from your GP. It took 4 months to see the first endo. Seeing another one will likely be the same process and timeline. I am in touch with some endocrinologists in the US for second opinions.

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Zack - good endocrinologists are a challenge to find in :canada:


Here is another article. I did some digging to see if I could come up with anything else but the two I previously listed seem to be the major ones that would fit what you deal with. It also seems like the Hb Wayne trait is fairly rare and it may not be something doctors immediately think of (or check).

If you had a fructosamine level checked and it was normal, that combined with your normal sensor and glucose readings would lay credence to the your A1c being level being inaccurate. I would ask your GP if you can get the A1c done doing the boronate affinity method. (How that is done vs. whatever way they normally do it, I don’t know).
You may need a hematologist to investigate things further. They are the blood specialists and may be better able to lock down what is off with your A1c testing.

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An elevated A1c with normal CGM readings isn’t used to diagnose diabetes either. That’s indicative of some other issue.

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He’s got symptoms of hyperglycemia.

Let not go looking for unicorns in a horse stable. Especially with a new guy. You know better than that. This guy is at risk. Don’t send this guy on some needless wild goose chase that leads him to harm. I’m not responding to further comments on this matter because of the potential to do harm to this individual who is struggling.