Numbers

Type 2
#1

I just got back from the Drs and got my results but not sure what the numbers are exactly…

I assume all of these numbers are mmol/L because I’m in Canada?

Hemoglobin A1C - 00.61 (is this 6.1%)?
Fasting Glucose - 5.4 (97)

Cholesterol - 4.82
HDL Cholesterol - 2.16
LDL Cholesterol - 2.26
Triglycerides - 0.88
(do I convert all of these for mg dl values? And what would I use to convert?)

I was told my kidney and liver function was perfect also… But what should I be looking for on my sheet for these numbers ie: sodium, potassium, chloride etc etc…

I did ask about being tested for LADA and presented the Dr with a printout but he said my numbers were too low to be tested for something like this right now? Not sure what to think as this is the second Dr that has told me this…

So, I was told to come back in 3 months for another A1C test and to keep up the good work.

What do you think?

Thanks, Paul

#2

I think you are doing great. I know you have worried about your blood sugar spiking after meals, but your HbA1c does not lie. A 6.1% is a good value. You cholesterol can be converted from mmol/L to the american standard mg/dl by multiplying by 39, thus your numbers are TC 189, HDL 84, LDL 88, Tris 34. Absolutely perfect.

It will be difficult to argue to any doctor that you need further tests and changes to your treatment unless you are having trouble meeting your blood sugar control targets. If your HbA1c is 6.1%, your fasting numbers are normal as above and your 2hr postprandial blood sugar is routinely (> 75% of the time) below target (140 mg/dl) then you are fully in control. I know you worry about things, but you are doing great, just keep it up.

#3

Hi Paul, Good job.

I remember you talking about all the weight loss you where having and how you were struggling with that and concerned… What did your Dr attribute that too? I would continue to press him to see if your LADA so you get a baseline here on the next visit. Your young and thin and really dont fit the mold for T-2 and preservation of your remaining beta cells here are key. I am sure others will jump in here… Thanks for the post.

#4

I don’t know if they use mmol/l instead of mg/dL in Canada, but here’s a nice conversion table and calculator. Way to go on your numbers. :slight_smile:

http://professional.diabetes.org/GlucoseCalculator.aspx

#5

That fasting glucose is great! Other than that I don’t know…hope it is a 6.1 because that would be awesome.

#6

BSC, Hi,

I have a question for you.

Bernstein talks about his patients achieving an A1C of 4,3 -4.8. I have never seen that on members profiles on this site or in diabetes daily. How achievable is that for a diabetic?

I know he talks about the meter salesman coming into his clinic, young and in their twenty and all with this low of A1C and considers that normal. What are your thoughts about this?

#7

Ahh, Paul, you are doing great. I can see how it’s confusing too. You are correct, your A1C is expressed as a percentage, and 6.1 is excellent (translates to 6.5 mmol average over the last 3 months). The report quotes both in mmol and mg for you re fasting glucose as 5.4 mmol / 97 mg.

To roughly & quickly translate mmol vs mg, multiply Cdn mmol by 18 (or vice versa if figuring the other way around), and I see Lizmari gave a calculator link for you. Usually, if I can’t do the math in my head (who knew I needed my 18 times tables when I was in grade school!), I usually just bring up my windows calc.

#8

Thanks bsc…

I’m feeling pretty good overall about my results and my fasting numbers at 7am just lately are in the 4.5 range!

What do you think about the LADA test or do you think I should just leave things for now and just go for my A1C again in 3 months?

Thanks…Paul

#9

Hi Pauly,

When I told the Dr about the weight loss he contributed it to my fast metabolism and reduced carb intake. I have noticed in the last 2-3 weeks I have gained 3-4 lbs so I think I’m just going to monitor it and try for that 2500cal/day intake…

Would I have to pay for the LADA test? I’m in Ontario so not sure if Ohip would cover it?

Thanks, Paul

#10

Thanks Lizmari,

I think the 0.061 is 6.1%? i found a different calc here…http://childrenwithdiabetes.com/converter.htm

Paul

#11

Hi Pauly,

I’m not sure but on my test result sheet next to my A1C number it does say “4.0 - 6.9 Optimal Range”.

I’m assuming that is the optimal range for anyone because this isn’t a diabetic specific test result sheet?

Paul

#12

Hi Jamie,

Yes, I found one online here… Overall I’m very happy with the test results…

Thanks, Paul

#13

Bernstein talks about achieving those levels, and while there are diabetics that I know of that have gotten below 6%, you dont’ find very many. It requires a level of control, particularly for an insulin dependent diabetic that is a “lot” of work and compromise. Peruse his forum at www.diabetes-book.com and many of the people there list their HbA1cs in their signatures and you will see many at 5s and 6s. He talks about non-diabetics testing in the 4.3-4.8 range, but he would only push a patient down to that level if he had confidence that they were adhering strictly to his guidance over time. I would suggest that most Bernstein patients that follow his diet (6-12-12) could readily aspire to the low 5s without much trouble.

Now, on the LADA test. The test for LADA is basically an autoantibody test which consists of four separate tests, GAD65, ICA, II-2 and Islet Cell. In the US, you can order tests yourself without a prescription, and there are places that you can get the test for $300. Personally, I would just hold off on the LADA test until you have more concern over your blood sugar control and some more evidence that you might be LADA (like lack of reponse to medications and degraded blood sugar control).

#14

Not sure about payments Paul on LADA Someone from Canada will likely read this and jump in and answer it. If your numbers start creeping up I would insist for the LADA tests though. Great job on everything!

#15

As always thank you BSC for your detailed response.

#16

Yeah, I think A1C percentage is the same percentage used, worldwide, and can be then converted to either mmol/l or mg/dL to estimate the average glucose, whichever one you use… so yeah, it is 6.1%

#17

FYI : I read on page 44 of the Canadian Diabetes Association’s 2008 Clinical Guidelines : NOTE : not all Labs are using same reference targets. As a useful guide an A1C target of 7% refers to a threshold, that is approx. 15 % above the upper limit .The way, I read this : an A1C result here is not necessarely same as there ( in Canada ) .

Your best bet likely would be to call OHIP and you may have to go into some detail with them , if you don’t get a response from ON TU members/others re your question about LADA test payment soon .
When my C-peptide was done , here in BC , in 2000 , before going on the pump , BC Pharmacare covered the cost.
Glad to read , you are gaining weight .
My ( in Canada , BC ) Lab has Target range of CHOL : < 4.0
LDL : < 2.0
HDL : 1.0 ( Male , 1.2 Fem
TRIG : < 1.5
CHOL/HDL ratio : ,4.0

#18

The HbA1c is a percentage, and hence it has no units and therefore there is no need to convert between units. That being said, for many years, labs did not use a common calibration standard and it was difficult to compare results different labs. There is an effort to standardize the HbA1c, it is called the National Glycohemoglobin Standardization Program (http://www.ngsp.org/), that is focused on getting labs to adhere to a common calibration standard. Previously each lab ran open loop, and a 7% at one lab might correspond to a 6% at another lab. For labs adhering to the NGSP, they are required to be within 10% of the standard (still pretty cr*ppy as far as I am concerned).

In the CDA guidelines you cite above, the reference to the HbA1c target of 7% means that they are saying it was set 15% above the reference range for normal which was listed as 4-6% (i.e. 7% is 15% higher than 6%). All labs adhering to the NGSP should be working from the same calibration standard.

#19

But I should be happy with my 6.1% right?

Paul

#20

You should be proud proud. Real proud. You have stood up and taken it head on, and are gonna win. My hat is off to you. It was and is not easy.

6.1 for A1c is good stuff. Time and experience may drive that down even more, so you can be in the 5’s, and really strut your stuff :slight_smile:

Fasting numbers are terrific, and the 6.1 indicates you don’t spend a lot of time around the 140 mark (U.S. numbers ) so you are doing it just like you need to.

Maintain, and keep taking the small steps, one day at a time.

Kudos,

John