What the heck? How's this even possible?


From the above summary for the last 12 weeks, and considering that my average number of fingerstick readings per day is ~15, one would assume that my HbA1c for the 12-week period would be ~5.2% or so. But I was so disappointed to see what the lab test showed it to be - a 6.3%. ?????????????????????????

This is my first HbA1c after going on the pump. Considering that I was 8.9 before I went on the pump, I know that it's a significant improvement...but still...6.3%???????????? After all those fingersticks and precautions not too stay >140 for too long?

Yeah, I'm quite bummed out. And I'm sure I'll be alright tomorrow, but today, I get to be majorly disappointed.

I’m not sure if this is fact or not, but according to my endo, HbA1c is mostly affected by your post meal BS. If you have great numbers during the day and you have bad numbers after a meal, then that’s what affects your HbA1c… I’m new at this so it could just be a load of crap, but that’s what I was told. I wish I was in the 6% range… I’m still struggling to get under 9… but it’s only been three months since my diagnosis…

But I tested, on average, 15 times/day…that’s almost 1/hour when I’m awake…and my bed-time and morning numbers have always been excellent with very few exceptions. So, I can’t understand where those highs were hiding. I’ve also been wearing my Dexcom 7+ CGMS for a few weeks now and they bear out my belief that I’m fine at night and my PP highs are not common. As you can see, out of 1,227 readings, 240 were >140mg/dL. That’s a small fraction. And a 6.3% corresponds to an average of 147mg/dL. Still can’t figure out what’s happening with the numbers.

Does the glucose distribution that you get off the 7+ match the glucose distribution that you get off your bg meter?

I was 8 on my last a1c and now after my pump and got tested it dropped to 6.4. I am hyped. I know you will be too. Because that is a significant drop. In three months for it to go down that much it is a great thing for me. You said 12 for you right? That is still great. Hang in there, it will drop even more, I know it will. Yay for the pump!!! And yay for you too!

My A1C was 5.5% which corresponds to an average of 111 mg/dL. At the time the 7+ stats showed a mean of 108 with a SD of 30. Sometimes my bg was above 200 but never below 40. Therefore I expect the average to be higher than the mean. In other words: the 7+ stats were a good predictor for my A1C.

6.3 is a great improvement! :slight_smile:

My wife tells me that there are different calibrations for the actual lab. Ie two machines will give out different readings. Each facility may have a different acceptable range.

I was 8.9 at diagnosis in a urgent care, then ONE WEEK later I was 7.9 at my new endo.

There must be different A1C/eAG converters out there. The one at

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

shows

The equivalent of 6.3 % A1C is 134 mg/dl eAG.

I only downloaded my bg meter once in my life when I applied for the 7+. My bg average was 130, SD 57. My A1C was 5.7. I must have had a tendency to prick my fingers when my bg was high.

Repeat after me:

I am not my number,
I am not my number,
I am not my number

BTW, great job getting that number down! :slight_smile:

I am not my number,
I am not my number,
I am not my number,

Terry

Well, how long have you been on the pump? The A1c is an average of 3 months…so if you’ve only been on the pump, using a cgm or testing 15x’s p/day for the last month then you need to also figure in the readings for the months prior. You have shown an awesome improvement so don’t be so hard on yourself! Your next A1c should be a more accurate reading of all your hard work…GREAT JOB!

I have the exact same issue. My last A1C was 6.1 and yet my average BG is around 100. I very rarely go over 120. It seems as if my A1C is always the highest number I get after meals, NOT my average, just as Elizabeth said. When I was first diagnosed, my AIC was 7.2, an average of 160, although I was still seeing a fasting of about 80. 160 was usually how high I went after meals. I too have tested up to 15 times a day (including at 3 AM, and 45 minutes after eating) and I know I don’t have undetected highs. My noon-D husband recently had an A1C of 5.9 even though I have never tested him above 95, so I’m not sure that A1C is really the most accurate measure for some folks.

Sorry you’re disappointed, but it is a great improvement!

Think what this may show, in addition to everyone else’s comments, is how inaccurate our meters are. A ± 20 can make a difference.

I think you did have enough highs to cause the 6.3. If you consider where your SD is, that makes sense…

John,

I understand the strong focus on A1C unless someone has a CGM. The CGM data is much more valuable. I focus on my time spent outside the normal bg range. If my CGM tells me that I spent 20% of the time above 140 this is way more significant to me than an 106 average. My primary goal is to minimize the time spent above the normal range. Take a look at the CGM data. It might provide all the answers. Let’s assume the numbers you posted were from your CGM (I know that they are not).

Average BG: 106, Above 140: 20% ( 5 hours/day ), A1C: 6.3

Let’s compare this with my CGM numbers:

Average BG: 108, Above 140: 12% ( 3 hours/day ), A1C: 5.5

Thanks for all the replies.
Dave, my 3am numbers match my 6am numbers.
Dex is in excellent agreement with my meter. I did not miss any PP highs.

And Kristy SOLVED IT! Red blood has an average life of 120 days. I started pumping 90 days before my A1c test. So, giving a 90-day weighting to my expected 5.2% and a 30-day weighting to my 8.9% pre-pump A1c, I get the correct value for my real A1c ~6.2%…and my lab test showed 6.3%.

Thanks, again…I feel much better now that it has a rational explanation.