Lower glucose readings, higher Hemoglobin A1C

[Tink70]

In your history of practise have you or anyone else on this forum had lowered glucose numbers (ie. fasting readings, 2 hour post prandial readings, etc) but then tested out at a HIGHER Hemoglobin A1C????? (Forgive me if I get the letters and numbers mixed up - is it HC1a or Ha1C?????  I can never remember.
Since being put on Lantus Insulin - my readings have been alittle lower but my HA1C is higher.  It jumped .3 %.  I had this problem with oral meds aswell.   My HC1a was 6.0 - then I went on oral meds (three different ones) and didn't respond well to them over a course of three months - My HC1a jumped to 6.2.  I went off the orals and took nothing for another 3 months but saw a nutrionist that recommended that I increase my carbs as she suspected that my liver was actually making sugar because I followed an extremely low carb diet.  I followed those directions and my readings were fasting: 130s to 150s (these have not changed until the use of insulin where they are high 120's to 140's now) and post prandials were 160s to 180s with a 5 hour reading (I was instructed to eat every 5 hours) or before meal reading of 130s to 140s.  My 2 hour dinners were always the highest - ranging anywhere from 150s to 200s depending on what I ate.  My bedtimes were (4 hours after dinner usually) around 150s to 170s.   The next HC1a I had before going on insulin (Lantus) was 6.1.   I have been on Lantus since Feb. 08 - started at a nominal 2 units in the AM and have just gone up to 3 units as of yesterday (yes-I know that is extremely low but it has lowered my readings by 10-20 points at most 2 hour post prandial readings).  I just had another Hemoglobin test done on 4/1/08 and it was 6.3!!!!!   No one seems to beable to explain this to me....

[Anita Ramsetty, MD]

Hi,
A1C levels can vary slightly withotu meaning too much in terms of your control, so going from 6.1 to 6.3% may not mean that much in the grand scheme of things, and may be subject to lab error as well.
Other things to consider:

1)perhaps your post meal numbers are high or higher. A1Cs reflect all averages, so it may be other times of day that are higher on newer regimens.
2)some medications can falsely elevate or lower an A1C, talk to your doctor about those.
3) changes in your blood count(your hemoglobin) also affect A1Cs so if that bounces around for some reason, it may be the cause of some of the fluctuations.

Hope this helps, take care

[Tink70]

Also need to say that I the doc. I saw on 4/1 mentioned something about my liver not producing glucagon due to alcohol abuse. (I am a recovering alcoholic with 2 years of sobriety) didn't really understand it and he didn't have "time" to explain.  What does that have to do with my hemoglobin test and/or my readings and anything else??? (And by the way - my endo knows that I am a recovering alcoholic but he doesn't think there is any correlation.  My liver and kidney function tests were normal.
Thanks