That's great news about your hgb getting back into normal range! Keep the positude flowing!
You don't say exactly how high your fasting blood sugar was but A Hgb A1C is the average of your blood sugar over the last three months. A 6.1% means that your average fasting blood sugar is 123.
Anything above 100 is considered prediabetes. In other words, insulin resistance....and that lowers treatment success. Plus, interferon can make it worse.
I wouldn't be so anxious to get in a trial without first checking to see of you're insulin resistant.
BTW....coffee raises your blood sugar if you're prediabetic and even worse, it increases the level of insulin....which makes interferon ineffective.
Here's the study that found out that having a fasting blood sugar over 100 decrease SVR....
Glucose >100 mg/dl Reduces Interferon/RBV SVR
@hobo2; thank you. :)
@CoWriter; I am a little confused by your comments. If, as they stated, my blood glucose was only one point too high last time at 114, but a 6.1 hgb A1C averages to 123 (What? Daily? Monthly? I don't know) and is inside the acceptable range, then that doesn't even make any sense. Also, believe me when I tell you that I am NOT "so anxious" to get in a trial, I am as nervous as a long tail cat in a room full of rockers! I don't know why anyone would be when you read all the possible side effects. But I do know that eventually I will have to treat to clear. Being clear is my goal. And as for my little joke about coffee...well it was just that, a little joke. But I thank you for the concern and for the link.
My glucose level at screening was 102 and reported as high and an exclusion on my test results. The trial coordinator told me it really wasn't an exclusion as there is a error rate of +/- 10% on all labs. She also said that my Hgb A1C was within range (5.9%) and therefore not an issue. Range for the Hgb 1AC is 4.3% -6.1%. She never mentioned to me that I was insulin resistant nor did she recommend any diet changes.
CoWriter could you share the formula you used for the fasting blood sugar aver three months. If positudes is 123 mine must be close. How can the three month be at 123 and the glucose at 114. I am confused.
I just spoke with the Coordinator of my study about the glucose issue. My last blood glucose was 97 before the "week one" blood draw last week which indicated a blood glucose of 114. My Hgb A1C was 6.1 and needed to be under 7.0; which it is. So I am not excluded due to my blood sugar as it is not at this time a problem and falls well within the range of acceptable. I was told that there can be a lab differential of "up to 20" on the draw anyway, hence the double check with the Hgb A1C.
Long story short, my blood sugar is fine and will be monitored throughout treatment as the Interferon can raise blood glucose levels. Thank you all, as always, for your comments.
The A1c test is a ‘glycated (or glycosylated) hemoglobin’ test. It measures the amount of glucose that adheres to red blood cell over the lifetime of the cell; about 90-120 days on average. The results *approximate* blood sugar results; a table that compares finger-stick tests and A1c results can be found here:
Be sure to review the column that uses mg/dL that we use here in the states; I can’t post the table here because I think formatting will prevent copy and paste.
An important note; the type of anemia we develop while using ribavirin can significantly skew the A1c results; rapid hemolosys of red cells = shorter red cell life span = the test reflects blood sugar results much lower than what we experience. If your doctor tries to monitor your blood sugar using A1c results *while you are treating*, you’ll have to remind him you are hemolyzing very rapidly. From the wiki article linked above:
“Glycated hemoglobin measurement is not appropriate where there has been a change in diet or treatment within 6 weeks. Likewise the test assumes a normal red blood cell aging process and mix of hemoglobin subtypes (predominantly HbA in normal adults). Hence people with recent blood loss, donated blood recently or hemolytic anemia, or genetic differences in the hemoglobin molecule (hemoglobinopathy) such as sickle-cell disease and other conditions are not suitable for this test.”
Thank you Bill, I appreciate the input. Very good point about the hemolytic anemia as well. It makes more sense now. :)
Thanks Bill - I always appreciate your informative responses.
"My glucose level at screening was 102"
"She never mentioned to me that I was insulin resistant"
Tell her that according to the American Diabetes Association, you are pre-diabetic (insulin resistant)....and insulin resistance lowers treatment success.
From the American Diabetes Association's website.....
"Normal fasting blood glucose is below 100 mg/dl. A person with pre-diabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person has diabetes."
CoWriter could you share the formula you used for the fasting blood sugar aver three months. If positudes is 123 mine must be close.
Here's a table that shows the conversion
How can the three month be at 123 and the glucose at 114. I am confused.
That's because your fasting blood sugar is not always the same number. If you check your blood sugar every day for 90 days, some days it will be lower than others.....and the A1C test will tell you the average over the 90 days.
The A!C test is used to measure blood sugar control in diabetics....to see how well their treatment is working. They set a goal and every 3 months they check to see if they've reached it.
It is something I would certainly not use to check for insulin resistance.
Bottom line, a fasting blood sugar over 100 means insulin resistance and when you're insulin resistant (insensitive to insulin), the pancreas has to produce bigger amounts of insulin to keep your blood sugar in the normal range. Too much insulin is called hyperinsulinemia. It lowers treatment success.
From "Hyperinsulinaemia reduces the 24-h virological response to PEG-interferon therapy in patients with chronic hepatitis C and insulin resistance" (Aug 2009)
"Hyperinsulinaemia reduces the cellular response to Pegylated-interferon in CHC(Chronic Hepatitis C) with Insulin Resistance. Strategies to reduce insulin levels before initiation of treatment should be pursued to improve efficacy of anti-viral treatment"
"The reduced response to interferon seen already 24 h after the first injection in our
patients with high baseline insulin and HOMA-Insulin Resistance correlated with reduced virological response at week 4 as well as with reduced SVR, in agreement with previous studies that have reported lower rates of SVR to IFN-based therapy in HCV patients with high baseline HOMA-Insulin Resistance. Our findings have
practical implications for the design of clinical trials in HCV patients with Insulin Resistance and also for initiation of antiviral therapy in these patients in everyday practice. They clearly indicate that insulin (and HOMA-Insulin Resistance) levels should be normalized before initiation of anti-viral therapy, independently of the strategy (diet, exercise, metformin, pioglitazone) used."
Your blood sugar is only a couple of points higher than it should be. You can lower it.