Healthy fasting and postprandial blood glucose but high a1c, how is that possible

I knew a woman in her late forties who said her fasting and postprandial were well within the healthy range, not even pre-diabetes, but her a1c was over 8. How is that possible? That works out to an average blood sugar of about 190. I think her 2 hour postprandial was only about 110, fasting in the 80s.

Were her red blood cells just extra long lived? Also she said when she changed her lifestyle her a1c dropped to under 6, so there is that. I just don’t get how that is possible. It seems with her glucose readings no matter what she ate she’d rarely approach 190, let alone average out there.

Her readings are all over the place; she needs to take more readings in order to get a better idea of her average. A reading of 80 is dangerously low. I can get mine down into the 120 range just by watching what I eat and exercising; still I need to lose more weight to consistently get into that range without having to beat myself at the gym everyday.

80 is in the normal range. Not even close to dangerous.

It depends, for someone without diabetes 70-130 is considered normal. For someone with hypoglycemic unawareness the target range goes up because they may not be aware that there sugar levels are dropping. Unexpected low blood sugars can lead to dangerous situations. Normal blood sugar range for someone who is considered at risk for diabetes needs to be determined by their doctor. Of course you are a doctor and most likely know better that I do. :slight_smile:

80? I don’t worry about 80 unless I have bolus insulin in me. Heck, I like 80. I don’t worry until it starts to get below 70, assuming, of course, that I don’t have a hefty bolus pulling me down even more. (T1 Diabetic here).

As far as the woman in the OP, yeah, that seems odd. If I were her, I’d be checking a whole lot more than just before/after eating. She’s got to be spiking in there somewhere.

My point exactly. It almost sounds like she knows how to get her blood sugar level low enough in the morning (wake up to thread mill?) and then eats a low carb breakfast and takes her second and only other measurement of the day two hours later. Then goes off and eats junk food the rest of the day.

Low blood sugar isn’t really a problem for me right now so I don’t have much experience with it and the numbers. But what I do know is that you can convince yourself that you don’t have a problem by not paying attention to your A1C numbers and just measuring in the morning. Especially when you are in your forties and want to deny that you may have an issue.

Just chiming in for the drift that when I’m 80 I feel very hypo.

Jeez, I can’t remember the last time I was hypo. :frowning:

I’m the opposite. I tend to have blood glucose in the 150-180 range on a normal day, even with insulin, but my H1AC is like 6 or below. Shrug

And I start to feel shaky around 100.

Note that there are TWO DIFFERENT UNITS for measuring blood glucose, and they have very different normal ranges.

In the U.S., blood glucose is measured in milligrams per deciliter (mg/dL). In this American system, the top of the normal range is about 100 mg/dL, and 101-125 mg/dL is considered pre-diabetic.

In Europe, blood glucose is measured in millimoles per liter (mmol/L, or mM). In this European system, the top of the normal range is about 5.5 mM, and 5.6-6.8 mM is considered pre-diabetic.

80 would not be low. I’ve been occasionally down in the 70’s without feeling odd.

My last A1C check was 6.2, down from nearly 9 when I was diagnosed two years ago.

As for the woman in the OP, is she gorging on ice cream at night or something? :dubious:

Well, I figured if he was saying 80 is low, he was referring to mg/dL because certainly 80mM wouldn’t be low in anyone’s reference ranges!