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What Do My Blood Test Reports Indicate?

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Posted on Sat, 19 Mar 2016
Question: I just had complete blood work done. I haven't had it done for almost 4 years before this. Everything was very good, actually improved alot because of exercise and diet etc. However, one thing concerns me, though my doctor is not at all concerned. I have never had any blood sugar deviations from norm. My fasting has been 80's to low 90's previously. A1c around 5.2 or so. This time, however, fasting was 100 and a1c 3.8. I have been dealing with chronic bladder infections since XXXXXXX and was and am on Macrobid, Ampicillin and Augmentin (the last one currently) in that order... Much of the time a1c would be testing. The day of the test, I was extremely anxious, heart pounding. I was so fearful of the results. I am rather phobic about health issues. I did read that fasting blood sugar can rise 10 to 15 pts, just from fright or flight reaction, which would put me back into my usual range. My doctor says it's normal range now but does agree that stress and the infection and meds could make it higher He's not at all concerned and says a1c is perfect. I however, read that the fasting is pre-diabetes and the a1c is too low. It doesn't even make sense to me. I am a 64 year old female. I have been told that the urinary tract infections are probably due to post menopausal changes and have been using bio identical estriol cream vaginally. I also use progesterone plus tri-estrogen cream topically. Also bio identical. I've been using the latter for about 22 years and the vaginal a few months off and on and continually for a few weeks. FYI, my cholerstoal is 179, hdl 71, ldl 97, triglycerides 126. So,how does all this sound to you? The a1c and fasting don't make sense to me... As a1c would suggest low blood sugar and fasting borderline high.
I do have diabetes in my family, my father and his brother and my maternal great-grandmother.
doctor
Answered by Dr. Dr. Abhay A Mali (51 minutes later)
Brief Answer:
Though HbA1c and FBS do not matching you should not worry.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

As you correctly mentioned Fasting blood sugar level varies with illness, anxiety, calories intake on previous day, duration of fasting.

HbA1c denote blood sugar level over period of 90 to 120 days.
HbA1c of 3.8 is absolutely within normal range for non diabetic patient (may be worrisome in patient with diabetic on medicines).

HbA1c is more reliable than Fasting blood sugar in predicting possibility of diabetes, prediabetes.
Hence you should not worry regarding these values.

As there is a strong family history of diabetes in you try maintain healthy lifestyle in the form of modest calories intake, regular exercise, keeping Body mass index within normal limit as you are following currently.
Keep eye on blood sugar level and HbA1c once in a year.

Regarding Lipid profile HDL and LDL levels are absolutely within normal limit for non-diabetic person.

Hope this helps you.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Abhay A Mali (1 hour later)
Okay that question showed up so I'll try this again.
I was wondering if ldl and hdl and also triglycerides show a movement towards diabetes. I was encouraged that my total is down a little from 4 years ago, hdl is up alot, ldl down alot. Triglycerides are higher than I would like. I would prefer under 100. I have had them in the 70's and also in the 100's. They seem quite variable. I have had more sweets since the holidays which I know can influence them. So is 126 good? And do the other numbers and their improvement indicate I'm in a good place with regards to pre-diabetes or diabetes? Also, I have been exercising on and aerobic machine, similar to elliptical which also works muscles, 5 or 6 times a week for 35 minutes with an extra 15 or so of stretches. I also aim at 7-10000 or more steps a day. I've been doing that for 18 months. I went from 155lbs to 126 (135 after holidays :(. I'm 5'5) could this account for lowered a1c? I also worry that I've read hypo can precede hyperglycemia. However I don't feel any different. I have always felt I needed to eat something before I exercise and I usually have lunch or dinner after. Sometimes I get shakey but don't know if that's nerves or blood sugar but I do eat something if I feel like that. Doesn't happen all the time.... Just sometimes. I've always eaten several meals a day (3 meals plus 2 or 3 snacks). But, as I said, none of this is new or unusual and I've had many a1cs over the years.
Does this sound okay? Should I be concerned about a lab error? Then I'd worry the a1c is actually high! Btw, my hemoglobin is 15.6 with no iron supplements and iron free vitamins. HCT is 46. Rbc 4.88....so I am most definitely not anemic but could these high numbers affect a1c either way? I know anemia does which is why I'm asking. Are these too high? Doc says they're great. I worry about everything so I think iron overload. Is that possible?
Thanks... As you can see, my mind goes everywhere!!
doctor
Answered by Dr. Dr. Abhay A Mali (13 hours later)
Brief Answer:
Please do not misinterpret your test results.

Detailed Answer:
Hi,

Regarding your lipid profile it is absolutely within normal limits.
From lipid profile one can predict development of Metabolic syndrome and not diabetes itself.
Triglycerides of 126 is considered as within normal limit for you.
Triglyceride level may fluctuate with intake of calories and fat.
High level of HDL and low level of LDL make you relatively safe against cardiovascular disease.

I really appreciate you for your exercise pattern and weight reduction achieved, keep following it.

Keep following current meal pattern three major meals with 2 to 3 snacks in between.

Possibility of Hypoglycemia is rare in your case.
In your case hypoglycemia can be develop only with unusual fasting or in severe infection or other illness.

Lab error regarding estimation of HbA1c is possible which can be easily excluded by doing another reading from NGSP (National Glycohaemoglobin Standardization Programmer) certified laboratory.

Iron overload cannot be labelled only on the basis of high Hemoglobin.
There needs to be other clinical evidence to predict possibility of iron overload.
Hb of 15.6 is absolutely normal for you.
It will not affect HbA1c reading.

Don’t apply everything you read regarding medical science to your self.

Hope this will help you to clarify your doubts.





Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Dr. Abhay A Mali (7 hours later)
Thank you, you spent a lot of time on that answer.
One quick question for clarification... So if lab error, you're saying it may be the technique or standardization method used? If I find out if I that this lab meets the standard you specified, should I leave it alone? I guess I was thinking more of a mixup or just doing it wrong or whatever. The other thing is my other Labs in the 5.2 range were all from that same lab....4 Years and more ago
doctor
Answered by Dr. Dr. Abhay A Mali (5 minutes later)
Brief Answer:
Leave it alone.

Detailed Answer:
Almost all lab follows standardized method for doing HbA1c.
You should accept the the test result and leave it alone as all test results are from same lab.

Hope this helps you.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

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What Do My Blood Test Reports Indicate?

Brief Answer: Though HbA1c and FBS do not matching you should not worry. Detailed Answer: Hi, Thanks for your question. Noted your concern. As you correctly mentioned Fasting blood sugar level varies with illness, anxiety, calories intake on previous day, duration of fasting. HbA1c denote blood sugar level over period of 90 to 120 days. HbA1c of 3.8 is absolutely within normal range for non diabetic patient (may be worrisome in patient with diabetic on medicines). HbA1c is more reliable than Fasting blood sugar in predicting possibility of diabetes, prediabetes. Hence you should not worry regarding these values. As there is a strong family history of diabetes in you try maintain healthy lifestyle in the form of modest calories intake, regular exercise, keeping Body mass index within normal limit as you are following currently. Keep eye on blood sugar level and HbA1c once in a year. Regarding Lipid profile HDL and LDL levels are absolutely within normal limit for non-diabetic person. Hope this helps you. Regards, Dr. Abhay Mali. Diabetologist.