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What Does The HbA1c 4.6 To 6.2 Indicate?
Question: I talked to someone last year because my a1c was 4 with fbs of 100. Your doctor and mine said that was fine because you go by a1c. Now a1c is 4.4, fbs is 117 so I'm panicked. But my doctor isn't at all. He said the a1c shows all is fine. Other blood work normal... Liver, kidneys, lipids etc. Hemoglobin 15.4. I just keep wondering of anything could be giving a false low a1c and I really have pre-diabetes. Doctor says no. Just says I can eat less carbs especially at night of I want that fasting number to come down... But he's still unconcerned. I am 66 year old woman... So post menopausal.
Brief Answer:
A bit more details needed;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern carefully!
Before giving you a more detailed information regarding your query, would you please inform about the normal ranges of HbA1c at your laboratory?
Normally they are 4-5.6%. Is it the same there also?
It'll be a pleasure to help you further.
Awaiting...
Kind regards,
Dr.Mirjeta
A bit more details needed;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern carefully!
Before giving you a more detailed information regarding your query, would you please inform about the normal ranges of HbA1c at your laboratory?
Normally they are 4-5.6%. Is it the same there also?
It'll be a pleasure to help you further.
Awaiting...
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
4.6 to 6.2 but my doctor still says mine is good
Brief Answer:
About HbA1c level;
Detailed Answer:
Welcome back!
Your HbA1c result is suggestive for episodes of hypoglicemia (blood glucose under 70 mg/dl). As fasting blood sugar is higher than normal, than HbA1c should be at the upper normal level or above it.
The fact that it is still under the normal ranges (despite high fasting blood sugar) is highly suggestive for low blood sugar during the day that are more harmful than a slightly elevated fbs.
The episodes of hypoglicemia are manifested with; fatigue, feeling hungry, tremor, stomach ache ect. At this moment you should check the blood sugar to confirm hypoglicemia.
There is a tendency for impaired fasting glucose tolerance, but it should be confirmed twice to make a diagnosis.
So keep monitoring the glucose level and keep us in touch.
Will be a pleasure to help you further.
Best wishes,
Dr.Mirjeta
About HbA1c level;
Detailed Answer:
Welcome back!
Your HbA1c result is suggestive for episodes of hypoglicemia (blood glucose under 70 mg/dl). As fasting blood sugar is higher than normal, than HbA1c should be at the upper normal level or above it.
The fact that it is still under the normal ranges (despite high fasting blood sugar) is highly suggestive for low blood sugar during the day that are more harmful than a slightly elevated fbs.
The episodes of hypoglicemia are manifested with; fatigue, feeling hungry, tremor, stomach ache ect. At this moment you should check the blood sugar to confirm hypoglicemia.
There is a tendency for impaired fasting glucose tolerance, but it should be confirmed twice to make a diagnosis.
So keep monitoring the glucose level and keep us in touch.
Will be a pleasure to help you further.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Nagamani Ng
My doctor said I didn't need to test myself as he wasn't concerned with the fbs because of the good a1c. He said that the fbs is not that high and it's just a moment in time and could be stress. I'm super stressed now. It's early morning and I couldn't sleep all night because of fear of this. Honestly, you kind of made me more scared.
Brief Answer:
There is no need to worry;
Detailed Answer:
Hi again,
As i mentioned before, your fbs can not be considered normal, but it should be confirmed twice.
HbA1c is lower than normal, that can be explained only with episodes of hypoglicemia during the day.
There is nothing to be scared for, the question is to adjust the diet properly during the day, so you can avoid hypos/ hyper, improve Hba1c and your quality of life.
Best wishes,
Dr.Mirjeta
There is no need to worry;
Detailed Answer:
Hi again,
As i mentioned before, your fbs can not be considered normal, but it should be confirmed twice.
HbA1c is lower than normal, that can be explained only with episodes of hypoglicemia during the day.
There is nothing to be scared for, the question is to adjust the diet properly during the day, so you can avoid hypos/ hyper, improve Hba1c and your quality of life.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Isn't it true that stress can temporarily raise fbs? How do I change diet? I already exercise. So what are the suggestions for diet? My blood lipids are good so there doesn't seem to be any other signs of metabolic syndrome... I'm just so confused. Am I suppose to be self testing glucose?
Brief Answer:
Some more information;
Detailed Answer:
Hi again,
You didn't mention if you have signs or symptoms of hypoglycemia during the day ( especially after eating a meal rich in carbohydrates). The presence of hypoglycemia is presumed by the low HbA1c but it should be confirmed by checking the blood sugar during these episodes.
If reactive hypoglycemia is confirmed, the diet consists in:
-Eating frequently: Breakfast, lunch, and dinner are important, but snacks are equally as important. Have a mid-morning snack, a midafternoon snack, and a bedtime snack.
-Protein and fat – Be sure to include a bit of protein and healthy fat with every meal and snack. Protein and fat are slower to pass through the digestive tract causing sugar to be released into the bloodstream more slowly. Good choices include nuts, meat, beans, and dairy foods for protein, and nuts, olive oil, coconut, yogurt, and avocado for fat.
-Glycemic Index – Familiarize yourself with the glycemic index and avoid foods with an index of 60 or higher. This includes all refined sugars, candies, desserts, white bread, soda, fruit drinks, and more.
-Eliminating alcohol and caffeine
The above-mentioned suggestions will help to prevent Diabetes too.
No need to keep monitoring your blood sugar continuously.
Just check it once again fasting and after meals or during the day if you experience episodes of hypoglycemia.
Best wishes,
Dr.Mirjeta
Some more information;
Detailed Answer:
Hi again,
You didn't mention if you have signs or symptoms of hypoglycemia during the day ( especially after eating a meal rich in carbohydrates). The presence of hypoglycemia is presumed by the low HbA1c but it should be confirmed by checking the blood sugar during these episodes.
If reactive hypoglycemia is confirmed, the diet consists in:
-Eating frequently: Breakfast, lunch, and dinner are important, but snacks are equally as important. Have a mid-morning snack, a midafternoon snack, and a bedtime snack.
-Protein and fat – Be sure to include a bit of protein and healthy fat with every meal and snack. Protein and fat are slower to pass through the digestive tract causing sugar to be released into the bloodstream more slowly. Good choices include nuts, meat, beans, and dairy foods for protein, and nuts, olive oil, coconut, yogurt, and avocado for fat.
-Glycemic Index – Familiarize yourself with the glycemic index and avoid foods with an index of 60 or higher. This includes all refined sugars, candies, desserts, white bread, soda, fruit drinks, and more.
-Eliminating alcohol and caffeine
The above-mentioned suggestions will help to prevent Diabetes too.
No need to keep monitoring your blood sugar continuously.
Just check it once again fasting and after meals or during the day if you experience episodes of hypoglycemia.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
My whole life I have had what myself and doctors have assumed was mild blood sugar drops but never clear whether that was true or stress related. Nothing has exacerbated before this reading. The feelings are mild shakiness and some sweating and feeling of weakness though no real weakness or inability to function. Usually would happen with stress, heat or need to eat. Eating a piece of cheese or something usually takes care of it. It has also happened mildly if I forget a snack before exercising. However a quick jog over to the crackers and a couple will do it. Could be in my head, lol, since it doesn't last long. This is far from a daily thing. It's occasional. I've always tried to balance carbs with protein. It also isn't related to high carb meal. I can eat a horribly high carb meal and that doesn't happen at all.
My typical breakfast is oatmeal with stevia, ginger and cinnamon and sometimes a tiny bit of butter. I also have non fat plain Greek yogurt with blueberries (half a cup each). I checked the carbs and glycemic index this morning. Seemed good. But now I'm freaking out about what I can eat for lunch and dinner. I try to have a snack in between with some protein (half a low carb, high protein bar or piece of cheese etc) But can I have a sandwich with whole grain bread? Is pizza out forever? And what about small servings of ice cream?
My typical breakfast is oatmeal with stevia, ginger and cinnamon and sometimes a tiny bit of butter. I also have non fat plain Greek yogurt with blueberries (half a cup each). I checked the carbs and glycemic index this morning. Seemed good. But now I'm freaking out about what I can eat for lunch and dinner. I try to have a snack in between with some protein (half a low carb, high protein bar or piece of cheese etc) But can I have a sandwich with whole grain bread? Is pizza out forever? And what about small servings of ice cream?
Brief Answer:
About daily diet:
Detailed Answer:
Hi again,
I do not think these symptoms are psychological as your low HbA1c suggests events of low blood sugar that you should try to avoid and not to treat them after they happen.
The diet you described seems healthy enough. Try to keep the same regime for breakfast, add a fruit to the morning and afternoon snacks (not a sandwich).
Lunch should be rich in protein ( fish, poultry, meat) and dinner reduced in portion and carbs.
A sandwich with a whole grain bread may be an alternative for lunch twice a week.
Small service of ice cream before physical activity and about the pizza I prefer to avoid it.
Wish you good health!
Dr.Mirjeta
About daily diet:
Detailed Answer:
Hi again,
I do not think these symptoms are psychological as your low HbA1c suggests events of low blood sugar that you should try to avoid and not to treat them after they happen.
The diet you described seems healthy enough. Try to keep the same regime for breakfast, add a fruit to the morning and afternoon snacks (not a sandwich).
Lunch should be rich in protein ( fish, poultry, meat) and dinner reduced in portion and carbs.
A sandwich with a whole grain bread may be an alternative for lunch twice a week.
Small service of ice cream before physical activity and about the pizza I prefer to avoid it.
Wish you good health!
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
So based in my numbers now, would you classify as pre-diabetes, hypoglycemia or healthy with episodes of hypoglycemia? Be careful because I'm super obsessed and worried about physical stuff. Thanks
Brief Answer:
About your diagnosis:
Detailed Answer:
As I mentioned before there should be 2 fbs values over 105 mg/dl to be called prediabetes or impaired fasting glucose intolerance. If it still persists high, yes it is impaired fasting glucose intolerance or preDiabetes.
A low HbA1c in a person without anemia is due to hypoglycemia.
So, reactive hypoglycemia (as it does not happen fasting) should be also present and HbA1c is not reliable in these cases to diagnose prediabetes or Diabetes but only glucose levels.
So, i would say you should have reactive hypoglicemia and impaired fasting glucose intolerance to be confirmed.
This is all what your HbA1c and fbs 117 mg/ dl suggest.
Best wishes,
Dr.Mirjeta
About your diagnosis:
Detailed Answer:
As I mentioned before there should be 2 fbs values over 105 mg/dl to be called prediabetes or impaired fasting glucose intolerance. If it still persists high, yes it is impaired fasting glucose intolerance or preDiabetes.
A low HbA1c in a person without anemia is due to hypoglycemia.
So, reactive hypoglycemia (as it does not happen fasting) should be also present and HbA1c is not reliable in these cases to diagnose prediabetes or Diabetes but only glucose levels.
So, i would say you should have reactive hypoglicemia and impaired fasting glucose intolerance to be confirmed.
This is all what your HbA1c and fbs 117 mg/ dl suggest.
Best wishes,
Dr.Mirjeta
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Above answer was peer-reviewed by :
Dr. Kampana
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