Is It Possible To Have A Normal A1c But Have Diabetes Symptoms?
I am just curious if someone is experiencing a roller coaster of blood sugar readings, small ketones, and symptoms of diabetes if their A1C could still be normal?
TheOrange Evil - Yes, it's possible. I know a few people who had technically normal A1cs who were then diagnosed with diabetes after an Oral Glucose Tolerance Test.
An A1c, as you know, is just an average of blood sugar levels over the past 90 days. If you are spiking very high and then crashing, your A1c may not reflect the highs. If you are spiking very high, but your blood sugar doesn't stay high for very long, the effect might be the same. If you're having spikes, but they're not that often, the A1c probably wouldn't show that you are experiencing diabetic blood sugar sometimes. Also, if you're Type 1 and only recently has your insulin production ceased/been diminished, your A1c wouldn't necessarily reflect how high your blood sugar is. The A1c tends to be weighted toward most recent blood sugar, but the A1c could appear more borderline in people whose high blood sugar is recent.
Trace ketones can be caused by numerous factors, like a low-carbohydrate diet, but if they're occurring in the presence of diabetic blood sugar, then that can quickly become quite serious. The A1c is a valuable tool, but like any diabetes test, it has its limitations. If my blood sugar were testing in diabetic range, I had ketones, and my A1c were normal, I'd forget the A1c and ask to be tested for diabetes using other available methods.
John W - The H1A1C is a test of the average glucose level that a blood cell has been exposed to, blood cells live for 90 to 120 days but new cells are manufacture constantly so the average age of the blood cells in a sample is 30 to 40 days therefore the test gives you an average over the last 30 to 40 days not 90 days as the math illiterate may think, but 30 to 40 days.
Yes it is possible to have a normal H1A1C and have diabetes, the H1A1C is the average and diabetes is a regulation problem. My own H1A1C was 5.5% prior to being hospitalized with high glucose levels ( literally prior ) and has been 5.5% ever since though I've been first on oral meds for several months and then on basal insulin as the oral meds were leading to hypoglycemia. I've even skipped the insulin for weeks at a time and the H1A1C doesn't rise much above 5.5%, perhaps to 5.6 or 5.7%. They even did a full CBC to test the ages of the cells in my blood because of the consistent H1A1C levels. If you are diabetic and have normal H1A1C levels but still have hyperglycemia, it means you also have enough low glucose level periods to average the high ones out in the average. The average of 5, 5, and 5 is 5 but the average of 4, 4, and 7 is also 5.
Small ketones would be from going through periods of time where there isn't enough insulin for your cells to use the glucose in the blood so they used fats and proteins instead thereby producing the ketones. The ketones are not necessarily from high glucose levels but a lack of insulin would also result in high glucose levels even if the only source of glucose was the liver as opposed to diet.
It isn't the combination of ketones with high glucose levels that's dangerous, it's just that the ketones can build up and can acidify the blood if the ketones are being produced fast enough. The ketone production just coincides with glucose retention with diabetics. It's possible to suffer from ketoacidosis without high glucose levels, that's just not common as the liver also produces glucose hence even on a low carb diet such as the Atkins diet, you're not completely without glucose. It's just that without insulin, the cells must rely entirely on fats and proteins for fuel hence the ketone production is at a peak, far greater than the kidneys can handle.
maria - As a diabetic, you may always have a test named Hemoglobin A1c(HbA1c) or A1c test, but perhaps you haven’t known what it exactly means and why you should do this test. In fact, the HbA1C test is one of the best techniques to test whether Diabetes is under control at present. You can know what your average of blood glucose level has been during the past three months. Some people may have Diabetes Mellitus for many years before they are diagnosed because symptom of this disease is unobvious at the beginning especially for Type 2 Diabetes. Once the symptoms begin to develop, they vary but the most common two are increased thirst and frequent urination. Because high blood sugar will absorb more water into your blood from the tissues, you will feel dehydrated and always want to drink a lot of water, which will then lead to frequent urination.
Other warning signs of Diabetes:
Weight gain or weight loss. Poor vision. Increased fatigue.
I am just curious if someone is experiencing a roller coaster of blood sugar readings, small ketones, and symptoms of diabetes if their A1C could still be normal?
TheOrange Evil - Yes, it's possible. I know a few people who had technically normal A1cs who were then diagnosed with diabetes after an Oral Glucose Tolerance Test.
ReplyDeleteAn A1c, as you know, is just an average of blood sugar levels over the past 90 days. If you are spiking very high and then crashing, your A1c may not reflect the highs. If you are spiking very high, but your blood sugar doesn't stay high for very long, the effect might be the same. If you're having spikes, but they're not that often, the A1c probably wouldn't show that you are experiencing diabetic blood sugar sometimes. Also, if you're Type 1 and only recently has your insulin production ceased/been diminished, your A1c wouldn't necessarily reflect how high your blood sugar is. The A1c tends to be weighted toward most recent blood sugar, but the A1c could appear more borderline in people whose high blood sugar is recent.
Trace ketones can be caused by numerous factors, like a low-carbohydrate diet, but if they're occurring in the presence of diabetic blood sugar, then that can quickly become quite serious. The A1c is a valuable tool, but like any diabetes test, it has its limitations. If my blood sugar were testing in diabetic range, I had ketones, and my A1c were normal, I'd forget the A1c and ask to be tested for diabetes using other available methods.
John W - The H1A1C is a test of the average glucose level that a blood cell has been exposed to, blood cells live for 90 to 120 days but new cells are manufacture constantly so the average age of the blood cells in a sample is 30 to 40 days therefore the test gives you an average over the last 30 to 40 days not 90 days as the math illiterate may think, but 30 to 40 days.
ReplyDeleteYes it is possible to have a normal H1A1C and have diabetes, the H1A1C is the average and diabetes is a regulation problem. My own H1A1C was 5.5% prior to being hospitalized with high glucose levels ( literally prior ) and has been 5.5% ever since though I've been first on oral meds for several months and then on basal insulin as the oral meds were leading to hypoglycemia. I've even skipped the insulin for weeks at a time and the H1A1C doesn't rise much above 5.5%, perhaps to 5.6 or 5.7%. They even did a full CBC to test the ages of the cells in my blood because of the consistent H1A1C levels. If you are diabetic and have normal H1A1C levels but still have hyperglycemia, it means you also have enough low glucose level periods to average the high ones out in the average. The average of 5, 5, and 5 is 5 but the average of 4, 4, and 7 is also 5.
Small ketones would be from going through periods of time where there isn't enough insulin for your cells to use the glucose in the blood so they used fats and proteins instead thereby producing the ketones. The ketones are not necessarily from high glucose levels but a lack of insulin would also result in high glucose levels even if the only source of glucose was the liver as opposed to diet.
It isn't the combination of ketones with high glucose levels that's dangerous, it's just that the ketones can build up and can acidify the blood if the ketones are being produced fast enough. The ketone production just coincides with glucose retention with diabetics. It's possible to suffer from ketoacidosis without high glucose levels, that's just not common as the liver also produces glucose hence even on a low carb diet such as the Atkins diet, you're not completely without glucose. It's just that without insulin, the cells must rely entirely on fats and proteins for fuel hence the ketone production is at a peak, far greater than the kidneys can handle.
maria - As a diabetic, you may always have a test named Hemoglobin A1c(HbA1c) or A1c test, but perhaps you haven’t known what it exactly means and why you should do this test. In fact, the HbA1C test is one of the best techniques to test whether Diabetes is under control at present. You can know what your average of blood glucose level has been during the past three months.
ReplyDeleteSome people may have Diabetes Mellitus for many years before they are diagnosed because symptom of this disease is unobvious at the beginning especially for Type 2 Diabetes. Once the symptoms begin to develop, they vary but the most common two are increased thirst and frequent urination. Because high blood sugar will absorb more water into your blood from the tissues, you will feel dehydrated and always want to drink a lot of water, which will then lead to frequent urination.
Other warning signs of Diabetes:
Weight gain or weight loss.
Poor vision.
Increased fatigue.