Question: I am 64, female and was diagnosed with T2 diabetes about four years ago. I have been controlling this by diet, no drugs. My annual Hb1AC tests have been around the 48-52 mark until the most recent one which was around 80! My first reaction is to have the test re-done – it’s quite a leap. All the other tests I had done at the same time - cholesterol, liver/kidney function - were normal and my blood pressure is around 130/70, normal for me.

What puzzles me is that nothing has changed over (a) the last year and (b) the previous years. My weight has remained constant at 100kg, overweight I know for a height of 163cm but keeping a food diary for a month showed an average of 1600 calories/day and I am eating more or less the same types of food. Level of exercise is also the same - I know more would help with weight loss.

The only thing I can think of is that following diagnosis of a hiatus hernia at the beginning of this year I have been taking 20mg Omeprazole daily.

I have made an appointment to see my GP to discuss this but another viewpoint would be helpful.

Thank you for your reply XXXXXXX it was really helpful

(1) iron deficiency anemia – pink nailbeds and under eyelids, so probably not.

(2) pernicious anemia- an illness where there is a lack of vitamin b12 due to poor absorption of the vitamin in the stomach – I’m not a vegetarian/vegan so plenty of meat, fish, dairy and eggs in my diet. However, looking this up I’ve found that long term use of proton pump inhibitors (such as Omeprazole) “can worsen deficiency because gastric acid is needed to release vitamin B12 bound to proteins in food”. I think this is worth following up – I don’t have any other symptoms of pernicious anemia but low vitamin B12 could be a factor.

(3) hypothyroidism- low levels of thyroid hormone –I am hypothyroid, diagnosed about 15 years and controlled by 100micrograms Levothyroxine. Should have been part of panel of blood tests which showed up the high Hb1AC but diabetes nurse didn’t mention result (they are a bit single-minded!) – will check the result when I see my GP.

(4) very large doses of aspirin or chronic opiate use – I have taken aspirin for general pain relief within the last 3 or 4 months but we’re talking about 650mg a couple of times in 24 hours for not more than a couple of days – not very large in my book. No opiate use at all.

This will help me when I see my GP. I’m also going to do another food diary to check for any “hidden” sugars and carbs and that my animal protein (vitamin B12) input is what I think it is.

So, no follow-up question unless you want to comment on any of the above and once again, many thanks for your input.

I thought you’d like to know I’ve now seen my GP and will be re-doing the Hb1AC test, also the thyroid function test as this also came back with an odd result – TSH apparently undetectable! All part of the “fun” of being hormonally challenged ;) .

Thanks again