HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Do These HbA1c Levels Indicate?

Posted on Mon, 31 Aug 2015

Question: Hi,
I have a cataract formed recently in the left eye, starting one month ago. It was of a type that could be related to diabetes (posterior subscapsular). I have done the full blood tests to check for diabetes with following results:

HbA1c- NGSP = 5.2%
HbA1c-IFCC of 33 mmol/mol

Further, the plasma glucose (random) three hours after eating a beef meat pie was 4.7 mmol/L and the fasting plasma glucose about 18 hours after last meal was 4.8 mmol/L.

Are these blood sugar levels enough to rule out diabetes or pre-diabetes with a very high level of certainty? Is pre-diabetes still possible or Type 1 diabetes mellitus?

Also, I did the HbA1c after having done a blood test with 4 test tubes of blood taken about one week earlier and I'm not sure if that would affect the results for that test.

Thanks,
Regards.

Answered by Dr. Shehzad Topiwala (49 minutes later)

Brief Answer:
Diabetes

Detailed Answer:
It is very likely you have normal glucose tolerance because you have undertaken two of three types of tests for diagnosing diabetes/pre diabetes.

Both your HbA1c and fasting glucoses after fasting overnight are normal. Yes I have noted the 18 hours fasting and the recommendation is actually only 8 to 14 hours, but even then it is fairly acceptable.

(The glucose value after 3 hours of the beef pie is hard to standardize so it is not worth discussing that)

However, the gold standard to ascertain the possibility of diabetes/ pre diabetes is the Oral Glucose Tolerance Test. The standard way to perform it is as follows:
OGTT PROTOCOL FOR NON PREGNANT ADULTS TO SCREEN FOR DIABETES

1 OGTT = ORAL GLUCOSE TOLERANCE TEST

2 PLEASE FAST OVERNIGHT FOR 8 TO 14 HOURS

3 IT IS ALL RIGHT TO DRINK WATER AND TAKE ALL/ANY OF YOUR PILLS BEFORE THE TEST IN THE MORNING

4 DO NOT RESTRICT YOUR USUAL DIETARY CARBOHYDRATE INTAKE DURING THE 3 DAYS PRECEDING THE TEST.

5 AFTER THE FIRST BLOOD SAMPLE IS TAKEN FOR BLOOD GLUCOSE AT 0 HOURS, YOU WILL BE OFFERED A GLUCOSE DRINK THAT CONTAINS 75 GRAMS OF GLUCOSE IN WATER. PLEASE DRINK THAT WITHIN A FEW MINUTES AND BE SEATED FOR 2 HOURS.

6 DURING THESE 2 HOURS PLEASE DO NOT EAT OR DRINK ANYTHING NOR SHOULD YOU WALK AROUND. WATER IS OK. YOU MAY READ SOMETHING IF YOU WISH, WHILE SEATED

7 EXACTLY 120 MINUTES AFTER YOUR FIRST BLOOD SAMPLE WAS TAKEN, YOU WILL BE CALLED FOR A SECOND BLOOD DRAW FOR CHECKING BLOOD GLUCOSE LEVELS

8 THIS CONCLUDES THE TEST

9 PLEASE NOTE THERE IS NO NEED FOR ANY URINE SAMPLE, EVEN IF THE LABORATORY INSISTS ON IT

10 FURTHER, THERE IS NO NEED TO HAVE BLOOD SAMPLES TAKEN MORE THAN TWICE AT THE ABOVE RECOMMENDED PRECISE TIMES. REFUSE SUCH INCORRECT TESTING EVEN IF THE LABORATORY PERSONNEL INSIST

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (25 hours later)

Thanks Dr. Shehzad,

I will also look at the OGTT.

Is it possible to have diabetic conditions such as cataracts (which are caused by the body condition being similar to that of a diabetic) even though the tests do not confirm diabetes?

I also have the yeast growing around the glans penis. It is a condition normally only found in diabetics.

Thanks,
Regards.

Answered by Dr. Shehzad Topiwala (19 hours later)

Brief Answer:
Follow up

Detailed Answer:
No it is not possible to ascribe the development of cataracts to diabetes when the blood tests show no evidence of diabetes.

It is true that yeast infections around glans penis are seen more commonly in diabetics, but it is not exclusive to them. Those without diabetes can also experience this problem.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar