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Test Results Showed Hba1c Was 5.2, Fasting Blood Sugar 70 And Mean Glucose EBT 103. Does This Indicate Diabetes?

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Posted on Thu, 4 Jul 2013
Question: On Apr 20th 2013, I had my annual physical:
CMP with eFGR for Glucose was 105

On Apr 25th 2013, I had more tests done related to Glucose:
Hba1c was 5.2
Fasting blood sugar test was 70
Mean Glucose EBT ( I think it is EBT) was 103

Does this point to pre-diabetes?
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
This is not tantamount to Pre diabetes. The following constitute the latest cut offs for diagnosing glucose anomalies : Normal fasting glucose is 70-99 mg/dl; 100-125 is impaired fasting glucose also called Pre diabetes. Anything greater than or equal to 126 after 8 hours of overnight starvation is compatible with diabetes. If the oral glucose tolerance test is performed then normal glucose reading is less than 140 at the two hour XXXXXXX 140-199 is impaired glucose tolerance which is again consistent with Pre diabetes. Anything greater than or equal to 200 qualifies as diabetes. Recently A1c became acceptable as a screening tool for diabetes and pre diabetes. Less than 5.7 is normal. 5.7 to 6.4 is Pre diabetes. 6.5 and higher is diabetes. For more information peruse this web link WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (18 minutes later)
So, what can we infer from the fact that CMP Glucose is above the normal range, but a1c & FBS are both normal.
And what does the Mean Glucose EBT ( I think it is EBT) = 103 imply?
Does CMP values go up with age?
doctor
Answered by Dr. Shehzad Topiwala (3 hours later)
There is no such thing as CMP glucose. Even the term EBT glucose is new to me. It seems to suggest the 3 month averaged glucose value as indicated by the A1c. It is well within normal limits
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (8 hours later)
What I meant by the CMP Glucose was the reading that is part of the Complete Metabolic Panel...that was 105.
doctor
Answered by Dr. Shehzad Topiwala (3 hours later)
Was it fasting ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Yes, all my testing was done when I was fasting.
doctor
Answered by Dr. Shehzad Topiwala (55 minutes later)
so it seems on one occasion your fasting glucose was 70 and another time it was 105. I suggest checking a third time to be sure.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (16 minutes later)
I think I'm not being clear enough.
The first time my Glucose result was 105 as part of the CMP test.

Since it was above the normal range, I followed it up with a Hba1c (the result was 5.2) and Fasting Plasma Glucose(FPG) (the result was 70). There is one more reading called as Mean Glucose Est (which is 103), which I think is the same as Estmated Average Glucose and co-relates to the Hba1c reading.
doctor
Answered by Dr. Shehzad Topiwala (35 minutes later)
Yes I got it. It was 70 on one occasion and 105 on another. Both were fasting. Owing to this discrepancy, it may be worth checking a third time to eliminate doubt in your mind.
Although I am fairly convinced there is no glucose anomaly because the A1c is well within normal limits. I am aware of the shortcomings of the A1c test but by and large it is pretty reliable
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (36 minutes later)
Thank you for your patience.
Please answer the 4 questions below.
It will help me understand the situation better.

The reason for all of these questions is b'coz of what and how my PCP explained the readings:
Assumptions:
------------
**** All tests were fasting tests taken first thing in the morning around 10 am.
(1) Mean Glucose Est is the same as Estimated Average Glucose -- Is this true?
(2) Test name of "Glucose" in the report means a Fasting Plasma Glucose Test (FPG). It was done as part of the Hba1c test. -- Is this true?

According to my PCP,
(1) the CMP Glucose reading of 105 (first time testing) and the Mean Glucose Est of 103 (second time testing) are one and the same.

---But, from my research, what I have found is this:
Hba1c readings can also be equated to more easily understandable numbers, in the form of Mean glucose Est or Estimated Average Glucose.
In other words, Hba1c is the same as Mean glucose Est or Estimated Average Glucose.
Hba1c, btw, was 5.2.

So, is my PMP wrong in telling that the CMP-Glucose and Mean glucose Est/Estimated Average Glucose are the same?

(2) the CMP Glucose reading of 105 (first time testing) and the Fasting Plasma Glucose reading of 70 (second time testing) are 2 different tests and are tested differently.
--- In my report for the second time testing, the test name is "Glucose". This, my PCP tells is a FPG test. Is this correct?
doctor
Answered by Dr. Shehzad Topiwala (7 hours later)
1) Mean Glucose Est is the same as Estimated Average Glucose -- Is this true?

yes


(2) Test name of "Glucose" in the report means a Fasting Plasma Glucose Test (FPG). It was done as part of the Hba1c test. -- Is this true?

yes

According to my PCP,
(1) the CMP Glucose reading of 105 (first time testing) and the Mean Glucose Est of 103 (second time testing) are one and the same.

---But, from my research, what I have found is this:
Hba1c readings can also be equated to more easily understandable numbers, in the form of Mean glucose Est or Estimated Average Glucose.
In other words, Hba1c is the same as Mean glucose Est or Estimated Average Glucose.
Hba1c, btw, was 5.2.

yes correct


So, is my PMP wrong in telling that the CMP-Glucose and Mean glucose Est/Estimated Average Glucose are the same?

(2) the CMP Glucose reading of 105 (first time testing) and the Fasting Plasma Glucose reading of 70 (second time testing) are 2 different tests and are tested differently.
--- In my report for the second time testing, the test name is "Glucose". This, my PCP tells is a FPG test. Is this correct?

yes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (9 hours later)
So, my PCP telling that the CMP-Glucose and Mean glucose Est/Estimated Average Glucose are the same, is wrong?
doctor
Answered by Dr. Shehzad Topiwala (11 hours later)
Let us not focus on who is right and wrong. There can be misunderstandings and miscommunications. You are now more informed than you were before. That si what counts. This is the objective at healthcare magic....to empower you with knowledge of your health condition
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (39 hours later)
Hi Doc,
I had repeat fasting blood work done on Thu of last week:
Here are the results:
Comprehensive Metabolic Panel with eGFR - Glucose - 89 (this has gone down from 105)
Hba1c - 5.5 (this has gone up from 5.2)
Triglycerides - 73 (this has gone dowm from 179)

Am I at risk of diabetes or pre-diabetes?

Does Hba1c levels stay up once they are up or can they go down with diet and exercise?
I do consume alchohol (used to drink scotch..but have stopped and only consume wine now). It is once a week. Do I need to stop alchohol completely?
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Forgot to add:
(1) My FPG was also 89
(2) I take abt 3-4 drinks a week.
(3) I have lost abt 10 pounds since the first blood test results came back in Apr 2013.

Can you please comment on my last blood work results done as of last week?
doctor
Answered by Dr. Shehzad Topiwala (2 days later)
I am sorry for the late reply.

The current laboratory values are in acceptable limits. It doesn't suggest prediabetes.

Hba1c is an average of 3 months blood sugar. Since the value is an average estimate, it would remain at fairly constant level unless there are gross sugar fluctuations (as in diabetes). Your value is in normal limits (below 5.6%) and that is acceptable.

Triglyceride value under 150 is normal.

As liver is an important organ that regulates lipid metabolism, excess alcohol affects both liver as well as lipid levels. So alcohol consumption is accepted unless it is in moderation.

Hope I have clarified all your doubts.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (5 hours later)
Again, thank you for your patience and time in answering my questions.
Two final questions:
1)
Some people say the Hba1c normal range is bet 4-6%.
You have mentioned it to be 5.6.
Since, my last a1c is 5.5, I feel it is too close to comfort.
Or, are you saying that since it is a 3 month estimated average, it is bound to go up and down?
2)
Next time when i get tested, if the FPG is normal, but the a1c is above 5.6, does that indicate pre-diabetes?
doctor
Answered by Dr. Shehzad Topiwala (19 hours later)
The latest Hba1c cut-off value to suspect prediabetes is 5.6%. And yes, this is an average estimate and the values could fluctuate marginally.

If Hba1c values go beyond cut-off values, it might be worthwhile to consider glucose tolerance test. It is a sequential blood sugar monitoring done in a fasting as well as one hour and 2 hours after 100mg of oral glucose. That should clarify any doubts regarding prediabetes / diabetes.

Hope I have addressed all your concerns.
If you do not need further elaboration, please close this discussion.

Regards
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

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

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Practicing since :2001

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Test Results Showed Hba1c Was 5.2, Fasting Blood Sugar 70 And Mean Glucose EBT 103. Does This Indicate Diabetes?

This is not tantamount to Pre diabetes. The following constitute the latest cut offs for diagnosing glucose anomalies : Normal fasting glucose is 70-99 mg/dl; 100-125 is impaired fasting glucose also called Pre diabetes. Anything greater than or equal to 126 after 8 hours of overnight starvation is compatible with diabetes. If the oral glucose tolerance test is performed then normal glucose reading is less than 140 at the two hour XXXXXXX 140-199 is impaired glucose tolerance which is again consistent with Pre diabetes. Anything greater than or equal to 200 qualifies as diabetes. Recently A1c became acceptable as a screening tool for diabetes and pre diabetes. Less than 5.7 is normal. 5.7 to 6.4 is Pre diabetes. 6.5 and higher is diabetes. For more information peruse this web link WWW.WWWW.WW