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What causes elevated Hba1c levels despite following a strict diet?

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Posted on Thu, 5 May 2016
Question: In the month of 15 Dec15, when I did my regular checkup, found that my glucose levels are normal and Hba1c was 6.1.
After discussing with dietician, restricted my sugar and carbohydrate intake. Also I started 30 minutes walk.
When I had my checkup once again recently on 24- feb, found that glucose levels are normal but my hba1c increased to 7.1.
Can Hba1c levels increase so fast even after following diet when it's an average of 3 months ?
is there a possibility that the levels have increased due to some other reason temporarily.
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Answered by Dr. Abhay A Mali (2 hours later)
Brief Answer:
You need further evaluation.

Detailed Answer:
Hi Mr. XXXXXXX

Thanks for your question.
Noted your concern.

HbA1c should be correlated with blood sugar levels.
But it may not be always possible to check blood sugar at different times of the day so one can miss actual high readings as we check fasting and post-prandial blood sugar levels usually.

In your case I may suggest to repeat HbA1c from good lab (NGSP- National Glycohemoglobin Standardization Program certified).
If it is still high then your can do AGP (Ambulatory Glucose Profile) or CGMS (Continous Glucose Monitoring System) though AGP is more practical.

HbA1c more than 6.5 confirms the diagnosis of diabetes and requires treatment.

Coming to your actual questions-
HbA1c usually may not fluctuate so high without changes in blood sugar levles over a short period of 3 months.

Whatever the reason for HbA1c of 7.1 it should be reflected by your blood sugar levels.

Even with HbA1c of 6.1 (which denote pre-diabetes state) I may have suggested Tab Metformin along with life style modification if there is-
- Obesity or overweight (BMI more than 25)
- Family history of Type 2 Diabetes.
- Clinical signs of insulin resistance.

Hope this helps you.

Regards,
Dr. Abhay Mali.
Diabetologist.
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

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What causes elevated Hba1c levels despite following a strict diet?

Brief Answer: You need further evaluation. Detailed Answer: Hi Mr. XXXXXXX Thanks for your question. Noted your concern. HbA1c should be correlated with blood sugar levels. But it may not be always possible to check blood sugar at different times of the day so one can miss actual high readings as we check fasting and post-prandial blood sugar levels usually. In your case I may suggest to repeat HbA1c from good lab (NGSP- National Glycohemoglobin Standardization Program certified). If it is still high then your can do AGP (Ambulatory Glucose Profile) or CGMS (Continous Glucose Monitoring System) though AGP is more practical. HbA1c more than 6.5 confirms the diagnosis of diabetes and requires treatment. Coming to your actual questions- HbA1c usually may not fluctuate so high without changes in blood sugar levles over a short period of 3 months. Whatever the reason for HbA1c of 7.1 it should be reflected by your blood sugar levels. Even with HbA1c of 6.1 (which denote pre-diabetes state) I may have suggested Tab Metformin along with life style modification if there is- - Obesity or overweight (BMI more than 25) - Family history of Type 2 Diabetes. - Clinical signs of insulin resistance. Hope this helps you. Regards, Dr. Abhay Mali. Diabetologist.