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A1c does not match blood glucose levels

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Posted 8/21/2021 12:02 AM (GMT 0)
Has anyone experienced this? I'm 68 (female) and my A1c last 3 times (3 mos. apart) has been 5.8, which is prediabetic. So I bought a glucose meter and I have NEVER been over 135 in any instance, my fasting levels are always 74-91, 1 hour after eating usually 120, and 100-110 2 hours after eating. So what's up with my A1c? I've been tracking this for many months and always the same results. I have low number of RBC (comparatively) but I am not anemic. I take Tramadol nightly. I think the A1c algorithm just doesn't work for me. Any ideas? Thanks!
Posted 8/21/2021 12:33 AM (GMT 0)
Hi Ratfancy and welcome to HealingWell. I hear you! One explanation (and I really don't know of another, actually) is that the A1c is the average of our blood sugar all the time, even while we're sleeping, but the average on our blood sugar monitor is only of the readings when we happen to test our blood sugar.

So if you choose to take your own readings only before meals, then your meter will only give you your 'before meal' average. That's very specific. The A1c is the average of all day and all night for about three months.

I know it's frustrating. But it seems you've got it under control and that's great! Congratulations! If you want to read more info about all aspects of blood sugar, click on the link in my signature.

I'm glad you posted and I hope you stick around! smile
Posted 8/27/2021 12:22 AM (GMT 0)
Yes, that's correct. A1c reflects an average over about three months and the glucose level is 'right now'.

For a medically correct explanation:
https://www.cdc.gov/diabetes/managing/managing-blood-sugar/a1c.html
Posted 8/27/2021 1:53 AM (GMT 0)
Spot on. HT
Posted 8/28/2021 3:28 PM (GMT 0)
I think my mismatch situation is due to Tramadol (opiate), which I take for restless leg syndrome. I understand well how the A1c test works, and again, my blood sugars don't match the 5.8 result.
Posted 8/29/2021 5:44 AM (GMT 0)
It can have a fluctuating element when other meds increase or decrease our levels.
Mirtazapine increases, generally, mirtazapine munchies, prednisone, massive spikes, however the median level may also be dependent if your chasing your tail with smashing the insulin, etc. If not time to seek an endocrinologist, if your not consulting one. Other things could be reactive components, my mate has this due digestive issues and metabolism issues.
Seek out your pharmacist regarding if any of your meds will spike your bsl, as some combos can.
We get ya know your a1c. HT
Posted 8/29/2021 2:33 PM (GMT 0)
Ratfancy, as I said, your meter average is only the average of the readings that you take. Your meter has no idea what your blood sugar is at other times so that's why its average wouldn't match your A1c. If you think it's the Tramadol, then speak to your doctor.

According to this old article on WebMD, 1 in 1,000 people taking Tramodol may experience hypoglycemia. https://www.webmd.com/pain-management/news/20141208/painkiller-tramadol-linked-to-low-blood-sugar.
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