Good Glucose Levels - Why Do You Have Good Fasting Blood Sugar Levels But a High HbA1c?.
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Type 2 diabetics diligently test their blood sugars every morning and detect no problems. Then the doctor orders an HbA1c test and the results indicate your blood sugar levels are completely out of control. It's one of the great mysteries of managing type 2 diabetes.
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The way doctors translate HbA1c numbers into average blood glucose levels, literally varies from lab to lab (due to slight variations in the way test chemicals are used), but most doctors in the USA use a formula very close to this:
Average blood sugar level = 28.7 times the HbA1c level less 47
Suppose you had an HbA1c level of 8.0%. An approximation of your average blood glucose over the last two to three months would be 28.7 times 8, or 229 (rounding off for significant digits), minus 47, or 182mg/dL (10.2 mmol/L). But what if your fasting blood glucose was consistently below 100mg/dL (5.5 mmol/L)?
The answer:
If you have good fasting blood sugars and a bad HbA1c percentage, then the problem is that your blood sugars are soaring out of control after meals. There are at least three ways to deal with this problem:
1. Eat smaller portions at your main meals, and if you are still hungry, eat a high-protein or high-fat snack... whole-milk yogurt, or if you are vegan or vegetarian, any kind of soy food or nuts.
2. Consider taking insulin injections before meals.
3. Emphasize plant foods and sour foods at every meal. This slows down the passage of food through your stomach and gives your pancreas a chance to release enough insulin to keep up with the release of glucose from digested food.
Acceptable fasting blood sugars combined with a high HbA1c percentage indicates that your blood glucose levels go up and down a great deal during the course of every 24 hours. Fluctuating blood glucose levels can cause even greater problems with insulin resistance than blood sugars that are high all the time. If you don't get your after-meal blood glucose levels down, eventually your fasting blood sugars will rise too.
The best eating plan for all type 2 diabetes is just to "think small" and "eat small". Reducing portions gives your body a better chance of dealing with any dietary indiscretion, and gives your pancreas time to release the insulin you need to keep your blood sugar levels under control.
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