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You are here: Experts > Health/Fitness > Medical Specialists > Endocrinology (including Diabetes) > High fasting levels but normal A1C
Expert: Catherine Burns. RN. BS. - 10/20/2009
Question
Hello, My husband and I both had fasting blood glucose tests at our doctor's office. We both tested high, mine was 127 and my husband's was 140. We have never tested high before. My doctor had us return and take an A1C test. Mine was 5.6 and my husband's was 5.5. Based on these results, the doctor did nothing and told us to come back for our usual check up in 3 months. I'm confused as both those fasting levels are high, yet the A1C tests are in the normal range. Does this happen often and, if so, what does it mean? I'm wondering if the lab made an error in our fasting glucose as we both tested high on the same day, and my doctor has his own lab which leaves me wondering. Thank you very much.
Answer
Dear Barnette,
• A normal fasting blood glucose reading is less than 100 mg/dl.
> • A pre-diabetes alert if the FBG reading is between 100 mg/dl and 125 mg/dl.
> • A diabetes alert if the FBG reading is 126 mg/dl or higher after two consecutive blood tests.
>
> • An AIC level test checks the blood glucose level over past 2 - 3 months.
A normal AIc range is 4% to 6%.
The fasting blood glucose indicates the current status of the pancreas.
The solution to your situation is getting tested for diabetes per the American Diabetes Association recommendations.
The following lab values are the American Diabetes Association practice guidelines for the diagnosis of diabetes:
• A random plasma glucose value of 200 mg/dl (11.1 mmol/L) or more (in the presence of diabetes symptoms)
• A fasting plasma glucose value of 126 mg/dl (7 mmol/L) or more
• An oral glucose plasma glucose value of 200 mg/dl or higher at 2 hours post-glucose load2
The ADA also maintains that a definitive diabetes diagnosis requires a second positive test performed on a different day.
The physician’s lab has to be certified by law. Yes, lab errors do occur, but
you could request a repeat fasting blood glucose test. If you get repeat high results your
physician will address it with appropriate medical intervention. If the results are normal, then have it checked at 3 months.
You could use another lab within your insurance’s network for this testing.
I would expect that HbAIc levels are elevated well in advance of the clinical development of type 2 diabetes, however, the HbAIc alone is not used to diagnose DM.
I recommend the oral glucose tolerance to test the current pancreas status.
Good health to you both.
Sincerely,
Catherine Burns. RN. BS.
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