April 7, 2008

Lab time again

I get labs every six months. This time my doctor checked my B-12 and Vitamin D levels, along with the usual stuff.

My A1c was 5.7%. That's pretty much what it always is. I had a cold last week and my blood sugars were higher than usual, so actually this A1c is better than I expected. It was 5.8% last October.

Using the most recent formula to equate A1c with blood sugar level, the one described HERE. this equates to an average blood sugar of 117 mg/dl.

My many meter readings are always lower than any A1c formula predicts, which suggests that I'm one of those people who is a high glycator. That topic was discussed HERE

My meter shows that my actual blood sugar average is closer to 100 mg/dl. But the biggest problem I have with blood sugar is my fasting blood sugar. I have a ferocious counter-regulatory response that fights all attempts to lower it. If I use even 1/4 of a unit too much Lantus, I'll wake up at 4AM with heart pounding and blood sugar at 107 mg/dl--a sure sign that I dipped into the 70s and caused that counter-regulatory response. If I don't use any insulin, even with a very low carb diet my fasting blood sugar will be in the 120s. So for now, I do what I can during the day to keep the blood sugar down. I'm still trying to tweak the Lantus dose to find one that will work, but for now my morning fasting blood sugar is 98-108 though I can get it to drop into the 80s during the day.

At my endo's suggestion, I've been supplementing with 1000 IU of Vitamin D every day for six months. My Vitamin D level was 39.8, with the normal range range being defined as 32-100 ng/ml. So it looks like I can boost my Vitamin D level without worrying about overdosing.

I'm using Vitamin D for its supposed usefulness in fighting melanoma not for any supposed effect on blood sugar. Though I initially saw a strong impact on my insulin sensitivity when I started the Vitamin D supplementation--I was hypoing on normal doses of insulin--it wore off very quickly. Now Vitamin D has no effect at all on my insulin sensitivity. Vitamin D does seem to improve my mood through the dark, short, sunless days of a New England winter. Plus, anything I can do to discourage rogue melanoma cells from taking root is all to the good.

My Vitamin B12 was on the high side, so that's good. Metformin can deplete Vitamin B12, so it is a good idea to check it every year if you are taking metformin.

My cholesterol was excellent. As usual the total was very high--I have that "longevity" variant of cholesterol that Dr. Nir Barzilai identified in the Albert Einstein Medical School Longevity Study. This gene makes for very large, "fluffy" LDL and HDL particles which tend not to clog arteries. My dad's cholesterol was measured at 340 when he was 70. I got into that study because he was a centenarian.

For the complete list of Longevity Study publications, click HERE.

So when I look at my cholesterol test result, what I look at is triglycerides and HDL. When I'm eating the right amount of carbohydrate and have my insulin set right, TGs are low and HDL is high. This time my HDL was 76, which is the highest it has ever been, and my TGs were 83 which is very healthy.

So I'm happy. But my doctors will probably look only at the total Cholesterol number which is 294 and have fits. That is what they always do. I have printed out data about the study and explained to them that I was informed that I do carry the longevity variant of CETP, and I have asked them to put it in my file, but it makes no difference, since none of them ever read my file but only look at the latest lab sheet.

My microalbumin test was great <3.0 with normal being defined as 0-20 mg/dl. The ratio of microalbumin to creatinine was <3.2, which is also great.

So basically, if I don't walk into the path of an oncoming car, or contract MRSA, or get bit by the wrong mosquito this summer, it looks like I should be around for many years to come.


John C. said...

I'm wondering if the variance between the A1c prediction and your actual meter readings are due to the 20% inaccuracy of the meter.

I think Mendosa spoke about the difference between accuracy and precision. Maybe the meter is accurate (tells you your high when you're high and low when you're low) but it might not be precise (you are running exactly 97 mg/dL).

Anyway, enjoy your info.

Jenny said...


I doubt that the meter precision is the issue, as my Ultras have always tested pretty close to lab when I've done a compare.

I've had this problem through many, many meters. I'm always about .5% higher than I'd predict. That review I cited says that this turns out to be typical. People who are higher than predicted by glucosamine testing on one A1c test will be high by the same margin on another. Ditto with low.

The formula only works for the mean of a large group.

Anne said...

Congratulations on you good labs. I know you have worked hard to get there. I am hoping my next lab will show continued improvement.

Anonymous said...

great job on getting your microalbumin tested. There are several studies as you know linking a high level to cardiovascular disease. they are also working on moving the normal level down to <5 on that test.