What are the possible causes for raised HBA1C level?

Question

Hi doctor,

I am 62 years male and have had IgA nephropathy for the past 13 years, which is being treated with Cardace 10 mg, Stamlo 5 mg, Rosuvas 10 mg, and fish oil capsules. In addition, I have thyroid nodules and a benign prostrate. I have been taking Urimax 0.4 mg medication. His blood pressure is around 130/80 mm Hg. I exercise daily for about 45 minutes. My recent blood and urine test results are as follows:

1. Routine urine examination showed no protein, glucose, or RBCs in urine.

2. Albumin creatinine ratio 101.56 ug/mg, and protein creatinine ratio 0.17 mg/mmol.

3. Serum creatinine level is 1.41 mg/dl.

4. FBS is 88 mg/dl.

5. HBA1c is 6 %.

I am concerned with the HBA1c level, which has been at 5.7 % for a few years and has increased to 6 %. However, additional sweets, cakes, biscuits, and in-season mangoes have been consumed during the past three months. I would appreciate your views on whether there is any cause for concern, that is, the increase in HBA1c and a diabetes diagnosis. There is a diabetes history in my family.

1. Would the HBA1c levels be affected by the consumption of mangoes?

2. Despite daily exercise and monitoring my consumption of sweets, etc., the HBA1c level has persisted at around 5.7 %. How do I reduce this? My diet is usually idli in the morning, a handful of rice in the afternoon, chapati at night, and vegetables and fruits like apples and pears.

3. Are there any other blood tests I can conduct to determine if there is a diabetes risk?

4. I started Rosuvas 10 mg. The previous was Atorvastatin 10 mg; could the use of Rosuvas also be a reason for the HBA1c increase from 5.7 % to 6 %?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

1. Yes, the risk for going from prediabetes to diabetes is high for HbA1c, 6 % versus 5.7 %

2. Not just mangoes, but the sweets, cakes, and biscuits could have contributed.

3. Diet and exercise are the key. As long as you keep it at 5.7 %, then it is good. Try cutting down further on carbohydrates and increasing fiber in your diet.

4. No additional tests are needed. You can consider a 24-hour continuous glucose monitor to see how your glucose trends throughout the day, what makes it go up and what makes it go down, etc.

5. Theoretically, medicines like Atorvastatin or Rosuvastatin can increase insulin resistance, but it would be impossible to say whether that was the cause for an individual patient.

6. The albumin-creatinine ratio is higher. Please repeat it at the next blood test in three months

7. HbA1c measurement has pitfalls, so please repeat after three months in a different laboratory, and if it has come down to 5.7 %, then good.

8. Continue the excellent work of diet and exercise.

I hope this information will help you.

Thanks.