HPA1C blood test

[Malibucyprus]

Hi,

I know asking for medical advice is frowned upon, but was wondering whether anyone knew why the Dr would request repeat glucose and HPA1C blood tests on my 14yo DD?

She has a large lump at the bottom of her neck, possible Lipoma, first steps were blood tests, all have come back “no further action” apart from the above mentioned.

Do they suspect diabetes?

I’ve been told the Dr will call me Monday to discuss, but I suffer with health anxiety and I’ll be worrying all weekend.

Hba1c yes. It's to test for diabetes. It will give you the 'average' blood sugar in your daughter's blood over the lifetime of a blood cell, roughly three months. Compared to glucose which does a 'here and now' sample. So it gives a much better picture of her health.

Sorry. It's never a nice thing to go through. However the results only take a day or so to come back. Fingers crossed it's just an erraneous result.

Thank you for the reply.

I’m assuming something was off, for them to want to retest.

You can buy a testing kit from any chemist. If the BG is more than 11 mmol a couple of hours after food, that is diagnostic for diabetes and you should take your child to A&E. GPs are notoriously bad at diagnosing type one diabetes. HBA1C is not a diagnostic test for type one (which is overwhelmingly common in children compared to other types) but GPs often think it is because they more frequently deal with the diagnosis of type two. I'm assuming that your child is not obese?

No she isn’t obese, she’s average height and weight I’d say.

She eats fairly healthily at home, but is known to spend her pocket money on sweets and chocolate when she’s out with friends.

She’s also very recently become a vegetarian, I doubt that’s relevant but it is a recent change in diet. I have no knowledge really with diabetes, other than my maternal Nan was type 1.

She’s under the hospital for diagnosis, as her bloods were taken in paediatrics, and they’re following up with physio and scan for the neck lump, so assuming they’ll deal with blood test results.

Is she showing signs for diabetes. The signs are 4Ts - toilet, thirst, thinner, tired.

HbA1c tests don't take a day to get the results. You can get them within a minute or so. Never knew this was used to test for diabetes.

So what are hba1c tests for?

She’s tired a lot, which is another reason for the blood test. She drinks a few litres of water a day, and when I asked her earlier how often she goes to the loo, she said 3 times during school hours. So I wouldn’t say excessive.

Hba1c is helpful for diagnosing type 1 diabetes because it is unaffected by recent meals which an instant blood test would be. If done as an outpatient it will take a couple days but as an inpatient same day. Obesity and diet has nothing to do with the cause of type 1, though after diagnosis diet and exercise help in controlling it, though insulting injections will be needed.
The Lipoma is probably something unrelated as anyone could have that and is not a symptom of diabetes as far as I know.

I have type 1 and had no symptoms. I was pregnant at the time of diagnosis.

Insulting? I mean insulin!

My DN has type 1 and his diagnosis was a blood glucose test at the GPs and then a blood test at hospital.

He gets his HbA1c tested at every hospital clinic appointment and it takes minutes.

Diagnosing type 1 diabetes is quite straightforward.

Re test as in she's just had it and they're doing it again? (sometimes in children BG can be slightly elevated during an infection and it's not diabetes) Or did she originally have the test a few months ago?
Do you know what the number was that came back on the hba1c ?

HBA1C is, put simplistically, a test that measures the average blood glucose over the past three months. So if it was elevated that would suggest diabetes (of any kind). It's not recommended as a test for type one diabetes because BG levels can become problematic over a period of a couple of weeks and this wouldn't necessarily show up on an HBA1C test. So a high HBA1C is diagnostic of diabetes, but it's not the best test for type one. Fasting glucose is not a good test either as it requires waiting for the test (not helpful as undiagnosed T1D can become life threatening over a matter of days). If she seems unwell, take her to A&E - particularly if drinking/urinating a lot, smelling of pear drops, vomiting, losing consciousness, heavy breathing, etc. Otherwise, as @GinandGingerBeer says, it is possible for a child to have a slighted elevated BG during illness and not to have T1D.

I asked the question about obesity because an HBA1C test is a diagnostic test for type two diabetes (which is extremely rare in children but does occur occasionally in obese children). Type one diabetes is not related to lifestyle.

The original blood test was 10 days ago, I wasn’t given any figures as I spoke to the Drs receptionist, I’m booked for a phone consultation with the GP on Monday.

She just said that she needs a retest for glucose and HBA1C, and the GP will go through it during the phone call.

I took her to the Drs for a swelling on the back of her neck/top of her back, GP wasn’t sure so queried lipoma. She has appointments for ultrasound and physio over the next few months for that. Dr also ordered the blood tests as I’d say she seemed excessively tired, napping every day after school.

I’ve asked her about fluid intake and urinating, she said she doesn’t feel particularly thirsty but does get through 2 litres of water, and approx 3 wee’s during the school day.

How did she get on @Malibucyprus?

@GinandGingerBeer thank you for asking, the GP called me yesterday to give full blood results, she doesn't seem too concerned, as the original test wasn't a fasting one, so the sugars were probably raised due to her eating breakfast.

She said we could retest 'if I wanted to' which I found strange, so I said yes I'd like to, seeing as she's always tired.

Fasting bloods were taken at 7.50am this morning, should have results by Friday, they're testing for some other vitamins too, as she said Vit D, thyroid, HB were all normal on the last bloods.

What was the glucose level in the random test? (BTW fasting glucose is NOT the correct test for type one diabetes - some GPs drive me mad on this.)

Hmmm, you don't do fasting bloods to test for type 1.
A blood test just to see what current blood sugar is, is just a finger prick. Result there and then.

A blood test to see what the average has been over 3 months is the hba1c. The latter wouldn't matter if she had eaten breakfast or not as it's a 3 month average. I'm not sure your GP knows the difference between T1 and T2. Believe me, there are a fair few who don't as T1 is relatively rare.
Anyway, it doesn't sound like her blood glucose was concerning them and with T1 you become very poorly quite quickly and it would have been picked up if that were the case. Make sure you get the actual numbers back from all the tests though and tag me if you want re the hba1c (if that's what she's had repeated)

I’m a bit baffled by it all tbh, I took her for the neck lump rather than concerns for her blood sugars.

I will make sure that I get exact figures when I call them on Friday for the results.

Thanks for your comments.