2

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I think I figured out why my HbA1c is high even though I'm in ketosis, what do you think?

Answered on August 19, 2014
Created March 07, 2013 at 4:08 AM

After following a low carb diet for 2 years, my HbA1c was 5.7%. Then I decided to try out nutritional ketosis, and when I checked my HbA1c after 72 days of being in ketosis the majority of the time (documented by blood ketones)... if found that my HbA1c was still 5.7%.

The best explanation I came up with was:

Low Carb -> Lower Blood Glucose -> Longer RBC lifespan -> Higher HbA1c

What do you think?

I wrote a two part blog post here and here if you want to read more.

I'm also interested in other people's experiences.

0f6f5440163056aeeffcc7ec0425a837

(80)

on March 08, 2013
at 04:37 AM

That is really weird. I assume you also test your blood sugar after eating, and that doesn't go high either?

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 10:40 PM

Haven't heard of this... it's something I'll definitely have to look into.

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 03:54 PM

I'm 5'9,and before i started ketosis I was around 180-184 lbs.. and at the time of this blood tests my weight came down to 176-178 lbs. I estimate my body fat to be around 20%

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 06:33 AM

I agree that I shouldn't be chasing numbers, but it really caught my attention that despite eating very low carb, low enough to be ketotic. My average fasting AM sugars were 83 over the course of my 72 day trial and my HbA1c of 5.7% which is equivalent to an average blood sugar of 117. I wanted to be sure that my glucose wasn't out of whack despite being in ketosis and having good AM blood sugars. There's also a paper where they describe the fact that RBC lifespan is actually shorter in the presence of higher average blood sugars.. I linked on my site, but should have linked it here

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 06:28 AM

I test my Daily AM fasting blood sugars constantly, and they have always ranged from 70-90, with an average of 83. That's why this bothered me so much, because my HbA1c of 5.7% was equivalent to an average blood sugar of 117 mg/dl... and these numbers didn't jive..

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4 Answers

2
62442eec80b7d248ccfa08f98f736748

on March 07, 2013
at 05:38 AM

Your hba1c looks fine if not great. So why ate you chasing numbers to begin with? And RBC lifespan is not significantly affected by glycosylation so I don't think your hypothesis is correct...the fact that RBC lifespan is relatively stable in most individuals is why hba1c is such a good market of long term glucose control in the first place.

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 06:33 AM

I agree that I shouldn't be chasing numbers, but it really caught my attention that despite eating very low carb, low enough to be ketotic. My average fasting AM sugars were 83 over the course of my 72 day trial and my HbA1c of 5.7% which is equivalent to an average blood sugar of 117. I wanted to be sure that my glucose wasn't out of whack despite being in ketosis and having good AM blood sugars. There's also a paper where they describe the fact that RBC lifespan is actually shorter in the presence of higher average blood sugars.. I linked on my site, but should have linked it here

1
A2c38be4c54c91a15071f82f14cac0b3

(12682)

on March 07, 2013
at 06:45 AM

Another possibility is that acetone, produced during ketosis, is metabolized to methylglyoxal which is a notable glycating agent. Without knowing your diet it's also possible you simply changed any number of things about your diet, like taking in less thiamine, which played a role.

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 10:40 PM

Haven't heard of this... it's something I'll definitely have to look into.

0
Medium avatar

(10611)

on March 07, 2013
at 02:35 PM

Are you overweight? My A1C came down with weight loss, over a year.

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 03:54 PM

I'm 5'9,and before i started ketosis I was around 180-184 lbs.. and at the time of this blood tests my weight came down to 176-178 lbs. I estimate my body fat to be around 20%

0
0f6f5440163056aeeffcc7ec0425a837

on March 07, 2013
at 06:20 AM

Do you test your blood sugar? Sometimes going too low carb drives your fasting blood sugar up.

B2634bf90fa31b48a60e7c4f06761200

(694)

on March 07, 2013
at 06:28 AM

I test my Daily AM fasting blood sugars constantly, and they have always ranged from 70-90, with an average of 83. That's why this bothered me so much, because my HbA1c of 5.7% was equivalent to an average blood sugar of 117 mg/dl... and these numbers didn't jive..

0f6f5440163056aeeffcc7ec0425a837

(80)

on March 08, 2013
at 04:37 AM

That is really weird. I assume you also test your blood sugar after eating, and that doesn't go high either?

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