HbA1c level is less than 6, but random blood glucose remains high; is this diabetes?

If the level of HbA1c (glycated hemoglobin) is normal in the test and RGB is high, then how to know whether you have diabetes or not. Know what happens like this?

Random blood glucose high but HbA1c normal: When you get your blood test done and the result shows HbA1c level less than 6, you are relieved that you are not at any risk of diabetes. But when you see the random blood glucose (RGB) report, its result is very high. The question arises from here that when HbA1c is normal, why is the sugar high? Is this a sign of diabetes? For this, we have to understand why the RGB report is not normal when HbA1c is normal.

 

HbA1c, also known as glycated hemoglobin, is the report card of your blood sugar for the last 2 to 3 months. It tells you what your average sugar level was during these months. If HbA1c is less than -6, it means that your sugar level has been normal most of the time. But remember, this is an average, so if the sugar level has increased or decreased in between, it can be hidden in it.

 

 

what is RBG

RBG (Random Blood Glucose) is a quick sugar test done at that time. There is no fasting or time restriction in this. If you ate sweet or high-carb food or were under stress, sick, or took any medicine before the test then RBG can come high at that time. Even if your HbA1c is normal.

Normal: 5.6% or less

Pre-diabetes: 5.7% to 6.4%

Diabetes: 6.5% or more

Why does the RGB come high even though HbA1c is normal?

According to Dr Ajay Kumar of Delhi MCD, sometimes the situation becomes the opposite. RGB can be high even if HbA1c is normal. This happens when your blood sugar level remains normal but sometimes it suddenly increases. This can happen if you have taken more sugar that day and have not taken protein, but if these spikes are happening repeatedly then it is not good for the body, because suddenly increasing sugar level can damage blood vessels and nerves.

RBG may increase in the test after eating sweets

Sometimes the timing of the blood sugar test changes everything. Suppose you ate something sweet half an hour before the test, then it is almost certain that the RBG (random blood glucose) will be high. But this does not mean that you have diabetes. It may also happen that on the day of the test you are sick, have some infection, or are under a lot of stress. In these conditions, some hormones in the body change due to which the sugar level increases. That is, it is not right to conclude a conclusion by looking at a high report once.

Double-check if needed

But, if your RBG is repeatedly coming 200 mg/dL or above even if HbA1c (average sugar of the last 23 months) is normal, then the doctor will definitely ask you to get further tests done. You may have prediabetes or impaired glucose tolerance. This means that your body is not able to control sugar properly. But HbA1c still shows the initial stage. In such a situation, the doctor often gets OGTT (glucose tolerance test) or fasting blood sugar test done, which can clearly tell whether there is diabetes or not.

So then what should be done?

Dr Ajay says that if HbA1c is normal but RBG is high, then there is no need to panic. But do not take it lightly either. Check blood sugar at different times for a few days - sometimes on an empty stomach, sometimes 2 hours after eating. This will reveal a pattern. If the reading is high repeatedly, then consult a doctor. Also improve your diet and lifestyle. Avoid eating sweets and high-carb foods, eat more fiber-rich food, do light exercises daily and try to reduce stress.