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#1
walleyedave

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I am just wondering what everyone does the day before a fasting A1C test. The last time i had 1 done i screwed it up because i woke up in the morning and had low blood sugar so i had to eat something before the test. They told me after the fact that i should only take half of my lantus the nite before. What do you do before your tests?
Names Dave, love fishing for Walleye's, hence the user name walleyedave.:)

Metformin 500mg x 3 daily
36 units lantus/day
Humalog 1 unit/ 8 carbs with meals

#2
fairyblood

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You don't have to fast for an A1c. You must be getting your cholesterol done. I don't have to do fasting blood work very often. If I do I make sure that I do it first thing in the morning. My basal is pretty right on so I don't really as low as I am careful to not over bolus then I am fine not eating as long as I want. I often don't eat until lunch or dinner on a regular day anyways.

#3
Subby

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I can attest to this! A1c = no fasting. Cholesterol usually = fasting. If you are getting both done (and you should) then the practical need is the same.

It can be quite hard to fast during this time. I usually eat a bit at night as it's the "rough end" of my basal (in other words, I find it hard to pin my pump's basal down for this period) so it's a bit of adjustment. Gearing up for it tonight, matter of fact.

I found it extremely hard on MDI. Reducing your basal if taken at night might make it easier to skate through. If you are relatively happy with your current basal dose, I'd consider something more like 60 -70%. 50% sounds too drastic to me, I'd be extremely high and sick if I did that.

Plannig to get there first thing in the morning if you can might help as well. Or, if you can sleep in to the time you need to go, it might again be easier. Being up and about especially on MDI makes things harder as you might need to get on the bandwagon of food/corrections sooner rather than later.
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#4
Scratch

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Once again.

You don't need to fast for an A1c test. In case that's not clear, you do not need to fast for an A1c test.

If you're getting blood drawn for lipids, then you'll need to fast because that test demands fasting levels. A1c is in no way fasting dependent for its result.

So you never fast for an A1c test. You might fast for lipids, or some other tests, and since A1c is often taken along with a blood draw for lipids, then you coincidentally end up fasting.
MDI, Lantus and Novolog
A1c 2/12 -- 5.9%

#5
walleyedave

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oops, I guess they were testeing me for more than just the
A1C then. I guess I should read Diabetes for dummies or something. lol
I always have had the fasting tests booked for morning, as early as possible so its easier not to eat because i am sleeping hopefully. I am still wondering if there is something I should be doing as far as insulin goes. So I don't go low before getting the blood drawn.
Names Dave, love fishing for Walleye's, hence the user name walleyedave.:)

Metformin 500mg x 3 daily
36 units lantus/day
Humalog 1 unit/ 8 carbs with meals

#6
walleyedave

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My wife just had a gestational diabetes test. They told her she could eat if she wanted to. Her friend also went for her gestational diabetes test too and she was told to fast for hers. I don't get it. Did I just fall off the turnip truck yesterday or what?
Names Dave, love fishing for Walleye's, hence the user name walleyedave.:)

Metformin 500mg x 3 daily
36 units lantus/day
Humalog 1 unit/ 8 carbs with meals

#7
hodgsonsurvivor

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I schedule my labs as early as possible and make sure I eat as late as possible without screwing up my fast. Then I make sure I have my breakfast immediately after.
Kristina
A1C 07/08 8.5% :(
A1C 11/08 9.1% :(
A1C 02/09 8.0% :(

#8
LancetChick

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I don't get it. Did I just fall off the turnip truck yesterday or what?


It can certainly feel that way if you believe everything health care workers (including doctors) tell you. Once you stop blindly believing them and start relying on common sense and your own experience and research, everything will fall into place nicely.

With the A1c test, for example..... it is a test that measures the average blood sugar over the last 3 months, with the latter periods of time being more influential than the earlier days. That is well documented. So knowing that, it is pretty easy to discount the advice of someone who tells you to take half of your Lantus before the test, which makes NO sense at all.

I have found in all situations that when a health care "professional" is asked for the reasoning behind a statement that makes no sense, the best that he or she can come up with is "well, that's the rule", which I discount immediately.

#9
sable_032592

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in defense of fasting for an A1C... i don't know about the rest of the world, but in canada, you have to fast for 8 hours before the blood test... in other words, if you go for your bllod tests at 7am or 8am, then you need to stop eating or drinking (other than water) at midnight...

everytime i get blood work done for just the A1C, i get asked if i stopped eating 8 hours ago... so no breakfast, no late night snacks... just water...

and i do get lows sometimes when i go for my tests... but usually just when i go for the 12 hour fasting ones... but what's weird, is the morning of my last blood tests, i was at 4.8 (86) and i saw the doc on tuesday and he said it was at 9 (162)... guess it's the pre-dawn phenomina (sp?)...

but yeah, i don't give myself my humalog the morning of the tests, but since i give myself my lantus around 11pm - 12am, i'm ok for giving myself my full dose the night before...
sable,
type 1 diabetes since march 25th, 1992

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#10
jillrapp

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Hey Dave,
If you have to fast for other tests, the reasoning behind lowering your basal insulin is so that you won't go too low while waiting to eat after your labs are complete. I agree lowering basal by 50% seems drastic - maybe try this before your test and experiment to see what the perfect percentage to decrease is right for you. If you wake up very high the day of the test and need to take a little rapid acting to lower a bit, that's okay - it won't hurt your lab work unless you're having other tests specifically diabetes related - like a fasting glucose test. For a normal HbA1c - no worries :)

Again though, try and schedule your lab tests for first thing in the morning or use that morning to basal test? :)
Jill in AZ

#11
hodgsonsurvivor

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I don't know about the reducing your Lantus dose to take a test or to avoid a low. I think with some planning you could be just fine. But, as I've read, I think I remember someone pointing out the time that your dose is given. I take mine in the mornings...so that may account for the difference...but, either way, maybe some planning for labs is necessary regardless?:confused:
Kristina
A1C 07/08 8.5% :(
A1C 11/08 9.1% :(
A1C 02/09 8.0% :(

#12
walleyedave

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in defense of fasting for an A1C... i don't know about the rest of the world, but in canada, you have to fast for 8 hours before the blood test... in other words, if you go for your bllod tests at 7am or 8am, then you need to stop eating or drinking (other than water) at midnight...

everytime i get blood work done for just the A1C, i get asked if i stopped eating 8 hours ago... so no breakfast, no late night snacks... just water...

and i do get lows sometimes when i go for my tests... but usually just when i go for the 12 hour fasting ones... but what's weird, is the morning of my last blood tests, i was at 4.8 (86) and i saw the doc on tuesday and he said it was at 9 (162)... guess it's the pre-dawn phenomina (sp?)...

but yeah, i don't give myself my humalog the morning of the tests, but since i give myself my lantus around 11pm - 12am, i'm ok for giving myself my full dose the night before...


Wow the more I keep reading the more questions I get. Sorry, So now i'm curious. What is the difference between 8 hour fasting and 12.?
Names Dave, love fishing for Walleye's, hence the user name walleyedave.:)

Metformin 500mg x 3 daily
36 units lantus/day
Humalog 1 unit/ 8 carbs with meals

#13
sable_032592

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Wow the more I keep reading the more questions I get. Sorry, So now i'm curious. What is the difference between 8 hour fasting and 12.?


12 hour fastings are the lipid tests... cholesterol, hdl & ldl, triglycerides... i always have to fast 8 hours for the glucose A. C. and HB glycemic... not sure if that's their names, i'm going based on the tests i have to get done in march 2009... there's a * beside the tests and on the back it says to observe fasting from midnight or 8 hours in a row, no food and no drink, other than water... the 12 hour (lipid tests) have 2 *s and it says to fast for 12 hours before the blood test, no food, no drink except water and no alcohol for 48 hours before the tests...

when i had blood tests done in alberta, it was the same, so i figure it's the same for all of canada...
sable,
type 1 diabetes since march 25th, 1992

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#14
lorilei

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I just had my lipids done with regular bloodwork and no one told me to fast at all...i called up and verified that it was indeed a fasting series...a time frame was not mentioned though...would hate to have to repeat!

lori;)


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#15
Subby

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With the A1c test, for example..... it is a test that measures the average blood sugar over the last 3 months, with the latter periods of time being more influential than the earlier days. That is well documented. So knowing that, it is pretty easy to discount the advice of someone who tells you to take half of your Lantus before the test, which makes NO sense at all.


True, but what seems to be the case is that walleyedave was asked to fast for a range of tests and quite possibly lipids is in there. You need to check that walleyedave (did you ask?) In the context of fasting for a lipids check, and having difficulties with lows in the morning you obviously can't adjust for with food or short acting, reducing basal the night before is pretty sound advice. Although as I said I think 50% is probably a bit too aggressive just to avoid any irregular dip in the morning.

I just had my lipids done with regular bloodwork and no one told me to fast at all...i called up and verified that it was indeed a fasting series...a time frame was not mentioned though...would hate to have to repeat!


I've had this happen to me many a time, very frustrating. I have no idea why some docs can't just give clear instructions for fasting! Even once you estabish it's fasting there seems to be an allergy to letting you know how long!

The thing is that I think the fasting issue often slides by and then your lipids can certainly be heightened from not fasting... so when you go to get your tests just be sure to remember they might be skewed and may want to get again to recheck.
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#16
walleyedave

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And once again the good people of Diabetes forums come through with much great info and advice again. Thanks Folks:)
Names Dave, love fishing for Walleye's, hence the user name walleyedave.:)

Metformin 500mg x 3 daily
36 units lantus/day
Humalog 1 unit/ 8 carbs with meals




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