Pros and Cons of being diagnosed as Diabetic

[LouiseW]

I know this is a strange topic but this is my situation: A number of years ago (10?), I was told I was pre-diabetic with a reading of 6.1. I can't remember if that was the fasting number or if I had further testing. Between then and now, I lost and regained 100 pounds, losing mostly through low-carbing, gaining back by falling back into old habits. After having some symptoms, I've been monitoring my blood sugar with my husband's kit and have seen a random 12,8 as well as morning fast numbers in the 7s. I understand this puts me as a diabetic.

I have jumped right back onto Low Carb with a vengeance. I'm experienced in how to eat low carb so it feels like putting on an old shoe - comfortable and safe. My last off-program food was two date squares on Thursday night and it's Sunday now. After getting morning readings in the 7s for the past few days, today seems better and I've had 5.9 and 5.1 postprandial after lunch and dinner respectively.

This is in some ways an ethical question. I do believe that I am diabetic. I haven't been to my doctor for about a year for any blood testing and at that time, my blood sugars were perfect since I was pretty strictly low carb. I do hope that my readings will return to normal in a relatively short time with low carbing.

My dilemma: I can wait a few months, go to the doctor, and possibly have perfect numbers with regular testing. To him, there would be no flags for diabetes. This would have a positive impact on some things like insurance. But the down sides of not being diagnosed? I would assume that things like going for surgery would be hazardous if the surgeon and anesthetist are not aware beforehand. And checking for secondary damage -- if I can get the numbers on track, do I have to worry about it? I did have an eye exam recently for something unrelated and the eye doctor asked if I am diabetic. My response at that point was "not that I am aware of" although I strongly suspected it.

Being labelled is a for-life thing. I don't know whether it's better to just get labelled and get it over with or hold on to the non-label as long as I can.

I'm basically a very honest person so this is a bit of a dilemma for me. Comments?

[halfpint]

Hi LouiseW

Thats interesting, 'cos that is kinda where I feel I am. If I went back on the sugar in tea, plus the biscuits and cakes (which I didn't eat before anyway, unless someone baked us a cake 'cos our oven is c**p ), plus the odd mars bar etc. I am pretty sure that my readings would be considerably higher than they are now. I don't particularly want to give my body any additional months of strain just to get a positive, but getting a positive would mean that you would be flagged as needing extra watching which would reduce the incidence of possible damage not being picked up.

I have just had an official blood test this morning, and I think that once I get the results, I will follow the advice given on my post , to go to the doctor and ask for a GTT and see what that shows up.

[Mushroom]

Hi, I was diagnosed in May. I am following a low carb and high fat diet and losing weight. My Hb results are now 'comparable to a non-diabetic' as the DSN says. The pros would be that you are offered eye tests, blood tests and someone is keeping an eye on you. Depends whether you want to take the NHS advice on carbs with every meal or want to take the tablets which the nurse has on her ticklist. Sounds like you are aware of how to test and low-carb to keep your sugars down so there is the main benefit, diagnosed or not - you are keeping yourself well and avoiding complications and that is the main thing in the long run. Yes, I have had to declare that I have a 'chronic' disease to my dentist and chiropodist but as far as insurance goes, my car insurance was not worried because I am not on insulin and the travel insurance only wanted to know if I am on more than two different tablets, so not any cons there. Perhaps that diagnosis, for you may give you the incentive to stop you 'slipping' in future? Good luck with your journey.

[borofergie]

As an accomplished low-carber I'm sure you could con your Doctor, but is it really worth it?

You'll miss out on regular HbA1c and cholesterol tests, both of which are important measures of how well you are managing your diabetes.

There is also the psychological aspect of properly accepting that you have this for life. You've had a good experience with low-carbing in the past, but you've also fallen pretty heavily off the waggon. In my experience you're much less likely to do that, if you have to face a HbA1c test every three months. There is no hiding from that...

I'm not sure that there is a downside to insurance premiums because you have a T2D diagnosis, although I haven't tried buying life insurance since I was diagnosed.

[Fraddycat]

Hi Louise, I think honesty is the best policy, I found that my diagnosis has made no difference to my insurance for both travel and car. The travel insurance wanted to know about my meds but didn't make any change to the premium and gave me a covering letter. If you are diagnosed and put on meds you can get a medical exemption certificate so your meds and eye tests are free, the medical profession, opticians and dentists take good care of you knowing you are diabetic, and like Borofergie says, maybe it will help you to accept the inevitable.

I personally choose to ignore their dietary advice etc but I will be glad to have everyone on hand if I ever got retinopathy or any of the other scary 'opathies.

If I was you I would resolve my dilemma and make that appointment - good luck!

[sterling]

Pros of Type 2 diabetes:

medicine fees exemption
entilement to 'flu injection
entitlement to pneumococcal injection
improved medical supervision
many regular tests
opportunity to get cholesterol under control
opportunity to get blood pressure under control
first into an operation
better understand of weight control
motivation to get key risk factors under control
improved diet
incentive to get fitter generally

[LouiseW]

Thanks for your feedback, everyone.

My inclination certainly was to go to the doctor and discuss my test results. Since I'm in Canada, and have excellent medical coverage through my own as well as my husband's work, some of the things you write about aren't an issue for me but others are, such as more frequent testing. I don't really look forward to being on the radar if everything is OK but the only way to be sure everything is OK is to be on the radar and be tested. I don't know what his approach to low carbing is. I do already see an endocrinologist but it's for a thyroid condition - continued follow-up from thyroid cancer.

Falling off the wagon is a real issue. As a chronic and compulsive overeater, I have cycled through good and bad spurts my whole life with a dedication that can rival any alcoholic. Low carb has been the only way of eating that I've been able to sustain for any period of time so that it's good that it's the same regimen needed for diabetes control.

I don't ever want to get to the point of having to inject 10 needles a day which is where my brother is. He eats what he wants to and injects to balance.

[borofergie]

I don't ever want to get to the point of having to inject 10 needles a day which is where my brother is. He eats what he wants to and injects to balance.

If you stick with the low-carb, you can be pretty sure that that won't happen (and if it does, you'll know that you did your absolute best to avoid it).

[LouiseW]

I've made an appointment and see my doctor next Friday. Not looking forward to the expected barrage of tests and appointments but I do know it's for the best and for my benefit. I just feel as though over the past 12 years, I've had so much medical stuff that I don't really want to go back and start again. I just looked back and in the last 12 years, I've had thyroid cancer (should be fine now), a hysterectomy, gall bladder removal, two other surgeries to repair stuff, a broken collarbone that didn't heal so had surgery for that too. I can be thankful we have a health system so that I don't worry about the cost, but I really am tired of medical stuff.

[LouiseW]

I've been reading a bit more and see that prednisone has adverse effects on BG levels. I looked back at the readings I got and the worst ones were when I was on a course of prednisone just over a month ago. It will be interesting to see what the doctor has to say about diagnosis because I have gone directly onto low carb eating. My body has responded well and my fasting BG this morning was 5.7. Maybe I am still pre-diabetes? I'll let the doc work through how to test, I guess.

[viviennem]

Hi LouiseW

I can empathise with your sutuation - who wants to be labelled? - but I think you need to bite the bullet and accept that you are, or most certainly will be, diabetic.

I was diagnosed Type 2 in April 2010. I promptly went low-carb (Atkins Induction), have lost 60lbs+, and seldom have a BG reading outside non-diabetic. If I went for diagnosis now I would not be labelled even pre-diabetic! But I am. I am still Type 2, and it only needs a couple of days off the wagon for my fasting BG to tell me that my pancreas still can't cope with too much glucose.

Diabetes is the best thing that ever happened to me - it gave me a real kick up the a**e. I now have to diet - no more slipping on and off, no more knickers to it. If I stop caring now, I could die, slowly and horribly. Yes, I still have bad times - but I have diabetes to pull me back. My best friend is my blood glucose meter - it tells me when my control is slipping.

Think of all those pro's listed above - jump in and join us

I hope your tests go okay, and that you can have a really good talk with your doctor. Let us know how you go on.

Viv

[Joyola]

I was diagnosed with T2 15 months ago, I went for my check up with our diabetic nurse this morning, and the first thing she said to me wa 'Don't you look well'

In the last 15 months I have followed a low carb diet, I have lost 60lbs and dropped 5 dress sizes. I know the foods that trigger my sugar levels, rice, wheat and potatoes, so I steer clear of them, and to be honest, I don't miss them now, I feel better than I have in years and can wear clothes I like, rather than shapeless ones that cover my bulk. I walk and attend aquarobics, and even my asthma had improved. Like one of the other FM's said, diabetes gave me the kick I needed to sort my life out.

[mousemat]

Go... Simply because as a diabetic you get the monitoring that you would get if you paid for one if these diagnostic private tests.

[LouiseW]

I have the appointment coming up. I have been eating low carb but strangely, I haven't shed any weight although I have a pile to lose. Today before dinner, my BG was 3.3 - so it is having a positive effect!

[LouiseW]

My numbers have all come back ... 5.7 fasting on that day, and a1c of 0.062 ... does the 0.062 mean 6.2%? Verdict: Not diabetic.

My doctor said that diagnosis in Canada is made solely on the basis of the fasting number or the GTT. So at 5.7, I'm not diabetic, not even pre-diabetic. So my comment was that I had been low carbing for about a month before that reading, so what would the impact be. Strangely, my BG on my meter that morning was 7.6. It's a Bayer meter, brand new, and I assume reasonable quality. However, the 7.6 was around 9 in the morning and I didn't have the blood drawn until about 11 -- time for the Dawn Phenom to subside.
And the doc says that the a1c is not a diagnostic tool. In my case, it was also probably not an accurate reading since I was on prednisone for part of the time and then also was low carbing which would bring the numbers down.

I think I'm sounding quite the hypochondriac here, looking for a diagnosis.

Bottom line, I am continuing to eat low carb and treat myself as though I am at least insulin resistant. Maybe I'm overreacting. Looking back, I've had fasting glucose of 6.1 and 6.5 on official lab tests. So even if it hadn't turned into full-blown diabetes, I know I am at risk and need to continue on a low carb regime with or without a diagnosis.