PLEASE HELP - PANICKING

Triceraptors

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It seems that my endo is convinced that I have T1 and it was sudden onset. Normal fasting and HbA1c but failed OGTT. He already ordered Type 1 tests.

I basically was sent on semi-urgent referral to an NHS endo by GP, which would have happened in January or February. However, I could not wait because losing weight severely and being afraid of eating carbs, skipping work was too much for me. I managed to get an appointment with private endo today and came back with mostly sad and anxious mood.

Private health insurance in UK does not cover chronic health conditions like diabetes, I was told this by the representative. This leaves me at the mercy of NHS. However, having been diagnosed by a private, how can I get an NHS endo to give me instructions and supplies? I am afraid to die or get worse waiting for the appointment and people at work definitely seem to getting fed up with me being absent. I lost too much weight and even climbing stairs makes my heart race.

Please provide some guidance to new lost soul ...
 
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Mr_Pot

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If your HbA1c is ok why do they think you have T1D? Are you going to get the results of the T1D test before you are due to see the endocrinologist?
 
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Triceraptors

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If your HbA1c is ok why do they think you have T1D? Are you going to get the results of the T1D test before you are due to see the endocrinologist?

I was at endo today. He said that in early stages, there is enough insulin to keep BG normalish. In addition, if stuff goes wrong recently, then Hba1c is useless because the average nulls out the recent spikes. The endo is the one who took all T1 tests.

I have all the symptoms. He was interested in how tired and fatigued I am. Also, I am thin as hell and there is no way I have Type 2.

Anyone knows any pointers besides calling 111 and asking there?
 
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TheBigNewt

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So in the UK health insurance that you already have and pay for doesn't cover diabetes? What the hell DOES it cover, flu shots? Also, if the sole cause of all your weight loss IS IN FACT TYPE 1 DIABETES then you're in DKA. And if you're in DKA (since January??) yes you lose weight, but your A1C isn't normal, your blood sugar isn't normal, and you'd be put in a hospital. Methinks there's something rotten in Demark here.
 
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therower

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Endo was interested in how fatigued and tired you are......
If you have T1 diabetes a good endo would probably be more interested in the fact that you have a medical condition that will kill you without treatment involving the use of insulin.
If the endo has your test results then I suggest you take them to your gp and request medication to control your type 1 diabetes a.s.a.p.
 
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paulus1

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seriously. a consultant diagnosed you with a very normal hba1c and normal bgs. thats very interesting. did you mention your eating issues. just a note there is no pre diabetic stage in type 1 you either have it or you dont. a slow gradual climb is much more type 2 or lada. but your bloods are not even in that range. 1 test is not safe to make a dignosis on so your wonky gtt is not important until its repeated. how much did you pay this guy. no doctor will give you insulin because your not diabetic. yourfinger pricks would be a heck of a lot higher than 5 if you diabetic.
 
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catapillar

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You haven't been diagnosed with anything. You are currently at "the mercy" of a private physician who has decided you will pay for tests, even though they are not clinically indicated.

The only thing that can diagnose diabetes is high hba1c or high blood glucose. You have neither.

Without high hba1c there is no indication for antibody testing. It is possible to be antibody positive and not get diabetes.

The only indication for fructosamine testing would be if you don't have normal erythropoiesis, normal glycation and normal erythrocyte rates.

If you are under the care of a private endocrinologist and you don't have type 1 then presumably your treatment is covered by your health insurance (although I suspect they might have something to say about paying for tests that aren't clinically indicated if they looked at it too closely). In the highly unlikely event the private tests result in a diabetes diagnosis and you are permanently resident in the uk you will get perfectly reasonable care in the NHS.
 
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paulus1

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So in the UK health insurance that you already have and pay for doesn't cover diabetes? What the hell DOES it cover, flu shots? Also, if the sole cause of all your weight loss IS IN FACT TYPE 1 DIABETES then you're in DKA. And if you're in DKA (since January??) yes you lose weight, but your A1C isn't normal, your blood sugar isn't normal, and you'd be put in a hospital. Methinks there's something rotten in Demark here.
he his talking about private insurance. some folks have that to jump ques nowt to do with the nhs.
 

Snapsy

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So in the UK health insurance that you already have and pay for doesn't cover diabetes? What the hell DOES it cover.
The NHS covers it, @TheBigNewt . However, I understand that the OP wanted to be seen sooner than an NHS endocrinologist could offer him an appointment, so the OP consulted a private one instead.
 
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Guzzler

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I was at endo today. He said that in early stages, there is enough insulin to keep BG normalish. In addition, if stuff goes wrong recently, then Hba1c is useless because the average nulls out the recent spikes. The endo is the one who took all T1 tests.

I have all the symptoms. He was interested in how tired and fatigued I am. Also, I am thin as hell and there is no way I have Type 2.

Anyone knows any pointers besides calling 111 and asking there?

Thin people can and do develope Type 2 Diabetes, up to 20% of all T2s are of normal weight.
 

paulus1

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Type 2
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i really think the op has a problem. but its not diabetic related yet. please get back to your gp and be honest about your emotional issues and that it effects your eating. this is your major issue.
 

Triceraptors

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You haven't been diagnosed with anything. You are currently at "the mercy" of a private physician who has decided you will pay for tests, even though they are not clinically indicated.

The only thing that can diagnose diabetes is high hba1c or high blood glucose. You have neither.

Without high hba1c there is no indication for antibody testing. It is possible to be antibody positive and not get diabetes.

The only indication for fructosamine testing would be if you don't have normal erythropoiesis, normal glycation and normal erythrocyte rates.

If you are under the care of a private endocrinologist and you don't have type 1 then presumably your treatment is covered by your health insurance (although I suspect they might have something to say about paying for tests that aren't clinically indicated if they looked at it too closely). In the highly unlikely event the private tests result in a diabetes diagnosis and you are permanently resident in the uk you will get perfectly reasonable care in the NHS.

The point he made is that in early stages, the pancreas can stabilise blood sugar over time if no new insulin-required molecules go into bloodstream. As they die, the fasting blood sugar will rise, hba1c will rise and then people will start experiencing thirst, peeing all the time because glucose levels are too high and leak through kidneys. Then people run to the doctor. And end up diagnosed with fasting 10 mmol/l and hba1c of 8-10%. Some power through symptoms and finally succumb at ICU with the meter reading "High".

He would not have done any tests if OGTT was normal. He told me it is necessary to repeat it and at the same time order antibodies tests. He told me there were a few cases of normal glucose parameters who turned out to be in early stages and were diagnosed in the office instead of ICU.

i really think the op has a problem. but its not diabetic related yet. please get back to your gp and be honest about your emotional issues and that it effects your eating. this is your major issue.

Yes, I do. Having read a bunch of stuff on this forum and elsewhere, I am worried my blood glucose will shoot up, because of all indicating symptoms I have, and I cause damage to myself in this event. Better be safe than sorry. I have severe mental issues, even before diabetes. Related to relationships, my place on this planet and other things.
 
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Rokaab

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He was interested in how tired and fatigued I am.

If I was as anxious/stressed as you come across in your messages then I would probably be sleeping terribly, so that may be why you're feeling tired and fatigued.

Whilst yes you are worried, I think you need to take a step back and wait til you actually get your results back rather than assuming you have diabetes.
 
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Kittycat_7_

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Type of diabetes
Type 2
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Insulin
Please go back to your GP, you can't be diagnosed diabetic with normal fasting blood glucose or HBA1C normal.
Most Drs do two tests to diagnose.
Something is causing the weight loss and other symptoms.
Take care
 

Bluetit1802

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He would not have done any tests if OGTT was normal.

How many times do we need to tell you - you failed the OGTT simply because you hadn't eaten for 3 days beforehand and were very dehydrated. The test also made you very ill after about an hour, so that will have made matters worse by the crucial 2 hour mark. Of course you failed it - anyone would have. Did you tell the Endo this? The fasting glucose test you had immediately before the OGTT as a baseline for the test was 4 point something.

As you have been told to ask for another OGTT please make sure you eat at least 150g carbs per day for at least 3 days beforehand, and drink plenty of fluids. You have been given the glucose drink manufacturer's instructions about this on another thread. There are very good reasons for doing this, and you have admitted you understand this.
 
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How many times do we need to tell you - you failed the OGTT simply because you hadn't eaten for 3 days beforehand and were very dehydrated. T
This is very true.

From the Wikipedia article for OGTT.

Preparation

The patient is instructed not to restrict carbohydrate intake in the days or weeks before the test. The test should not be done during an illness, as results may not reflect the patient's glucose metabolism when healthy.

A full adult dose should not be given to a person weighing less than 42.6 kg (94 lb), or the excessive glucose may produce a false positive result
.
Usually the OGTT is performed in the morning as glucose tolerance can exhibit a diurnal rhythm with a significant decrease in the afternoon.

The patient is instructed to fast (water is allowed) for 8–12 hours prior to the tests

https://en.wikipedia.org/wiki/Glucose_tolerance_test
 

Triceraptors

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i really think the op has a problem. but its not diabetic related yet. please get back to your gp and be honest about your emotional issues and that it effects your eating. this is your major issue.
How many times do we need to tell you - you failed the OGTT simply because you hadn't eaten for 3 days beforehand and were very dehydrated. The test also made you very ill after about an hour, so that will have made matters worse by the crucial 2 hour mark. Of course you failed it - anyone would have. Did you tell the Endo this? The fasting glucose test you had immediately before the OGTT as a baseline for the test was 4 point something.

As you have been told to ask for another OGTT please make sure you eat at least 150g carbs per day for at least 3 days beforehand, and drink plenty of fluids. You have been given the glucose drink manufacturer's instructions about this on another thread. There are very good reasons for doing this, and you have admitted you understand this.

I told the endo about this and he said it makes negligible difference. The fasting blood glucose is not that important because body had 10-12 hours to put it back. The rate of putting it back depends on insulin amounts. When body is flooded with glucose, if not enough insulin is produced even in low fasting blood glucose and spikes high, then there is something wrong with glucose metabolism. Now what it is, is a different matter to tell. There are other tests for that.

However, I do agree that NHS reasoning makes sense, but endo seems to think, in his experience, this means not that much for the accurate result. I am simply stating what he said.
 

paulus1

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Messages
843
Type of diabetes
Type 2
Treatment type
Tablets (oral)
then that really
The point he made is that in early stages, the pancreas can stabilise blood sugar over time if no new insulin-required molecules go into bloodstream. As they die, the fasting blood sugar will rise, hba1c will rise and then people will start experiencing thirst, peeing all the time because glucose levels are too high and leak through kidneys. Then people run to the doctor. And end up diagnosed with fasting 10 mmol/l and hba1c of 8-10%. Some power through symptoms and finally succumb at ICU with the meter reading "High".

He would not have done any tests if OGTT was normal. He told me it is necessary to repeat it and at the same time order antibodies tests. He told me there were a few cases of normal glucose parameters who turned out to be in early stages and were diagnosed in the office instead of ICU.



Yes, I do. Having read a bunch of stuff on this forum and elsewhere, I am worried my blood glucose will shoot up, because of all indicating symptoms I have, and I cause damage to myself in this event. Better be safe than sorry. I have severe mental issues, even before diabetes. Related to relationships, my place on this planet and other things.

then this is where you need to concentrate. im sorry if i come across as not sympathetic i am. your clearly very worried. can i ask has this occurred with other health conditions. there is a condition called factitious disorder that you may want to look up.

look re the diabetes there is nothing that any doctor can do even if your going to develop a form of diabetes.
with your bg at these low levels no doctor would prescribe blood glucose lowering medication. and defiantly not insulin. they would all be sending you into hypos.

re your private doctor your very unlikely to have any symptoms at 10 and to order expensive antibody tests before a proper dignosis is made is very bad practice. here is the current gps guidence for type 2 but the diagnosis is the same .https://www.gp-update.co.uk/files/docs/GP_Update-Spring_2013_diabetes.pdf

his statement that hba1c is not to be used for type 1is correct. what he seems to have missed is that your normal blood glucose levels currently are normal so a high level is not being hidden by earlier low bg levels. you dont swing low if your not getting treatment. diet would not do it alone either. it would slow the rise but it would still be going up.

im so sorry you so stressed. its why i said eat normally and then test so you can see what your real levels are.