Neebie from France needing advise.

[Toulouse31]

Hi
This morning I had my usual TSH for thyroid, Vitamin D and fluu blood count and ESR
amongst a lot of other bloods a fasting glucose result on the e-mail (which arrived 4 hours after the tests)


GLYCEMIE 1,19 g/l * N: 0,74 - 1,06
6 , 6 1 m m o l / l * N: 4,11 - 5,89

I was actually at the GPs yesterday because I am going to England later today and had torn my rotor coff (again) and needed a steroid injection into the tendon to get me through the next 4 days.

I have pre existing Fibromyalgia, joint hypermobility syndrome which makes my joints prone to injury, tennis elbow, tendonitis, plantar facilitis, carpal tunnel, etc etc. I have for some years thought I had some sort of hypo/hyper sugar issues and have become concerned in the last 2 years or so of a large increase in weight (30lbs) most of which 10 inches has gone on my middle changing me from a Pear to a short fat middle aged apple! Extreme tirdness over and above the fibro. I am totally exhasusted most of the time. I wake up tired, go to bed abour 10pm even more tired. .I have been gluten free due to intolerance for 10 years and always try to eat low carb, I feel fab on a very low carb Atkins type diet and was never overweight until my joint injuries started up. I avoid white carbs and sugar (unless I find a bag of crisps or fizzy sweets then all self control goes out the window! am planning to go to Boots later today and get a glucose meter and strips and start testing during the day then see my GP when I get back. I am not lookig forward to this, he is old, nice and kind but tends not to be proactive. I have an appointment to see my UK optition this afternon and will ask if anythng is showing (there wasn't)

So ...: What are the main symptoms I should be concerned about ?over and above the fibro? If I start with all of the above I will need all day! I need to focus and know what I am actually asking for.
Which monitor should I buy today (I have about 1/2 hour to shop and want to start testing today)? I have seen negative reviews of some on-line and want a good one that I can strips here for in France online at a reasonable cost. How any times a day should I test?
Lastly AM I pre-diabetic or is it really all in my head, off to catch my ride to the airport now but will check later for feedback. thanks for listening.

 

[phoenix]

1)That 1.19g/l is in the impaired fasting glucose bracket but would require a second confirmatory fasting blood test.
If you have had a virus recently that could have impacted on your fasting glucose level so a second reading might not confirm this.
Some of symptoms might be related to diabetes but not necessarily

2) I doubt very much that a French GP will prescribe strips . (well they will prescribe them but they won't be reimbursed under the French system ; they are now legally very much restricted for T2s even when they take medication and thus have 100% reimbursement

3) UK Meters are in mmol/l , French ones in mg/dl which doctors and patients tend to read as g/l.
I'm normally quite good at converting one to the other but It can get confusing when talking to French doctors and trying to keep units straight. (I've been there)

4) since you probably won't get prescribed strips, it is worth while investigating a meter sold online. Many of the T2s on here use one called the codefree. It's strips are quite reasonably priced and I gather they will send to France.


If you really want to buy a meter in the UK, it is a bit of a minefield finding one that you can buy strips in both countries for. I think you will be OK with the ones that I've highlighted but can't guarantee it !
Here is a guide to all those available in France even those that look similar don't actually take the same strips. (accuchek meters which are probably one of the most easily available in the UK are different
http://www.afd.asso.fr/webform/guide-choisir-son-lecteur-de-glycemie

The BGstar seems to have the same strips in both countries (that one is sold on the Boots site and is the one I'm relying on but haven't had to buy any in the UK yet)
The Abbott Freestyle Optimum also seems to have the same strips (Freestyle optimum)
(the other Abbott meters look similar but have a slightly different name and so have the strips ( in the UK Freestyle lite strips in France Freestyle Papillon strips. I can't say whether they are actually the same)
The Bayer contour XT (France) appears to be the same model as the Bayer contour Next in the UK (both use contour next strips)
One touch Ultra strips are available in France (they fit the Ultra mini in the UK but I don't think you can get them from pharmacies in the UK now; though they are still on Amazon

. Pharmacies in France mostly seem to charge the fixed price that the SECU will reimburse which is around 19€ for 50

 

[Toulouse31]

Thanks for the detailed reply. I will have a good read of the forum too. Optition found no eye issues thank goodness.

 

[Totto]

Hi Toulouse, I'd say your thyroid isn't working properly. The internal shivering sounds familiar for example, as the fatigue, the weight gain and most of the symptoms you list including fibro. Have you had cortisol tested? Sodium level?

 

[Brunneria]

Hi Toulouse,

The problem is that a single fasting blood glucose test is a bit like a snapshot at a moving target.
Personally, my fasting BG tests come out anywhere from 6.0 to 8.5 mmol/l depending on stress, sleep deprivation, physical activity level, food the day before and wind direction!

Some of your symptoms match diabetes. But, as @Totto says, they match other stuff too.

You need much more data before anyone draws a conclusion.

So I suggest that it is either buy your own test meter as @phoenix has suggested, or have some more tests done.

Good luck. And please come back and let us know how things go?

 

[Toulouse31]

Thanks all, got an Accuchek and the DK diabetes book and the metabalism miracle which is me to a T. I think i might be having hypo, hyper swings i often go many hours without eating on a ,good, day. Big wake up call so will do lots of monitoring over next 3 days as usul then start the 8 week low carb stage one of Mm as soon as i get home. I always feel great on atkins but clearly some carbs are good and i have to stop the all or nothing rollrcoaster! If i eat a food is the 2 hour after result all needed to tell me if or are swings faster slower, longer, ia first thing, before and 2 hours after eating enough with a last onebeforebed ok? I never eat after 8pm usually and this obviously is not helping I HAVE A LOT TO LEARN. Any advise and links really helpful, my health is going to take a front seat gor a while . I.m glad the fbg was higher , it was the wake up call i needed. I have no intention of being T2 if i can do anything about it which is within my power with help, self education and advice from you peeps who have been there
, done that first sorry for spelling i,m. Not good on my travel smart phone yet, are there any android appps for recording food etc and effects on Bg that you use more than others?.

 

[Toulouse31]

I tested a lot today before and after meals, 5.6 on waking then highest 11.2 45 mins after breakfast, down to 9.4 2 hours later. 5,.8 B before lunch I am getting headaches st anything over 8,. Very thirsty and gettng up to wee seversl times tonight so very tired. Started reading the 101 book,very scary stuff. This is so simlar to when i developed an underactive thyroid but with ,in range, TSH.

 

[Brunneria]

Hi,
How's it going?
Is your metabolism miracle book the one by Diane cress?
I'm 6 weeks into her phase one, in the diabetes miracle book, which is fairly similar, I think.

Still getting the headaches?
Remember to drink masses, and don't go hungry! That's the worst thing to do, because you risk falling off the wagon.

With your blood glucose testing, do you know the levels you are aiming for?

Oh, and many f us use the MyFitnessPal app, but make sure you check the nutrients in the various foods are accurate, because they are added by users, and are not always accurate!

 

[Toulouse31]

Hi,
How's it going?
Is your metabolism miracle book the one by Diane cress?
I'm 6 weeks into her phase one, in the diabetes miracle book, which is fairly similar, I think.

Still getting the headaches?
Remember to drink masses, and don't go hungry! That's the worst thing to do, because you risk falling off the wagon.

With your blood glucose testing, do you know the levels you are aiming for?

Oh, and many f us use the MyFitnessPal app, but make sure you check the nutrients in the various foods are accurate, because they are added by users, and are not always accurate!

 

[Toulouse31]

Hi, Well thanks for asking.....................I
Yes that is the Miracle book hoping to finish it today, I also finished the kindle version of 101 you link to on the flight back. I am still getting the headaches which are a lot worse when the strong painkillers and ibrupro for my shoulder wear off (I don't normally take painkillers unless for specific injuries). I have never been a headachey person unless ill with something else. I wake up with a 'hangover feeling' even if I havn't had a drink.
After a few days of lots of monitoring with Accuchk & Diabetes.co.uk app so starting to see baselines, patterns, get averages, After the initial panic I am feeling a lot calmer and not so overwhealmed now that I'm home, I am always happy with some data to analyse, excel makes me happy I put some batteries in my blood test/pulse monitor and it is 145/87 this morning which is high for me, I usually tend to low/normal.

Before asking my GP to post me a blood test prescription for 2 hour GTT and Hba1c (can't go and see him until OH gets back as can't drive with the shoulder issue) I'm working up the courage.... He only included the fasting G test to be nice and his response to my e-mail (no comments added from me) of the results was 'all looks ok, keep doing what you are doing'. Anything else I should ask for, can these results mimic/be a consequence of other undiagnosed medical conditions I might have?
He told my husband last year who also had raised, but not so high Fasting glucose it was ' occupational' (wine trade) and not to worry .

Thank goodness I felt well for a few days on holiday as it made me realise how ill I was feeling and that it really isn't normal, even for me!

Highest results so far 11.6 yesterday, 4 hours after a Gluten free ham and tomato roll, surprisingly higher than after a chinese takaway and 2/3 glasses of white wine at my sisters at the weekend and even higher than the 11.2mmol/l after breakfast of 1/4 bar of chocolate and 5 haribo sour sweeties from trick or treating nephews, my version of GTT to get a baseline. Normal eating was a challenge while away although I did eat at meal times only.
Is there anyone/you who could look at my Excel Data dump of monitor from the app/reactions to foods and tell me what it looks like or if I am totally barking up the wrong tree? If I give him too much data he won't look at it I need to know what to prioritise.

Bet you wish you hadn't asked now!

 

[Brunneria]

I'm the same with info. Knowledge is so much more reassuring than ignorance!

Glad you have found 101 useful. Have you tried the website? It's a brilliant quick reference.

How many carbs does the MM book allow per meal?
The diabetic miracle gives 5g quick release carbs a meal, as a late night snack, and in the middle of the night, if you wake up (used that last night - bloody urban foxes!)

The headaches will ease off soon. Promise. But keep drinking the water.
And my experience is that my BP is consistently lower, when low carbing than when higher carbing - so that may well take care of itself.

You can do an HbA1c at any time, but you can't do an oral glucose tolerance test while on low carb. So it is worth remembering that you need to eat 150g or more carbs a day for several days before the test (a week to be safe). If you don't, the test results will be much higher than they should be. The reason is complicated, but basically the body gets out of the habit of dealing with carbs when on low carb, and needs several days to get back into practice. Don't worry, you don't lose your capacity to deal with carbs for ever.

Where possible, try testing consistently
Before food
Then 2 hours later
That will give you better comparisons with different meals and specific carbs. Although I realise that life makes this impossible sometimes!

That 11+ at four hours after the ham roll is surprising. I'd expect you to be high at 2 hours, then go lower by four. Worth testing if your reaction is higher with wheat products than with other carbs. It is for some of us, including me. Just a thought.

The results of your choc and haribo test May have been affected slightly by the fat in the choc. It never spikes me as high or as fast if there is fat in the food. Fat and protein free foods get digested very fast.

When you go to your doc, the best thing (in my opinion) would be to take as many readings as possible, but in graph form (Excel?) so that he can see at a glance.

Bear in mind that once you started the metabolic miracle eating plan, your blood glucose should have steadied down very quickly, and really won't show results that illustrate your 'problem'. Since I have been on phase 1, my BG meter has not read above 7 after food, and any doc will consider that perfectly 'normal' and dismiss your concerns.

On the other hand, your results of 11+ are much more likely to cause him to investigate.

Sorry I can't comment on your thyroid or fibro (but I have definitely read posts on this forum who say that their fibro improved with low carbing. But I'm afraid I can't remember who said it!

Keep in touch?

 

[Toulouse31]

I'm the same with info. Knowledge is so much more reassuring than ignorance!

Glad you have found 101 useful. Have you tried the website? It's a brilliant quick reference.

How many carbs does the MM book allow per meal?
The diabetic miracle gives 5g quick release carbs a meal, as a late night snack, and in the middle of the night, if you wake up (used that last night - bloody urban foxes!)

The headaches will ease off soon. Promise. But keep drinking the water.
And my experience is that my BP is consistently lower, when low carbing than when higher carbing - so that may well take care of itself.

You can do an HbA1c at any time, but you can't do an oral glucose tolerance test while on low carb. So it is worth remembering that you need to eat 150g or more carbs a day for several days before the test (a week to be safe). If you don't, the test results will be much higher than they should be. The reason is complicated, but basically the body gets out of the habit of dealing with carbs when on low carb, and needs several days to get back into practice. Don't worry, you don't lose your capacity to deal with carbs for ever.

Where possible, try testing consistently
Before food
Then 2 hours later
That will give you better comparisons with different meals and specific carbs. Although I realise that life makes this impossible sometimes!

That 11+ at four hours after the ham roll is surprising. I'd expect you to be high at 2 hours, then go lower by four. Worth testing if your reaction is higher with wheat products than with other carbs. It is for some of us, including me. Just a thought.

The results of your choc and haribo test May have been affected slightly by the fat in the choc. It never spikes me as high or as fast if there is fat in the food. Fat and protein free foods get digested very fast.

When you go to your doc, the best thing (in my opinion) would be to take as many readings as possible, but in graph form (Excel?) so that he can see at a glance.

Bear in mind that once you started the metabolic miracle eating plan, your blood glucose should have steadied down very quickly, and really won't show results that illustrate your 'problem'. Since I have been on phase 1, my BG meter has not read above 7 after food, and any doc will consider that perfectly 'normal' and dismiss your concerns.

On the other hand, your results of 11+ are much more likely to cause him to investigate.

Sorry I can't comment on your thyroid or fibro (but I have definitely read posts on this forum who say that their fibro improved with low carbing. But I'm afraid I can't remember who said it!

Keep in touch?

Thanks , I havn't started the MM diet yet but think it was 5g? I read on the forum about the low carbing affecting the GTT results so won't start until Friday but I'm feeling so awful that I thought I would stay fairly low carb, be sensible. I don't eat wheat at all, entire family are coleiac/gluten intolerant (yet another missed/late NHS diagnosis) and have gradually lost the urge to munch bread, pasta etc only really eat Gluten free versions with in england or when I can get it here. I cook mainly from scratch so its not really a problem. Need to check on the gms of carbs allowed before starting the 8 weeks, really encouraging to hear how well you are doing on the diet so far. The GF roll was 28.2 net carbs but 2nd ingredient is Potato starch, I have been eating quite a few potato (and nightshades) recently as I had a good harvest this year and it is often used in GF cooking. today for my 'trial' meal I'll bake one for lunch and see what the meter says... before plucking up the courage to ring the GP LOL

 

[Toulouse31]

1)That 1.19g/l is in the impaired fasting glucose bracket but would require a second confirmatory fasting blood test.
If you have had a virus recently that could have impacted on your fasting glucose level so a second reading might not confirm this.
Some of symptoms might be related to diabetes but not necessarily

2) I doubt very much that a French GP will prescribe strips . (well they will prescribe them but they won't be reimbursed under the French system ; they are now legally very much restricted for T2s even when they take medication and thus have 100% reimbursement

3) UK Meters are in mmol/l , French ones in mg/dl which doctors and patients tend to read as g/l.
I'm normally quite good at converting one to the other but It can get confusing when talking to French doctors and trying to keep units straight. (I've been there)

4) since you probably won't get prescribed strips, it is worth while investigating a meter sold online. Many of the T2s on here use one called the codefree. It's strips are quite reasonably priced and I gather they will send to France.


If you really want to buy a meter in the UK, it is a bit of a minefield finding one that you can buy strips in both countries for. I think you will be OK with the ones that I've highlighted but can't guarantee it !
Here is a guide to all those available in France even those that look similar don't actually take the same strips. (accuchek meters which are probably one of the most easily available in the UK are different
http://www.afd.asso.fr/webform/guide-choisir-son-lecteur-de-glycemie

The BGstar seems to have the same strips in both countries (that one is sold on the Boots site and is the one I'm relying on but haven't had to buy any in the UK yet)
The Abbott Freestyle Optimum also seems to have the same strips (Freestyle optimum)
(the other Abbott meters look similar but have a slightly different name and so have the strips ( in the UK Freestyle lite strips in France Freestyle Papillon strips. I can't say whether they are actually the same)
The Bayer contour XT (France) appears to be the same model as the Bayer contour Next in the UK (both use contour next strips)
One touch Ultra strips are available in France (they fit the Ultra mini in the UK but I don't think you can get them from pharmacies in the UK now; though they are still on Amazon

. Pharmacies in France mostly seem to charge the fixed price that the SECU will reimburse which is around 19€ for 50

do

thanks phoenix great info, do you happen to know/have a link to the bg glucose ranges for pre- and T2 in France, for the french version of NICE France, I am hoping they are a bit more realistic than the UK/NHS. I want to be sure of my ground before phoning my GP later. He is English by the way but does some surguries locally.

 

[phoenix]

1.26 or over on two fasting tests is diagnostic of diabetes
'Lorsque la glycémie est comprise entre 1,10 g/l et 1,25 g/l, le diagnostic d’hyperglycémie modérée à jeun (prédiabète) est posé. '
'En cas de « prédiabète », prévoir le renouvellement du test de dépistage du diabète à 1 an. La prévention du diabète repose sur l’éducation nutritionnelle (activité physique et alimentation équilibrée réduite en graisses) et l’obtention du changement durable du comportement (6, 10). '
ie I the fasting test is between 110mg/dl and 125mg/dl (6.1mmol/l -6.9mmol/l) do the test again in a year . Prevention of diabetes relying on a durable change in habits ie physical activity and adopting a balanced,, reduced fat diet.
This is from the HAS which is the French equivalent to NICE
Later in the document they give some more detail about both physical activity and diet. Both of which I've found to be stressed here as being equally important.
http://www.has-sante.fr/portail/upload/docs/application/pdf/2014-04/guide_pds_diabete_t_3_web.pdf
There is actually a Maison du Diabete in Toulouse
http://www.maisondudiabete-toulouse.org/

 

[Toulouse31]

1.26 or over on two fasting tests is diagnostic of diabetes
'Lorsque la glycémie est comprise entre 1,10 g/l et 1,25 g/l, le diagnostic d’hyperglycémie modérée à jeun (prédiabète) est posé. '
'En cas de « prédiabète », prévoir le renouvellement du test de dépistage du diabète à 1 an. La prévention du diabète repose sur l’éducation nutritionnelle (activité physique et alimentation équilibrée réduite en graisses) et l’obtention du changement durable du comportement (6, 10). '
ie I the fasting test is between 110mg/dl and 125mg/dl (6.1mmol/l -6.9mmol/l) do the test again in a year . Prevention of diabetes relying on a durable change in habits ie physical activity and adopting a balanced,, reduced fat diet.
This is from the HAS which is the French equivalent to NICE
Later in the document they give some more detail about both physical activity and diet. Both of which I've found to be stressed here as being equally important.
http://www.has-sante.fr/portail/upload/docs/application/pdf/2014-04/guide_pds_diabete_t_3_web.pdf
There is actually a Maison du Diabete in Toulouse
http://www.maisondudiabete-toulouse.org/

Thank you for that, off to do a bit of reading

 

[Toulouse31]

I'm the same with info. Knowledge is so much more reassuring than ignorance!

Glad you have found 101 useful. Have you tried the website? It's a brilliant quick reference.

How many carbs does the MM book allow per meal?
The diabetic miracle gives 5g quick release carbs a meal, as a late night snack, and in the middle of the night, if you wake up (used that last night - bloody urban foxes!)

The headaches will ease off soon. Promise. But keep drinking the water.
And my experience is that my BP is consistently lower, when low carbing than when higher carbing - so that may well take care of itself.

You can do an HbA1c at any time, but you can't do an oral glucose tolerance test while on low carb. So it is worth remembering that you need to eat 150g or more carbs a day for several days before the test (a week to be safe). If you don't, the test results will be much higher than they should be. The reason is complicated, but basically the body gets out of the habit of dealing with carbs when on low carb, and needs several days to get back into practice. Don't worry, you don't lose your capacity to deal with carbs for ever.

Where possible, try testing consistently
Before food
Then 2 hours later
That will give you better comparisons with different meals and specific carbs. Although I realise that life makes this impossible sometimes!

That 11+ at four hours after the ham roll is surprising. I'd expect you to be high at 2 hours, then go lower by four. Worth testing if your reaction is higher with wheat products than with other carbs. It is for some of us, including me. Just a thought.

The results of your choc and haribo test May have been affected slightly by the fat in the choc. It never spikes me as high or as fast if there is fat in the food. Fat and protein free foods get digested very fast.

When you go to your doc, the best thing (in my opinion) would be to take as many readings as possible, but in graph form (Excel?) so that he can see at a glance.

Bear in mind that once you started the metabolic miracle eating plan, your blood glucose should have steadied down very quickly, and really won't show results that illustrate your 'problem'. Since I have been on phase 1, my BG meter has not read above 7 after food, and any doc will consider that perfectly 'normal' and dismiss your concerns.

On the other hand, your results of 11+ are much more likely to cause him to investigate.

Sorry I can't comment on your thyroid or fibro (but I have definitely read posts on this forum who say that their fibro improved with low carbing. But I'm afraid I can't remember who said it!

Keep in touch?

Well I'm confused now, I went to my previous GP yesterday afternoon (as my current one fobbed me off by e-mail offering to do a urine test at the end of the week...........) and she said from symptoms, examed my monitoring results I am T2 diabetic and sent me for a HbAc1 to confirm diagnosis. She prescribed 1 x 500mg Metaform after dinner and said to go back in a week with results. Hopefully this will kick in soon and do something about the symptoms especially the mouth and drinking weeing until the diet kicks in.
I just got the e-mail with the results 5.7% (range 4-6%) which is not! So not sure what is going on??? we have many serious illnesses and clinically are often very ill with so called 'normal/in range' blood test results so It does not worry me other than a proper diagnosis would stop well meaning family members from patiently telling me its all in my head, which I know it is not. It would also make it easier to stick to the low carbing amongst family who allready think I'm nuts for not eating bread and pasta etc. It took literally years form my tyhroid bloods to accuratly reflect my clinical status and so much damage was done being untreated. This will be about the FOURTH time this has happened to me....... If I get it under control with diet it was all in my head

 

[Brunneria]

don't show your family the hba1c result.
just show them your meter readings from when they were over 8mmol/l

I'm afraid I TOTALLY understand. This has happened to my mother, over thyroid, and myself over type 2 diabetes.

You can also quote the umpteen studies and new nutritional data available which suggests low carb and fat being healthy.

Or you can say something like 'thank heavens they caught it while it was borderline! Imagine how rough it would be if I had waited until I got it bad! So I really need to stick to my diet to avoid developing severe diabetes and going on insulin!'

 

[Toulouse31]

don't show your family the hba1c result.
just show them your meter readings from when they were over 8mmol/l

I'm afraid I TOTALLY understand. This has happened to my mother, over thyroid, and myself over type 2 diabetes.

You can also quote the umpteen studies and new nutritional data available which suggests low carb and fat being healthy.

Or you can say something like 'thank heavens they caught it while it was borderline! Imagine how rough it would be if I had waited until I got it bad! So I really need to stick to my diet to avoid developing severe diabetes and going on insulin!'

Thanks for that Brunneria, It really helps to have someone to bounce off LOL Is 8 a 'magic' number or just as its above 7.8? (this is the range I highlighted on my monitor printout)
I need to take a deep breath! It going to make life difficult wth my usual GP though. Is there a list anywhere of things that can cause depressed/false low Hbac1 readings? other drugs i.e. prozac, thyoid meds? low Vit D, etc etc then I would be happier in my own mind

 

[Brunneria]

8 is just a nice round number that I quote along the lines of

'normal people are usually under 6.6 two hours after eating. look! The fact that Im over 8 means that things are definitely not right. and that High I got, the time we ate the cream tea? well that was 14.7!' dramatic pause 'So that proves I can't eat that again, doesn't it?'

you can always offer to stab their finger and test them too - always remembering to use a clean lancet, of course.
Mr B is usually in the 5s, after stuffing his face with carbs. Me? 8+ with a teasp of rice or mash.

I'm not an expert on hba1cs. but there is something that affects the results. I think it may be anaemia. have a google for things that affect it...

the other thing to bear in mind is that the hba1c is an AVERAGE figure. so if someone is having highs and lows, with massive swings and generally feeling cr*ppy, then they may end up with an a1c in the middle - giving the impression that things are not as bad as they are.

 

[phoenix]

If she is going to make it an official diagnosis, then make sure that you get it listed as an ALD . (sorry don't know how it is done because the hospital organised it for me. I know it is marked on the 'attestation' and on the chip of my carte vitale)http://www.ameli.fr/professionnels-...ction-de-longue-duree/les-ald-exonerantes.php
With an ALD any drugs, treatment for diabetes (including opthamology checks, cardiology, blood tests) are reimbursed at 100% by the assurance maladie. You will get flu jabs offered.
Unlike in the UK, it only applies to diabetes related things so for example thyroid medication isn't 100%.
In effect, if you have a top-up insurance, it doesn't make much difference (though it's a safeguard and means that top-up insurers don't have to (aren't allowed to) take chronic conditions into account when they set premiums) You still often have to pay up front when you visit a doctor.
You will probably also get an invitation to use Sophia which is a sort of telemedicine advise line. I haven't because I hate speaking French on the phone and I get good hospital based care in any case.
https://www.ameli-sophia.fr/
( By the way, I'm' just' up the road from you , well about 140km N of you in the Aveyron)