HbA1c

Teddysmum

Member
Messages
21
I am 66 years old and have had type two for over six years; all that time being on 'diet and exercise' with no medication.

Prior to my latest annual MOT, in July, either the diabetes nurse or another practice nurse have just told me my readings are fine and so I have no idea of previous values. However, now they provide a card with results and targets.

Before July, I had been rather naughty with sweets (not excessive), as I felt a bit down, and had much reduced my exercise due to a deteriorating spine problem .My cholesterol was well within limits but my HbA1c was 49 with a target of 48.

Today, I got the results of my 3 month re-test and find that though my cholesterol is even lower, my HbA1c is 52.

Am I in danger of being put on medication or is this reserved for higher readings?

(I'm asking as the diabetes nurse is on leave, so I can't ask her.)
 

DeejayR

Well-Known Member
Messages
2,381
Type of diabetes
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Diet only
Hello. Depends on individual GPs and practices. Anyway, the choice to take pills or not is yours. Perhaps you can simply resolve to get your BS back down with diet and exercise.
We can help you do that, and you should think about getting a meter to test yourself regularly so you can keep a check on your daily levels.
 
Messages
6,107
Type of diabetes
Type 2
Treatment type
Diet only
They have tick charts and 48 and above means you have a tick. This is the level considered to be diabetic so I would not be surprised if their flow chart said Metformin. Cut the sweets or other carbs to bring the reading down. You know it makes sense.
 
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ButtterflyLady

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Messages
3,291
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Tablets (oral)
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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I am 66 years old and have had type two for over six years; all that time being on 'diet and exercise' with no medication.

Prior to my latest annual MOT, in July, either the diabetes nurse or another practice nurse have just told me my readings are fine and so I have no idea of previous values. However, now they provide a card with results and targets.

Before July, I had been rather naughty with sweets (not excessive), as I felt a bit down, and had much reduced my exercise due to a deteriorating spine problem .My cholesterol was well within limits but my HbA1c was 49 with a target of 48.

Today, I got the results of my 3 month re-test and find that though my cholesterol is even lower, my HbA1c is 52.

Am I in danger of being put on medication or is this reserved for higher readings?

(I'm asking as the diabetes nurse is on leave, so I can't ask her.)
Now's a good time to reduce your sugar and carb intake, so your HbA1c doesn't go any higher. In fact it can go lower, with some eating changes. @daisy1 has info for newbies about this.
 
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daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
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Tablets (oral)
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Cruelty towards animals.
@Teddysmum

Hello and welcome to the forum :) Here is the information we give to new members even though you are not newly diagnosed. Following the advice in here to reduce carbs your levels should improve. Ask more questions and someone will come and help, as they have already.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

Teddysmum

Member
Messages
21
Thanks for the replies.
I do have a monitor from when you got a freebie without being on meds , but have rarely used it since free strips were stopped. ( Just tried and it reads 7.2, but the strips are out of date).

I think that is when the rot started, as I used to test about once a week.Then the odd sweeter thing sneaked in (ie sponge pudding or icecream for dessert ) as there was no way of seeing any effect. In the last year, I've tend to add a bit more and a bit more sweet treat, especially when bored, due to pain reducing my movement/exercise and nothing has shown up in the MOT until now (well nothing that's been commented on).

My trouble is that I don't like food and don't have a large appetite, so my diet is restricted even before considering what I eat . I used to get lots of diabetes recipe books from the library, but the foods were all alien to me, as I don't like spicy food or pasta. Also, my back problem makes preparing meals a long drawn out task, so when the meals ready I've my appetite and a husband who is very fussy about what he will eat doesn't help, when you are only preparing meals for two.

Maybe it's my odd taste buds, but vegetables don't taste nice (too bitter or too sweet) . I used to like tiny sprouts, cabbage, cauliflower and carrots (but I've had some horrid ones lately), so that leaves peas and green beans .Fruit (especially apples and nectarines) seems tasteless and I've had to return to lots of oranges as they were either dry or had too tough to chew segments. I have tried wholemeal breads, but don't like the nutty taste or find them dry.

I saw a dietician, 6 years ago, who said my diet wasn't bad, but I've gone off some of the foods since then (ie horrid veg , tasteless meats and even eggs lack flavour). She recommend eating anything, except sweets, in moderation, though she said a snack size Mars bar was an ok treat ( I don't like Mars bars so no danger of large ones) and didn't suggest cutting well down on carbs.

When my late dad was diagnosed, in his late 70s, he said he saw little point in existence if he could only have horrible food. I'm not house bound like he was (He had Parkinsons), but partly see his point.

For breakfast I have a yoghurt or some flake cereal with dried fruit (gave up on Special K when they made it sweet). Lunch can be soup or a sandwich, with an occasional Weighwatchers frozen meal. By evening meal,
I'm struggling to find anything I want, so often feed my husband and do without or steal a couple of chips from his plate. At bedtime a rich tea or digestive biscuit with my tea, but not every day.

I think I'm going through the feeling sorry for oneself, as on first diagnosis and probably because my neurology consultation ,yesterday resulted in tests for more possible ailments (increased hypothyroid and possible osteoporosis), but didn't cover things I hoped to discuss (felt a little fobbed off after just 10minutes,when I usually have over 30) , so I'll bounce back at some stage....if I don't starve to death.:wacky:


PS Any suggestions for yummy food for someone as fussy as me ? ie tasty, not spicy, satisfying but not over filling ?



.
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
Cereal, bread and biscuits will not help you get your blood glucose levels down. There are food ideas in the low carb diet forum and the threads like "what have you eaten today".

It's normal for our ability to taste food to decrease with age, but I am wondering if there is some medical reason why you no longer enjoy the taste of many foods and have low appetite. It might pay to get that checked out.
 

Teddysmum

Member
Messages
21
If I see doctors more than I do , they will throw me off their list.
This year I've been for stronger painkillers (back problem), anticonvulsants (ditto), swollen legs, vertigo and nausea (caused by back/chest spasms) an ear infection and a skin problem.

The lack of appetite is probably because of the stress and pain involved in getting a meal ready and the nausea caused by contraction of muscles near my stomach, besides not liking many vegetables.

I don't think the GPs know what to do with me, as they tell me to refer my symptoms to my neurologist, but I only see him once a year (He's the head of department and very busy ) .

I'm really down after Friday's visit, as he allocated much less time than on previous occasions, meaning I did not get to discuss my problems properly or even mention some. Usually he is very thorough and asks for more info.. He gave me the blood test results that I couldn't get from the GPs, as the diabetes nurse is on leave and they wouldn't release the results without her approval, so a double disappointment , as I expected my HbA1c to have dropped, not gone up, as I had mended my ways (but not as much as I could).

So a miserable weekend ,especially as the food prospects are bleak.

I really will have to look at the ' What have you eaten?' thread, but looking at the recipes on here, I can't see a single thing I fancy.

Ah well,I will lose weight again, which won't hurt as I am over a stone overweight ( I lost 2st when first diagnosed and got told off by my husband for punishing myself, but have put on weight due to pregabalin ,which I no longer take and the inability to exercise as I used to)
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
If I see doctors more than I do , they will throw me off their list.
This year I've been for stronger painkillers (back problem), anticonvulsants (ditto), swollen legs, vertigo and nausea (caused by back/chest spasms) an ear infection and a skin problem.

The lack of appetite is probably because of the stress and pain involved in getting a meal ready and the nausea caused by contraction of muscles near my stomach, besides not liking many vegetables.

I don't think the GPs know what to do with me, as they tell me to refer my symptoms to my neurologist, but I only see him once a year (He's the head of department and very busy ) .

I'm really down after Friday's visit, as he allocated much less time than on previous occasions, meaning I did not get to discuss my problems properly or even mention some. Usually he is very thorough and asks for more info.. He gave me the blood test results that I couldn't get from the GPs, as the diabetes nurse is on leave and they wouldn't release the results without her approval, so a double disappointment , as I expected my HbA1c to have dropped, not gone up, as I had mended my ways (but not as much as I could).

So a miserable weekend ,especially as the food prospects are bleak.

I really will have to look at the ' What have you eaten?' thread, but looking at the recipes on here, I can't see a single thing I fancy.

Ah well,I will lose weight again, which won't hurt as I am over a stone overweight ( I lost 2st when first diagnosed and got told off by my husband for punishing myself, but have put on weight due to pregabalin ,which I no longer take and the inability to exercise as I used to)
I sometimes don't want food after preparing it, so I put it in the fridge and when I feel like eating it, I reheat it in the microwave.

Are doctors allowed to throw a patient of their list for seeing them too often? What if all the visits are due to genuine/important medical needs that the patient can't do anything about?

If your doctor says you need to see your neurologist about an issue but you only see them once a year, wouldn't the doctor need to deal with the issue themselves? A lot of medical conditions can't wait that long to be resolved.

Some of my specialists are the HOD and if they can't see me then I see one of their registrars instead.