Diabetes newbie

[Crispy17]

Hi All,

I had a blood pressure and glucose level test on the 8th by a local pharmacist. Both came back high, with the pressure being 196/110 and the glucose reading 23. The pharmacist told me I needed to see my doctor but also asked me to see him the next day (Thursday) so he could do a fasting test. This again came back high reading 16.9, I told him I'd already booked an appoinment to see my doc which was for Tuesday, he advsied me this wasn't soon enough and I needed to request a fasttrack appointment (he showed me his instruction booklet which said this).
On his advice I contacted the doctors and explained the situation, initially they refused to move the appointment forward but after I told them the readings and they consulted with the doctor himself I was told to go in first thing in the morning.
When I got to see the doctor all they did was tell me to make an urgent appointment to see the practice nurse for blood (pressure and fasting glucose) and urine tests. I didn't get an appointment until the following tuesday morning but the samples were taken and I was told the results would take 3 days and so an appointment was booked for the Friday so I could dicuss the results with the doctor.
Instead atjust before 6 that evening I got a call from the doctor saying I needed to go down and pick up a letter and then go straight to A&E for treatment as my urine sample had shown high levels of ketones which could indicate internal organ damage. Gave me a bit of a fright I don't mind telling you! After 6 or so hours sitting round in A&Ebetween having yet more blood and urine tests I was sent home with a letter and instructions to present myself at my doctors first thing for urgent treatment (are you seeing a pattern yet?).
So Wednesday morning I at the doctors with letter in hand as they open the doors, only to be told Its not us you need to see you need to go to the diabetes clinic at the hospital. I explained I'd been told by the hospital that I was to see my own doctor and showed them the letter I'd been given which was addressed to him personally. Still they were adamant it needed to be the diabetes clinic I saw and told me they would arrange for an appointment to be mad and call me to let me know when. I got a call in the early eveniing confirming an appoinment had been made for 10am the next day.
So Thursday I finally got to see someone who actually started giving me some information, firstly she confirmed I did have diabetes, most likely type 2 although there was a small chance it could be type 1. She explained what ketones were and what the previous blood tests results meant. I then saw a consultant who gave me essentially the same information but also advised he would be prescribing medication (Metformin) and how I was to take it. Then back to the nurse who gave me some ketostix and a meter and showed me how to use them. I understand I only have the meter temporarily as they don't normally provide them for type 2 and the ketostix are just to keep an eye on the ketones ( I'm to go to A&E again if I get any sustained high readingd).

Sorry for the long post but it's been a bit of a nightmare and I just wanted to know if this kind of carry on is normal. Being told you have diabetes is bad enough but what really stressed me out was keep being told that everything is urgent and then nothing remotely urgent being done?

 

[cath99]

yes i had same treatment i was all ready to go down for a op with gown and stockings on hahah and my urine test come back at 18.1 she said the op was cancelled and there would be no xmas pudding for me this year and sent me on my way in a blurr,, if i had knew now what i did then i would of been alot more angry, but welcome anyways to the world of diabeties if im honest this place is the only place you will recieve tried and tested results as you go along, gp/nurses ahaha all full of air and guildlines, it is a serious problem to you but can easy be controlled quickly with adjustments and exersize reletivly quickly to , i was diag in dec last yr 10 months on 7 half stone gone i do low carb and it works wonderfuly for me so stick here and ask ask ask away xxx

 

[Crispy17]

Thanks Cath99 I think I'd have been raging if I'd been in your shoes, sorry stockings. Had another high reading yesterday but managed to get into the diabetes clinic to get the blood test done so halved the time waiting, been less than trace all day today so happy days. BG is through the roof though .

 

[Brunneria]

Blimey.
Words fail me.
The stress you must have been under won't have helped either your blood glucose or your blood pressure!

Are you writing to complain? Asking that they ALL clarify their procedures?

Unfortunately, you won't be the first person to get that runaround - and you certainly won't be the last, unless something changes!

But welcome, and you have come to the right place! You will get more info and help here than from a clinic full of consultants!

 

[cath99]

what sort of stuff are you eating if i can ask plz x

 

[andcol]

Hi Crispy17 what awful treatment you received. I am surprised with A&E to be honest. I understand why your doctors sent you to the hospital with high BG and ketones. This is generally a sign of little/no insulin (generally seen in T1) but can be found in T2s and is very severe. Did the hospital not actually do anything? I wonder if they sent you home because after sitting for 6 hours in A&E (probably with little to eat) you levels will drop to a reasonable level. This is such a cop out by the hospital.

Sorry that you have had to join our club. I would ask your doctor to perform some tests to determine if you are T2 or LADA (T1) just because you had ketones. Do you know what your HbA1c reading was. The doctor will be able to tell you. I expect it was pretty high and normal is up to 42 with anything over 48 being declare as diabetes. This will tell you how far from ideal levels you currently are.

There are 2 simple ways to lower your BG levels and I am afraid it isn't metformin; those are diet and exercise. Exercise helps our muscles use the glucose in your blood stream and diet helps you not raise your BG levels too high.

@daisy1 will be along shortly to give you basic advice

 

[daisy1]

Hi Crispy17 and welcome to the forum

As @Andrew Colvin mentioned, here is the information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will come along and help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 100,000 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.

 

[Crispy17]

I'm due to see the dietician on Tuesday but at the moments I'm basically just following the advice in the booklets they've given me. Essentially just cutting out the surgary stuff, switched to sweetners in my coffee no sweets or desserts, just sticking to meat and veg.

My HbaC1 reading was 114 if I remeber rightly most of my bg reading have been in the high teens early twenties.

I have to say the diabetic clinic have been superb so far but seriously not impressed with my doctors.

I got the impression from the A&E triage nurse that the local docs often fob newly diagnosed diabetes patients to the hospital, the cubicle next to me had a woman in who'd been sent by her GP in exaclty the same way I had, she was much more distressed than me.

I believe I've only got the meter because they are sure I'll need more than the two a day 500mg Metformin and want to get an idea of my BG reading to determine what level try rather than working up one step at a time.

If metformin doesn't help the body absorb the glucose what's it's purpose? I just assumed that was what it was prescribed for.

Edit: Thanks Daisy1 I'll have a read through that.

Quick question on meters is it worth investing in my own at this stage or should I wait until I've had confirmation of whether Im' T1 or T2?

 

[Brunneria]

I'm due to see the dietician on Tuesday but at the moments I'm basically just following the advice in the booklets they've given me. Essentially just cutting out the surgary stuff, switched to sweetners in my coffee no sweets or desserts, just sticking to meat and veg.

My HbaC1 reading was 114 if I remeber rightly most of my bg reading have been in the high teens early twenties.

I have to say the diabetic clinic have been superb so far but seriously not impressed with my doctors.

I got the impression from the A&E triage nurse that the local docs often fob newly diagnosed diabetes patients to the hospital, the cubicle next to me had a woman in who'd been sent by her GP in exaclty the same way I had, she was much more distressed than me.

I believe I've only got the meter because they are sure I'll need more than the two a day 500mg Metformin and want to get an idea of my BG reading to determine what level try rather than working up one step at a time.

If metformin doesn't help the body absorb the glucose what's it's purpose? I just assumed that was what it was prescribed for.

Edit: Thanks Daisy1 I'll have a read through that.

Quick question on meters is it worth investing in my own at this stage or should I wait until I've had confirmation of whether Im' T1 or T2?

Re diet, lots of us here find the NHS diet options deeply unsatisfying and outdated - but it is important that you make up your own mind.

Re the meter, I wanted to know ASAP, but it really depends on how long you are going to have to wait. Sometimes the wheels of the NHS grind very slowly. If you do want to buy immediately, the cheapest I've ever heard of is the Codefree. available from Amazon and eBay, and delivery is usually fast.

At the moment, with a dietician's appt on Tuesday, I would spend my time reading up on the different diet options, and becoming aware of what you are likely to be told on Tuesday. Your appointment may be very helpful, or it may give you advice that many people on this forum is absurd. But again, I stress, you must make up your own mind on eating, depending on your tastes and any other health conditions.

I eat low carb exactly because MY tastes and other health conditions make it a no-brainer. But you'll find quite a vociferous debate on here about all the different options. The one thing we all agree on is that controlling carbs is the best way to reduce your blood sugars. Then it is up to your body how much you reduce, and what you eat instead.

 

[andcol]

Metformin does help your body proces glucose from your blood stream but its effect at maximum dosage will not bring you anywhere near normal levels from your starting point. Your 114 mmol/mol HbA1c equates to an average 17.4 mmol/l from your meter. Of course you do not run at average all the time and will have levels above and below this. with metformin maximum dose you are likely to see a 2.5mmol improvement at best with no other changes which will take you down to an HbA1c of about 97mmol/mol.

Cutting out the sugar, cakes, sweets etc will help if you ate a lot of those buut have a read of Daisy's information. It isn't only sugar but the quality of carbs that you are eating.

There are many "success stories" on the forum - you can see a link to mine in my signature where I went from nearly your level to normal in 3 months and stopped all medication - have a read of the different peoples stories and ask questions as you feel you need. This will be a confusing time for you and we will help you through it as best we can.

Good luck

 

[Lamont D]

Hi crispy, most on here have turned to this forum because of the lack of care.
Yes get a meter. How will you know what your blood glucose levels are?
Have a good read around after reading the greeting by @daisy. Ask away!

 

[Crispy17]

Thanks guys, Andrew I'm going to have a read of your thread now.

Edit: That's an amazing journey you've been on Andrew and pretty inspirational. Your pre diagnosis lifestyle reads scarily familiar.

 

[Crispy17]

Just to add a bit of icing to the cake I ran out of the strips that came with the testing machine so opened the new box I got with a prescription from my doctor only to find they've given me the wrong type. So at the moment I can't test.

 

[andcol]

Thanks guys, Andrew I'm going to have a read of your thread now.

Edit: That's an amazing journey you've been on Andrew and pretty inspirational. Your pre diagnosis lifestyle reads scarily familiar.

I am sure your journey will be just as amazing.