Falling down hole of diagnosis

Shallis

Member
Messages
8
Hello everyone. So as this doesn't turn into massively long and over involved tale of woe, I will try and be as brief as possible: I have been seriously unwell for two years, undiagnosed and bumped all over the place because of it. My doctor recently flagged up an 'unrelated' pre-diabetic test result and I have just had another surgery test, but am too ignorant at moment to know how I should be tested in non-cursory way. Hence this post. It takes weeks to get a doctor's appointment at my surgery, so I need as much information as I can get before I see the doctor at the end of this month. And information on what self testing (or inexpensive private) to do now and how, and whether, from the description below, I could be diabetic, or something related. It has always felt to me that something is just systemically 'out of whack' (like not having oil in your car). The NHS is not at its best with non-standard diagnosis, and one gets ignored - and dismissed as anxious or hysterical - though they think they have nice, understanding ways to say that! So one is on one's own seeking diagnosis, or more importantly, relief.


I have had episodes of hypoglycaemia for years (sudden blood sugar crashes: shaking, faintness, feeling about to black out if don't eat NOW, and an overwhelming weird feeling that defies description) which I learnt to control pretty well myself and though the symptoms I get now are not identical they are nearer that than anything else. They are, however, chronic and not easily controllable when they flare. They are certainly exacerbated by not pacing food intake (a late evening meal will be hugely debilitating) as they certainly are by stress, tiredness and a recent heavy cold. Symptoms do not go away if I eat, however.

Major symptoms: intense internal shaking that tends to escalate during day and interfere with sleep at night, with random extra severe attacks, sometimes with racing or irregular heart rate. The shaking is no small thing. Not anxiety. It is accompanied by an intense sort of dizziness (made worse by suddenly moving head or something) and spaciness, often nausea (especially if physically exert self for any reason) and that overwhelming weird feeling that defies description. Sound seems warped (a bit like when super tired). Disorientation and confusion, this can make navigating a train station or map problematical, familiar places don't 'sit right'. A feeling of thinking through drunkenness which is really challenging. Though my 'in the moment', intellectual capacity is not affected, I do have memory problems that I never had before, which means I totally blank things in a non-normal way, and thus also have 'continuity' problems in my work. I have put this down to the amount of energy diverted to think at all through the 'fug', but it may be more than that. Other things: frequent urination; two years ago when this condition first started (with intense severity and difficulty getting about), I had what was described as an 'unrelated' retinal tear (but I have always questioned how 'unrelated' that was). I do not have 'fatigue', have not had weight loss (I am not overweight either, my BMI is very low on the scale), do not have excessive hunger or thirst; I am in my late fifties; my father had late onset diabetes (after his pancreas packed up a few years after acute pancreatitis, so not sure that counts as family liability).

I would be hugely grateful for feedback on whether this all sounds blood sugar related. As I said, my doctor dismissed the idea. Any help on how to proceed with self help and especially, interfacing with doctors, massively appreciated.
 

Liam1955

Master
Messages
10,964
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Anti-Gay People, Self Centre People, Two Faced People and Bad Language.
@Shallis Hello and Welcome to the Forum. Tagging @daisy1 who will provide you with some basic information that all new members receive. Do you know if it was HBA1C test that your GP did for you?
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Treatment type
Diet only
Hi and welcome,

There is a section on these forums for reactive hypoglycaemia people

http://www.diabetes.co.uk/forum/category/reactive-hypoglycemia.70/

If you have a read through some of those threads you may find you have something in common with the contributors.

Have you got your own blood glucose meter? If not, it will be very much in your interests to buy one so you can check your levels when you have these episodes. This is important.
 
  • Like
Reactions: Liam1955

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
@Shallis Hi :)

You say that your symptoms don't go away if you eat - is that correct and not a typo?

If so, it seems very possible there might be something else going on.

Nobody here is a medical professional so we can only offer our suggestions, but could it be an inner ear problem or similar? You mention nausea and dizziness. Or blood pressure? Or some kind of adrenal response?

If it was me, I'd be back at the doctors pushing for more investigations in the hope of getting a proper diagnosis and treatment.

Hopefully, your upcoming appointment will be of help.
 

ellagy

Well-Known Member
Messages
1,448
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Take what you have written here with you to the appointment and show your doctor. Welcome to the forum!
 
  • Like
Reactions: Chook and Liam1955

CherryAA

Well-Known Member
Messages
2,171
Type of diabetes
Type 2
Treatment type
Diet only
Once you have read the hypo forum section, it might be worthwhile writing down what food you are eating that is not helping, it sounds like you might be having contiiual high swings in blood sugar, maybe from one extreme to the others, so getting a monitor and doing so testing would make sense. That way you will have a record to show your doctor if it shows bs levels out of the ordinary.
 
  • Like
Reactions: Liam1955

Shallis

Member
Messages
8
Thank you SO much for responses. So much to learn before doctor's appointment. I would very much like to test myself before then. Have no idea what test I had. They weren't looking for diabetes per se. And I think the test I had last week was a repeat of the same thing (a couple of months after first) to see if still elevated. Just routine they said. It wasn't ordered for any particular time or after fasting.
This all may well be a red herring but need to explore possubilities. It does not seem obviously related to eating but is definitely made worse if I don't, particularly in the evening when I will crash if not careful. Symptoms are usually calm first thing in the morning and climb through the day until terrible in the evening. But as I am living in a bit of a Kobe experience/snow storm, I might be missing some usually obvious connections.
It is quite hard to 'push for tests' past a certain point. If a routine cursory test of something is negative it doesn't seem possible to access more detailed testing on NHS. And any investigations happen sequentially and with long months to wait for appointments. Hence my concern to test myself for this in best way, following best procedure too so don't get false negative. (I have had time-wasting false positives for things along the way too). A false negative would close off further testing and diagnosis.
Is a glucose meter the only thing I need? Are they all the same? It is hard to detect 'episodes' in something which is pretty constant, so don't know when to test. Should I get other tests? There seem to be several and I am confused as to difference.
I am aware I fit some, but not all hypoglycaemia symptoms. But my symtoptoms are so intense and specific, I CAN'T be the only one. I have enjoyed good health all my life, it has been a bit of a shock to be so ill and now for so long without diagnosis or treatment.
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Treatment type
Diet only
It might help if you ring the surgery receptionist and ask which blood glucose tests you had, and what the figures were. You may have a better idea of where you stand on the diabetes front. You can also ask for a print out of the results, and if you are in England you may find your surgery has put them on-line as they were advised to do (by April 2016). Your receptionist will know this and will be able to tell you how to apply for on-line access.
 
  • Like
Reactions: azure

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
I second @Bluetit1802 's advice above. I'd also ask what other tests you had so that you can at least keep your own list of things that have been ruled out, eg anaemia, coeliac disease, thyroid, etc, etc.

Then you'll have a better idea of the way forward and be more informed prior to your doctor appointment.
 
  • Like
Reactions: Bluetit1802

Shallis

Member
Messages
8
Thanks for suggestion to get the results. Didn't occur to me! I will ring surgery. I have a file of other test results, I normally ask for them but the doctor was so dismissive of relevancy to anything that I went along with it. Until I started thinking. Testing has been a bit random and cursory really. Mostly asked for by me. And I am not a doctor! Actual doctor's are kind of dismissive in sense don't suggest referrals or deep testing. Been a bit of a shock, as I said. I think 'shaking' is a trigger word for thinking hysterical patient too.
Started reading the links, very helpful. It's all a foreign language at the moment but will persevere through the swift learning curve. CherryAA's attached diet looks really interesting. Just experimenting in summer with 'diet as medecine' (not related to thoughts of possible hypoglycaemia) and eating no carbs and very healthy diet (and complete rest) did correlate with noticeable lessening of symptoms before very bad fluey cold triggered major, raging out of control relapse since then. It's a way of eating that has always suited me. I will extensively test now then get on to it.
Should I get my own HbA1c test too? Is that the most reliable?
A huge thank you for responses. Incredibly helpful.
 
  • Like
Reactions: Bluetit1802

Lamont D

Oracle
Messages
15,940
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi, I have a condition called Reactive Hypoglycaemia.
There are many types of hypoglycaemia.
No one patient is the same, it is how we process food that does count.
Healthy food is not healthy for a hypoglycaemic.

I had exactly the same symptoms as you have described.
The memory loss one especially. I can't remember most of the last decade except being ill.

You could have 'normal' blood glucose levels. And still have Hypoglycaemia!
Please insist on getting a referral to someone who knows what Hypoglycaemia is.
Most doctors are unaware of what to test for, or how to treat the condition.

Food!
The reason why you still feel awful after eating can depend on what you have just eaten. You do not have control. Until you do, you will continue to feel ill and be ill!

Do have a read of the reactive hypoglycaemia forum. There is some great knowledge there.

Welcome to our forum @Shallis.

Any questions please ask.
 
  • Like
Reactions: KezG

CherryAA

Well-Known Member
Messages
2,171
Type of diabetes
Type 2
Treatment type
Diet only
Thank you SO much for responses. So much to learn before doctor's appointment. I would very much like to test myself before then. Have no idea what test I had. They weren't looking for diabetes per se. And I think the test I had last week was a repeat of the same thing (a couple of months after first) to see if still elevated. Just routine they said. It wasn't ordered for any particular time or after fasting.
This all may well be a red herring but need to explore possubilities. It does not seem obviously related to eating but is definitely made worse if I don't, particularly in the evening when I will crash if not careful. Symptoms are usually calm first thing in the morning and climb through the day until terrible in the evening. But as I am living in a bit of a Kobe experience/snow storm, I might be missing some usually obvious connections.
It is quite hard to 'push for tests' past a certain point. If a routine cursory test of something is negative it doesn't seem possible to access more detailed testing on NHS. And any investigations happen sequentially and with long months to wait for appointments. Hence my concern to test myself for this in best way, following best procedure too so don't get false negative. (I have had time-wasting false positives for things along the way too). A false negative would close off further testing and diagnosis.
Is a glucose meter the only thing I need? Are they all the same? It is hard to detect 'episodes' in something which is pretty constant, so don't know when to test. Should I get other tests? There seem to be several and I am confused as to difference.
I am aware I fit some, but not all hypoglycaemia symptoms. But my symtoptoms are so intense and specific, I CAN'T be the only one. I have enjoyed good health all my life, it has been a bit of a shock to be so ill and now for so long without diagnosis or treatment.

Given how strongly this is bothering you, it might be worth investing in one of these and wearing it for two weeks? it records your blood sugars once per minute and you can put in when you eat and make an estimate of the carbs you are eating.
The data gets downloaded onto your computer and there is then a report you can print out which shows what happened each day. By the end of the two weeks you will have a very clear picture of what is happening to you on the blood sugars front.

The cost would be £150 inclusive of one entire month of testing kit, so you could try one now and then adjust your diet and try again in a few months time. While it seems expensive it would certainly give you the data to see what is happening. They are dead easy to set up. I found it invaluable once I had understood it - you would also have data you could share on here with people who are familiar with what their own data looks like .

https://freestylediabetes.uk/our-products/freestyle-libre
 

Energize

Well-Known Member
Messages
810
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Given how strongly this is bothering you, it might be worth investing in one of these and wearing it for two weeks? it records your blood sugars once per minute and you can put in when you eat and make an estimate of the carbs you are eating.
The data gets downloaded onto your computer and there is then a report you can print out which shows what happened each day. By the end of the two weeks you will have a very clear picture of what is happening to you on the blood sugars front.

The cost would be £150 inclusive of one entire month of testing kit, so you could try one now and then adjust your diet and try again in a few months time. While it seems expensive it would certainly give you the data to see what is happening. They are dead easy to set up. I found it invaluable once I had understood it - you would also have data you could share on here with people who are familiar with what their own data looks like .

https://freestylediabetes.uk/our-products/freestyle-libre
Hi @Shallis and welcome to the forum

I agree with CherryAA re Freestyle Libre, if you can afford it. It's painless to apply and so easy to just scan as and when you want to. In between your scans, your glucose levels are still recorded, which you can see on the device on a small screen and/or you can download to computer and then can both save the downloaded file, as txt / pdf and see graphs on computer screen.

It's clearly a more expensive option but will definitely give the best picture. Again, as CherryAA suggests, you can then use the second sensor (supplied with the initial kit) sometime at a later date to see how things may have improved. Further sensors are available but at further cost, of course.
 

Maggie/Magpie

Well-Known Member
Messages
279
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Butternut Squash, Cabbage and confrontation.
Given how strongly this is bothering you, it might be worth investing in one of these and wearing it for two weeks? it records your blood sugars once per minute and you can put in when you eat and make an estimate of the carbs you are eating.
The data gets downloaded onto your computer and there is then a report you can print out which shows what happened each day. By the end of the two weeks you will have a very clear picture of what is happening to you on the blood sugars front.

The cost would be £150 inclusive of one entire month of testing kit, so you could try one now and then adjust your diet and try again in a few months time. While it seems expensive it would certainly give you the data to see what is happening. They are dead easy to set up. I found it invaluable once I had understood it - you would also have data you could share on here with people who are familiar with what their own data looks like .

https://freestylediabetes.uk/our-products/freestyle-libre

This seems very expensive for a condition you may not have, it may give you good data but you can make your own if your vigilent. Buy a blood glucose monitor, lancets and strips to match the machine you buy. You can get them on line or at your local Boots or pharmacist. Buy a note book and test your own blood sugars when you wake, before each meal and two hours after and also at bed time. At the same time keep a record alongside of what you are eating and when. Lay out all this information clearly for each day in the note book. It takes more effort but should cost you less than £50. Then take your note book with you when you see the GP.
If its an on going problem you can always make an appointment with GP as you leave the last one, just a thought.
Good luck
 

CherryAA

Well-Known Member
Messages
2,171
Type of diabetes
Type 2
Treatment type
Diet only
This seems very expensive for a condition you may not have, it may give you good data but you can make your own if your vigilent. Buy a blood glucose monitor, lancets and strips to match the machine you buy. You can get them on line or at your local Boots or pharmacist. Buy a note book and test your own blood sugars when you wake, before each meal and two hours after and also at bed time. At the same time keep a record alongside of what you are eating and when. Lay out all this information clearly for each day in the note book. It takes more effort but should cost you less than £50. Then take your note book with you when you see the GP.
If its an on going problem you can always make an appointment with GP as you leave the last one, just a thought.
Good luck


I agree that its an expensive option, but I now realise that my extensive ( very) testing was not giving me the same understanding that a short period with the monitor provides (especially overnight) . I think that for most people who are concerned about the effect of their diet on their health, diabetic or not it's the kind of investment in their health that could transform it We all save for holidays - but in the end they can only be enjoyed when we are in full possession of as much health as we can give ourselves.

If the result of a months testing is to KNOW that we do not have a problem , then its probably £150 well spent. .
 
  • Like
Reactions: kokhongw

kokhongw

Well-Known Member
Messages
2,394
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
I would be hugely grateful for feedback on whether this all sounds blood sugar related.

Your description of the symptoms match those who have experienced hypoglycemia.

Testing your glucose level when you feel those symptoms would give a fairly indicative confirmation of whether it is related to your blood glucose level. You may even take a series of readings, eg every half hour till the symptoms wear off...

If your glucose level is indeed low when experiencing those symptoms, then taking small amount of glucose or virgin coconut oil should help to stabilize it.
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
@Shallis

Hello Shallis and welcome to the forum :) As mentioned above, here is the basic information we give to new members and I hope you will find it useful. Ask more questions when you need to and someone will be able to help.


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 well over 220,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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 blood glucose 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.
 
  • Like
Reactions: Freema

catapillar

Well-Known Member
Messages
3,390
Type of diabetes
Type 1
Treatment type
Insulin
@Shallis first step would be testing your blood sugar to confirm whether or not you actually are hypoglycaemic when experiencing theses symptoms. If your having symptoms even immediately after eating, it might not be blood sugar related as I'd expect you to be euglycaemic then.

I would think a freestyle libre is probably rather extreme in term of £££ and effort as a first step before you even confirm whether you have any abnormal blood readings at all by using a bog standard glucose monitor.

If you are hypoglycaemic when having symptoms, that should give your doctor a course to investigate what causing this and a diagnosis, the RH forum might help with tips on what the investigations should be. If self testing confirms you are euglycaemic it will set investigations on a different course.
 
  • Like
Reactions: Freema

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
@Shallis Hi :)

You say that your symptoms don't go away if you eat - is that correct and not a typo?

If so, it seems very possible there might be something else going on.

Nobody here is a medical professional so we can only offer our suggestions, but could it be an inner ear problem or similar? You mention nausea and dizziness. Or blood pressure? Or some kind of adrenal response?

If it was me, I'd be back at the doctors pushing for more investigations in the hope of getting a proper diagnosis and treatment.

Hopefully, your upcoming appointment will be of help.

I'm quoting my own post again here @Shallis because it's perfectly possible yoyr symptoms are nothing to do with blood sugar, especially as you've described them as chronic and that they don't go away when you eat.

I know you seem to be being fobbed off to some extent by your doctor, but sometimes we have to be firm to be taken seriously. That's wrong, I know, but I'm sure I'm not the only person who has learnt that from experience.

By all means buy a cheap blood glucose meter if you want to do a few tests prior to seeing the doctor. That would be useful. But keep your mind open to other possible causes of your unpleasant symptoms.

And do update is if you get any answers :)