My husband was diagnosed with Diabetes Type 2 about four weeks ago. His fasting reading on his last blood test was 15.4 and his HBA1c is 11. We saw the nurse in the doctor's diabetic clinic last Thursday and she wanted another blood test, this time accompanied by a urine test, which happened today. Alarmed that these readings are very high, I have been told that they are not and we can't have another appointment with the nurse (to sort out any meds or action plan) until mid-April and that the tests cannot be 'fast-tracked' :? . Is this normal? Are these rewadings high? Should I be worried that things are being left for another month?
Need advice on readings and action
- Thread starter lizziemcgill
- Start Date
I don`t know the answer, but I hope by bumping your question someone who does will come along. All I can tell you is that my fasting test was 11, and after glucose it went to 24. I was seen by the nurse in days, but that could be the way my surgery works.
Jeannemum said:
Many thanks for your post Jeannemum. I am beginning to suspect that it is the way the surgery works and that we shoiuld endeavor to speed things up.
Grazer
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Hi lizzie, your husband has been definitively diagnosed, so regardless of the time scales your surgery follows, he needs to take immediate steps to change his diet now. His readings are high, so the sooner he starts to bring them down the better.
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reducXe the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own if you haven't already – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Welcome and good luck!
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reducXe the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own if you haven't already – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Welcome and good luck!
xyzzy
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Hello Lizzie
I saw your post earlier but didn't then have time to respond as fully as I thought you deserved. I see Grazers just replied as well as I was typing! I suspect his and my advice will be largely the same so sorry for the overlap!
Unfortunately no one on the forum can do any kind of proper diagnosis as doing that over the internet would be wrong. However I will relate to you my experiences which are remarkably similar to your husbands and offer my non professional medical opinion.
The kind of treatment you are receiving from your surgery is unfortunately pretty typical. Some surgeries are a lot more proactive and progressive but I'm afraid many are not. Many people, including me, arrived on the forum with near identical stories as your own.
If your husband had a urine test in all probability that was to detect things called keytones. Keytones are one of the easy to detect markers that help doctors determine if someone is a Type 1 or Type 2 diabetic. The fact that your husband is not being immediately treated by going onto to insulin implies they found no keytones (I would check) and as such he is most likely Type 2. If he is middle aged and to be blunt even slightly overweight then that Type 2 diagnosis is in the vast majority of cases correct. If you know how to calculate his BMI then overweight is anything above 25. If you don't now how to calculate it just type "BMI calculator" into Google as there are many online ones. All you'll need to know is his current height and weight. Another way is to measure around his middle at the biggest part. If it's over 38" its a good risk indicator for Type 2 diabetes. Being over weight as well as increasing risks of heart attacks etc also increases what's known as insulin resistance. Losing weight lowers insulin resistance and makes what insulin your husband produces work far better. Many people wrongly think that Type 2 diabetics don't produce insulin in fact in most cases they are producing loads but their insulin resistance stops it working properly. A Type 2 will go on and lose (or may have already lost at diagnosis) some or all of their insulin production capability dependent on how much damage has been done to their insulin producing cells by running dangerously high blood sugar levels.
Moving on to his blood sugar readings. He's starting out roughly where I was and like him was told I would have to wait over a month before seeing the nurse. I have a Type 1 insulin injecting adult son who told me my readings were very high and I should start what's called a low carbohydrate diet immediately to bring them down.
An HbA1c of 11% is very high a non diabetic would score in the high 4%'s. An HbA1c measures the average blood sugar level in your husbands blood over the last 3 months. If he had been having blood readings taken each day over that 3 month period an HbA1c of 11% means his blood sugar levels were on average around 16. A non diabetic would expect to see their average blood readings in the 4's for most of the time. If you are diagnosed diabetic the internationally accepted safe limit that should not be exceeded by a Type 2 diabetic is 8.5 two hours after eating. That 8.5 figure was set 40 years ago and today many of us believe and try and keep our readings under 7.8 as that is the level that diabetic damage to the eyes and other critical things has been shown to start from. Again to be blunt depending on how out of touch your surgery is your husband may never get told those figures and be told that either aiming for safe values is not achievable or not necessary.
So now some good news. I was only diagnosed 14 weeks ago but now I have the blood sugar levels of a pretty average non diabetic person. I am not cured because if I eat the wrong things BOOM but so long as I keep to a good diet I am always under that safe magic 7.8 level. Once I did get to see the nurse she prescribed me a useful and safe drug called Metformin however it is not a magic bullet and only reduces blood sugar levels by one or two points but it is useful at stopping blood sugars rise to quickly after eating. All diabetic drugs except insulin can only do so much. In my opinion none of them do one tenth as much good as adopting the right diet and sticking to it.
Like your husband I was on my own for a few weeks and I decided with my sons and this forums help to get a head start.
So if you remember my son told me to adopt a "low carbohydrate diet". What this means is firstly to stop or drastically reduce eating anything that has plain old sugar in it as sugar is just a highly refined and dangerous form of carbohydrate. So cakes, biscuits, pure fruit juices, non diet versions of fizzy drinks, sugar in tea and coffee etc should really be a thing of the past except on special occasions. Secondly and just as importantly he should reduce by at least half the amount of starchy carbohydrates he eats so this is rice, pasta, bread, potatoes, cereals and anything else made with flour. That's obviously going to leave a big dent in his diet and you should replace with extra meat, fish, cheese and especially vegetables. Don't worry too much to start with about eating a high fat content at the moment the aim is to get his blood sugars safe and you can deal and read about fat, protien and carbohydrate balance later down the line. With vegetables try to eat the ones that grow above ground but carrots are usually fine. Things like yoghurt are fine as is a small quantity of fruit. Diet versions of drinks like diet coke are also fine. On the starchy carbohydrates left in his diet swap to brown wholemeal or better Burgen soya bread, brown basmati rice, brown or the tri-coloured pasta. Avoid mashed potatoes in fact the best potatoes for a diabetic are roast ones.
It is this kind of diet that the majority of the forum members have adopted and if you were in a more enlightenned country like Sweden or Germany that information would be told to you at diagnosis time. In the good old NHS which still relies on dietary research done over 40 years ago you may find that your surgery tells you to eat ALL of the foods in quantity that I just told you are bad. That's your husbands choice but to be blunt I'm the one with the normal blood sugar levels.
How do I know I have normal blood sugar levels. I know because I test my own sugars with a blood glucose meter. Again a complete post code lottery in the UK. Some surgerys will prescribe your husband a meter, test strips and encourage him to test (the progressive approach that most of the health care proffesionals who post on this forum advocate) others will tell you its not for Type 2's and some will aggressively tell you DON'T TEST, some will even tell you it will send you mad. The UK NICE guidelines state that a Type 2 who both understands what the numbers mean and is reacting to what the numbers tell them SHOULD be prescribed a meter and test strips. You still may not get them even if you quote the rules to them as all a GP has to say is "well it wont suit you" and that's it.
I personally wouldn't wait to see about testing as how else is your husband going to be able to see what foods are safe or dangerous for him to eat. At the moment there is a meter called an SD CODEFREE that's available with 50 teststrips from healthcare.co.uk that many forum members have been buying. If you buy that from their eBay shop it will cost less than £20 and could be with you in the next couple of days. If you do decide to buy one make sure you buy the UK mmol/l version and not the US mg/dl version. I was lucky I inherited my sons old meter.
Take care and ask as many questions as you need to
I saw your post earlier but didn't then have time to respond as fully as I thought you deserved. I see Grazers just replied as well as I was typing! I suspect his and my advice will be largely the same so sorry for the overlap!
Unfortunately no one on the forum can do any kind of proper diagnosis as doing that over the internet would be wrong. However I will relate to you my experiences which are remarkably similar to your husbands and offer my non professional medical opinion.
The kind of treatment you are receiving from your surgery is unfortunately pretty typical. Some surgeries are a lot more proactive and progressive but I'm afraid many are not. Many people, including me, arrived on the forum with near identical stories as your own.
If your husband had a urine test in all probability that was to detect things called keytones. Keytones are one of the easy to detect markers that help doctors determine if someone is a Type 1 or Type 2 diabetic. The fact that your husband is not being immediately treated by going onto to insulin implies they found no keytones (I would check) and as such he is most likely Type 2. If he is middle aged and to be blunt even slightly overweight then that Type 2 diagnosis is in the vast majority of cases correct. If you know how to calculate his BMI then overweight is anything above 25. If you don't now how to calculate it just type "BMI calculator" into Google as there are many online ones. All you'll need to know is his current height and weight. Another way is to measure around his middle at the biggest part. If it's over 38" its a good risk indicator for Type 2 diabetes. Being over weight as well as increasing risks of heart attacks etc also increases what's known as insulin resistance. Losing weight lowers insulin resistance and makes what insulin your husband produces work far better. Many people wrongly think that Type 2 diabetics don't produce insulin in fact in most cases they are producing loads but their insulin resistance stops it working properly. A Type 2 will go on and lose (or may have already lost at diagnosis) some or all of their insulin production capability dependent on how much damage has been done to their insulin producing cells by running dangerously high blood sugar levels.
Moving on to his blood sugar readings. He's starting out roughly where I was and like him was told I would have to wait over a month before seeing the nurse. I have a Type 1 insulin injecting adult son who told me my readings were very high and I should start what's called a low carbohydrate diet immediately to bring them down.
An HbA1c of 11% is very high a non diabetic would score in the high 4%'s. An HbA1c measures the average blood sugar level in your husbands blood over the last 3 months. If he had been having blood readings taken each day over that 3 month period an HbA1c of 11% means his blood sugar levels were on average around 16. A non diabetic would expect to see their average blood readings in the 4's for most of the time. If you are diagnosed diabetic the internationally accepted safe limit that should not be exceeded by a Type 2 diabetic is 8.5 two hours after eating. That 8.5 figure was set 40 years ago and today many of us believe and try and keep our readings under 7.8 as that is the level that diabetic damage to the eyes and other critical things has been shown to start from. Again to be blunt depending on how out of touch your surgery is your husband may never get told those figures and be told that either aiming for safe values is not achievable or not necessary.
So now some good news. I was only diagnosed 14 weeks ago but now I have the blood sugar levels of a pretty average non diabetic person. I am not cured because if I eat the wrong things BOOM but so long as I keep to a good diet I am always under that safe magic 7.8 level. Once I did get to see the nurse she prescribed me a useful and safe drug called Metformin however it is not a magic bullet and only reduces blood sugar levels by one or two points but it is useful at stopping blood sugars rise to quickly after eating. All diabetic drugs except insulin can only do so much. In my opinion none of them do one tenth as much good as adopting the right diet and sticking to it.
Like your husband I was on my own for a few weeks and I decided with my sons and this forums help to get a head start.
So if you remember my son told me to adopt a "low carbohydrate diet". What this means is firstly to stop or drastically reduce eating anything that has plain old sugar in it as sugar is just a highly refined and dangerous form of carbohydrate. So cakes, biscuits, pure fruit juices, non diet versions of fizzy drinks, sugar in tea and coffee etc should really be a thing of the past except on special occasions. Secondly and just as importantly he should reduce by at least half the amount of starchy carbohydrates he eats so this is rice, pasta, bread, potatoes, cereals and anything else made with flour. That's obviously going to leave a big dent in his diet and you should replace with extra meat, fish, cheese and especially vegetables. Don't worry too much to start with about eating a high fat content at the moment the aim is to get his blood sugars safe and you can deal and read about fat, protien and carbohydrate balance later down the line. With vegetables try to eat the ones that grow above ground but carrots are usually fine. Things like yoghurt are fine as is a small quantity of fruit. Diet versions of drinks like diet coke are also fine. On the starchy carbohydrates left in his diet swap to brown wholemeal or better Burgen soya bread, brown basmati rice, brown or the tri-coloured pasta. Avoid mashed potatoes in fact the best potatoes for a diabetic are roast ones.
It is this kind of diet that the majority of the forum members have adopted and if you were in a more enlightenned country like Sweden or Germany that information would be told to you at diagnosis time. In the good old NHS which still relies on dietary research done over 40 years ago you may find that your surgery tells you to eat ALL of the foods in quantity that I just told you are bad. That's your husbands choice but to be blunt I'm the one with the normal blood sugar levels.
How do I know I have normal blood sugar levels. I know because I test my own sugars with a blood glucose meter. Again a complete post code lottery in the UK. Some surgerys will prescribe your husband a meter, test strips and encourage him to test (the progressive approach that most of the health care proffesionals who post on this forum advocate) others will tell you its not for Type 2's and some will aggressively tell you DON'T TEST, some will even tell you it will send you mad. The UK NICE guidelines state that a Type 2 who both understands what the numbers mean and is reacting to what the numbers tell them SHOULD be prescribed a meter and test strips. You still may not get them even if you quote the rules to them as all a GP has to say is "well it wont suit you" and that's it.
I personally wouldn't wait to see about testing as how else is your husband going to be able to see what foods are safe or dangerous for him to eat. At the moment there is a meter called an SD CODEFREE that's available with 50 teststrips from healthcare.co.uk that many forum members have been buying. If you buy that from their eBay shop it will cost less than £20 and could be with you in the next couple of days. If you do decide to buy one make sure you buy the UK mmol/l version and not the US mg/dl version. I was lucky I inherited my sons old meter.
Take care and ask as many questions as you need to
The advice i would add is that you need to learn as much as possible as fast as possible. there are some pretty good resources available. D-solve, diabetes 101, are good on-line information sources. I personally keep a copy of Dr. Bernstein's's Diabetes Solution on my shelf. it's a very comprehensive book. More like a textbook than some others. that suits my mind-set, but may not suit yours. It's also written using American units. the conversion factors are not difficult, but I don't know of an english edition.
It's not cheap to buy and many libraries don't have a copy. Also it's probably got more to say to type1s than type 2s. However I'd still recommend you look at it
And those carbs MUST be reduced.
Hana
It's not cheap to buy and many libraries don't have a copy. Also it's probably got more to say to type1s than type 2s. However I'd still recommend you look at it
And those carbs MUST be reduced.
Hana
Thank you to all who have replied to my questions. It has made my mind clearer that we must push for an early action plan but also it has been helpful in how to lower the glucose levels. Many, many thanks again! I'm touched that you took so much time to answer so fully. 
xyzzy
Well-Known Member
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No problem Lizzie. Forgot to add eggs as a thing that's GOOD to eat. When you first start its quite counter-intuitive as for so long you have been told low fat is good. That's (mostly) fine for a non diabetic but for your husband the priority should now be low carbohydrate. If the first few weeks my lunch alternated between an egg, bacon and mushroom fry up and cheese and ham omelette so definitely not low fat! I couldn't deny however that it worked and my blood sugar levels fell progressively back to normal. A few weeks further down the line I've learnt more about good and bad foods so the balance is a bit better however I do eat more fat and protein that I ever use to. Swapping to that low carbohydrate higher fat diet has actually meant I have lost 35lbs (yes two and a half stone) in 14 weeks. I do no more exercise than walk my dogs for an hour each day which is what I have always done. Talking about diet and weight loss you should never think of a low carbohydrate regime as a diet in the classic meaning of the word. It is first and foremost the best way of getting control of blood sugars, using it as a diet is secondary. Once you get going what most people on the forum do is to begin to add up the amount of carbohydrate they eat each day. You can get the amounts of the backs of packets but remember to use the TOTAL carbohydrate value and not just the "of which sugars" value. If you want to try that then aim for around a total carbohydrate intake of around 120 to 150g / day. That's the rough value that most forum members would recommend to start at and is also the value you'd be recommended if you were Swedish or German. Using our blood meters we then adjust up or down from that starting value until you can get your blood sugars back in safe ranges. Everyone's tolerance is different mine is quite low at around 75g / day, Grazer who also posted has a tolerance of up to 180g / day. It's this reason why testing is so important as being just a few grams over my 75g / day or eating the wrong thing can make my blood sugar levels rocket.
Good luck and let us know how you get on.
Good luck and let us know how you get on.
