Old diagnosis, new awareness

[gibbsyns3]

Hello forum.

I was diagnosed type 2 in 2013.

Since then my 'involvement' in diabetes has been one of taking 2 metaforminas daily (I mainly remember), and a feeling of guilt that accompanies everything I eat and drink that I know I shouldn't (although I have already seen in the forum that my understanding of what I should feel guilty about may not be correct anyway).

That doesn't seem good enough at all.

Part of my problem is that I live in Spain, and the language barrier makes access to information on health services difficult. My Spanish is reasonable, but not so good as I can run searches on medical policy and proceedures, or ask questions on outcomes when with a healthcare professional who is not willing to make allowances on my lack of native Spanish - which is surprisingly commonplace.

I don't really know why I have chosen now to finally take on board that I need to take diabetes seriously, but I have.
I am hoping within the forum that the 'global' in its description may help me hook up with other English speakers who have diabetes living in Spain, to help with the health services side of living with diabetes, and in sourcing general guidance and information that can be actioned independently.

First impressions are good - I've only been here 5 minutes and I read that carbohydrates are a problem - I expect it will sound ridiculous to other members of the forum that I did not know that. My attention (what little there has been) has been focused entirely on sugar as in what I perceive as sugar - chocolate and sweet things. I am in a state of aware-denial over alcohol, I mean it can't be good can it, but until I see it in black and white .... I know, ridiculous.

I also need to find out about testing, self-testing. From the point of diagnosis i was called back for tests twice at 6 month intervals and since then nothing. I have no idea even of the outcome of those tests (assumed not disastrous as not followed up), nor whether things have improved worsened or to what degree for the last 3/4 years.

If anybody reading this can help me on those two particular points great, but i use forums a lot generally so i'm sure i'll find my way around. I'll probably start in newly diagnosed - i'm not, but in terms of knowledge i really am.

Finally, thanks to whoever the founders and main contributors/respondents are - there are a few in every forum who deserve kudos.

Nick

 

[Grateful]

Welcome! I am tagging @daisy1 who will give you the excellent blurb for newcomers.

What would help, if you don't mind giving personal details, is knowing the result of your last HbA1C test. Also, I assume you are taking Metformin and nothing else?

This forum is a wonderful resource. Like you, I did not discover it until some time after diagnosis, but I wish I had!

 

[Bluetit1802]

Hello and welcome aboard!

Firstly I will tag @daisy1 so you can read her very useful post for newcomers.

Yes! Carbohydrate is a problem for Type 2s on diet only or Metformin. It isn't just sugar. Sugar is just one of the carbs. All carbs turn to glucose once inside the system, so it makes sense not to eat too many. Carbohydrate will raise blood sugar levels as much as plain sugar.

It isn't good enough that you don't know where you stand, so I do strongly urge you to buy a glucose meter and start testing yourself. Even in Spain you should be having blood tests at the very least annually if not 6 monthly, with a medication review. I think you need to chase this up with your doctor, and take an interpreter with you if you can. Whilst there, you need to ask what your diagnosis test results were, and any you have had since. These should all be on your records, and a simple computer print out will show them. The diagnostic test is called an HbA1c and is sometimes accompanied by a fasting plasma glucose test. Try asking for the print out. If this is not possible, at least find out what the numbers were.

There are some other ex-pats on here that live in Spain - hopefully they will be along to talk to you.

 

[gibbsyns3]

Welcome! I am tagging @daisy1 who will give you the excellent blurb for newcomers.

What would help, if you don't mind giving personal details, is knowing the result of your last HbA1C test. Also, I assume you are taking Metformin and nothing else?

This forum is a wonderful resource. Like you, I did not discover it until some time after diagnosis, but I wish I had!

thanks for your response grateful - well there is a good example of the spanish factor - i don't know what a HbA1C test is, let alone any results.

 

[gibbsyns3]

Hello and welcome aboard!

Firstly I will tag @daisy1 so you can read her very useful post for newcomers.

Yes! Carbohydrate is a problem for Type 2s on diet only or Metformin. It isn't just sugar. Sugar is just one of the carbs. All carbs turn to glucose once inside the system, so it makes sense not to eat too many. Carbohydrate will raise blood sugar levels as much as plain sugar.

It isn't good enough that you don't know where you stand, so I do strongly urge you to buy a glucose meter and start testing yourself. Even in Spain you should be having blood tests at the very least annually if not 6 monthly, with a medication review. I think you need to chase this up with your doctor, and take an interpreter with you if you can. Whilst there, you need to ask what your diagnosis test results were, and any you have had since. These should all be on your records, and a simple computer print out will show them. The diagnostic test is called an HbA1c and is sometimes accompanied by a fasting plasma glucose test. Try asking for the print out. If this is not possible, at least find out what the numbers were.

There are some other ex-pats on here that live in Spain - hopefully they will be along to talk to you.

thanks bluetit.

yes the spanish health service is generally very good - i think it may be my doctor that is the issue - one who is always going to need pushing. hence i thought i'd find out what i could to go to an appointment with him a bit more clued up - and it is working already - i now know what to ask about my blood tests - appreciated

 

[Grateful]

thanks for your response grateful - well there is a good example of the spanish factor - i don't know what a HbA1C test is, let alone any results.

Prueba de hemoglobina glicosilada (HbA1c). It is a measure of the average level of glucose in your blood over the previous 8 to 12 weeks and is the "gold standard" in diagnosing diabetes. It is also used to track the long-term blood-glucose control of people after they have been diagnosed.

See my signature for just one example of how it is used. You have diabetes if your HbA1C level at diagnosis is equal to, or higher than, 6.5% (48). There are two measurements systems unfortunately, so I have given both.

 

[Guzzler]

Hi there and welcome. You did right to avoid the sugary treats but alcohol is a mixed bag. Have a look at the current thread titled 'Missing Alcohol', lots of info there.

 

[Grateful]

yes the spanish health service is generally very good - i think it may be my doctor that is the issue - one who is always going to need pushing. hence i thought i'd find out what i could to go to an appointment with him a bit more clued up - and it is working already - i now know what to ask about my blood tests - appreciated

Just a few thoughts. Please bear in mind that I have no professional medical expertise and your doctor should be the source of that.

If you are taking only Metformin and were diagnosed four years ago and your doctor has been testing you regularly, the normal assumption would be that your blood glucose numbers are not astronomically bad. But that is why it is so important to find out. If possible, try to get your doctor to give you not just your current HbA1C number, but all of them: the number at diagnosis in 2013, and all the ones in between.

Now, assuming that the numbers are no worse than "moderately bad" (and that is yet to be determined!) you will find that many members of this forum have managed to bring their Type 2 diabetes (T2D) entirely under control using only a low-carb diet and Metformin, or even, without Metformin. We cannot say if this would work for you; only, that it does seem to work for quite a few people. Other people need additional drugs, which works well for them.

But you need to know, if you do not know it already, that this "low-carb" approach is (strangely enough) considered controversial by the medical establishment. There is no guarantee that your doctor in Spain will even consider it, beyond perhaps giving some vague advice about "avoiding sugar" or "eating a balanced diet."

Congratulations on your decision to bring this under control!

Here's the good news. Perhaps you know this already? If you can bring your blood glucose (BG) levels under control so that they remain below diabetic levels over time, you are drastically less likely ever to suffer from the complications of the disease.

 

[gibbsyns3]

Hi there and welcome. You did right to avoid the sugary treats but alcohol is a mixed bag. Have a look at the current thread titled 'Missing Alcohol', lots of info there.

is there hope with booze - you've brightened my day - i'll have a read. y'know it's not like wanting to come off as some sad gutter living alchy, but on balance i'd have to concede that a control plan allowing for a drink would be much more appealing than one that didn't.

 

[Bluetit1802]

is there hope with booze - you've brightened my day - i'll have a read. y'know it's not like wanting to come off as some sad gutter living alchy, but on balance i'd have to concede that a control plan allowing for a drink would be much more appealing than one that didn't.

Red wine, spirits with water or sugar-free mixers, Prosecco and very dry white wines are fine as far as diabetes is concerned as long as you are moderate in the consumption! Personally, I have a glass of red daily, a bit more at weekends. Moderation is the key.

 

[gibbsyns3]

Just a few thoughts. Please bear in mind that I have no professional medical expertise and your doctor should be the source of that.

If you are taking only Metformin and were diagnosed four years ago and your doctor has been testing you regularly, the normal assumption would be that your blood glucose numbers are not astronomically bad. But that is why it is so important to find out. If possible, try to get your doctor to give you not just your current HbA1C number, but all of them: the number at diagnosis in 2013, and all the ones in between.

Now, assuming that the numbers are no worse than "moderately bad" (and that is yet to be determined!) you will find that many members of this forum have managed to bring their Type 2 diabetes (T2D) entirely under control using only a low-carb diet and Metformin, or even, without Metformin. We cannot say if this would work for you; only, that it does seem to work for quite a few people. Other people need additional drugs, which works well for them.

But you need to know, if you do not know it already, that this "low-carb" approach is (strangely enough) considered controversial by the medical establishment. There is no guarantee that your doctor in Spain will even consider it, beyond perhaps giving some vague advice about "avoiding sugar" or "eating a balanced diet."

Congratulations on your decision to bring this under control!

Here's the good news. Perhaps you know this already? If you can bring your blood glucose (BG) levels under control so that they remain below diabetic levels over time, you are drastically less likely ever to suffer from the complications of the disease.

thanks - well i have only ever had two tests. the first shortly after diagnosis and the second around six months later. i've had none since 2013. i did get a badly photocopied healthy eating sheet given me - nothing specific to my memory, just the sort of thing you'd expect any doctor to give you in any situation - like even if you weren't ill. but diabetes or no diabetes - i'm too fat - less carbs will do me no harm at all.

i have just looked at meters available online - sure they are not a replacement for a proper lab test, but 70€ for a meter and a good supply of all the gizmos and refills is nothing really.

 

[Grateful]

is there hope with booze

Booze contains carbohydrates. Some kinds of booze much more than others. Off the top of my head:
--A pint of good beer could have 20g (grams) of carbs (which is why I gave up beer).
--A glass of dry red wine only 4g. Dry white wine, even less.
--Champagne: very low-carb!
--Some spirits, such as whisky, could be zero-carb.
--Conversely, sherry (Xeres in Spanish) and liqueurs could be very high-carb.

Apparently the booze is an issue if you are, for instance, insulin-dependent as it makes it harder to balance insulin levels. Also, some people in this forum report "spikes" from booze (on their BG meters) that are bad enough that they have given up, or drastically reduced, the booze.

Me? I drink in moderation. (Before my T2 diagnosis, I was immoderate.)

Finally, booze does lower inhibition. So if you are trying to stick to low-carb and moderate drinking, the booze could sabotage your plan!

 

[gibbsyns3]

Red wine, spirits with water or sugar-free mixers, Prosecco and very dry white wines are fine as far as diabetes is concerned as long as you are moderate in the consumption! Personally, I have a glass of red daily, a bit more at weekends. Moderation is the key.

i thought all alcohol was off limits. shame about the dryness of wine, i'm a bit of a heathen in preferring Liebfraumilch to Prosecco, but i guess that sweet tooth is why i'm here in the first place. So a future of Rum and Red wine. That I can live with

re your earlier comment I've just looked at meters available online 70€ for a meter and a good supply of all the gizmos and refills is nothing really.

 

[Bluetit1802]

i have just looked at meters available online - sure they are not a replacement for a proper lab test, but 70€ for a meter and a good supply of all the gizmos and refills is nothing really.

Do be careful when ordering one. Take note of the price of replacement strips. You only need one meter but you do need many thousands of test strips - and the strips is where most manufacturers make their money.
The 2 popular ones here on the forum are the Codefree and the Tee2 because they have the cheapest strips, but I'm not sure if they send them outside the UK

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/

 

[gibbsyns3]

brilliant - thank you forum - i feel like i've done more, learned more, in the two hours since i joined the forum than the preceding 4 years since being diagnosed.

 

[Grateful]

thanks - well i have only ever had two tests. the first shortly after diagnosis and the second around six months later. i've had none since 2013. i did get a badly photocopied healthy eating sheet given me - nothing specific to my memory, just the sort of thing you'd expect any doctor to give you in any situation - like even if you weren't ill. but diabetes or no diabetes - i'm too fat - less carbs will do me no harm at all.

i have just looked at meters available online - sure they are not a replacement for a proper lab test, but 70€ for a meter and a good supply of all the gizmos and refills is nothing really.

Just in case you don't know this already:

• The HbA1C test is normally done at the clinic. You can get "home kits" for this or you can look at the "predicted" HbA1C on a home glucose meter, but you should try to get a proper one done at the clinic/doctor's office. Initially this may be even more important than getting a home testing kit, because it will give you an accurate baseline as to how good (or bad) your blood-glucose control has been over the past 8 to 12 weeks.
• The daily (or even hourly) readings on home testing kits (or on a device called a Continuous Glucose Monitor or CGM) are quite different. They use different units, and the significance of the numbers is different. They tell you "how I am managing my diabetes on a day-to-day basis." Lots of advice about that on this forum.

Edited to add: some of us choose to do without the daily testing (I'm one of them). But, in my opinion, you should not skip the HbA1C test -- it is the first priority for you.

 

[gibbsyns3]

Do be careful when ordering one. Take note of the price of replacement strips. You only need one meter but you do need many thousands of test strips - and the strips is where most manufacturers make their money.
The 2 popular ones here on the forum are the Codefree and the Tee2 because they have the cheapest strips, but I'm not sure if they send them outside the UK

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/

good advice - i thought that when i read the 35€ for 50 strips on the spanish site i'm looking at.

be cool if they are available on spanish prescriptions - we pay 40cents for a box of metforma

one question is you have time - the testing gadget i'm looking at mystar plus, claims to be the only one to measure a1c - is that a feature i'm likely to value, or just a sales gimmick? it goes on about it as if it is the best thing since sliced bread (gluten free of course- see i'm learning)

 

[gibbsyns3]

Just in case you don't know this already:

• The HbA1C test is normally done at the clinic. You can get "home kits" for this or you can look at the "predicted" HbA1C on a home glucose meter, but you should try to get a proper one done at the clinic/doctor's office. Initially this may be even more important than getting a home testing kit, because it will give you an accurate baseline as to how good (or bad) your blood-glucose control has been over the past 8 to 12 weeks.
• The daily (or even hourly) readings on home testing kits (or on a device called a Continuous Glucose Monitor or CGM) are quite different. They use different units, and the significance of the numbers is different. They tell you "how I am managing my diabetes on a day-to-day basis." Lots of advice about that on this forum.

Edited to add: some of us choose to do without the daily testing (I'm one of them). But, in my opinion, you should not skip the HbA1C test -- it is the first priority for you.

thanks, no i didn't. i'm pretty confused by all the anacronismes already - but i'm sure it will all come together. i hear the importance of the HbA1C test loud and clear though - it will be my first question to doc, and ensuring regularity in the future.

 

[Grateful]

i thought all alcohol was off limits. shame about the dryness of wine, i'm a bit of a heathen in preferring Liebfraumilch to Prosecco, but i guess that sweet tooth is why i'm here in the first place. So a future of Rum and Red wine. That I can live with

For the next few weeks your life will be full of surprises.

• Rum is essentially zero-carb, according to Google (I must admit to finding that incredibly surprising, given that it is distilled from sugarcane!!!)
• Liebfraumilch is OK (3g of carbs in one glass).

Here's another one for you. Milk is fairly high-carb (many of us T2s avoid it almost completely). Cheese is low-carb however.

I could go on all day. Look them up!

 

[Rachox]

good advice - i thought that when i read the 35€ for 50 strips on the spanish site i'm looking at.

be cool if they are available on spanish prescriptions - we pay 40cents for a box of metforma

one question is you have time - the testing gadget i'm looking at mystar plus, claims to be the only one to measure a1c - is that a feature i'm likely to value, or just a sales gimmick? it goes on about it as if it is the best thing since sliced bread (gluten free of course- see i'm learning)

Here’s a link on this site about the machine you are looking at.
http://www.diabetes.co.uk/blood-glucose-meters/sanofi-aventis-mystar-extra.html
It doesn’t actually measure your HbA1c, it estimates it from the readings you in put, as I understand it. I just have the cheap SD Code Free and enter my readings into the MySugr app, which does a similar thing. The accuracy of the HbA1c will depend on how many readings you take per day. My last HbA1c taken at the Drs was 36, that day MySugr was saying 34.4 so not too far off.