White coat syndrome

[saudidave]

Hi, can anyone tell me if White coat syndrome exists relating to blood sugar levels in type 2's or glucose resistant individuals?

I suffer badly from this when having my blood pressure measured by the medical profession. Despite the fact that I'm not at all worried, it goes through the roof, often to around 150/95 or even higher! when I check it it is a perfect 120/70

Today I went for the results of my first A1c ( it turned out to be 5.5) and despite the fact that I've been a constant 5.5 to 5.8 in the mornings, for a month, today it was inexplicably 7.7. I checked it 3 times at 10 minute intervals and it was constant. My diet was unchanged as was my activity level and tonight before my dinner it was 5.5 again!

 

[pianoman]

Great A1c result!

Yes it is possible for physical or emotional stress to raise Blood Glucose.

 

[Grazer]

Well done on the HbA1c. As pianoman said, your BG could be effected but it wouldn't have affected your A1c

 

[catherinecherub]

NICE have put forward new guidelines for people suffering from White Coat Syndrome.

http://www.guardian.co.uk/society/2011/ ... sdiagnoses

 

[saudidave]

NICE have put forward new guidelines for people suffering from White Coat Syndrome.

http://www.guardian.co.uk/society/2011/aug/24/blood-pressure-test-changes-misdiagnoses

Thanks for that Catherine and I was actually aware of it. Wearing a 24 hour monitor is how I convinced the medical profession that my BP was normal. It took a lot of persistence and if I had listened to what they told me I would have been taking blood pressure pills needlessly for the last 12 years.

My concern here is does the same process occur with blood sugar? Is the thought of going for a test enough to increase it and cause misdiagnosis? Some 6 weeks ago a sister at my local medical centre who had specialised in diabetes care and treatment for over 20 years phoned me to say that I was definitely type 2 based on two consecutive fasting glucose tests of. 7.0 and 7.1, despite being aware that I had had a GTT that showed me with a level of 5.8 after 2 hours. Now, an A1c shows me at. 5.5% during the period in question. I am not diabetic ( yet), I am still very much pre diabetic. There is a significant difference and the implications of misdiagnosis are very far reaching in every respect.

My faith in the NHS is eroded yet further. If you don't pay for it the standard of treatment in this country is pitiful.

 

[noblehead]

Stress can undoubtedly cause an increase in bg readings. As for 'White Coat'....well I take my home bp readings with me every-time and my gp/consultant is more than happy to take note of them.

Nigel

 

[daisy1]

I take my BP readings which I have done at home to my doctor. Before this I took my BP monitor into one appointment and compared the readings it took with hers so she's happy to accept my home readings now. In her surgery my readings were horrific. In that case it's certainly a "white coat syndrome".

Like the garage syndrome: you take your car into the garage because it's been making a funny noise. When you get to the garage it doesn't make the noise any more.

 

[saudidave]

Whilst I am grateful for responses to this thread, would you please note that my question didn't concern blood pressure, but the effect of stress on blood glucose levels. I have BP White coat syndrome and wondered if the same applied to BG.

As a point of interest, within 48 hours of my inexplicably high morning BG, the reason became apparent. I have a rather nasty flu like virus with a painful throat and aching muscles. No doubt my BG was high as a result of that.

 

[pianoman]

As I said above: emotional and/or physical stress(including infection) can raise Blood Glucose (think about the the Fight or Flight response.. we need quick energy to do either), but I doubt that it would raise BG above the normal range in a person who does not already have impaired Glucose tolerance (Pre-Diabetes or Diabetes)... in normal health, there are mechanisms in place to keep the BG within range -- in much the same way that a non-Diabetic person can eat any amount of Glucose without the BG going out of range.

Unless it has some employment or insurance implications for you, I'm not sure that the difference between a diagnosis of Pre-Diabetes vs Type 2 Diabetes is significant... I'd personally advise the same interventions in terms of diet, physical activity, BG testing etc... for both.

 

[bowell]

[youtube]l-lJZiqZaGA[/youtube]

 

[saudidave]

[quote="pianoman"
Unless it has some employment or insurance implications for you, I'm not sure that the difference between a diagnosis of Pre-Diabetes vs Type 2 Diabetes is significant... I'd personally advise the same interventions in terms of diet, physical activity, BG testing etc... for both.[/quote]

Thanks piano man and whilst I wholeheartedly agree with your comments, sadly, this has both employment and insurance implications for me. The "diagnosis" which I maintain wasn't either well considered or particularly accurate has cost me a tax free executive job paying £150,000.00 per annum, tax free and all found, in the carribean. Instead I must continue working 70 hours a week in this blighted island as a freelance consultant in the construction industry. That punishing and Stressful regime' which I have been undertaking for the past decade decade is probably 50% of the reason I got overweight, stopped exercising and got in this state. Instead of retiring after 3 years in the sunshine' I must now carry on for another decade, if I live that long. All because a quack got it wrong.

As for insurance, to add insult to injury, my life assurance just went up £100 per month

 

[Osidge]

I am sorry that you feel the NHS has let you down, SaudiDave. For myself, I have had extremely good treatment from the NHS. I remember on one occasion going to my GP for pain in my oesophagus and, as I am diabetic and coronary pain can present in unusual places for us, he sent me straight to hospital where they were waiting for me and had me immediately on an ECG machine. I can also remember waiting only 1 week to see a consultant neurologist for my enlarged prostate and only 2 weeks to see a consultant neurologist for my Parkinson's Disease diagnosis. I have access to private health care but the NHS response has meant that I have rarely used it.

I am sorry to hear of the large increase in your life insurance. I am surprised that it is only on account of the diabetes. I would expect an insurance company to be looking at your cardiac risk also (BMI etc). If you feel that you have been misdiagnosed with diabetes, ask your GP for a referral to a consultant diabetologist or an endocrinologist. That should clear things up.

Regards

Doug

 

[saudidave]

Thanks Doug, I appreciate anyone taking the tome to respond. My opinion of the NHS is indeed low but as the parent of two children I've spent my fair share of time in casualty departments and I never cease to be amazed by the number of staff hanging around. The cleanliness of Stepping Hill' my local hospital in Stockport was atrocious when my wife was admitted as an emergency about 5 years ago. It isn't referred to as MRSA central for nothing! A blood spill on the vinyl floor in front of my wife's bed lay undisturbed for well over 24 hours. We kept sn eye on it to see how long it would be before it was cleaned up.

Private health care is costing me a fortune but I do believe it is money well spent. I've never waited more than a day or two to see a consultant, never mind a week. The peace of mind and access to body scans et al with no wait is worth every penny

My BMI is 27 and my BP is 120/70 ( I take no medication of any kind) and my premium got jacked up when I disclosed my Type 2 "diagnosis" so I can't see what else it could be. Mnd you, they load my premium because my father died of a coronary aged 52. He Smoked 40 or more untipped woodbine cigarettes per day for 35 years and was the only one of 7 brothers and sisters not to see their 80th birthday, so I don't see what that has got to do with me!

 

[Osidge]

I guess that the NHS is not consistent but can only speak from my own experiences. Perhaps you can access a consultant through your private health cover that would confirm or otherwise the diagnosis of diabetes. You could then renegotiate the life insurance premium or get premium quotes from other places.

Regards

Doug

 

[saudidave]

Thanks Doug. Whilst the insurance issue is annoying it isn't what has brassed me off - it is losing a dream job that would have cut my working week by 30 hours and allowed me to retire early. I am under no illusions that I have blood sugar issues but I just think a box has been ticked without due diligence, by someone who possessed neither the skill or intelligence to tick it.

 

[saudidave]

Thanks Doug. Whilst the insurance issue is annoying it isn't what has brassed me off - it is losing a dream job that would have cut my working week by 30 hours and allowed me to retire early. I am under no illusions that I have blood sugar issues but I just think a box has been ticked without due diligence, by someone who possessed neither the skill or intelligence to tick it.

 

[viviennem]

You could refer the matter to the Insurance Ombudsman if you think you have been treated unfairly. They are very good.

Viv 8)

 

[Osidge]

Hi Dave

If you have blood sugars but don't have diabetes then, if I was you, I would want to know my actual status. If you do have diabetes then I am not sure what you would have expected a health professional to say. I am a tad confused but you can only control your situation if you know what it is.

Take care

Doug

 

[saudidave]

I still have a virus, although it is subsiding a little now ( I'm on day 4 or 5 of it now) and I think it is safe to confirm that the effect on blood sugar is marked. For a month my morning reading has been 5.5 - 5.8 as an average, whilst the readings over the past few days have been 6.8 to as much as 7.8. I'm using an Accu-Chek compact plus meter and I changed the cassette yesterday to ensure there wasn't an issue with that. It made no difference. My evening pre and post meal readings are higher too. My food intake is unchanged but since I've felt rather unwell I haven't been on my usual daily 10 mile bike ride.

I can only conclude that the virus is to blame!

 

[Grazer]

I understand you wanting to discover that you're not diabetic, and it's right you should investigate, but I don't think a non-diabetic would get fasting readings that high because of a virus. You might need to accept that the diagnosis made by those health professionals wasn't that wrong after all.
Can't understand the insurance premium bit unless you were just renewing at the time. Existing policies wouldn't increase, and your cover would be valid, providing you weren't aware of your diabetes when you made the original medical disclosure.