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Type 2 and doc wants me higher than I like

Daniel95503

Member
Messages
21
Location
California, US
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Good morning. I am a noob on here and have been looking for a good forum for many questions. I am type 2, was diagnosed November 2014. My doc (she is 12, lol) told me that because I am diabetic she wants me to be around 140-160. That just does not make sense to me. I am looking for a new doc with experience in diabetes at the mo. What are your thoughts on her advice? I want to be in the 80-120 range and do my best, but have had a bout of low 300 to high 200 even in morning. I upped my met to two 1000mg met twice a day and a glip when I get higher than 170 before bed. Rambling there, what are your thoughts on her advice?
 
@Daniel95503

Hello Daniel and welcome to the forum :) To help you, here is the information we give to new members and I hope you will find it helpful. Ask more questions 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 over 150,000 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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.
 
Good morning. I am a noob on here and have been looking for a good forum for many questions. I am type 2, was diagnosed November 2014. My doc (she is 12, lol) told me that because I am diabetic she wants me to be around 140-160. That just does not make sense to me. I am looking for a new doc with experience in diabetes at the mo. What are your thoughts on her advice? I want to be in the 80-120 range and do my best, but have had a bout of low 300 to high 200 even in morning. I upped my met to two 1000mg met twice a day and a glip when I get higher than 170 before bed. Rambling there, what are your thoughts on her advice?

I have used the converter and see where your doctor wants you to be, but when does she want you to be there? After eating, an average of that range or something else? I'm sure you can probably understand that would potentially impact on views.

It would also be useful to know if you are otherwise healthy or have other health issues she may be taking into consideration. :)
 
@AndBreathe she did not say, hence my apprehension to her knowledge of diabetes, like I said, she is 12. I have had to do all my own research on what I should be doing or trying. I want a doc with experience and one who starts out a sentence as 'I have found...' As opposed to 'research says...' When I suggest something I get told a flat NO.
 
What about Prozac for reducing glucose level, foot pain and just overall depression or stress? I asked about that and was given the stanard NO
 
Hi @Daniel95503 and welcome to the forum. You don't sound too happy with your 12yo GP!
Are there other GPs at this practice? GP Surgeries with more than one GP are supposed to have one who specialises in diabetes.
 
Hi @Daniel95503 and welcome to the forum. You don't sound too happy with your 12yo GP!
Are there other GPs at this practice? GP Surgeries with more than one GP are supposed to have one who specialises in diabetes.
@Prem51 well, she might be good at gp, but I don't go to doc unless I need to, and I consider a possibility of losing limbs, eyesight, etc is a need to sitch. Where I live, in northwest California, docs are hard to come by so I am stuck with her for the minute. There are other gps at practice, but no one here is taking new patients, at same practice
 
Is it possible that she’s wanting you to be at 140-160 only temporarily? I ask because you mentioned your morning levels hover around 300 mg/dl.

Of course, we all want to be below 100 mg/dl, but sometimes we have to walk before we run. Not only that, but it can be very unpleasant to lower your blood sugar too fast. Some people can experience the symptoms of “False hypos” when their blood sugar drops too rapidly even if that means it drops from 300 down to 150 (which is still high).

When I was first diagnosed, my blood sugar was 500+. My doctor put me on slow-acting (basal) insulin which kept my levels at around 250-400 for the next two weeks. After that, I began fast-acting/meal-time (bolus) insulin and got my levels down to below 120. Looking back, I’m glad she gave me that advice.
 
Is it possible that she’s wanting you to be at 140-160 only temporarily? I ask because you mentioned your morning levels hover around 300 mg/dl.

Of course, we all want to be below 100 mg/dl, but sometimes we have to walk before we run. Not only that, but it can be very unpleasant to lower your blood sugar too fast. Some people can experience the symptoms of “False hypos” when their blood sugar drops too rapidly even if that means it drops from 300 down to 150 (which is still high).

When I was first diagnosed, my blood sugar was 500+. My doctor put me on slow-acting (basal) insulin which kept my levels at around 250-400 for the next two weeks. After that, I began fast-acting/meal-time (bolus) insulin and got my levels down to below 120. Looking back, I’m glad she gave me that advice.
@TorqPenderloin thanks for the reply. Once I was down to normal levels she told me to come up to higher levels and when I questioned that she said 'research states...people who have diabetes should be at 140 (sorry, didn't use converter) to prevent heart disease. I was already, with diet and meds, between 80 and 120. I understand walk before you run and all, and do appreciate you reply. The reason I joined this site is to get real advice from real diabetics and so far I am glad I am here. I felt so alone for the past 2 years and was finally tired of being alone. I may seem bitter, but am just frustrated with a bad doc...I just need real info from real people who are real diabetics, so I am so glad I am here

Again, sorry to seem so bitter and angry, I just want to be normal again. I truly do appreciate any and all advice and comments I get.
 
Her advice is definitely puzzling and under normal circumstances 140 is definitely high (as you already know).

If you're having trouble finding doctors willing to accept new patients you may consider expanding your search to nurse practitioners. Oddly enough, my "Diabetes specialist" is a nurse practitioner and she's absolutely phenomenal. Aside from her business card, she's an Endocrinology doctor as far as I'm considered.

Side note: I'm in the US (Texas) as well.
 
@AndBreathe she did not say, hence my apprehension to her knowledge of diabetes, like I said, she is 12. I have had to do all my own research on what I should be doing or trying. I want a doc with experience and one who starts out a sentence as 'I have found...' As opposed to 'research says...' When I suggest something I get told a flat NO.

Hi Daniel, unfortunately, many seem to be this way, my diabetes consultant wants me to stay at 7.0, even though I answer back, that being in the 5's and 6's would surely be better, but he said 5, 6, 7 are basically the same and 5 and 6 are too low and run the risk of hypo's ( I am Type 1)
 
Hi Daniel, and welcome.

You will need a converter for this, but these are the national UK guidelines our heath service uses. I hope it helps. Many of us aim for the non-diabetic targets

Target Levels

Non-diabetic*
fasting and before meals 4.0 to 5.9 mmol/L......... At least 90 minutes after meal under 7.8 mmol/L
Type 2 diabetes fasting and before meals 4 to 7 mmol/L........... At least 90 minutes after meal under 8.5 mmol/L
 
@TorqPenderloin thanks for the reply. Once I was down to normal levels she told me to come up to higher levels and when I questioned that she said 'research states...people who have diabetes should be at 140 (sorry, didn't use converter) to prevent heart disease. I was already, with diet and meds, between 80 and 120. I understand walk before you run and all, and do appreciate you reply. The reason I joined this site is to get real advice from real diabetics and so far I am glad I am here. I felt so alone for the past 2 years and was finally tired of being alone. I may seem bitter, but am just frustrated with a bad doc...I just need real info from real people who are real diabetics, so I am so glad I am here

Again, sorry to seem so bitter and angry, I just want to be normal again. I truly do appreciate any and all advice and comments I get.

That does seem a bit strange. I could understand if she was planning the 140 level as a stepping stone, post-diagnosis.

If she tells you "...research states...", I would ask her for the research she takes that from. There are ways you can phrase that, so that you are seen as wanting to become in informed patient, as opposed to directly challenging her knowledge. Going head to head, in conflict, with our health care professionals, often doesn't end in a mutually respectful relationship, or happy outcomes.

In the meantime, have you tried consulting Dr Google to see if you can find the paper she seems to be referring to?
 
Thank you all for your replies. Again, apologies for sounding so negative and bitter earlier on in post. I am working getting in to open door clinic, they have an amazing (from what I have heard) PA there that is excellent with diabetes peeps, again from what I have heard. They are only taking new patients that are on medical at the mo, but they are trying to get me in since my spouse is already an established patient there. If I get to see this Dr Chris West, a lot of my stress will go away. @TorqPenderloin i agree that PA's are wonderful, I am usually thrilled when I get to see one instead of my regular "doc".
 
I think 140 equates to about 7.8 in UK units. From everything I have read, that is a level you want to be below for as much of the time as possible, as 7.8 is a level at which damage to blood vessels ( and therefore the likelihood of complications) starts to be a problem. I cannot imagine where she got her research from that suggest a healthy heart needs higher blood sugar levels. Sorry but that sounds like madness or misinterpretation of whatever report she 's read. Sometimes hard pressed docs only ever read the excerpts or conclusions so don't fully understand the implications of any report - or they are advised by drug company reps and guess who wants you to need more meds?
Metformin does not put you at risk of a hypo. Your other medication may but only if your carb intake was really really low. Many type 2s on here follow the low carb high fats (good fats!) way of eating and find it really helps to lower blood sugar. My mother was given gliclizide and found she needed to reduce the dose once she was eating a lower carb diet as she sometimes felt light headed after exercise on the full dose. Much better though to reduce your need for medication by following a low carb diet and reducing blood sugar naturally than relying on medication.
As well as the info on here I recommend looking at thewww.dietdoctor.com website as it has a lot of great info on low carb diets both for weight loss and to control diabetes and much of it is free and they don't try to sell you anything. You can become a member but you don't need to at all. also a lot of good links for the site to other research and to various heart doctors who are also advocating low carb higher fats for healthy hearts.
 
I'm totally confused now, my doc also said my HBA1C was getting a bit low at 40 UK and here was me thinking low=good and high=bad all these years, oh well back on the bread, crisps, pies and chocolate then.
 
I'm totally confused now, my doc also said my HBA1C was getting a bit low at 40 UK and here was me thinking low=good and high=bad all these years, oh well back on the bread, crisps, pies and chocolate then.
numan43 - aside from my diagnostic test, all my HbA1cs have all been lower than 40, and I've never had guidance to bring it up at all.

A score of 42 is the level at which prediabetes would be diagnosed, so it seems unlikely she wants you in that bracket, or higher.

For some T1s, using insulin or other diabetics using potentially hypo inducing meds, a low score, like 40 could suggest they must be having lots of hypos to achieve it. Just on Metformin for you, or no meds for me, that concern doesn't apply, provided you are feeling well in yourself.

Keep fighting the good fight. In my opinion, you're doing just fine. :)
 
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