Newly diagnosed but confused by the diabetic nurse

[Chook]

Must have been a steak day yesterday - I had sirloin steak with oven baked celeriac chips and salad

Most people lose some weight when they first start low carbing. I lost 5st but have since put 2st back on. I'm working at getting rid of those 2st now using the Newcastle Diet with real food.

 

[Pinkorchid]

I had a letter from my GP in June saying my blood test results showed my sugar levels were high. Booked in to see diabetic nurse who confirmed me as officially T2 diabetic. During the course of the very short appointment she told me she didn't want me to use a tester. How can I monitor my blood sugar levels without testing? She's going to see me again in "3 months" to decide if I need treatment but I feel as though they're not that bothered. I'm concerned because about 5 years ago I saw my previous GP because I have numbness and tingling in both my big toes but they didn't seem perturbed by that and didn't test for diabetes at the time. I don't feel I've been offered any support at all. Fortunately my husband is insulin dependent so knows a bit about it. Meanwhile, am I getting more nerve damage the longer I leave it untreated?

Your nurse can't tell you not to test if you are willing to pay for the testing strips yourself it is your decision no one else's and if you do it just don't tell her. At the moment you do not know if you have any nerve damage only a doctor can tell you that and it may not be so.. Diabetes is finding out what works for you not what works for others because we are all so different. The general opinion here.. it is not the NHS guidelines though.. is to cut down or cut out the starchy carbs like pasta rice bread potatoes and of course all sugar and that will help to lower blood sugar levels and aids weight loss if that is needed .

 

[Petrolhead276]

I had a letter from my GP in June saying my blood test results showed my sugar levels were high. Booked in to see diabetic nurse who confirmed me as officially T2 diabetic. During the course of the very short appointment she told me she didn't want me to use a tester. How can I monitor my blood sugar levels without testing? She's going to see me again in "3 months" to decide if I need treatment but I feel as though they're not that bothered. I'm concerned because about 5 years ago I saw my previous GP because I have numbness and tingling in both my big toes but they didn't seem perturbed by that and didn't test for diabetes at the time. I don't feel I've been offered any support at all. Fortunately my husband is insulin dependent so knows a bit about it. Meanwhile, am I getting more nerve damage the longer I leave it untreated?

Hi Jackie,

I don't understand this three month testing scenario either.
Personally I would expect a monthly test, reviewing the results that are three months apart.

I had this with my wife's diabetes and got her a free meter from one of the manufacturers.

This idea of try changing your diet seems to be a normal first step, and I have never read anywhere why this is.

 

[Alison Campbell]

Hi @Petrolhead276

The HBA1C covers average glucose over 3 months hence 3 monthly testing to see the results of any changes in diet and meds etc

A good change in diet can get some people down to normal levels avoiding medication and avoiding the potential side effects of medication. There is a NICE guidline chart for medical staff detailing the steps in the process.

 

[ringi]

If HBA1C is tested more than every 3 months, it is possible the get very misleading results. For example, think of someone that

Had a very good diet 3 and 4 months ago
Eat a lot of sugar 2 months ago
Had a reasonable diet for the last month​

The HBA1C one month ago while they are eating lots of sugar can be less than the HBA1C a few weeks after they have improved their diet!

 

[Petrolhead276]

Hi @Petrolhead276

The HBA1C covers average glucose over 3 months hence 3 monthly testing to see the results of any changes in diet and meds etc

A good change in diet can get some people down to normal levels avoiding medication and avoiding the potential side effects of medication. There is a NICE guidline chart for medical staff detailing the steps in the process.

Do you have the link to the NICE guidelines?

I would like to print them off and take them to appointments with GP.

 

[Bluetit1802]

Do you have the link to the NICE guidelines?

I would like to print them off and take them to appointments with GP.

Are these the ones you want?

https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#blood-glucose-management-2

 

[Petrolhead276]

If HBA1C is tested more than every 3 months, it is possible the get very misleading results. For example, think of someone that

Had a very good diet 3 and 4 months ago
Eat a lot of sugar 2 months ago
Had a reasonable diet for the last month​

The HBA1C one month ago while they are eating lots of sugar can be less than the HBA1C a few weeks after they have improved their diet!

Exactly, and surely that is why one needs to see the snapshot in time of the average 3 monthly figure on a monthly (or more frequent) basis, this then gives a truer indication or what is happening in the patients life.

So for example:

A test on say 31-March would cover the 90 days prior (jan-mar)
A test of 30-April covers the 90 days prior (Feb-Apr)
And so on
Therefore giving 12 values of assessment over a year rather than the current 4 assessments.

Much easier to correct a wayward diet month over month than quarter over quarter and thus get a quicker improvement.

 

[Alison Campbell]

Do you have the link to the NICE guidelines?

I would like to print them off and take them to appointments with GP.

Here is the chart I was thinking of: https://www.nice.org.uk/guidance/ng...in-adults-with-type-2-diabetes-pdf-2185604173

 

[ringi]

Exactly, and surely that is why one needs to see the snapshot in time of the average 3 monthly figure on a monthly (or more frequent) basis, this then gives a truer indication or what is happening in the patients life.

So for example:

A test on say 31-March would cover the 90 days prior (jan-mar)
A test of 30-April covers the 90 days prior (Feb-Apr)
And so on
Therefore giving 12 values of assessment over a year rather than the current 4 assessments.

Much easier to correct a wayward diet month over month than quarter over quarter and thus get a quicker improvement.

But my own readings 2hr after meals gives me much more useful data.....

 

[Bluetit1802]

Exactly, and surely that is why one needs to see the snapshot in time of the average 3 monthly figure on a monthly (or more frequent) basis, this then gives a truer indication or what is happening in the patients life.

So for example:

A test on say 31-March would cover the 90 days prior (jan-mar)
A test of 30-April covers the 90 days prior (Feb-Apr)
And so on
Therefore giving 12 values of assessment over a year rather than the current 4 assessments.

Much easier to correct a wayward diet month over month than quarter over quarter and thus get a quicker improvement.

What you need is a meal by meal evaluation, and we can do this at home with our meters. This is a much better indication of our control than the HbA1c, which actually can be quite unreliable.

 

[woodywhippet61]

Actually it's much easier to correct a wayward diet after each meal. i.e. you test, you eat something and then 2 hours after eating you test again. If your bloods have spiked or are still too high after 2 hours then you know that you've eaten something that is going to raise your BG. So you can either not eat it again or eat less of it or you could eat it and then go for a walk and see what effect that has.

So you adjust your diet at that point. Almost instant feedback. (Some people with slow digestive systems take 3 hours so might be an idea to check then as well).

The A1c is important because your HCP's will base their advice and any meds on it. It also of course adds to our information about how diabetes and our lifestyle is affecting us. BUT it not as important as testing to see what effect food has on our bg.