As Lucozade has changed its recipe is there something else that I could use to do a DIY OGTT?

gardengnome42

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Next month I have to submit a weeks blood pressure results to the GP and had thought of asking for a blood test. However I am concerned that an HbA1c might see me over the threshold as my low carbing efforts haven't really been brilliant. I felt that a home test might be a case of 'Forewarned is forearmed'! It would stir me into action should it be necessary before I do present for an official blood test.

Incidentally can I ask for an HbA1c or do I first have to see the GP/nurse?
 

DCUKMod

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Next month I have to submit a weeks blood pressure results to the GP and had thought of asking for a blood test. However I am concerned that an HbA1c might see me over the threshold as my low carbing efforts haven't really been brilliant. I felt that a home test might be a case of 'Forewarned is forearmed'! It would stir me into action should it be necessary before I do present for an official blood test.

Incidentally can I ask for an HbA1c or do I first have to see the GP/nurse?

Well, the OGTT isn't used as a diagnostic tool any more, except for gestational diabetes, but it can be done at home.

If you chose to use Lucozade, you just need to take a bit more of it, to add up to the required carb level. I won't do the calculation for you as I made a mistake when I did my own and actually took on board a few extra gramms of glucose. Doh!

Alternatively, there's a preparation called "Rapilose" which is pre-prepared, in a sachet, which you just squeeze into your mouth. You can buy it online. That's what @Bluetit1802 used when she did hers.

Surgeries vary, but I imagine if you're not on a diabetes radar, they might ask why you wanted on if you just asked for it.

I'm not sure what your fear is relating to having it done and your low carbing? It is what it is, and even if not exactly as you would like, it would inform you if you were progressing, and if so, by how much.

As a pre-diabetic, you may not have to go Ninja-LC (OK, you get the drift!), you might find just trimming back the carbs a bit is enough to keep you away from a diagnosis. We're all so different, which is both the beauty and the infuriating nature of diabetes.
 

rmz80

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You can buy a packet of Glucose from Superdrug or Boots for about £1.50.
 

Bluetit1802

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I would ask you why you are worried about being forewarned? It is what it is, and an OGTT at home won't change things. Why not just ask for the HbA1c when you see your doctor and accept what it tells you.

Home OGTT
The solution I used when I did my home OGTT was Rapilose, as DCUKMod said. It is a drink that contains exactly 75g of glucose and nothing else at all. You just pour it into a glass and drink it in 5 minutes. It is used in many surgeries now that Lucozade has gone reduced sugar.

https://www.gpsupplies.com/rapilose-ogtt-glucose-solution-300ml-pack-of-1

You do need to be organised when you do the test. You should also eat 130g carbs a day for 3 days beforehand or the test may be inaccurate. You will need to pick a morning when you have nothing else to do. Fast overnight, no food. Test your fasting BG. Drink the liquid. Sit quietly for at least 2 hours - no food, no water, no moving about, no smoking, no stress or disturbances. Then you test at whatever frequencies you chose, but as a bare minimum at 1 hour and 2 hours after finishing the drink. If you want extra information you can test half hourly and keep going after the 2 hour mark. You need to record all these readings with the times.
 

gardengnome42

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You can buy a packet of Glucose from Superdrug or Boots for about £1.50.
You can buy a packet of Glucose from Superdrug or Boots for about £1.50.
Ok thank you. What are the pros and cons of being on the diabetes register and am I alone in not wanting to be put on the register? My reason for doing a DIY test is that I loathe going to the GP. I couldn't stand the patronising attitude of the nurse combined with all the blood tests I had to have for hypertension 5 yrs ago. I vowed I'd lose weight for good and sort the blood pressure problem out but although I lost the weight the BP didn't alter by sufficient and I take medication for it.
I felt it was a stigma and a diabetes diagnosis would only compound the stigma. Am I ridiculous in feeling like that, do others feel stigmatised I wonder? At the same time I read that there are more fat people who don't have diabetes than thinifers who do. I don't know if this is in fact true?
 
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Bluetit1802

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Ok thank you. What are the pros and cons of being on the diabetes register and am I alone in not wanting to be put on the register? My reason for doing a DIY test is that I loathe going to the GP. I couldn't stand the patronising attitude of the nurse combined with all the blood tests I had to have for hypertension 5 yrs ago. I vowed I'd lose weight for good and sort the blood pressure problem out but although I lost the weight the BP didn't alter by sufficient and I take medication for it.
I felt it was a stigma and a diabetes diagnosis would only compound the stigma. Am I ridiculous in feeling like that, do others feel stigmatised I wonder? At the same time I read that there are more fat people who don't have diabetes than thinifers who do. I don't know if this is in fact true?

There is a current thread on the pros and cons of a diagnosis. https://www.diabetes.co.uk/forum/threads/pros-and-cons-of-official-diagnosis.136019/

One major thing I like about my diagnosis is I have full blood tests every 6 months. (although I only see the nurse annually). Otherwise it would be every few years on a routine MOT unless another health problem cropped up. I track my blood test results, checking I am not deteriorating in any of them. If I notice a trend towards abnormal, I research and try to find the reason so I could attempt to put it right before it became too late. I have even asked for vitamin/mineral tests to be added when I felt it necessary, rather than blindly take supplements. Bloods are so very important, for all of us, not just diabetics. It is taking responsibility for my own health, because no-one else will.
 

gardengnome42

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I would ask you why you are worried about being forewarned? It is what it is, and an OGTT at home won't change things. Why not just ask for the HbA1c when you see your doctor and accept what it tells you.

Home OGTT
The solution I used when I did my home OGTT was Rapilose, as DCUKMod said. It is a drink that contains exactly 75g of glucose and nothing else at all. You just pour it into a glass and drink it in 5 minutes. It is used in many surgeries now that Lucozade has gone reduced sugar.

https://www.gpsupplies.com/rapilose-ogtt-glucose-solution-300ml-pack-of-1

You do need to be organised when you do the test. You should also eat 130g carbs a day for 3 days beforehand or the test may be inaccurate. You will need to pick a morning when you have nothing else to do. Fast overnight, no food. Test your fasting BG. Drink the liquid. Sit quietly for at least 2 hours - no food, no water, no moving about, no smoking, no stress or disturbances. Then you test at whatever frequencies you chose, but as a bare minimum at 1 hour and 2 hours after finishing the drink. If you want extra information you can test half hourly and keep going after the 2 hour mark. You need to record all these readings with the times.[/QUOTE

Thanks Bluetit, Is it actually 'what it is' if going low carb lowers the HbA1c? Would you say that it wouldn't be an accurate reading and would I just be delaying the inevitable? I'm only trying to keep off the radar and is this a good idea or not? Is it that just being a prediabetic is little different to being full T2, I need to sort my carbs and can't allow things to slide?
I've never really got my head round this carb counting exercise, it all sounds technical but having said that I do trim back on the obvious and fill up on leafy vegetables. It's quite possible that I'm worrying unnecessarily but I do feel that I've let things slide since Christmas so maybe I should just bite the bullet as you say and ask for the HbA1c.
Incidentally my son [aged 49] has Hypothyroidism and was warned at his last check up that his HbA1c was also 43. He doesn't live in the UK so I gave him some tips on low carbing [who am I to talk!] and he later went for another test to another dr where he sent me the result of 'post prandial 7.5 - test method Hexokinase.' I asked him what that was and he said they had given him breakfast, he'd waited 2 hrs then was re-tested. He said the 'breakfast' was a croissant and a glass of orange juice !! I thought he was joking but he was quite serious.
 

Bluetit1802

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Well that was a peculiar OGTT! But Hexokinaise is another form of Rapilose or Lucozade. So if that was the method used, I have no idea why they gave him breakfast ontop of it, but I expect they knew what they were doing.

If you do this OGTT at home, you need to be really strict with yourself, and organised, or it won't work properly. My personal opinion is just have the HbA1c and accept the result. These are the instructions delivered to doctors.
http://penlanhealthcare.com/uploads/Rapilose-OGTT-Instructions-For-Use.pdf

But ask yourself - what will this tell me?
 

Olufisayo

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Ok thank you. What are the pros and cons of being on the diabetes register and am I alone in not wanting to be put on the register? My reason for doing a DIY test is that I loathe going to the GP. I couldn't stand the patronising attitude of the nurse combined with all the blood tests I had to have for hypertension 5 yrs ago. I vowed I'd lose weight for good and sort the blood pressure problem out but although I lost the weight the BP didn't alter by sufficient and I take medication for it.
I felt it was a stigma and a diabetes diagnosis would only compound the stigma. Am I ridiculous in feeling like that, do others feel stigmatised I wonder? At the same time I read that there are more fat people who don't have diabetes than thinifers who do. I don't know if this is in fact true?[/QUOTE

I’m diabetic and hypertensive too. I’m not fat and not a thinifer
 

DCUKMod

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@gardengnome42 - My only comment would be that you've had an HbA1c done. You know what that score was. If you do an OGTT you have no comparative, so really it's comparing apples with pears.

And HbA1c indicates longer term, average blood glucose performance on an "all events" basis. The OGTT indicates your insulin response to one glucose incident (the Lucozade/Rapilose or whatever), which really isn't the same thing.

If you have an HbA1c and it has improved; fantastic. If you have the HbA1c done and the score has deteriorated, for whatever reason, you can at least compare it with what you were doing before and for the last x number of weeks and decide what to change/tweak.

I only did the OGTT on a whim, after I had been in a non-diabetic state, as defined by HbA1c for a few years.
 

gardengnome42

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@gardengnome42 - My only comment would be that you've had an HbA1c done. You know what that score was. If you do an OGTT you have no comparative, so really it's comparing apples with pears.

And HbA1c indicates longer term, average blood glucose performance on an "all events" basis. The OGTT indicates your insulin response to one glucose incident (the Lucozade/Rapilose or whatever), which really isn't the same thing.

If you have an HbA1c and it has improved; fantastic. If you have the HbA1c done and the score has deteriorated, for whatever reason, you can at least compare it with what you were doing before and for the last x number of weeks and decide what to change/tweak.

I only did the OGTT on a whim, after I had been in a non-diabetic state, as defined by HbA1c for a few years.


Perhaps the way to go is another HbA1c. It was October that it was last done and I didn't want to see that it had risen and the subsequent flak I might get from the GP/nurse, that was why I wanted to do my own but the way you put it sounds as though the OGTT is little different to testing before and after a meal. I feel this low carbing is so restrictive and life will never be the same again if I can't cook delicious meals.
 

gardengnome42

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Well that was a peculiar OGTT! But Hexokinaise is another form of Rapilose or Lucozade. So if that was the method used, I have no idea why they gave him breakfast ontop of it, but I expect they knew what they were doing.

If you do this OGTT at home, you need to be really strict with yourself, and organised, or it won't work properly. My personal opinion is just have the HbA1c and accept the result. These are the instructions delivered to doctors.
http://penlanhealthcare.com/uploads/Rapilose-OGTT-Instructions-For-Use.pdf

But ask yourself - what will this tell me?

Thank you for that reply Bluetit but I thought I'd lost my reply to you - it just disappeared and still I can't see it but since you replied re. the hexokinase you obviously received it. Strange goings on! I thought it was rather strange too. I think I'll bite the bullet and have the full HbA1c done when submitting the BP readings. Always assuming they will do one for me if I ask nicely!
 

Bluetit1802

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Perhaps the way to go is another HbA1c. It was October that it was last done and I didn't want to see that it had risen and the subsequent flak I might get from the GP/nurse, that was why I wanted to do my own but the way you put it sounds as though the OGTT is little different to testing before and after a meal. I feel this low carbing is so restrictive and life will never be the same again if I can't cook delicious meals.

You just seem to be a little frightened of what the HbA1c might reveal, and that is understandable especially if you are so unsure about low carbing. However, if you don't have it you will be in limbo. Have I got diabetes? Have I got pre-diabetes? Am I non-diabetic? What do I do? Whichever of those things, you know your body isn't coping too well with carbs or you wouldn't have seen that HbA1c last October, so whatever a new HbA1c reveals, you will still have to find some sort of suitable diet if you want to stay controlled, even if it shows you have improved. It will be so easy to slip backwards. Ultra low carbing may not be for you, but moderate carbs may well be the answer, with a little intermittent fasting thrown in if that floats your boat, (skipping breakfast for example), and of course, regular and structured testing and recording.
 

gardengnome42

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Thank you Bluetit, I really appreciate your comments. You are very perceptive and actually are spot on with how I feel. I have been doing some testing before and after dinner recently and seem to get post meal readings in the 9's and sometimes 10's which I'm sure is too high especially for a borderline case. usually about 3 points higher than before the meal and actually. That's why I'm so afraid the HbA1c might have risen. Only one way to find out of course! It would give me a good jolt if it has risen it would motivate me to actually do something about it. Do you have to ask permission at your practice for a blood test or do you just make an appointment with the phlebotomist?
 
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Bluetit1802

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Thank you Bluetit, I really appreciate your comments. You are very perceptive and actually are spot on with how I feel. I have been doing some testing before and after dinner recently and seem to get post meal readings in the 9's and sometimes 10's which I'm sure is too high especially for a borderline case. usually about 3 points higher than before the meal and actually. That's why I'm so afraid the HbA1c might have risen. Only one way to find out of course! It would give me a good jolt if it has risen it would motivate me to actually do something about it. Do you have to ask permission at your practice for a blood test or do you just make an appointment with the phlebotomist?

At my surgery a doctor or nurse has to order a blood test with the phlebotomist. It may vary elsewhere.
I agree, a higher HbA1c will give you some motivation to lower it by the next test.

Yes, your post meal levels are higher than acceptable, and reflect your carb consumption. Are you keeping a detailed food diary including portion sizes and all the ingredients, and are you recording your levels alongside? You can use this to look for patterns, analyse why some of the rises are happening, and tweak the meal appropriately. It may be you are mixing your carbs which then total more than your body can cope with in a single meal, so that would mean eliminating one of the carbs and trying again.

Personally I can eat 2 potatoes (new, roast, chipped) without a spike, but if I combine these with carrots and gravy, I see higher spikes, so I keep the gravy amount very low and severely restrict the amount of carrots. We all have a total carb tolerance for each meal, and at each time of day. I can't eat any proper carbs at breakfast but can eat those same carbs later in the day. If I exceed around 25g in one meal, I will spike. You can find your own tolerance levels at breakfast, lunch and dinner, but it is all trial and error, and mistakes will be made. Then hopefully, we can learn from our mistakes.
 

DCUKMod

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Perhaps the way to go is another HbA1c. It was October that it was last done and I didn't want to see that it had risen and the subsequent flak I might get from the GP/nurse, that was why I wanted to do my own but the way you put it sounds as though the OGTT is little different to testing before and after a meal. I feel this low carbing is so restrictive and life will never be the same again if I can't cook delicious meals.

Gardengnome - It is not your Doc or Nurse's place to scold you. It is their place to provide you with advice services and support.

Reducing your carb intake takes a bit of work and settling into, but I feel able to assure you my meals are delicious and I don't feel I'm missing out.

You are pre-diabetic. You may not even have to go full LC. It could be you just have to trim back a bit. Only you will be able to gauge that from a combination of your self-testing and periodic lab blood tests.

I was diagnosed in 2013 and I have never manipulated HbA1c test timing because it is what it is. If the lab work comes back good, I can smile and move on. If it were to come back with unpalatable numbers, it informs me I need to do something and gives me an indication of what I would need to do.

If we manipulate tests, who are we kidding? Well, we might be kidding the Doc, but is it his life and his health?

In my world, knowledge is power. If I know what's going on, I can plan and act on it. If I'm manipulating results, I don't really know what's going on, so could be pitching my lifestyle all wrong - too harshly or too lax.

In terms of delicious meals? I can honestly say our meals are delicious. The way I look at it is if we're having currey, but I'm not having rice, I get to have more of the tasty stuff, not the bulking carrier.

If we're having a roast, I'll have the odd roastie if they look particularly crispy, but the fat helps me out with those.

So, I'd say my meals may be different now, but often not too different, and certainly not any less delicious.
 

Incyb

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Gardengnome - It is not your Doc or Nurse's place to scold you. It is their place to provide you with advice services and support.

Reducing your carb intake takes a bit of work and settling into, but I feel able to assure you my meals are delicious and I don't feel I'm missing out.

You are pre-diabetic. You may not even have to go full LC. It could be you just have to trim back a bit. Only you will be able to gauge that from a combination of your self-testing and periodic lab blood tests.

I was diagnosed in 2013 and I have never manipulated HbA1c test timing because it is what it is. If the lab work comes back good, I can smile and move on. If it were to come back with unpalatable numbers, it informs me I need to do something and gives me an indication of what I would need to do.

If we manipulate tests, who are we kidding? Well, we might be kidding the Doc, but is it his life and his health?

In my world, knowledge is power. If I know what's going on, I can plan and act on it. If I'm manipulating results, I don't really know what's going on, so could be pitching my lifestyle all wrong - too harshly or too lax.

In terms of delicious meals? I can honestly say our meals are delicious. The way I look at it is if we're having currey, but I'm not having rice, I get to have more of the tasty stuff, not the bulking carrier.

If we're having a roast, I'll have the odd roastie if they look particularly crispy, but the fat helps me out with those.

So, I'd say my meals may be different now, but often not too different, and certainly not any less delicious.
DCUKMod, how did you get on with your DIY OGTT? I ask because the DN at my surgery wasn't pleased at my A1c of 30 and over 8 stone weight loss, because I achieved it through low carb and IF. She said spitefully "But you're still diabetic. An OGTT would prove it. In fact, I'll ask the doctor to order one."
If I thought I might achieve a normal one, I'd do it, purely to annoy her!
 
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DCUKMod

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DCUKMod, how did you get on with your DIY OGTT? I ask because the DN at my surgery wasn't pleased at my A1c of 30 and over 8 stone weight loss, because I achieved it through low carb and IF. She said spitefully "But you're still diabetic. An OGTT would prove it. In fact, I'll ask the doctor to order one."
If I thought I might achieve a normal one, I'd do it, purely to annoy her!

Now, I didn't carb up prior to doing the test because I didn't fancy it, and I'd previously had a conversation with an Endo a couple of weeks before about carbing up prior to a Coelia test, when we agreed I wouldn't. I was prepared for a failure, but these are the results. I also ended up having a few extra grams of glucose because I miscalculated.

I stopped at 150 minutes because my liver came into play, so I made some coffee and got on with my day.

I didn't like the early 9, but overall, I'm happy with that, and would certainly have passed a straightforward NHS version.

Lucozade is plain old vile, so I'm in no rush to have another go!
 

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Alexandra100

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I have been doing some testing before and after dinner recently and seem to get post meal readings in the 9's and sometimes 10's which I'm sure is too high
IMO yes, that is too high. I don't understand why you want another test at your doctor's, either A1c or OGTT. Your after meal tests are already telling you what you need to know - that you need to do something to lower your bg after meals, and the obvious thing to do is eat fewer carbs in those meals. The A1c test is only an average. Even if it came out lower this time, that number could be composed of highs after meals and lows at other times, which is not at all what you want. Spikes are harmful. And if you do an OGTT and it comes out well, so what? Maybe you react better to Lucozade or equivalent than you do to the bread or potatoes or biscuits or whatever in your normal diet. Maybe your stomach is slow to empty and the spike only comes 3 hours or later after the Lucozade. Are you going to say that because you got a good OGTT number, your after-meal numbers don't matter?

I am glad I'll be having another A1c test in 3 months, because I don't get up in the middle of the night to test, and also it will save me a lot of head scratching trying to average out my home testing numbers, but on the whole I see my home testing numbers as more important. I definitely won't be doing an OGTT test, because I don't want to treat my poor body so badly, after all the efforts I have made to give it the lower bg it needs. Even if a test "proved" that I am not diabetic, I'd still have to go on eating under 20 carbs a day to avoid seeing damagingly high bg after meals, so what would be the good of that?
 
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