Borderline slim diabetic, no help from GP

[ambera1]

I wondered if someone can help, or has been/is in the same position as me.

I went to the GP back in October 2019 with some general symptoms and they ran a Hba1c test which came back at 48. They did another a few months later and it came back at 47. Despite healthy eating, exercise and being very slim, even before the first test.

I purchased a blood glucose monitor shortly after to see what foods were causing the spikes. Regularly getting figures upwards of 9, 10, and sometimes as high as 12.

GP tried to refer me to the consultant for a glucose tolerance test back in January 2020. Finally, we have a response from the consultant saying that they will not take on my case and my blood sugar is ‘normal’. My GP states that below 11 is normal. Despite all of the research I have done, this contradicts it all.

Quite clearly my blood sugars are not normal. Not sure where to turn, I’m gutted I waited 6 months to be told that. I said to the GP that I would save up to go private and she said they’d just say the same. I don’t know where to turn.

I have, I believe, some female hormone issues which they agreed to look into for me. The GP said oh we can put you on metaformin if it turns out you have PCOS and it will help with tour blood sugar too, win win. Well I don’t want to go onto metaformin until I know exactly what I am dealing with here. I also have severe IBS and I’ve read this drug causes a whole host of stomach problems. I have all of the classic diabetes symptoms, and the blood sugar monitor results say it all, yet because I am borderline at 47/48, they won’t do anything for me. I am gutted. I just want to know what exactly is going on with my body before I take drugs for the rest of my life.

Anyone else dealing with similar, or has dealt with similar?

Unfortunately the Keto diet doesn’t work for me. My bloods didn’t improve very much on it either. I am already very slim and I got very underweight on this diet. Before anyone says I wasn’t doing it properly, yes I was.

 

[xfieldok]

PCOS and IBS can both be helped with low carb. Most newly diagnosed diabetics are overweight. However, once they have reached their target, they need to adjust fats and proteins to maintain it.

I would definitely keep an eye on your numbers. If they start to get very high, you may need medical advice.

 

[ambera1]

PCOS and IBS can both be helped with low carb. Most newly diagnosed diabetics are overweight. However, once they have reached their target, they need to adjust fats and proteins to maintain it.

I would definitely keep an eye on your numbers. If they start to get very high, you may need medical advice.

I already eat low carb and as explained in my post I am not overweight so this does not apply to me. To put in context, I am 7 and a half stone and 5 ft 5 in height.

 

[Buzzer81]

I wondered if someone can help, or has been/is in the same position as me.

I went to the GP back in October 2019 with some general symptoms and they ran a Hba1c test which came back at 48. They did another a few months later and it came back at 47. Despite healthy eating, exercise and being very slim, even before the first test.

I purchased a blood glucose monitor shortly after to see what foods were causing the spikes. Regularly getting figures upwards of 9, 10, and sometimes as high as 12.

GP tried to refer me to the consultant for a glucose tolerance test back in January 2020. Finally, we have a response from the consultant saying that they will not take on my case and my blood sugar is ‘normal’. My GP states that below 11 is normal. Despite all of the research I have done, this contradicts it all.

Quite clearly my blood sugars are not normal. Not sure where to turn, I’m gutted I waited 6 months to be told that. I said to the GP that I would save up to go private and she said they’d just say the same. I don’t know where to turn.

I have, I believe, some female hormone issues which they agreed to look into for me. The GP said oh we can put you on metaformin if it turns out you have PCOS and it will help with tour blood sugar too, win win. Well I don’t want to go onto metaformin until I know exactly what I am dealing with here. I also have severe IBS and I’ve read this drug causes a whole host of stomach problems. I have all of the classic diabetes symptoms, and the blood sugar monitor results say it all, yet because I am borderline at 47/48, they won’t do anything for me. I am gutted. I just want to know what exactly is going on with my body before I take drugs for the rest of my life.

Anyone else dealing with similar, or has dealt with similar?

Unfortunately the Keto diet doesn’t work for me. My bloods didn’t improve very much on it either. I am already very slim and I got very underweight on this diet. Before anyone says I wasn’t doing it properly, yes I was.

Very tricky but doesn’t have to be ‘Keto’.... I am seeing big improvements whilst lowering carbs but not losing them completely. The trick is to see which foods trigger you and which don’t. To do this I recommend testing yourself with a blood glucose monitor as you begin to eat a meal, and then two hours later. If you see a rise of more than 2mmol then you know that food is probably best avoided until your levels are managed. This has really worked for me. Everyone is different so it will take a lot of testing but you’ll quickly see what affects you. Like I can tolerate some
Whole meal pasta but whole meal noodles send me through the roof! Even one mouthful.

Please try this testing on all meals and make sensible low carb choices, I believe it will help you and you can maintain weight if you know which carbs you can eat.

Anyway, good luck to you.

 

[Member496333]

If you’re not overweight then you will absolutely need to replace the carbohydrate with equivalent energy levels of dietary fat. Otherwise you will feel sick and waste away. You don’t have to lose weight on keto. I gained weight, but evidently my liver must now be about half the size it once was

 

[Mini24]

Hi Mimi i am I was told by doctor was dietabet after a blood test.but I did not have any of the signs.but just told my blood sugar high go on meteform.I have I am a lot of other meds of other medical conditionals .I have no other test to say I am dieabet. I went for my yearly assessment and blood sugar check and was told my levels were to still to high increase tablets to 4.when I explained that like you i other medical confocal going on ,plus all my hospital app been cancelled to this virin. And being in pain due to chronic pain anymore and athrmic .she was not instructed and also illness can make your blood sugar go up .let me know what you think

 

[Daibell]

Hi. There is a possibility you are a Late onset T1 in the honeymoon period. Currently I would keep testing every so often and if the BS continues to rise you should ask the GP for the two tests for T1 i.e. GAD and C-Peptide. It may be something else such as PCOS affecting your BS but time will tell. BTW There is Metformin SR (Slow Release) which I've had for 15 years or so. It's much kinder than the plain variety.

 

[Tophat1900]

I'd look at getting your insulin production tested (c-peptide test).... if you are ketoing and still running high levels, it would be worth while knowing what your pancreas is producing. .

Log your glucose results before and after meals, 90mins to 2hrs after is standard advice. And log what your meals are. Data collecting is very useful in figuring things out.

 

[EllieM]

Did you reduce your daily carbohydrate intake between the tests? I thought that 48 put you firmly into diabetic range and 47 was prediabetic. I would also want to check your c-peptide levels and GAD antibodies to make sure that the prediabetes was leading to T2 and not LADA/T1.

Have you lost weight? Again, weight loss is a symptom of T1.

If it's any consolation, if your issues are T1 rather than T2 then they won't go away and going low carb will only delay the eventual onset of higher blood sugars and ketones and, if untreated by insulin, death. (Don't worry, as you are testing your blood sugar levels you will get a diagnosis long before you get really sick).

Are you in the UK? Am having trouble believing that a consultant in the UK would not admit that with that hba1c and those levels you are not at the very least prediabetic.

 

[LaoDan]

I wondered if someone can help, or has been/is in the same position as me.

I went to the GP back in October 2019 with some general symptoms and they ran a Hba1c test which came back at 48. They did another a few months later and it came back at 47. Despite healthy eating, exercise and being very slim, even before the first test.

I purchased a blood glucose monitor shortly after to see what foods were causing the spikes. Regularly getting figures upwards of 9, 10, and sometimes as high as 12.

GP tried to refer me to the consultant for a glucose tolerance test back in January 2020. Finally, we have a response from the consultant saying that they will not take on my case and my blood sugar is ‘normal’. My GP states that below 11 is normal. Despite all of the research I have done, this contradicts it all.

Quite clearly my blood sugars are not normal. Not sure where to turn, I’m gutted I waited 6 months to be told that. I said to the GP that I would save up to go private and she said they’d just say the same. I don’t know where to turn.

I have, I believe, some female hormone issues which they agreed to look into for me. The GP said oh we can put you on metaformin if it turns out you have PCOS and it will help with tour blood sugar too, win win. Well I don’t want to go onto metaformin until I know exactly what I am dealing with here. I also have severe IBS and I’ve read this drug causes a whole host of stomach problems. I have all of the classic diabetes symptoms, and the blood sugar monitor results say it all, yet because I am borderline at 47/48, they won’t do anything for me. I am gutted. I just want to know what exactly is going on with my body before I take drugs for the rest of my life.

Anyone else dealing with similar, or has dealt with similar?

Unfortunately the Keto diet doesn’t work for me. My bloods didn’t improve very much on it either. I am already very slim and I got very underweight on this diet. Before anyone says I wasn’t doing it properly, yes I was.

I think you need to find another doctor. Continue low carb and test regularly until you find one.

 

[EllieM]

I already eat low carb and as explained in my post I am not overweight so this does not apply to me. To put in context, I am 7 and a half stone and 5 ft 5 in height.

Just out of interest, have you tried testing your blood sugar when you aren't eating low carb? Your doctor sounds like a dinosaur who probably does not realise that diabetics can maintain lower blood sugars by reducing their carb intake. She might be more impressed by the levels you get if you eat "normally".

Honestly, at your age and weight I think T1 is more likely than T2 (though I am probably biased because I am T1). And there are other much rarer forms of diabetes (MODY anyone?) which you'd need an endocrinologist to diagnose. (And Mody is really weird and does not necessarily need insulin to treat).

It might be worth your while to invest in some urine testing strips for ketones. If your blood sugar levels go high (teens) plus high levels of ketones then you become at risk of diabetic ketoacidosis, at which point you need to ring for an ambulance. (And just to confuse matters, you safely get ketones when you are on a very low carb diet in dietary ketosis, but ketones plus high blood sugars are the danger.)

Good luck.

 

[ert]

GP tried to refer me to the consultant for a glucose tolerance test back in January 2020. Finally, we have a response from the consultant saying that they will not take on my case and my blood sugar is ‘normal’. My GP states that below 11 is normal. Despite all of the research I have done, this contradicts it all.
[/QUOTE]
With consultation with your GP, and as your blood sugars look relatively normal, it would be safe to do your own glucose tolerance test if you have a glucometer. I was given a bottle of Lucozade (66g carbohydrates) in mine. Here are the results you're looking for:
https://www.diabetes.co.uk/oral-glucose-tolerance-test.html

 

[Mini24]

Hi i was told that I type 2 .thanks for info I have to wait 4 months for another test if blood has not gone down enough it will be another tablet so that will be 5 tablets .my apptighted is gone so not sure why blood sugar is high.but they are not cheap as they would give them on scripe anymore

 

[Mini24]

That test stips

 

[JoKalsbeek]

I wondered if someone can help, or has been/is in the same position as me.

I went to the GP back in October 2019 with some general symptoms and they ran a Hba1c test which came back at 48. They did another a few months later and it came back at 47. Despite healthy eating, exercise and being very slim, even before the first test.

I purchased a blood glucose monitor shortly after to see what foods were causing the spikes. Regularly getting figures upwards of 9, 10, and sometimes as high as 12.

GP tried to refer me to the consultant for a glucose tolerance test back in January 2020. Finally, we have a response from the consultant saying that they will not take on my case and my blood sugar is ‘normal’. My GP states that below 11 is normal. Despite all of the research I have done, this contradicts it all.

Quite clearly my blood sugars are not normal. Not sure where to turn, I’m gutted I waited 6 months to be told that. I said to the GP that I would save up to go private and she said they’d just say the same. I don’t know where to turn.

I have, I believe, some female hormone issues which they agreed to look into for me. The GP said oh we can put you on metaformin if it turns out you have PCOS and it will help with tour blood sugar too, win win. Well I don’t want to go onto metaformin until I know exactly what I am dealing with here. I also have severe IBS and I’ve read this drug causes a whole host of stomach problems. I have all of the classic diabetes symptoms, and the blood sugar monitor results say it all, yet because I am borderline at 47/48, they won’t do anything for me. I am gutted. I just want to know what exactly is going on with my body before I take drugs for the rest of my life.

Anyone else dealing with similar, or has dealt with similar?

Unfortunately the Keto diet doesn’t work for me. My bloods didn’t improve very much on it either. I am already very slim and I got very underweight on this diet. Before anyone says I wasn’t doing it properly, yes I was.

You might've been doing keto properly, but were you doing it properly for someone of your size and weight? Most people start it to shed a few stone, diabetic or not, while you certainly can't miss more weight. Difference being, most people on keto mingle it with intermittent fasting, (one or two meals a day, no snacks, or going entire days without food). And you'd still need to eat at least 6 times a day (Three proper meals, three snacks), while getting enough fats and protein to stop you from losing weight. Have you tried just going moderately low carb rather than keto? How did that do for your blood sugars? Also, trust your gut. Your blood sugars are not normal, they're borderline diabetic/diabetic, so you need to tackle that somehow. I would try changing doctors...Because with your particular combination of numbers and weight, you don't want someone to shrug anything off. It's your life and quality of life we're talking about, and while that might mean little to your GP, this is your daily reality.

 

[Member496333]

Also, if you have no weight to lose (fat to oxidise) and you're not eating enough of it in your diet, your liver will be rampantly manufacturing glucose. This would go some way to explaining the lacklustre results in lowering sugar levels, as well as the further weight loss as your body is slowly deconstructed and turned into sugar for fuel.

You may think you were doing it 'properly' but, from my own experience, very slim people eating a ketogenic diet need to chug back a lot of dietary fat. And not in the form of vegetable/seed oils.

 

[ambera1]

Also, if you have no weight to lose (fat to oxidise) and you're not eating enough of it in your diet, your liver will be rampantly manufacturing glucose. This would go some way to explaining the lacklustre results in lowering sugar levels, as well as the further weight loss as your body is slowly deconstructed and turned into sugar for fuel.

You may think you were doing it 'properly' but, from my own experience, very slim people eating a ketogenic diet need to chug back a lot of dietary fat. And not in the form of vegetable/seed oils.

Hi Jim

Yes was eating A LOT of fat on the lower carb diet. I was having to make keto cakes full of double cream in the evenings to increase my fat intake even more. It’s true that you do lose weight on a low carb diet! Unfortunately I never did have any weight I needed to lose. I do still follow it even now but less strict and I am back to a healthy weight again. My GP keeps telling me to eat normally though!

Not sure where to turn because my GP referred me to the consultant at the hospital. If I was to change GP, it will still get referred to the same consultant and I’d get fobbed off again.

I’m simply at a loss to understand why my GP was concerned about my bloods, referred me for an ‘urgent’ review, went out of her way to seek advice from a specialist as they didn’t think it was T2, maybe late onset T1 and yet here I am 5 months down the line the consultant says my bloods are normal and to just get a HBa1c test every 6 months. Sounds like they are going to let it get considerably worse over the years before they will wake up and help me.

I wonder if I can appeal or something.

 

[ambera1]

Just out of interest, have you tried testing your blood sugar when you aren't eating low carb? Your doctor sounds like a dinosaur who probably does not realise that diabetics can maintain lower blood sugars by reducing their carb intake. She might be more impressed by the levels you get if you eat "normally".

Honestly, at your age and weight I think T1 is more likely than T2 (though I am probably biased because I am T1). And there are other much rarer forms of diabetes (MODY anyone?) which you'd need an endocrinologist to diagnose. (And Mody is really weird and does not necessarily need insulin to treat).

It might be worth your while to invest in some urine testing strips for ketones. If your blood sugar levels go high (teens) plus high levels of ketones then you become at risk of diabetic ketoacidosis, at which point you need to ring for an ambulance. (And just to confuse matters, you safely get ketones when you are on a very low carb diet in dietary ketosis, but ketones plus high blood sugars are the danger.)

Good luck.

Weirdly, since I have increased my carb intake over the last few months, I have been able to keep my bloods below 9 (which is a good figure for me) and I am back to a healthy weight. So that seems to work a bit better for me.

I also do intermittent fasting and will eat between 12-7pm only. I find this really easy to follow as I’m not hungry in the mornings anymore.

I think this is the route my GP was going down, with the T1 late onset, given my weight. However has been shot down by the consultant. It’s just so odd, considering the consultant sat on the referral for 5 months (pre Covid).

I feel I have nowhere to turn as the GP won’t help me and they said even if I went private I’d be told the same thing. I personally don’t agree. I just can’t afford to go private!

 

[ambera1]

I'd look at getting your insulin production tested (c-peptide test).... if you are ketoing and still running high levels, it would be worth while knowing what your pancreas is producing. .

Log your glucose results before and after meals, 90mins to 2hrs after is standard advice. And log what your meals are. Data collecting is very useful in figuring things out.

Yes already testing my bloods. Not as often as I’d like as the strips are costly. However it gives me an idea of how food is affecting me. Seems that since I’ve been increasing my carbs a little bit, I am getting less of a spike ironically.

Unfortunately the GP won’t do anything for me regarding the diabetes referral. Therefore no more testing for me . They are going down the hormone testing route now and said they’ll just put me on metaformin if I have PCOS. Problem is this hides a potential late onset T1 diagnosis!

Maybe I’ll see how this hormone testing goes and appeal from there depending on the outcome.

 

[Buzzer81]

Weirdly, since I have increased my carb intake over the last few months, I have been able to keep my bloods below 9 (which is a good figure for me) and I am back to a healthy weight. So that seems to work a bit better for me.

I also do intermittent fasting and will eat between 12-7pm only. I find this really easy to follow as I’m not hungry in the mornings anymore.

I think this is the route my GP was going down, with the T1 late onset, given my weight. However has been shot down by the consultant. It’s just so odd, considering the consultant sat on the referral for 5 months (pre Covid).

I feel I have nowhere to turn as the GP won’t help me and they said even if I went private I’d be told the same thing. I personally don’t agree. I just can’t afford to go private!

Intermittent fasting may also help. I’ve set a window to eat in between 12-8 per day. Early days but this has seen a reduction in blood sugars across the board. Now my figures are often in the 4s, nothing previously had achieved such results.