Bit of a quandary

[JohnEGreen]

My daughter's HbA1c was 48 at the hospital her consultant remarked that daughter was T2 but her GP says borderline or pre diabetes.

Doctor decided to repeat blood test this week when daughter phoned for result was told borderline.

The point is I believe as does her consultant and other doctors she has seen at the hospital recently that she is just within diabetic levels.

Here's the quandary as I follow a low carb diet and she eats what I have mostly for main meals her HbA1c is going to be lower do I advise her to eat normally until she has a test done again so as to get a diagnosis and then the proper diabetic checks such as for retinopathy and foot health.

or would that be counterproductive or even harmful.

I am not sure what would be best,

 

[zand]

Hmmm well i would probably go for the option of eating normally to get a diagnosis. Not junk food, but otherwise normal food. Others will disagree because you are right it is a tricky question.

I hope you come to the right decision for you both.

 

[Brunneria]

Personally, in the situation you have just described, I would weigh up whether her hba1cs have been increasing steadily over time (indicating a slow slide into T2 which will be diagnosed sooner or later, hopefully next hba1c)

Or whether her hba1cs were fine until this recent one (indicating a rapid descent into T2)

Obviously, both suggest that physical damage is being done, and that insulin resistance is present, but the latter suggests more urgency (to me)
Other health conditions may factor in too.

It is a sincere regret of mine that I drastically reduced my bgs by self testing and carb reduction before getting a diagnosis.
Had I known then what I know now, I would have persisted with the carbs until that diagnosis was confirmed.
As it is, my doc does not monitor me at all, and I am alone in all aspects of management.
(Attempts to show my doc the Libre records of T2 level blood glucose readings of 15+ mmol/l have failed. The doc refused to look at them, and just quoted my mid 30s hba1c with what can only be called a sneer, so weigh your decision carefully)

How does your daughter feel about it?

 

[hankjam]

I would go with @zand Need to know the underlying process and modifying diet might delay. As you say it's not clear cut. If she does low carb how long for?
hope this helps.

 

[Rachox]

I agree with @zand and @hankjam , I guess at 48 she wouldn’t have to eat too many carbs to push her into a definite diagnosis of type 2. It would be useful to know what were the actual HbA1c numbers that her GP described as pre diabetic or borderline.

 

[JohnEGreen]

Personally, in the situation you have just described, I would weigh up whether her hba1cs have been increasing steadily over time (indicating a slow slide into T2 which will be diagnosed sooner or later, hopefully next hba1c)

Or whether her hba1cs were fine until this recent one (indicating a rapid descent into T2)

Obviously, both suggest that physical damage is being done, and that insulin resistance is present, but the latter suggests more urgency (to me)
Other health conditions may factor in too.

It is a sincere regret of mine that I drastically reduced my bgs by self testing and carb reduction before getting a diagnosis.
Had I known then what I know now, I would have persisted with the carbs until that diagnosis was confirmed.
As it is, my doc does not monitor me at all, and I am alone in all aspects of management.
(Attempts to show my doc the Libre records of T2 level blood glucose readings of 15+ mmol/l have failed. The doc refused to look at them, and just quoted my mid 30s hba1c with what can only be called a sneer, so weigh your decision carefully)

How does your daughter feel about it?

She is uncertain she enjoys the low carb meals but is frustrated with the doctors attitude.

 

[hankjam]

She is uncertain she enjoys the low carb meals but is frustrated with the doctors attitude.

This I can understand.
I wish her well.
Hj

 

[JohnEGreen]

I agree with @zand and @hankjam , I guess at 48 she wouldn’t have to eat too many carbs to push her into a definite diagnosis of type 2. It would be useful to know what were the actual HbA1c numbers that her GP described as pre diabetic or borderline.

Her last 2 tests have been 48 which according to the information on this site indicated T2 diabetes but her GP it seems classes that as borderline and so no diagnosis forthcoming.

 

[Bluetit1802]

I am inclined to go with the rest of the responders. The cut off of 48 is a goalpost, a figure drawn from the air. If these follow up blood tests are to be fairly soon, a few sandwiches or porridge or an odd jacket spud might just do the trick. The regular blood checks and reviews, the foot and retinopathy checks are important. Look what happened to @Brunneria . She never has had a diagnosis, and has no checks of any description unless she pays for them herself and has to empower herself to do all this.

As you say, most GPs would have diagnosed her anyway with her last few HbA1cs being 48. Her GP seems reluctant, but technically, he is wrong.

 

[JohnEGreen]

Every time she goes to see her Dermatology consultant she says to Melody your T2 has an impact on your skin condition what is your GP doing for you about this.

When I took her to A&E last weekend the doctor there noted that she was T2 according to her hospital records so thought the head pains she was having could be linked to her diabetes

 

[lucylocket61]

Every time she goes to see her Dermatology consultant she says to Melody your T2 has an impact on your skin condition what is your GP doing for you about this.

When I took her to A&E last weekend the doctor there noted that she was T2 according to her hospital records so thought the head pains she was having could be linked to her diabetes

I would definitely go for raising her carbs for a short time, having read this. She needs that diagnosis as a gateway in my opinion. Best wishes to you both.

 

[DCUKMod]

John, I note you say your daughter is under a Dermatologist. Does she use steroids to control her skin condition perchance?

On a more general note, being a contrarian sort, and playing devil's advocate there, I would ask her Doctor why she is not being diagnosed, and quote the WHO diagnostic criteria, and listen to his response.

Of course, it depends how he responds and how you feel about his response, but I would be inclined to suggest that your duughter's wider health seems to be potentially being compromised, in that in A&E appeared to attribute the headaches necessitating her to attend A&E to her diabetes, and furthermore that her Dermatologist states her diabetes is likely impacting her skin condition, yet she is not recieving support for that.

Those would be my initial thoughts.

 

[Deleted member 308541]

My daughter's HbA1c was 48 at the hospital her consultant remarked that daughter was T2 but her GP says borderline or pre diabetes.

Doctor decided to repeat blood test this week when daughter phoned for result was told borderline.

The cut off point here in Australia is >48 mmol/mol for T2.

 

[Listlad]

It is a sincere regret of mine that I drastically reduced my bgs by self testing and carb reduction before getting a diagnosis.
Had I known then what I know now, I would have persisted with the carbs until that diagnosis was confirmed.

Not too dissimilar to my own history.

@JohnEGreen That’s me. I radically altered my diet in December 2014 and was never diagnosed as having T2 as you can see from the data in my signature. But I know I had it from the associated symptoms.

Because I wasn’t formerly diagnosed as such, it paves the way for certain parties to declare me as non diabetic.

 

[Listlad]

I would definitely go for raising her carbs for a short time, having read this. She needs that diagnosis as a gateway in my opinion. Best wishes to you both.

Indeed, for some people, if you haven’t been formerly diagnosed then you ain’t never had it.

 

[Daphne917]

Indeed, for some people, if you haven’t been formerly diagnosed then you ain’t never had it.

Makes sense. Surely it’s only by having a diagnosis that you know you’ve got it?

 

[Brunneria]

Not too dissimilar to my own history.

Actually, Listlad, I think there are several differences between you and I.

I am very careful to never declare that I am, or have ever been, a type 2 diabetic.
Though I do make free mention that there have been various periods of my life when I have self testing evidence of having had ‘diabetic blood glucose levels’.

I have extensive blood testing records of this should anyone ever need to see that evidence. This (in my opinion) entitles me to make that statement, but I never claim that I am, or have ever been, a T2, and will never do so without a proper diagnosis by a medical professional, using the current diagnostic criteria.

In contrast, I am happy to state that I ‘have’ RH, PCOS and various other conditions, because these have been discussed with consultant endocrinologists and I am under ongoing care.

Since I have not been diagnosed T2, I think it important to make that distinction, in order to avoid misrepresenting myself and misleading forum members.

 

[Listlad]

Makes sense. Surely it’s only by having a diagnosis that you know you’ve got it?

So you have all the symptoms and one 49 HbA1c result but had not been tested either side of that except after immediate dietary change after. Are you saying one never had it?

Surely it’s the diabetic symptoms or condition that count and not a figure in its own right.

At least that’s the way my GP sees it.

 

[Listlad]

Since I have not been diagnosed T2, I think it important to make that distinction, in order to avoid misrepresenting myself and misleading forum members.

Very commendable.

Whilst I respect opinion, I would rather go with my GPs opinion who still refers to my “diabetes”.

It does help to have a good GP.

 

[Daphne917]

So you have all the symptoms and one 49 HbA1c result but had not been tested either side of that except after immediate dietary change after. Are you saying one never had it?

Surely it’s the diabetic symptoms or condition that count and not a figure in its own right.

At least that’s the way my GP sees it.

Not necessarily but like many conditions symptoms of diabetes are similar to those of other conditions hence the blood test to confirm. I never had any symptoms of diabetes but was diagnosed after a routine blood test and confirmed 3 months later with the same result of 48 - granted just on the cusp but still diabetic. Unfortunately statins increased this figure to 54 within 6 months so there was no doubt. Looking at your stats your hba1c came down after your second hba1c which was only 2-3 months later therefore have you thought about the first hba1c test being incorrect hence why you have not been diagnosed with a condition that you probably didn’t have? Granted you were pre-diabetic but with an hba1c of 43 you were just outside of normal figures.