Long term damage?

[Demonikai]

Hi all This is my first post and would like to say a big thank-you for this forum and its mine of information.
My question: Is there anyway to find out how much damage you have sustained because of very high BG levels?
I was diagnosed Type 2 in June 2010. I was prescribed 3 x 500g a day of Metformin.
I had only 1 screen test and that was for feet. No eye test or dietician.
By Sept of this year I went back to my G.P and complained of never ending thirst, finding it hard to get out of bed and running for a wee all day and night. She changed my Metformin to 2 x 1000g a day and 1 x 80mg of Gliclazide at night and no Hba1c test. A further month passed and still no improvement or Hba1c test just told to increase Gliclazide to 2 x 80mg a day with the Metformin.
By the start of this month I was pulling my hair out in despair and demanded a Hba1c test. The result was 13%. She did say sorry for failing me but I am still quite angry it took so long to find out.
I have now been to see a Diabetic Nurse and she has started me on Insulatard 18units x 2 a day and keeping on with the 2000g of Metformin and 320mg a day of Gliclazide. My daily average is still arprox 9.6 but all the thirst and being tired have stopped ( Thankfully)
I am wondering though am I likely to have caused damage to my body by possibly having Hba1c at 13% or higher for 4 months? Is it just a wait see thing or are there ways to detect damage?
I'm sorry if I sound like a looney considering I was diagnosed 18 months ago but I really don't know a great deal and feel totally lost at the moment. I'm really upset about my driving license too.... Do you lose it for a long time when you go onto Insulin? /sigh

 

[daisy1]

Hi Demonikai and welcome to the forum I don't think a period of 4 months of high levels will do any particular damage but complications can occur with the best of control and you need to keep your levels as good as possible at all times. It sounds to me like you have not been testing your blood sugars. This is essential to maintain good control and to reduce the risk of complications. You need to test before and 2 hours after meals to see which foods you can safely eat. Have you asked your DN for testing equipment? She may not give it to you though so in this case you need to fund it yourself getting a free meter from a manufacturer or from offers on this forum and strips off the web. Regarding driving licenses, I think the only problem is if you have had hypos and needed assistance.

You may have already seen this but I am posting this for you anyway. This is information written for new members to help them to understand and get control of their diabetes. Ask as many questions as you need to as you are sure to get an answer here.

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 well over 30,000 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 ... rains.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

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 blood glucose 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.

 

[RussG]

For what it's worth, I ran at very high levels for probably six months or so, with an HbA1c of 13.7% at the end of that (and probably higher before that) before I started on insulin. No damage has become apparent after a year on insulin.

I would also suggest you ask for a test to see what type you actually are, in case you are not a type 2 but possibly a late onset T1 or latent autoimmune diabetes in adults (LADA). Have you been referred to a hospital diabetic clinic? I would certainly be asking for this if I were you.

As an insulin user you must be given access to testing equipment and a prescription for strips. This should not be a question - if you haven't been given this yet, please go back to a doctor.

As for the licence, you should not lose your licence just because you are on insulin. You have to fill in a form from the DVLA and you should be given a three year licence provided you have not had two severe hypos in the last 12 months (which it doesn't sound like you will have done!)

 

[Demonikai]

Hi Daisy and Russ
Thanks for your quick replies.
The info you posted daisy was very very helpful. I'm afraid my diet up until last week was dire. I didn't eat breakfast or lunch infact nothing to eat until 9pm at night when I would have a HUGE bowl of pasta and a nice cheese river running through it
Even though it's a little hard to change overnight I know I must so have been having half a green banana for breakfast and weetabix with Unsweetened Soya milk for lunch.

Russ,
I have now been to a Diabetic clinic and was given a prescribing letter to take to my GP for Insulin, Meter strips, Meter and Keytone sticks.
They have told me I am type 2 but I will ask them again seeing as they pretty much forgot about me for 18 months.
I'm pleased no damage has surfaced for you after running high levels.

Thanks again both