Does this sound like a plan?

[NannyClover]

Evening everyone.

Bit of a story, but please bear with me.

On 10th March I had my bloods done as part of my annual BP review (BP well controlled with medication). I recently became able to access my patient records online, so I logged in 2 days later to see if my results were through, mainly to check on my cholesterol. I discovered that my HbA1c was 68.

Obviously, I realised that this was not good news, but I was shocked to discover that at my previous routine blood test, 12 months earlier, my HbA1c had been 51. The surgery hadn’t informed me of this, though I appreciate that this was about the time all the COVID stuff hit the fan so I guess I got overlooked ‍

Like many newly-diagnosed, I Googled for about 24 hrs solid and fortunately one of the first sites I found was diabetes.co.uk. and these fabulous Forums. So much helpful information . Though a lot of it was confusing, I realised that I obviously had to cut out the carbs, which I did in the first week to the best of my ability. I’ve totally eliminated the big hitters - bread, potatoes, rice, pasta, biscuits, cake, chocolate etc. (though not actually counting gms of carbs) and based all my meals around protein, salads, veggies (above ground) and increased my fat intake. I’m limiting myself to one piece of fruit a day. This was a huge shift for someone who thought LCHF meant “Low Calorie, High Fibre”. Still no word from the surgery.

So many of you emphasised the need to test, test, test, so I bought the kit and began collecting my BG readings throughout the day, on rising, before and after meals, at bedtime and keeping a food diary. I wasn’t in a great hurry to arrange any appointments with HCPs as it would appear that they are a bit too eager to prescribe medication and that’s not my preferred course of action. The surgery contacted me on 23rd March to say that the nurse needed to discus my blood test results and I now have a telephone appointment for 19th April. No rush then?

I feel a whole load of conflicting emotions - I feel overlooked, I feel frustrated that I’ve wasted so many years on stupid, useless diets that have probably made things worse, I feel much better informed now, thanks to the tons of advice and information on these forums, but I also feel a bit scared that I’m kind of flying solo (notwithstanding my OH is TOTALLY supportive but no better informed than I am).

The point of all this rambling is to ask opinions on whether I can safely continue in this way, under no medical supervision until my appointment on 19th April?

*Continue to eat in this slightly imprecise but generally LCHF way (I have managed to lose 9 lbs)
*Continue testing in the hope that some sort of patterns begin to emerge (not managing to interpret them in any meaningful way as yet)
*Further increase my exercise (managing walks of between 5 and 8 km 3 to 4 times a week)
*Speak with the nurse in due course, hear what he/she has to say and take it from there.

Does this sound like a plan? Your thoughts/observations would be most welcome.

 

[bulkbiker]

I feel a whole load of conflicting emotions - I feel overlooked, I feel frustrated that I’ve wasted so many years on stupid, useless diets that have probably made things worse, I feel much better informed now, thanks to the tons of advice and information on these forums, but I also feel a bit scared that I’m kind of flying solo (notwithstanding my OH is TOTALLY supportive but no better informed than I am).

The point of all this rambling is to ask opinions on whether I can safely continue in this way, under no medical supervision until my appointment on 19th April?

*Continue to eat in this slightly imprecise but generally LCHF way (I have managed to lose 9 lbs)
*Continue testing in the hope that some sort of patterns begin to emerge (not managing to interpret them in any meaningful way as yet)
*Further increase my exercise (managing walks of between 5 and 8 km 3 to 4 times a week)
*Speak with the nurse in due course, hear what he/she has to say and take it from there.

Does this sound like a plan? Your thoughts/observations would be most welcome.

Sounds absolutely brilliant and exactly what I'd recommend.
Depending on the quality of your nurse you may get good advice or appalling and it's a complete lottery so you might well be best taking control yourself.
You've obviously been T2 for a while and they didn't even inform you which in my view is malpractice.
In your shoes I'd be quite peed off with the surgery as you have likely had a year of higher blood sugars than needed.
however you are now in charge and by the sounds of it know what to do.
Great news on the weight loss and what kind of levels are you seeing for your blood sugars now you are testing?
Also when are you testing?

 

[MrsA2]

Hi Nanny Clover
I'm just a year ahead of you. Had the tests end of Feb but didn't get phoned with the results until I asked for them on 25th March, 2 days after lockdown. I finally saw my first in the flesh hcp, a dn, just last month after I demanded a year review. Everything else (2 calls ) were by phone. Oh and then I discovered in my online record that I was prediabetic back in 2006 but no one had ever ever bothered to mention it to me. 14 extra years of carbs!

You are not alone, not the first and won't be the last, but your plan sounds admirable to me. It the were really worried they'd have you in pronto. Yes emotions will be up and down, it's a shock but it does get better.
The good side is that im coming out of lock down slim and with bg controlled. Friends are amazed and aren't noticing I've also gone grey and bearded (im female btw)

Diabetes need not affect common sense or sense of humour, unless we let it

 

[Antje77]

The point of all this rambling is to ask opinions on whether I can safely continue in this way, under no medical supervision until my appointment on 19th April?

Hi @NannyClover , and welcome to the forum!

Mind, we cannot guarantee anything, but seeing as your hba1c has gone up from 51 to 68 in as long as 12 months, and you are checking your blood glucose at home so you will notice if anything drastic changes, yes, you'll be safe for another 3 weeks, and with the changes you are making you will be well informed when it's time for your appointment.

You might want to confront them with forgetting to tell you you had diabetes a year ago before your actual appointment. For me it would be hard to separate the diabetes and your course of action from the disappointment in your practice if this appointment is the first moment of contact with them.

 

[bulkbiker]

Just to add a slight word of caution.

Low carb has been know to reverse hypertension so you might want to keep an eagle eye on your BP and you might be able to ditch those meds too.. do you have a home BP meter... might be a useful investment?

 

[jjraak]

Oh @NannyClover

I'd like to say the inaction is covid related,.but such was happening before .

Like you once I was concerned enough , I back tracked and checked my results going back to 2010

Horrendous, as I now know.

Good news is YOU are aware.

A bit like being in a strange part of town, and later telling friends, and seeing their shocked faces and hearing there were lots of muggings etc ..in that area

You'd take more care next time, right

So, you are taking affirmative action reducing the carbs which we are intolerant to ?

Good, that can only help you in the long run

Been said many times,
Maybe true for other illnesses but deffo true fur T2D.

You have to become an expert on you, the illness and causes & remedies, in this case food
No two ways about it

No disrespect, but The docs are GENERAL practitioners for a reason.

They have no idea what the next one through door has, so they must know a lot about everything ..
.
We only have to know about US.
Major advantage
We can stay up to date & spend hours on Research.

And here IS the international university for diabetes, and a universe full of advice.

Specialising in all types, but I find particulary for type two, over other unnamed sites.

Keep on doing what your doing ,and come your meeting I reckon you'll know as much as they do.

Good luck on your journey.

 

[VashtiB]

As previous posters have said even without covid this could have occurred. Like @jjraak said the reality is that we must be the ones to do research and the effect that carbs have on you.

What sort of readings are you getting?

 

[NannyClover]

Just to add a slight word of caution.

Low carb has been know to reverse hypertension so you might want to keep an eagle eye on your BP and you might be able to ditch those meds too.. do you have a home BP meter... might be a useful investment?

Thanks for this. I do test at home, though infrequently. I’ll make sure I keep an eye on my BP too

 

[NannyClover]

Thanks everyone for your reassuring and supportive replies. Game on!!!

I am trying to maintain cordial relations with the surgery, though I am disappointed in how useless they are. It’s sad to hear that this kind of poor service isn’t uncommon.

In respect of readings, well, not making much sense to me yet - I’ve only got about 10 days worth but here are some examples
21/3/21 - my first day testing - 12.2 on waking eeek! Messed up my testing during the day for various reasons but had lots of fingers with holes in! By evening, when I’d pulled myself together my readings were 7.5 before my meal and 8.8 after.
24/3/21 - 8.7 on waking, fasted until lunchtime. Reading before lunch was 10.1 (how can that happen? I hadn’t eaten a thing?) Reading 2 hrs after lunch was down to 6.4 (That’s a good one isn’t it, but I thought my reading would go up after a meal).
30/3/21 here’s the whole day
on waking - 6.5
9.00 - 9.2 breakfast was cheese and salami
11.00 - 10.2
12.30 - 7.0 lunch was smoked mackerel
14.30 - 6.5
20.00 - 6.4 dinner was prawn cocktail, avocado, feta, olives, salad
22.00 - 7.8

It does seem that my morning readings are coming down, though I have had several lunchtimes where my post-meal figure was significantly lower than my pre-meal and this doesn’t happen in the evening.
My 2 glasses of wine Saturday evening sent my reading up to 8.9. Does this mean it’s a no-no, or should I keep experimenting. - purely for scientific research!!

Anyway, I’ll keep on reading and keep on testing and hope to see some 5s. Or even 4s on the chart soon. Thanks again everyone xx

 

[Geordie_P]

Sounds like a great plan: stick with it!

 

[MrsA2]

Hello Nanny
Those readings all seem fine. There's a thing called Dawn Phenomenon that means for a lot of us bg rises for no good reason through the morning. Some people can stop their by eating something no carb, eg eggs, but for there rest if us nothing stops it except time.
Most meals your rise shouldn't be more than 2 points above where you started, and very low carb meal may well lower bg as the peak might have been before, or after you tested. Its not an exact science and the2 hour prick is literally a stab in the dark hoping to hit an elusive peak.
The food you quoted was all low carb. Wait to see the results when you have a cake, (or potatos or rice) then it will become clear what carbs are doing to your body
It does take time. I think I checked up to 7 times a day for a good few months until I was sure what I could eat.
Even then there can be surprises, wearing a cgm showed me that I am intolerant to the carbs in red peppers, not supposed to be carby but they send my levels sky high.
Don't expect to get it all and understand it all from the off. This is something for the rest of your life. No rush

 

[Mrs T 123]

Hello & Welcome @NannyClover - yes - sounds like a plan to me - go for it

 

[NannyClover]

Hello Nanny
Those readings all seem fine. There's a thing called Dawn Phenomenon that means for a lot of us bg rises for no good reason through the morning. Some people can stop their by eating something no carb, eg eggs, but for there rest if us nothing stops it except time.
Most meals your rise shouldn't be more than 2 points above where you started, and very low carb meal may well lower bg as the peak might have been before, or after you tested. Its not an exact science and the2 hour prick is literally a stab in the dark hoping to hit an elusive peak.
The food you quoted was all low carb. Wait to see the results when you have a cake, (or potatos or rice) then it will become clear what carbs are doing to your body
It does take time. I think I checked up to 7 times a day for a good few months until I was sure what I could eat.
Even then there can be surprises, wearing a cgm showed me that I am intolerant to the carbs in red peppers, not supposed to be carby but they send my levels sky high.
Don't expect to get it all and understand it all from the off. This is something for the rest of your life. No rush

Thank you MrsA2,
I see what you mean about the bg testing being a “stab in the dark” and a cgm may be on the cards if I am to gain a more full understanding of what is happening in my body.
Tbh I’m a bit afraid to try eating carbs at the moment but I’ll obviously have to have a go at some point to determine what I can tolerate. In the meantime I’ll plod on, hopefully get those numbers down and lose some weight before I speak to the nurse on April 19th. xx

 

[1970clea]

My previous doctor's surgery was a bit like this so I got on Google and checked reviews of local surgeries then transferred to one with better scores - haven't had any troubles since - you have the right to find better care.

 

[NannyClover]

UPDATE ON MY PLAN.

Evening everyone.

Well I had my chat with the Practice Nurse today. Not a DN, but she seemed pretty clued up. She started very gently, I guess she hadn’t really any clue about me or about my level of understanding of my situation. It must be hard for them to know just how to conduct a “First Contact” . She explained that she wanted to start me on Metformin but the conversation gained pace once I’d explained that was not my preferred course of action and I managed to convey to her how how much research I’d done and that I had decided to go for LCHF.

Fortunately I had some positive BG information to give her from my testing over the last five weeks and told her how I’d upped my exercise. So we’ve agreed I’ll continue doing what I’m doing and get another test 6 weeks from today. As @bulkbiker suggested, my BP is falling so she wants me to keep a close eye on that in case my medication needs adjusting, and I suspect it will. I was a little waspish with her about not being informed about my elevated HbA1c a year ago and she did have the grace to apologise, but what’s done is done and I want to move forward.

So, how’s it gone?
Well, five weeks ago, when I started testing, I was getting readings of 12.0 and 10.0 but now I’m mostly getting 6’s and 7’s. Tonight after dinner I got a 5.8 (happy dance), mind you, we did walk 10k today and I’ve got the sunburn to prove it! I downloaded the MySugr app and that suggests my HbA1c would be around 43 (from 68). I realise it’s not a diagnostic tool but it still made me smile
Not sure I’m seeing any “patterns” as such, but the trend is clearly downwards. Still not counting gms of carbs but as far as I can see the only carbs I am getting are from vegetables.
I’ve lost about 5kg - not spectacular but OK, my BP is down from around 140/80 to 120/68 and my RHR is down from 63 to 56.

I can’t emphasise just how important diabetes.co.uk and these fabulous forums have been to me during this time and I count my lucky stars that this was the first website I found once I started Googling. I’ve read all (and I mean ALL) of your inspirational success stories, Through you I’ve found DietDoctor, MySgr, Jason Fung, SLC bread (quite acceptable) and I’ve picked up meal ideas - even baked peanut butter cookies and low carb brownies!

Never underestimate just how influential you are when you give up your time to respond on here to people who are reaching out for help. I for one cannot thank you enough (kiss, kiss).

I’ll let you know when my next bloods are in.

Much love to you all.

 

[bulkbiker]

UPDATE ON MY PLAN.

Evening everyone.

Well I had my chat with the Practice Nurse today. Not a DN, but she seemed pretty clued up. She started very gently, I guess she hadn’t really any clue about me or about my level of understanding of my situation. It must be hard for them to know just how to conduct a “First Contact” . She explained that she wanted to start me on Metformin but the conversation gained pace once I’d explained that was not my preferred course of action and I managed to convey to her how how much research I’d done and that I had decided to go for LCHF.

Fortunately I had some positive BG information to give her from my testing over the last five weeks and told her how I’d upped my exercise. So we’ve agreed I’ll continue doing what I’m doing and get another test 6 weeks from today. As @bulkbiker suggested, my BP is falling so she wants me to keep a close eye on that in case my medication needs adjusting, and I suspect it will. I was a little waspish with her about not being informed about my elevated HbA1c a year ago and she did have the grace to apologise, but what’s done is done and I want to move forward.

So, how’s it gone?
Well, five weeks ago, when I started testing, I was getting readings of 12.0 and 10.0 but now I’m mostly getting 6’s and 7’s. Tonight after dinner I got a 5.8 (happy dance), mind you, we did walk 10k today and I’ve got the sunburn to prove it! I downloaded the MySugr app and that suggests my HbA1c would be around 43 (from 68). I realise it’s not a diagnostic tool but it still made me smile
Not sure I’m seeing any “patterns” as such, but the trend is clearly downwards. Still not counting gms of carbs but as far as I can see the only carbs I am getting are from vegetables.
I’ve lost about 5kg - not spectacular but OK, my BP is down from around 140/80 to 120/68 and my RHR is down from 63 to 56.

I can’t emphasise just how important diabetes.co.uk and these fabulous forums have been to me during this time and I count my lucky stars that this was the first website I found once I started Googling. I’ve read all (and I mean ALL) of your inspirational success stories, Through you I’ve found DietDoctor, MySgr, Jason Fung, SLC bread (quite acceptable) and I’ve picked up meal ideas - even baked peanut butter cookies and low carb brownies!

Never underestimate just how influential you are when you give up your time to respond on here to people who are reaching out for help. I for one cannot thank you enough (kiss, kiss).

I’ll let you know when my next bloods are in.

Much love to you all.

Brilliant news.. great you are already seeing lower figures.. such a motivation.
Well done for taking control of your health and to your PN for being more open minded than many.
Here's wishing you even more success for the future and getting that HbA1c even further down!