Advice needed - recent blood results

[FlumpyMumma]

Hi All,

I was diagnosed as T2 diabetic in 2018 with 52 mmol/mol. Went on a low carb diet and managed to get it down to 45. Gradually went back up a bit to 51 so onto metformin slow release in Feb last year. [normal metformin played utter havoc with my innards as i have IBS - fun times :-( ]

So fast forward to this week and I asked for a HbA1c test as have lost approx 23lbs since Jan this year continuing with low carbing, and feeling quite good about it. Got my results through this morning and they have jumped to 116mmol.mol.

I am devastated and confused as to what is happening. Been a stressful few months and I know that can have an affect on levels but surely not that much! Waiting to hear if I can get a telephone consultation from GP [ still no face to face appointments where I am] so am wondering what I should ask and will it be likely that I will need more medication and start self testing

Any advice would be so welcome as i am a bit devastated by my latest result

thanks Louise

 

[FlumpyMumma]

update - just got this through by email from GP

Thank you for your recent eConsult request. Your HbA1c has significantly increased from 6.8 in February last year to 12.8 in June this year. Ideally, it should be less than 7.5. It appears that you are already eating healthily and exercising regularly. A prescription for an additional medication to help improve your diabetes has been sent to your nominated pharmacy for collection. Please make an appointment with the nurse in 8 weeks time for a repeat HbA1c

so need to see what the additional meds are later today but i am a bit disappointed as i was hoping for some guidance or tweaks i could make to lower levels myself. Am i being unrealistic and should just accept the meds route without speaking to GP?
Sorry for all the questions

 

[Andydragon]

Hi All,

I was diagnosed as T2 diabetic in 2018 with 52 mmol/mol. Went on a low carb diet and managed to get it down to 45. Gradually went back up a bit to 51 so onto metformin slow release in Feb last year. [normal metformin played utter havoc with my innards as i have IBS - fun times :-( ]

So fast forward to this week and I asked for a HbA1c test as have lost approx 23lbs since Jan this year continuing with low carbing, and feeling quite good about it. Got my results through this morning and they have jumped to 116mmol.mol.

I am devastated and confused as to what is happening. Been a stressful few months and I know that can have an affect on levels but surely not that much! Waiting to hear if I can get a telephone consultation from GP [ still no face to face appointments where I am] so am wondering what I should ask and will it be likely that I will need more medication and start self testing

Any advice would be so welcome as i am a bit devastated by my latest result

thanks Louise

Hi there,

That’s quite a jump so can understand the concerns. When you say low carb, what does that consist of? Sone people tolerate higher carbs than others and your low carb may not be low enough for your body (we all are unique)

Also those levels should definitely trigger further conversations from the doctor. When I hit 78, there was immediate intervention from my doctors. (Which I see in your reply has happened)

But Given the jump and their talk about being healthy and exercise it seems you need more investigations so have you ever had any tests for checking you are not one of the other types of diabetes?

 

[bulkbiker]

Agree with @Andydragon that we really need to know how "low carb" your diet is.
Do you measure your blood sugars at home?
I'm guessing not or the result might have been less of a shock.
Were you trying to lose weight or did it just "happen"?
Sorry for all the questions but if you are one of the "other" diabetes types then you could ask for tests to determine that.
c-peptide for one.

 

[FlumpyMumma]

Hi, thanks so much for responding. When first diagnosed I immediately went onto the blood sugar diet by Michael Mosley which was a success for me. I have definitely slid a bit recently, though i still do not eat bread or pasta more than once or twice a week and am losing weight (but is that ketones now rather than me being careful?). But i guess its what i eat as well as weight loss i need to look at so will dig out the books again.

Never had any other tests to check diabetes type. My GP believes that my T2 diagnosis is a result of taking tamoxifen which can occasionally have an effect on blood sugars. I didn't think to ask for testing beyond that thought process seeing as Tamoxifen has given me so many other side affects! Can't really stop the Tamoxifen though unfortunately.

I think if after my next HbA1c in 8 weeks there is no improvement between new meds and back on blood sugar diet I will have to force the issue of at least a telephone consultation with a GP. Will also look at the diet and exercise threads to see if i can add anything else into what i am doing

 

[FlumpyMumma]

Results were a massive shock - been quite tearful as a result, but getting myself together now and looking out my blood sugar diet books this morning

 

[EllieM]

As the others have said, you really need the tests to see if you have one of the other types of diabetes, in particular cpeptide and GAD tests. These will check whether you have slow onset T1, sometimes called LADA, which typically responds well to a low carb approach at the start (because you need less insulin if you go low carb). But weight loss and a sudden increase in hba1c are both red flags for this and it is as well to rule it out.

You mention ketones : do you do urine tests for these?

 

[FlumpyMumma]

As the others have said, you really need the tests to see if you have one of the other types of diabetes, in particular cpeptide and GAD tests. These will check whether you have slow onset T1, sometimes called LADA, which typically responds well to a low carb approach at the start (because you need less insulin if you go low carb). But weight loss and a sudden increase in hba1c are both red flags for this and it is as well to rule it out.

You mention ketones : do you do urine tests for these?

I haven't tested my urine recently but I do think I still have test strips so will look them out too and start testing again. Going to get a meter to test myself too

 

[Andydragon]

Results were a massive shock - been quite tearful as a result, but getting myself together now and looking out my blood sugar diet books this morning

It will be a shock but there are options and ways forward. Drugs may be the right thing, but maybe your carbs are a bit higher than you realised

Plus type may be looked at as the huge jump given the other info you shared does seems unusual. maybe more tests. Do you have a meter? Really strongly recommend getting one and seeing what meals are doing for you

 

[bulkbiker]

Going to get a meter to test myself too

I'd also be requesting a c-peptide test at the very least from the doctor.
Once you have "ruled out" one of the T1 variants then we can advise on a more secure footing that you have been correctly diagnosed.

Edit to add.. some of the Moseley stuff is not particularly what most here would describe as "low carb".

 

[FlumpyMumma]

It will be a shock but there are options and ways forward. Drugs may be the right thing, but maybe your carbs are a bit higher than you realised

Plus type may be looked at as the huge jump given the other info you shared does seems unusual. maybe more tests. Do you have a meter? Really strongly recommend getting one and seeing what meals are doing for you

looking to buy a meter today - is there any one in particular that is recommended? I def think my carbs have creeped up so back to the blood sugar diet for me

 

[bulkbiker]

looking to buy a meter today - is there any one in particular that is recommended? I def think my carbs have creeped up so back to the blood sugar diet for me

The cost of meters is the strips so you can often get a free meter.

I use the Tee2

https://shop.spirit-health.co.uk/collections/tee2

if you phone and order you'll probably get it free..

@Rachox has a useful guide.

 

[jjraak]

Hugs indeed, required for you today.

So in order.

8 weeks is a long time to be so high.
i'd say get those tests started asap.
badger away until they do something positive.
this IS your health so important, try to be polite but insistent.
it's causing you distress, so don't let yourself be guilt tripped for asking for help, NOW

keep a food diary, post on here.
sure it is as good as you can make it, but it just might show that
your eating too much of something

and post meal, while not ideal.
i used a resistance band to make those muscles call out for the glucose, so it gets used up.
wouldn't want to be running etc after a meal, but to sit and exercise might help some..
Can't see it would hurt.

and then breathe, it won't stop the rise but it might help calm you down.
i know that feeling and it worked to relax me, just a bit when needed.

Best wishes it all resolves asap.

 

[pinkjude]

Results were a massive shock - been quite tearful as a result, but getting myself together now and looking out my blood sugar diet books this morning

It happened to me. Diagnosed at 54, dropped to 43 then up to 55 in October 2020 and 84 in March 2021. I spoke to the diabetic nurse via the phone and she offered Metformin , I refused it and started on the low carb programme via the NHS. You can google it and sign up yourself. There is a cost but you get so much help and support. There are lists of green foods that you can eat freely, amber foods to be eaten in moderation, and red foods to be avoided. Lots of recipes, exercise videos, cook alongs, tutorials, meal planners, zoom meetings with a health coach and other people just like you and they are very helpful. I have stopped eating pasta as they recommend no more than 20g dried as a portion size and it should be wholemeal anyway same as rice. I started testing my bloods and worked out what foods spike it so bread and potatoes are no good for me. I ate say boiled eggs with no bread one day and tested 2 hours later then did the same with bread with it and my numbers had jumped massively. I also walk straight after eating for 15 minutes rather than sitting and that helps to get numbers down. I am now getting 6.6/ 7.1/ 7.5 , not all the time but quite often. Give it a go

 

[Rachox]

Hi @FlumpyMumma and thanks for the tag @bulkbiker


Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.


Home Health have recently bought out the Gluco Navii, but I haven’t heard any reviews yet, links to strips and the meter:

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.


Disclaimer, I haven’t used the discount codes that I have quoted recently so I don’t know if they are still current.





Spirit Healthcare have a meter called the Tee2 + found here:



https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793

with the strips found here:



https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free:

Phone number 0800 8815423


With more expensive strips is their Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual





Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)

 

[KK123]

Hi @FlumpyMumma, I see you are now purchasing a meter which is absolutely essential if you want to know what effect certain foods have on your day to day levels. That way you will also obtain very useful data on an ongoing basis that you won't get just by comparing hb1acs, especially when they are done every 3 months or so. Without a meter you would have NO idea what your levels were doing real time. Your hb1ac of 12% equates to average glucose levels of 16 so that is high, as others have said you really do need further tests. I was diagnosed as 'pre diabetic' 3 years before my type 1 diagnosis so it is possible you are not type 2 but type 1. Of course we are all guessing, but if you are low carbing and getting levels of 16, further investigation is needed.

 

[searley]

I haven't tested my urine recently but I do think I still have test strips so will look them out too and start testing again. Going to get a meter to test myself too

Check the date on them many strips only last 6 weeks from opening

A lot of T2s don't get keytones as they are still producing insulin so getting energy from the food they eat so it hard to say weight loss would be from ketosis without checking for keytones

 

[pinkjude]

Hi @FlumpyMumma and thanks for the tag @bulkbiker


Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.


Home Health have recently bought out the Gluco Navii, but I haven’t heard any reviews yet, links to strips and the meter:

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.


Disclaimer, I haven’t used the discount codes that I have quoted recently so I don’t know if they are still current.





Spirit Healthcare have a meter called the Tee2 + found here:

I use the gluco navii

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793

with the strips found here:



https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free:

Phone number 0800 8815423


With more expensive strips is their Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual





Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)

 

[DavyPaul]

Hi @FlumpyMumma, I see you are now purchasing a meter which is absolutely essential if you want to know what effect certain foods have on your day to day levels. That way you will also obtain very useful data on an ongoing basis that you won't get just by comparing hb1acs, especially when they are done every 3 months or so. Without a meter you would have NO idea what your levels were doing real time. Your hb1ac of 12% equates to average glucose levels of 16 so that is high, as others have said you really do need further tests. I was diagnosed as 'pre diabetic' 3 years before my type 1 diagnosis so it is possible you are not type 2 but type 1. Of course we are all guessing, but if you are low carbing and getting levels of 16, further investigation is needed.

every three months ?!?! I am lucky to get an annual blood & urine test at my GP. (type II) I may investigate getting a meter.

 

[Andydragon]

every three months ?!?! I am lucky to get an annual blood & urine test at my GP. (type II) I may investigate getting a meter.

Aware of off topic. HBA1C guidance is every 6 months unless newly diagnosed:
https://www.nhs.uk/conditions/type-2-diabetes/going-regular-check-ups/

Some surgeries have changed this, delayed, due to COVID but shouldn't be delaying anymore. However in my personal experience, most surgeries I have ever been at are more likely to only do yearly checks, regardless of their obligations

@FlumpyMumma did you get further forward on meters and testing?