55yr old Newbie, stunned at NHS advice ...

[Polypsodd]

Hi Folks, another shocked newbie,
Diagnosed around three weeks ago after being sacked by Blood Donation Service as I was anaemic. HbA1c = 57 (fasting).
Straight on Metformin 500mg, now 1g after two weeks.
GP clear the condition is established and irreversible.
Have found the website invaluable already, working my way through 'Blood Sugar 101' too.
Gone low carb immediately, need to lose around 2 stone +.
Had my first Diabetic clinic appointment with the nurse yesterday and wasn't too surprised at the dietary advice, ie I need carbs in my diet, which will largely be ignored, thanks to this site.

She directed me to Diabetes UK as THE site and source for reliable information!

Now, what actually left me speechless was her response to my question about my anaemia ...

Start eating breakfast cereals ! They're fortified with iron you know. Surely also fortified with a touch of sugar?

Absolutely no suggestion of monitoring BG, which I started immediately on diagnosis anyway.

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Thanks to all the contributors here, it's a fabulous, invaluable resource, helping me get to grips with my health ...

 

[dbr10]

Hi Folks, another shocked newbie,
Diagnosed around three weeks ago after being sacked by Blood Donation Service as I was anaemic. HbA1c = 57 (fasting).
Straight on Metformin 500mg, now 1g after two weeks.
GP clear the condition is established and irreversible.
Have found the website invaluable already, working my way through 'Blood Sugar 101' too.
Gone low carb immediately, need to lose around 2 stone +.
Had my first Diabetic clinic appointment with the nurse yesterday and wasn't too surprised at the dietary advice, ie I need carbs in my diet, which will largely be ignored, thanks to this site.

She directed me to Diabetes UK as THE site and source for reliable information!

Now, what actually left me speechless was her response to my question about my anaemia ...

Start eating breakfast cereals ! They're fortified with iron you know. Surely also fortified with a touch of sugar?

Absolutely no suggestion of monitoring BG, which I started immediately on diagnosis anyway.

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Thanks to all the contributors here, it's a fabulous, invaluable resource, helping me get to grips with my health ...

You'll get lots of helpful advice here. Lots of us have a similar story. I actually find it too stressful to bother seeing the DN unless absolutely necessary. Blood Sugar 101 is a useful book. I read it early on after diagnosis and found it helpful.

It does seem a bit strange that there is no plan to address your anemia. Surely that should be investigated further. I believe that a low red blood cell count can affect the HbA1c result, so it may not be accurate.

 

[Guzzler]

@dbr10 is right, amaemia can skew the results of the HbA1c. Loads of iron in veggies, red meat etc.

Do you have access to your blood test results online? If not you can request a printout of these from your surgery. There are members here who can help you to interpret them should you so wish.

@Bluetit1802 knows about test results and can give you more help than I can. Tagging @daisy1 for the info pack offered to all newcomers.

 

[donnellysdogs]

What type of anarmia- was it iron deficient and anaemia or pernicious anaemia (would think they would have done tests for this though)

You can have low haemoglobin and low haemaocrits undicating an iron problem without having iron supplement.
If ferritin goes below target as well as the the other two then iron supplement can be given by GP.

Tge first port of call to do is to get copies of your blood tests. If you can get them online, brilluant. All doctors should do this in england niw.

If your ferritin is very low they should also rule out internal bleeding and talk to you about your red meat and veg intake to see the qty of iron from these foods.

Be aware though that iron supplements can make differences to bowel habits.

My GP prescribes me paedatric dose on prescription as its more concentrated than over the shelf products and less effect on bowel habits which could hospitalise me...

Iron thru cereals is recommended as they have to recommend for the majority still.. and based upon nhs guidelines for eating well!!

However, if you can up the intake of red meat and green leafy veg it is a better form for diabetics.

Do get copies / online of your blood test results. This is very important.

Did they talk to you about eye tests, looking after feet etc??

 

[daisy1]

@Polypsodd

Hello Polypsodd and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you want and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[Bluetit1802]

@Bluetit1802 knows about test results and can give you more help than I can.

Much depends on the type of anaemia and the state of your haematocrit levels. There is plenty of research on how certain red blood cell abnormalities affect the HbA1c, including high haematocrit levels. However, you need to find out more about your own personal situation as some abnormalities cause elevated HbA1c levels, and some cause falsely low ones. You need your test print outs and some more information from your doctor.

 

[Resurgam]

I don't need to have a protocol for dealing with bad advice, as since getting normal results I have not seen a nurse, and I think my doctor is sulking - not seen him since diagnosis.
I do get the eyetest appointments, one for a second test has just arrived.
You might have to go through the 'education' sessions - but by the third one my Hba1c levels were down to 47, from 91 - so the pair doing the 'education' were rather bewildered. I hope you are lucky enough to get the same response to changing your diet to reduce BG levels so as to confound your HCPs.

 

[Polypsodd]

Thanks everyone so far, I have an 'ordinary' eye test on Monday and received an appointment this morning for a Diabetic Eye Screening test on 22/05, I'm also having full bloods again the same day. I'll check my online GP access, last time summaries and test results weren't accessible but I have requested to do so. Seems such a supportive community here, glad I found it quickly! Cheers, everyone.

 

[Daibell]

Hi. The NHS can be very good and very bad. The training is very robotic and tries to cover too much. How can any nurse or GP deal with the breadth of health issues. The advice to have breakfast cereals was of course stupid if well intended. There are many ways to have iron such as the right vegetables as well as tablets. I have some vitamin tablets that contain 'everything' including iron. I've been lucky that with some exceptions my GPs/DNs have not offered diet advice or courses so I've avoided conflict. Just keep quiet and bite your tongue!

 

[Polypsodd]

Hi Again All,
I do now have access to summary medical notes and test results.
The results of my recent blood test are;

Pathology Investigations

Full blood count
Haemoglobin concentration 116 g/L [126.0 - 180.0]
Below low reference limit
Total white blood count 4.6 10*9/L [4.0 - 12.0]
Red blood cell count 4.82 10*12/L [4.4 - 6.0]
Haematocrit 0.366 [0.42 - 0.52]
Below low reference limit
Mean cell volume 75.9 fL [78.0 - 100.0]
Below low reference limit
Mean cell haemoglobin level 24.1 pg [27.0 - 32.0]
Below low reference limit
Mean cell haemoglobin concentration 317 g/L [310.0 - 350.0]
Platelet count - observation 271 10*9/L [140.0 - 450.0]
Red blood cell distribution width 15.8 % [11.0 - 16.0]

Differential white blood cell count
Neutrophil count 2.9 10*9/L [2.0 - 7.5]
Lymphocyte count 1.1 10*9/L [1.5 - 4.0]
Below low reference limit
Monocyte count - observation 0.5 10*9/L [0.2 - 0.95]
Eosinophil count - observation 0.1 10*9/L [0.01 - 0.7]
Basophil count 0.1 10*9/L [0.0 - 0.1]

Pathology Investigations

Urea and electrolytes Stage G1 CKD - Normal unless there is existing laboratory or clinical
evidence of kidney disease
Use an increase in serum creatinine level of more than 20% to infer
significant reduction in kidney function.
*For people of African-Caribbean or African family origin: multiply
the laboratory GFRcreatinine result by 1.159
Serum creatinine level 75 umol/L [64.0 - 104.0]
Serum urea level 5.6 mmol/L [2.5 - 7.8]
Serum sodium level 140 mmol/L [133.0 - 146.0]
Serum potassium level 5.0 mmol/L [3.5 - 5.3]
GFR calculated abbreviated MDRD > 90 mL/min

Plasma glucose level
Plasma glucose level 8.5 mmol/L [3.3 - 6.0]
Above high reference limit
Range applicable to Fasting Specimens only.

Liver function tests
Serum total protein level 74 g/L [60.0 - 80.0]
Serum albumin level 45 g/L [35.0 - 50.0]
Serum globulin level 29 g/L [23.0 - 40.0]
Serum alkaline phosphatase level 108 iu/L [30.0 - 130.0]
Serum alanine aminotransferase level 77 u/L [0.0 - 55.0]
Above high reference limit
Serum total bilirubin level 9 umol/L [0.0 - 21.0]

Serum lipid levels Please refer to appropriate national guidelines for recommended target
levels.
Serum triglyceride levels 2.10 mmol/L
Serum cholesterol level 4.9 mmol/L
Serum HDL cholesterol level 1.01 mmol/L
Serum non high density lipoprotein cholesterol level 3.9 mmol/L
Serum LDL cholesterol level Invalid.TG>4.6 or non fasting
Serum cholesterol/HDL ratio 4.8

Serum prostate specific antigen level
Serum prostate specific antigen level 0.41 ng/mL [0.0 - 3.0]


If anyone has a clue with regard to meaning in reference to anaemia I'd appreciate any info. GP hasn't really referred to it other than order repeat bloods, six weeks from this result.

Also may the Diabetes and Anaemia be linked or are they completely separate.

Thanks in advance..

 

[Bluetit1802]

Your haemoglobin and haematocrits are below the normal reference levels. This means that your HbA1c is likely to be inaccurate, and lower than it may otherwise have been. Sorry, that appears to be bad news as far as your glucose levels are concerned. You are definitely anaemic, but these don't tell you why. I hope the GP has included further tests to determine this, such as iron and ferritin levels. He can then decide what to do about it.

I don't know of any link between anaemia and diabetes.

There is another diabetes test for people with low red blood cell counts. It is called a Fructosomine test.
https://labtestsonline.org.uk/tests/fructosamine

 

[NicoleC1971]

Hi Folks, another shocked newbie,
Diagnosed around three weeks ago after being sacked by Blood Donation Service as I was anaemic. HbA1c = 57 (fasting).
Straight on Metformin 500mg, now 1g after two weeks.
GP clear the condition is established and irreversible.
Have found the website invaluable already, working my way through 'Blood Sugar 101' too.
Gone low carb immediately, need to lose around 2 stone +.
Had my first Diabetic clinic appointment with the nurse yesterday and wasn't too surprised at the dietary advice, ie I need carbs in my diet, which will largely be ignored, thanks to this site.

She directed me to Diabetes UK as THE site and source for reliable information!

Now, what actually left me speechless was her response to my question about my anaemia ...

Start eating breakfast cereals ! They're fortified with iron you know. Surely also fortified with a touch of sugar?

Absolutely no suggestion of monitoring BG, which I started immediately on diagnosis anyway.

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Thanks to all the contributors here, it's a fabulous, invaluable resource, helping me get to grips with my health ...

Hi and Welcome. I am glad you had prepared yourself to receive the standard (bad) advice. Cereals are 'fortified' with stuff that they have taken out and then sweetened to make them palatable.
For iron you are probably aware that you need pumpkin seeds, almonds, brazil, chashew and pecan nuts (all good for low carbing too) or pork but may not be aware that you need plenty of vit c, e and folic acid to help absorb it. Also if you have low stomach acid (are on a ppi/omeprazole for indijestion let's say) then this will also reduce your absorption of minerals.
Hope you start to get your energy levels back soon!

 

[Guzzler]

Just a piece of advice regarding your appointment with the optician. Sometimes our sight can be affected by high blood glucose levels and when we makes improvements to our diet and excercise regime the sight problems can show improvement so I wouldn't shell out on new specs for a while. Also remember to mention your T2 Diagnosis to the optician so it will be on record. The eye screening you will have for retinopathy looks at different changes, it is quick and painless but it is an invaluable test.

 

[HR-Guy]

Hi Folks, another shocked newbie,
Diagnosed around three weeks ago after being sacked by Blood Donation Service as I was anaemic. HbA1c = 57 (fasting).
Straight on Metformin 500mg, now 1g after two weeks.
GP clear the condition is established and irreversible.
Have found the website invaluable already, working my way through 'Blood Sugar 101' too.
Gone low carb immediately, need to lose around 2 stone +.
Had my first Diabetic clinic appointment with the nurse yesterday and wasn't too surprised at the dietary advice, ie I need carbs in my diet, which will largely be ignored, thanks to this site.

She directed me to Diabetes UK as THE site and source for reliable information!

Now, what actually left me speechless was her response to my question about my anaemia ...

Start eating breakfast cereals ! They're fortified with iron you know. Surely also fortified with a touch of sugar?

Absolutely no suggestion of monitoring BG, which I started immediately on diagnosis anyway.

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Thanks to all the contributors here, it's a fabulous, invaluable resource, helping me get to grips with my health ...

Welcome newbie, ah the medical field does not surprise me. Just talking about low carbs always sparks a good conversation with the nay-sayers. Just stay true to yourself and continue educating yourself.

 

[Ian_Laye]

Put it like this my GP was all smiles and conglatorary about my HBA1C results saying she'd never seen such a transformation until I told he I had ignored her advice , not taken the Gliclazide she had prescribed and only occasionally taken the Metformin.but instead adopted a low carb high fat diet.My Cholesterol levels had also improved.

 

[NewTD2]

Hi Folks, another shocked newbie,
Diagnosed around three weeks ago after being sacked by Blood Donation Service as I was anaemic. HbA1c = 57 (fasting).
Straight on Metformin 500mg, now 1g after two weeks.
GP clear the condition is established and irreversible.
Have found the website invaluable already, working my way through 'Blood Sugar 101' too.
Gone low carb immediately, need to lose around 2 stone +.
Had my first Diabetic clinic appointment with the nurse yesterday and wasn't too surprised at the dietary advice, ie I need carbs in my diet, which will largely be ignored, thanks to this site.

She directed me to Diabetes UK as THE site and source for reliable information!

Now, what actually left me speechless was her response to my question about my anaemia ...

Start eating breakfast cereals ! They're fortified with iron you know. Surely also fortified with a touch of sugar?

Absolutely no suggestion of monitoring BG, which I started immediately on diagnosis anyway.

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Thanks to all the contributors here, it's a fabulous, invaluable resource, helping me get to grips with my health ...

The NHS advice on diet are wrong and outdated.

Hope this helps mate -
https://www.dietdoctor.com/low-carb

And welcome!

 

[Brunneria]

Hi and welcome

You may find this link on anaemia and diabetes interesting..
The two often go hand in hand, but it rarely gets mentioned on the forum, and apparently few doctors know that the HbA1c becomes unreliable when anaemia is present.
https://www.webmd.com/diabetes/diabetes-and-anemia#1

 

[NewTD2]

 

[NewTD2]

 

[Prem51]

Wondering what others do when attending appointments, do you bite your tongue or try to inform and educate your health care practitioner?

Welcome to the forum @Polypsodd! When I was first told I was T2 my gp didn't tell me much except not to eat grapes - which I didn't anyway. I was referred for a DESMOND course which I got an appointment for within a few days due to a cancellation. I was given the standard NHS advice about the Eatwell plate. I didn't know enough then to know it wasn't good for T2s to eat starchy carbs.
Since lowering my HbA1c, after finding this forum, I have told my gp and practice nurse that I am following a lchf approach. My gp said low carbing would reduce my bs levels. The nurse also said lchf would reduce my bs, and that she didn't understand why the NHS didn't recommend it - she said it was probably because of the high fat part. She also said I am the surgery's star patient!
I think other forum members have had a more hostile response from their HCPs, so it depends on how open your HCPs are.