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a lot to take in!

AngieGribb

Member
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13
Hi – I was diagnosed last week but apparently I can’t attend the diabetic clinic until I have a second high hba1c test. Told to wait a month and get it tested again then make an appointment. Should I wait that long or just get it done asap? I’m currently self testing to see what foods affect me most.
I'm concerned that the GP was already talking about metformin and statins – I’m at the light end of bmi, do a lot of exercise and cholesterol is fine. My hba1c is under 7 so I’m keen to use diet in the first instance. I also wonder if I am late onset type 1 rather than type 2. Should I be pushing them to test for antibodies and insulin levels at this stage?
I looked back at some blood tests that I had done via work in 2013 and my hba1c then was 7.5! Unrelated to that in the last 18 months I have eaten a more moderate carb diet which would seem to have lowered it already.
Any advice much appreciated, this is a great site it’s really helped me get a grasp of the changes I need to make.


Thanks

Angie
 
Hi and Welcome!

And yes, there is a lot to take in. But don't worry, it gradually percolates through. :)

Re the HbA1c test, it really isn't worth you having them done too often. They result they give is kind of an average of your blood glucose over the last 2-3 months. There are several reasons why I say kind of, but all you really need to know at this stage is that i) the results might be off if you are anaemic. if you aren't, don't worry about it. And ii) if you really want to know the full effect of any diet and lifestyle changes on your HbA1c result, then wait around 3 months between tests.

If you have had raised HbA1c since 2013, then it is unlikely you will be T1, since that usually comes on hard and fast (matter of months), but there are other types of D known as LADA and MODY that are slower onset. Have a look round the forum for threads on the subject (there is a sub forum for 1.5/LADA) which you may find interesting.

Congrats on already moving towards low carb - it suggests to me that it could be the way forward for you, if you are already reaping the benefits.

What part of the world are you in, and what units is your HbA1c given in?

The table below suggests that with an A1c of 7.5 in 2013 you should have had a clear diagnosis back then, but there may be good reasons why your doc held off - worth having a good conversation with them about it...

3f47c989606bb210b6475f0b3e433f35.jpg
 
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Thanks Brunneria - I'm in the UK so think the HbA1c is %.
I have changed doc since 2013 - asked my current GP why they wouldn't have called me back 3 years ago and she said they didn't go by the HbA1c reading then - my fasting glucose was ok at the time although towards the higher end. It's much the same now. I will take a look at the LADA forum
 
Ah, that explains it. Here in the UK they have changed their units from % to mmol/mol but many doctors still work in the older units, because it often makes more sense to both them and their patients. ;)

Here is another table that does the conversion from % to mmol/mol (and also shows you the prick test meter reading comparison in mmol/l, so you can see how that compares)

Prediabetes is considered to be above 42 mmol/mol
Diabetes is considered to be above 48 mmol/mol
Many doctors seem to leave it to diet and exercise unless the A1c rises above 53 mmol/mol (7%)

hba1c-chart.jpg
 
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@AngieGribb You should ask for the GAD and c-peptide tests as a matter of course. You physically don't sound as though you have T2 characteristics so it's better to be safe than sorry.
 
Hi and welcome. One of the key pointers to Late onset T1 (LADA) is being slim at diagnosis and/or losing weight unexpectedly around diagnosis (I had both). Also if you are a LADA you will need some meds regardless of diet as your pancreas will be failing. Metformin isn't of that much help but Gliclazide can help LADAs for a while. My LADA took around 7 years to go from having an HBa1C around 6.5% and some tablets to needing insulin so it can come on at different speeds which is why the medics often miss it. You can ask for a GAD and c-peptide if you are slim but you may not get them. I had mine done privately in the end. I would continue the low-carb diet. Go along with Metformin if suggested as it does help everyone a bit (ask for the SR version if it gives you bowel issues) and is very safe. Personally I would stay away from statins unless there is a very good reason. Don't use your total cholesterol number but the breakdown ratios. I would wait for the appointment as you have a meter and can see the GP if it rises suddenly.
 
Thanks everyone for the helpful info. Daibell -I will stay well away from statins, my hdl is at a good level fortunately. I think I am most freaked out by the idea of medication for life as I have been lucky to not have much to do with docs so far. I guess at 52 I should expect that to change a bit !
Going to Italy in a couple of weeks and was so looking forward to the ice cream .....
 
hello and welcome to the forums, mind bogling all the information isn't it
 
@AngieGribb
Hello Angie and welcome to the forum :) Here is the information we give to new members and I hope you will find it useful. 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 over 150,000 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-and-whole-grains.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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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 bloodglucose 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.
 
Thanks everyone for the helpful info. Daibell -I will stay well away from statins, my hdl is at a good level fortunately. I think I am most freaked out by the idea of medication for life as I have been lucky to not have much to do with docs so far. I guess at 52 I should expect that to change a bit !
Going to Italy in a couple of weeks and was so looking forward to the ice cream .....
Oh yes....those gelatos...:hungry: If you are other wise 'good'...have a little, but don't do it into empty stomach so the sugar has fast spiking effect to your blood readings...and have a good walk afterwards to work it off...:angelic:
 
Thought I would post a quick update as I have had the results of a second HBa1c - this time it was 6.3% (from 6.7% a month ago) so back in the pre diabetic range - have to say I was really pleased as it looks like I can control with diet for now.
My GP was less than encouraging - he gave me a photocopied diet leaflet from 2001 (full of carbs) and said come back in a year for another test. I asked about being type 1.5 not type 2 but was met with a roll of the eyeballs and told I am type 2 (which I probably am but it would be nice to be certain) I'm going to go back in 4 months or so to a different GP and get another test just to make sure I am going in the right direction.

This site is the best place for information and advice - thanks everyone x
 
Thought I would post a quick update as I have had the results of a second HBa1c - this time it was 6.3% (from 6.7% a month ago) so back in the pre diabetic range - have to say I was really pleased as it looks like I can control with diet for now.
My GP was less than encouraging - he gave me a photocopied diet leaflet from 2001 (full of carbs) and said come back in a year for another test. I asked about being type 1.5 not type 2 but was met with a roll of the eyeballs and told I am type 2 (which I probably am but it would be nice to be certain) I'm going to go back in 4 months or so to a different GP and get another test just to make sure I am going in the right direction.

This site is the best place for information and advice - thanks everyone x

Re the T1.5 question, at this stage, carry on with the diet (it seems to be working! :D and KEEP TESTING!!!

One of the characteristics of T1.5 is that your bg climbs, now matter how few carbs you eat. So if that starts to happen (may take a loooooong time, if you low carb) make sure you go back to doc, and get help before your levels have been too high for too long. :)

Have you found the LADA section on the forum? Might be worth you checking it out. Hope that helps.
 
@AngieGribb You should ask for the GAD and c-peptide tests as a matter of course. You physically don't sound as though you have T2 characteristics so it's better to be safe than sorry.
Yes, do push for the antibody tests. Because if you're actually slow-onset T 1, treatment is different. If you take insulin now, you can prevent it getting worse.
 
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