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Advice needed about a test...

S

Sharlieboo

Active Member
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35
Hi

I was diagnosed with Type 2 diabetes back in December and have just had my first diabetic check since that time.

In case it helps, my details are that I'm 35, BMI 23.5, original blood glucose level was 18.5, dropped to 16.5 over 2 weeks, then prescribed 2 x 500mg metformin per day with advice to lose 2 or 3 lbs if poss but not essential (I was then BMI about 24.5). I've been suffering with diarroeah intermittently for last couple of years and when initially prescribed Metforim in was a side affect for a couple of weeks and, again, intermittently since.

At check a few days ago blood glucose had dropped to 9.7, my bp was up for me (126/86), there was sugar in my urine and also something which I thought the nurse said were 'acetates' in my urine too.

I think I must have misheard the word the nurse practioner used when she said 'acetates'. She thought there was a possibility I might have an infection which could be causing the levels but on the basis there might not, I am to drop in another urine specimin in a months time so she can check again (spec bottle says 'dir & micro'. I noticed that she split the existing sample in two and labelled both up to go off to the lab. She said a GP would call me in a couple of days if it was due to infection and I'd have to go and pick up some antibiotics. It's not an infection, nobody has called so my questions are:-

1. What are acetates? or what could she have meant that sounded like that? What do diabetics get checked for on that little stick they put into the samples?

2. She said that the levels could mean problems with heart and kidneys. Is this more likely to be that I already have complications with my heart and kidneys and that the levels are an indicator, or does it mean that unless the levels come down it could mean that I go on to develop complications with my heart and kidneys?

3. If the levels are still too high in a month, do you think this may mean my medications gets changed again? (at the appt I was switched over to slow-release metformin and double-dosed up to 4 x 500mg per day)

I know I should have asked in the appointment but to be honest I intended typing 'acetates' into google/search here and finding out more but, of course, I must have misheard because I can't find anything. My head was spinning in the appt from all the appts I was being booked in for (podiatry/diabetic course/repeat bloods and check etc etc).

Can anyone shed any light?

Any help appreciated.

Sharlie
 
1. What are acetates? or what could she have meant that sounded like that? What do diabetics get checked for on that little stick they put into the samples?

She may have said 'albumin' . If this is in urine then it is probably due to the high blood sugar levels you have had.

http://www.gpnotebook.co.uk/simplepage. ... 3609021840

2. She said that the levels could mean problems with heart and kidneys. Is this more likely to be that I already have complications with my heart and kidneys and that the levels are an indicator, or does it mean that unless the levels come down it could mean that I go on to develop complications with my heart and kidneys?

If you can get your blood sugar levels down to below 7, preferablly lower then this lessens the risk of developing complications.

3. If the levels are still too high in a month, do you think this may mean my medications gets changed again? (at the appt I was switched over to slow-release metformin and double-dosed up to 4 x 500mg per day)

If you change your diet and reduce the amount of carbohydrate you eat you may be able to drop your blood glucose levels.

I know I should have asked in the appointment but to be honest I intended typing 'acetates' into google/search here and finding out more but, of course, I must have misheard because I can't find anything. My head was spinning in the appt from all the appts I was being booked in for (podiatry/diabetic course/repeat bloods and check etc etc).

Can anyone shed any light?

Any help appreciated.

Sharlie
Click to expand...

Welcome to the forum. here is the advice we usually give to newly diagnosed type 2 diabetics.This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different .

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid or reduce are the complex or starchy carbohydrates such a bread, potatoes, pasta and rice also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating then two hours after eating you will see the effect of certain foods on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try !!

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.
Click to expand...
 
Thank you for taking the time to reply.

I did some more 'googling' and came up with this

http://www.patient.co.uk/doctor/Urine-Ketones-What-They-Mean-and-False-Positives.htm and

and, in particular,

"Most urine testing kits detect aceto-acetate, not the predominant ketone beta-hydroxybutyrate. It is possible for the test to be negative with high levels of beta-hydroxybutyrate and then, as ketoacidosis improves and ketone levels fall, the urine test becomes positive (to aceto-acetate)."

So I think this test is to do with my ketone levels? I had been limiting my carb intake so that might make sense. The nurse practitioner also told me 'don't lose any more weight' and that my diet was good and to eat carbs regularly throughout the day (I do, but have been limiting to a portion about the size of a handful at each meal).

Ummm all a bit confusing and wish that things could have been explained a little better at the last appointment :roll: .

Thanks again.

Sharlie
 
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