Am I Being Correctly Managed By Doctors?

[Rmoliv]

Hello,
This is my first post here as I am greatly concerned.
Last week my vision got blurry all of a sudden (both eyes). I also started experiencing other symptoms like fatigue, abnormal thirst, dry mouth, hot flushes, dizziness, nausea, headache, etc. I let it go expecting it to go away on its own. Since the symptoms persisted, on Friday night I decided to check my blood sugar level using a glucose meter and the result was about 500 mg/dL. I went to the doctor on the following day at my local medical center ER. There they checked among other things my blood sugar level (using a glucose meeter) and the result was about 350 mg/dL. The ER doctor told me to see my GP today, which I did. I presented him the results of my blood sugar levels hoping that he would acknowledge that I am diabetic and prescribe me an adequate drug to lower my blood sugar levels. To my surprise, he didn't! He told me that glucose meters are not reliable and should not be used in diagnosing diabetes and that a laboratory blood work should be done to check the blood sugar and also the glycated hemoglobin and urine. Until he has the results we won't prescribe me anything. So he did schedule an appointment to the following Thursday and I am going to have the blood work done tomorrow. In the meanwhile the symptoms are still here (especially the blurry vision) and I'm still in an hyperglycemic state. Do you think this procedure is normal?
I appreciate your feedback.

 

[Resurgam]

The ways of doctors are beyond my comprehension - but I'd be continuing to check blood glucose levels and cutting out sugars and reducing starches - particularly if affected by this heatwave.
I'm of the opinion that most people eat too many carbs as a result of their cheapness to supply by the supermarkets, and they are pushed as 'treats' and 'special' foods with health giving qualities. I used to work for Allied Lyons in product development so I could curl your hair with the way recipes were devised.
Even if you were diagnosed, it would be down to you to reduce your blood glucose by changing your diet to compensate for your inability to process carbs - there is no magic tablet to reduce blood glucose for type twos, which your symptoms do sseem to indicate is most likely.

 

[sally and james]

Hi @Rmoliv and welcome to the forum. I'll tag @daisy1 for the new member's information, which should appear on this thread a bit later on.
While we cannot diagnose, it does sound as if you may by type 2 diabetic and, as @Resurgam has said above, there is no magic pill to bring down sugar levels. The best way of keeping sugar levels close to normal (if you have insulin resistance, ie T2D) is to severely reduce the amount of sugar you are eating. Remember, starches break down to sugars as soon as you eat them, so it's not just candy and cake! For information on low sugar (ie Low Carb) diets, one of the very best sources is https://www.dietdoctor.com/low-carb
Sally

 

[EllieM]

Do you think this procedure is normal?

Well, yes and no.
Of course, we can't diagnose here but I agree it's likely but not certain that you're going to be diabetic. (Two blood tests, both way above normal).
By far the most common forms of diabetes are T1 (about 10%) and T2 (about 90%).
A week of high blood sugar in itself won't kill you, or even cause long term damage, so the doctor is waiting for results so that he can see whether you've certainly got diabetes.

The problem here is T1 diabetes, which is the only one that can kill you in the short term, via something called diabetic ketoacidosis. If you've got T1, then you're going to get sicker and sicker, and you'll need insulin. So if your symptoms get worse before you see the doctor again, then I'd suggest going back to ER urgently.

But I suspect that the doctor is assuming you're T2, which is basically an inability to process carbohydrates properly, and the meds for that are completely different to T1, and you can actually improve your symptoms by diet only (basically avoid carbohydrates, or at least greatly reduce them).

Even if you were diagnosed, it would be down to you to reduce your blood glucose by changing your diet to compensate for your inability to process carbs - there is no magic tablet to reduce blood glucose for type twos, which your symptoms do sseem to indicate is most likely.

I wouldn't rule out T1, but T2 is the most likely, particularly if Rmoliv has relatives with the condition and/or is carrying some extra kilos.

To @Rmoliv, welcome to the forums. Once you know whether you've got diabetes and what kind it is there'll be lots of help for you here. Good luck.

 

[Bluetit1802]

What your doctor is talking about is giving you what is known as an HbA1c blood test, which is the test used to diagnose diabetes. It is drawn from your arm and sent to a lab for analysis. It measures a sort of average of your blood glucose over the previous 2 to 3 months. If it is borderline or not particularly high, a second HbA1c should be done a week or so later to confirm the first. Ordinary finger prick tests using a blood glucose meter can be very unreliable, which is why they are rarely used for diagnosis purposes. All they show is a snapshot of your blood glucose at the time of the test, and this is dependent on when and what you last ate, so will vary accordingly.

https://www.diabetes.co.uk/what-is-hba1c.html

 

[Brunneria]

Hi and welcome @Rmoliv

Judging by the fact you are using mg/dl units to record your blood glucose, I am guessing you are not in the UK?
The best thing to do is to have an internet search for the specific criteria used for diabetic diagnosis in your country. There are a few generally accepted ways of diagnosing, but countries often have different standards of procedure, and sometimes different levels at which they diagnose pre-diabetes and diabetes.

Even within a country, doctors may vary in their preferences, as to whether they diagnose on HbA1c results, random or fasting blood glucose results, or by an oral glucose tolerance test.

So while your results do seem to be in the diabetic range, your doc is probably playing safe and arranging standard lab tests to confirm. After all, it would be a very dangerous and risky thing if someone could walk in off the street, claim a few home test results, and then walk off with potentially dangerous prescription meds.

 

[Dexterdobe]

I agree with what the others have said, but I would add that stress raises blood glucose levels, so try not to worry. Your doctor is wise to get the results of an HBA1c test before treating you. It will tell him what your average BG level has been over the last three months. If you do have T2 then he may prescribe medication BUT in any event, you must cut back on carbs and sugary food and increase your exercise levels if you want to get your BG levels down in the long-term. If you don't do that it is likely that your BG levels will not fall back to normal levels. There is lots of information in this forum and we love answering questions, so fire away.

 

[Pinkorchid]

Do you think this procedure is normal?

Yes I would say it is because until you had had the proper HbA1c blood test you are undiagnosed so medication would not be started. After the blood test they will decide if you do have diabetes and what type until then you should not make any changes to your diet

 

[Guzzler]

Think of it another way, I could go to my GP claiming that I had had some high readings with a home blood pressure meter. Should I then expect to be given a prescription for medication to lower my bp as I leave the consulting room? Making the correct diagnosis is fundamental to prescribing the correct treatment.
As members here will attest, a misdiagnosis can cause harm. The HbA1c results come back very quickly in most cases, if yours is sky high then you should be contacted immediately so that treatment can begin.

 

[Rmoliv]

Thank you everyone for your replies I feel more reassured now as I thought the doctors were not paying enough attention to my symptoms.

My diet has been all wrong for the last 10 years and I’ve gained and lost weight several times. I’ve lost 40 kg in 2014/2015 only to regain more than that this year. I currently weight 128 kg and the weight gain was very fast. This instability in my diet is due to my anxiety disorder even though I’m medicated for it. When I’m anxious or depressed I overeat carbohydrates like cakes, pasta, pizza, chocolates, ice cream, sodas, cookies... I’ve been going through a difficult time in my life these past two years.

I definitely will have to change my diet and start working out.

 

[Daibell]

It can be a problem. My GP told me to try dieting (with the useless NHS diet) for 3 months before the next appointment and first HBA1C test. I did start reducing carbs (my choice) but my HBa1C showed 12.5% when it was done and I obviously had very high sugar levels during that time. I would also make the point that GPs may assume T2 by default or assume if you were T1 you would be in DKA and in ER. LADA, which is T1 in adulthood can come on much more slowly and is often mis-diagnosed as T2 and inadequate treatment given.

 

[daisy1]

@Rmoliv

Hello 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 like and someone will 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
  
  
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