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Cast adrift and left to get on with it.

B

BonnieBonBon

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Hello,

I got the results of some blood tests at the GP last week and my Dr says that I am type 2 diabetic. I am a bit confused as my fasting blood glucose was 5.5 which is normal-ish? but the Hb test came back with a reading of 51. What does this really mean? Is it often the case with newly diagnosed patients that the two tests are at odds with each other?

It turns out that my thyroid is also out of kilter so I have been given levothyroxine for that, told to try and lose some weight and come back in two months for reassessment.

I hope that I'm not coming across as being in denial, there is a family background of type 2 diabetes so I'm not overly surprised to be diabetic but I have been given no diet to follow, no appointment with a diabetic nurse, no metformin, in fact no anything apart from "come see me in the new year to repeat the tests".

Apart from the obvious, cut down on the sugar and carbs to try and lose some weight, should I be doing anything else for this couple of months or just wait to see what happens? I feel as if I have been cast adrift with a wishy washy diagnosis and just left to get on with it. Do I just need to be more assertive and ask for help from the surgery or should I just wait and see what happens next.

Thanks for your time.
 
Hi Bonnie ...

I'm no expert but from what you say the two test results do seem to be at odds and your GP seems a wee bit airy fairy in his response, so I'd ask for the tests to be repeated now, you shouldn't have to wait until after the New Year for a proper diagnosis.
 
Hi Bonnie and welcome to the forum :)

I know you don't know where you are at the moment but it wouldn't do any harm to read this and follow the advice on diet. As for the rest at least you will see what you need to know when the time comes. Ask all the questions you like and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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 30,000 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 ... rains.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

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.
 
Your HbA1c of 51 (6.9 in old money) just about makes you a T2 diabetic. Your fasting results are near to normal.

I suspect your doctor is simply waiting to see how things pan out, reduce carbs intake, lose a bit of weight and do a bit of excercise
and when the tests are repeated you could well be in the normal range.

There is no need for any urgent action as your test results are not that bad really. So your doctor is doing what he/she thinks best, nothing for the time being, and I can't see anything wrong with that.

So cut down your carbs and lose some weight, do a brisk 20 min walk each day and you will be almost normal :D

H
 
Thank you so much for the replies and the information. I never fully appreciated just how daunting it can be to tackle this thing. I went looking to find a low carb vegetarian cookbook today to no avail, really don't know what I can and cannot eat but I guess a few changes to diet can have a big effect. I'm off to do some reading here, that should keep me occupied for a while :-)
 
Rose Elliot has a low carb veggie book there are also some of her recipes online if you googl her and low carb. Haven't tried any of the recipies myself so I can't say what they're like taste wise
 
Hi. A fasting blood test is not as reliable as the HBa1c due to the way the liver dumps glucose during the fasting period in varying amounts. The HBa1C provides a 3month average which provides a good overall view of your sugar control. It's good that your GP has done an HBa1c test early on; mine waited 3 months. The main thing at present is keeping the carbs at sensibly low level so you are doing the right things. Get hold of a meter and you will be able to find which foods affect you and how your sugars behave over the coming weeks.
 
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