Comment on test results please.

[Signs]

Hi folks,

Had a blood test a couple of weeks ago and as I'm in Scotland can access my results via mydiabetesmyway.scot.nhs.uk/

I have an appointment with diabetes nurse on Tuesday to discuss results so would like some input please.

I had a very stressful period July/August after which my BGs were all over the place for a couple of months. Eventually regained some sort of control towards the end of November. Given that, I'm actually quite pleased with the results and looking forward to better numbers in the New Year.

Currently on Glicklazide, Metformin & Peridropil. Was initiaaly on Glicklazide when diagnosed in March but managed to eliminate with low carb eating. Started on 2 daily Glicklazide again at the start of November and managed to cut that once more from 2 to 1 with low carb eating.

While readings most of the day are reasonable - between 4.5 and 6 before meals, my morning reading is always a bit higher between 7.5 and 8.5. ( I mentioned this to the DN and she asked me to take middle of the night readings. Took them at 4am and both times around 5.5)

Should I be concerned about the kidney function tests?

Any comments on my figures as well as the recomended numbers most welcome.

Thanks, John

HbA1c
March 2012 105 (11.8%)
December 2012 59 (7.5%)

Recomended 48 - 59 mmol (6.5 - 7.5 %)
==========================

BP 130/88
Target 130/80
=========================

Total cholestrol
March 2012 -- 4.5 mmol
December 2012 -- 4.0 mmol

(Recomended below 5)
==========================
HDL cholestrol
March 2012 -- 1.1 mmol
December 2012 -- 0.8 mmol

(Recomended higher than 1 preferably 1.5)
==========================

Triglycerides
March 2012 -- 1.9 mmol
December 2012 -- 2.8 mmol

(No recomendation given)
==========================
Creatinine umol/L
03/12/2012 107.0
04/05/2012 99.0
05/04/2012 93.0
08/03/2010 88.0
08/03/2010 88.0
05/03/2010 88.0
06/05/2009 107.0
06/05/2009 107.0
05/05/2009 107.0

(Recomended 60 -120)
==========================
eGFR ml/min
03/12/2012 60.0
04/05/2012 60.0
05/04/2012 60.0
08/03/2012 60.0
05/03/2010 61.0
05/05/2009 61.0

(Rec above 60)
==========================

 

[VickiT11979]

Hi John,

I'm type 1, but your results don't look bad at all! I'd personally try to get my HbA1c a bit lower, but (I have no problem with being corrected if others think I'm wrong) if you're on a sulphonylurea (gliclazide) your nurse shouldn't want you to increase the dose to get this lower, it should be by diet/exercise. If your BGs were out of control before Nov, that's likely to have pushed your A1c up a bit higher, and it should come down now you're getting on top of things again. It looks back at he last 12weeks of glucose levels, though recent sugars have more impact on it. Can you get it done again in 6-8 weeks to get a value reflecting your current control?
Your morning rise sounds like the Dawn Phenomenon, most people's livers use more insulin & make more glucose on waking. I hope others can suggest ways to reduce this as I just change my basal insulin rate!

Your eGFR is OK as long as you don't have glucose or protein in your urine when the nurse dipsticks it - 60 or more is normal in this case. eGFR is also not reliable if you're over 75 years old.
Your triglycerides might have gone up if your sugars haven't been well controlled & should improve if you reduce your carbohydrate intake - that & exercise might increase your HDL cholesterol (the protective cholesterol).

I don't see anything really terrible here, and well done on getting back into taking charge of your diabetes!

Vicki

 

[phoenix]

My thoughts
Your triglycerides have risen since the last test and are higher than normally considered to be ideal. ( 1.7 mmol/L or less after an overnight fast)http://www.patient.co.uk/health/Hyperlipidaemia.htm
Your HDL is also a bit low.
How to lower them ?
Obviously
Most sources say exercise can help improve both of these markers, including some omega 3 (oily fish) in your diet, excluding high glycaemic carbs (which I imagine you are doing anyway) and not drinking too much alcohol can also help.
http://www.webmd.com/cholesterol-manage ... ide-levels

Your egfr
http://www.patient.co.uk/health/estimat ... n-rate.htm
is a bit low but would only count as stage 2 CKD if there were also other problems (eg protein in the urine),it is on the borderline . However,since it hasn't really changed in 3 years, it doesn't seem to be deteriorating. I think that it's really important to try to keep blood pressure low in any case but it's really important if our kidneys aren't filtering at 100%.


If you look on the Edingburgh renal unit pages you find that their isn't really a renal diet (it varies from person to person and stage to stage) The only thing is not to eat a very high protein diet (moderate/normal is they say fine)
http://www.edren.org/pages/edreninfo/di ... isease.php

Edit: went to post and it looks much the same as the post above!

 

[Fraddycat]

Hi Signs, well done for taking control again. IMO your triglicerides are high, I had this and to reduce it I ate less processed foods (crisps, bread etc), drank less alcohol and did more exercise. Trigs are the ones that do the most harm - I read that they are the ones that convert food to fat which is stored in the body - so if you can get them down it will help with weight loss (you might not need to lose weight if so, please ignore me )

 

[Signs]

Thanks for the answers folks, appreciated.

My aim is to get BG levels down so that I can control BGs with diet and exercise and without glicklazide.

DN is OK with low carb but has her doubts as to whether I can maintain it. Numbers are going thr right way so I reckon she'll be fine with me suggesting that I get another test in 3 months. Really, really must make an effort to get in more exercise . . .

John