Confused! Not Hard . . .

[SheilaSalop]

Hi, I am a 71 year old woman who was diagnosed in May with Type 2, this isn't how I would normally introduce myself but it seems to be appropriate here. I am going to start with a bit of a moan, also not my normal style - perhaps diabetes brings out the worst in me? Firstly, this site is amazingly difficult to get into/navigate. Now I know that those of you who have been using it for years have no problems - otherwise you wouldn't be reading this, but trust me it is.
1. The 'I am not a robot' access to the site is rubbish!
2. I tried to find the most appropriate 'thread' to put my question without success

So, my apologies if I should have posted this elsewhere.

My background: My hba1c level [how do you describe this : blood glucose? Or is that something different?] started at 10,5 dropped to 79 by July and it is now 65. So I appear to be doing something right. I started on 1 x 2 Metformin but reluctantly agreed a couple of weeks ago to increase them to 2 x 2.

Now, I have a 'limp'. It began in April, prior to the diabetes diagnosis, and has got progressively worse. At first I couldn't get the GP interest so I paid to see a physio who said they thought it was neurological and I needed a scan and wrote the the GP accordingly. The GP sent me for an xray [all clear] I paid for my own mri [all clear] and now my GP is referring me to an orthopod. Now to my question! If, as I believe, this is a diabetic neuropathy apart from doing the exercises to strengthen my muscles and continuing to reduce my blood sugar levels, is there anything I can do?

 

[Prem51]

Welcome to the forum @SheilaSalop!
You seem to have accessed the forum now, and you have posted your question in the appropriate forum.
Your HbA1c is the blood test done by the doctor which gives an average of your blood glucose levels over the previous 8-12 weeks. You have done well to reduce it from 105(?) to 65.
You say you have a limp, is that because of burning sensation or pain in your feet? Were you tested for neuropathy? Usually after diagnosis as T2 diabetic, a practice nurse would test your feet for neuropathy - it is done by pricking the sole with a rubber spike to see if you can feel it.
The feet are the first place where neuropathy usually shows, as thicker sugary blood gathers there first.
If you do have neuropathy in your feet it can be helped by continuing to lower your blood glucose levels.

 

[Guzzler]

Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

Glad you got here in the end and yes, you posted in an appropriate section, though if you hadn't that would not have been a big problem.

As to your limp, unless and until you find the root cause/s of the limp it may be impossible to say whether the Diabetes is the problem. Well done on reducing your HbA1c, keep up the good work. When my A1c fell I noticed a diminishing of inflammatory sites so reducing your A1c further will not add to the problem. Good luck in finding the cause as soon as possible.

Have a wander around the forum and ask as many questions as you like.

 

[kitedoc]

Hi @SheilaSalop, At age 64 I too struggled at first with this site. The moderators (site stewards of sorts) are very helpful in assisting us trying to adapt to new fangled, non-logical ways. Welcome fellow wanderer.
In the Home section of the site (top horizontal bar far left) there is information in the Type 2 diabetes section. horizontal ? three across and then a series of topics vertically (sounds like crossword puzzle)! as well as Recipe section next right.
Limps have many causes. From my experience as a diabetic (and not as a professional advice or opinion) and reading about health: the questions I have have learnt to ask are: ( and I do not claim that this list is exhaustive, I hope it is not too exhausting)!
appearance of limping leg compared to non-limping one: same size or smaller in muscle bulk ?, skin colour - same or different?, bones not deformed (one compared to the other), or one leg warmer than the other?
skin condition and leg appearances - same or different (e.g. more fragile skin, sores, bulging veins etc, pain in toe nails) ?
condition of joints and past history of injury - swollen knee or foot?, stiff or painful hip. knee or foot?; bunions/toe deformities? sensation: painful all the time? pain wakes you at night?, only painful after walking a distance? limp only happens after walking a distance?, any numbness, tingling, where? any shooting, stabbing, 'electric shock type pain? ?pain elsewhere such as lower back, any tenderness, swelling, or pulsation in either groin, behind either knee or in either foot?
function: does the limp limit anything you do such as walking a distance, going up or down stairs, household tasks, past-times?
I assume that both your doctor and physiotherapist did physical examinations including checking for signs of any of the above.
And that I the Xrays/MRI scans were of your lower back and that no blood testing was done?
Did your GP inform as to why he referred your to an orthopod ?
I apologise for the above but hope the answers to some of the questions might help narrow the field of possibilities so that your GP will show more interest and earn his/her keep !!
If you are willing please post your answers to the above. One never knows what may prove to be relevant !! Best Wishes.

 

[Resurgam]

First of all welcome - and gold star for getting past the obstacles, but there are so many unwanted things trawling the internet these days that they are, sadly necessary. Now you are here there is so much useful information and help that I hope you think it worthwhile.
If you ever are on line late at night you might see the many spam messages which come in and are tidied away by the moderators and the senders sent packing, which may help to show just how necessary the precautions are.
When I was diagnosed I had recently been in a confrontation with a maniac in a car, and was using walking poles to get around. I was prescribed Metformin and a statin, and within days found that I was no longer recovering, I was getting worse, with aches and pains, and then the internal unease and worse, and then things began to taste strange, then itching all over began.
After five dreadful weeks I realized that my memory had been affected - so I threw the pills away and felt better quite quickly, but it took a year for the aches in my legs to go completely. My memory has improved too but only after many hours or relearning.
It is probably a good idea to start new threads rather than adding to one which is of some age, so it will be recognized as new person new question and get more responses.

 

[rosco 2]

Welcome! I too found this site a bit tricky to navigate three months ago. In terms of your issue, it really is wood and trees. It’s so tempting for health professionals and ourselves to blame whatever for an issue but it may be completely unrelated. Equally...it may be the cause.
Anyway, persevere with this site, lots of good people with fantastic range of expertise, practical info and support. Today - for example - I used whole milk in my coffee because someone wrote recently it spikes your BG less. I am very sensitive to carbs so this is important for me. Yay!! Two tests each before and 2 hours after a coffee confirm the lack of spike for me.

 

[Guzzler]

Welcome! I too found this site a bit tricky to navigate three months ago. In terms of your issue, it really is wood and trees. It’s so tempting for health professionals and ourselves to blame whatever for an issue but it may be completely unrelated. Equally...it may be the cause.
Anyway, persevere with this site, lots of good people with fantastic range of expertise, practical info and support. Today - for example - I used whole milk in my coffee because someone wrote recently it spikes your BG less. I am very sensitive to carbs so this is important for me. Yay!! Two tests each before and 2 hours after a coffee confirm the lack of spike for me.

Well done! As I have often said, it is sometimes tiny changes that can make a big difference and anything that elicits a big smile is worth a try. Keep it up!

 

[daisy1]

@SheilaSalop

Hello Sheila and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will 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 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
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[Gloucestergirl]

In answer to SheilaSalop, I am 72 but have had Type 2 since 1995, starting on tablets, including Metformin and finally on to insulin. Anyway, I saw a specialist diabetes nurse in May and had shown her my sugar levels over several weeks and thought some were quite high but she surprised me as she was quite happy with them. She said that I shouldn't strive to keep them down to "normal" levels, 4-7 etc. but to not be too concerned if they are higher as, at my age, I didn't need to be so strict and certainly shouldn't go too low. I suppose the thinking is that when you are this old you don't need to worry about damage to your organs as it's more than likely that you already have the damage anyway! The lower levels are more for younger people with a long life before them. She told me to aim for 7-9 before meals and 10-12 after meals and to avoid hypos as they are more concerned with the lows than the highs.

As for Metformin, I was on it for several years, even though I was not and never was overweight it is an appetite suppressant so I never felt hungry. Last year, as an experiment I stopped the tablets for a few days and it was miraculous my appetite came back and made no difference to my sugar levels. What Metformin had done however was to cause a B12 deficiency which was making me very tired so I had to have a course of B12 injections to boost it back up. It's one of the common problems with Metformin. I am still on the insulin but smaller doses, mainly because I have cut down on carbs, although it did make me lose 4kgs which I can't really afford to lose as I only weigh 60kgs.

SheilaSalop also mentioned a limp. I wonder if, at her age, she has been on osteoporosis medication, I say this because older people, especially women are prescribed it to "strengthen" their bones. I was on it for years and after slipping over and breaking my femur four years ago I started investigating the effects of bisphosphonates, the usual treatment for osteoporosis. I was eventually told that the fracture was caused by the osteoporosis medication and to never take it again. It seems that if you get pains or weakness in your leg or legs and/or groin as I had been getting for several months before this could be a lead up to something called an atypical fracture, caused by something as simple as stepping off a kerb or getting up from a chair. It was just a thought that if Sheila is on osteoporosis medication, the limp, especially if with pain or muscle weakness might not be to do with diabetes at all. Sorry if this has been a bit of a ramble but it might be something to think about.

 

[SheilaSalop]

Crickey! Thank you all for your welcome, interest and observations! In answer to some questions: yes I have pins and needles in my feet and a to a lesser degree my hands. I have had my feet checked and they are fine. I have no pain, swelling or abnormality in my feet, hip or legs and have good pain free movement - I just limp! My physio says that this is due to muscle wastage - thus the exercises, which I do daily - but it is very tiring walking so I get around less.
I am pleased with my dropping Hb levels but my GP is worried about my weight loss, I am thinking weight loss is good whilst my 'limp' is so bad - less stress on hips etc?

No I am not on osteo meds although I have a Vitamin D deficiency so I am taking daily supplement. I am now scheduled for a CT scan - this was originally to be of my liver [simple cysts] but the lovely consultant agreed to extend it to my pelvic area cos of my problems walking. It seems to me that it is as important what they don't find as what they do?

I think the GP did an orthopod referral cos she couldn't think of anything else to do and I wouldn't go away! I have not had any nerve conduction tests and I suppose this is the next step but if everything else is clear should I bother using NHS resources to confirm what I think I know ie that is diabetic neuropathy? As, if it is, the only 'treatment' is bringing my Hb levels down further - that is why I have agreed to double the Metformin dose. If anyone thinks differently please let me know.
I think, as Guzzler says, until I find the root cause I can make little progress but I wanted to check in and see what the experts ie users thought. Thank you all again for your very helpful comments and advice.
PS I am sorry I didn't reply to you all earlier - I couldn't find my post!

 

[Guzzler]

Crickey! Thank you all for your welcome, interest and observations! In answer to some questions: yes I have pins and needles in my feet and a to a lesser degree my hands. I have had my feet checked and they are fine. I have no pain, swelling or abnormality in my feet, hip or legs and have good pain free movement - I just limp! My physio says that this is due to muscle wastage - thus the exercises, which I do daily - but it is very tiring walking so I get around less.
I am pleased with my dropping Hb levels but my GP is worried about my weight loss, I am thinking weight loss is good whilst my 'limp' is so bad - less stress on hips etc?

No I am not on osteo meds although I have a Vitamin D deficiency so I am taking daily supplement. I am now scheduled for a CT scan - this was originally to be of my liver [simple cysts] but the lovely consultant agreed to extend it to my pelvic area cos of my problems walking. It seems to me that it is as important what they don't find as what they do?

I think the GP did an orthopod referral cos she couldn't think of anything else to do and I wouldn't go away! I have not had any nerve conduction tests and I suppose this is the next step but if everything else is clear should I bother using NHS resources to confirm what I think I know ie that is diabetic neuropathy? As, if it is, the only 'treatment' is bringing my Hb levels down further - that is why I have agreed to double the Metformin dose. If anyone thinks differently please let me know.
I think, as Guzzler says, until I find the root cause I can make little progress but I wanted to check in and see what the experts ie users thought. Thank you all again for your very helpful comments and advice.
PS I am sorry I didn't reply to you all earlier - I couldn't find my post!

There are two ways to keep an eye on your threads/postings. You could go into your own profile page and click on postings or you could click on the 'Watch Thread' tab which is in red lettering at top right of the page you wish to follow.

Just a word about the physio's mention of muscle wastage. You are most likely aware of this but it is worth repeating, as we age (especially after 50) we become less efficient at metabolising protein which is responsible for muscle growth and repair. A little extra protein in your diet (especially if you can space small amounts out throughout the day) will aid muscular health.

Let's hope your scan reveals all. Good luck.

 

[JohnEGreen]

Yes my grandson keeps saying granddad you don't eat enough protein for some one your age I say gerroutofit you young whippersnapper. But he is right.

 

[Guzzler]

Yes my grandson keeps saying granddad you don't eat enough protein for some one your age I say gerroutofit you young whippersnapper. But he is right.

I am really enjoying the extra protein, who doesn't enjoy the biggest steak in the pack instead of the smallest?