Confused Since Diagnosis

Hi Flora, that does seem a bit odd. Are you getting another HbA1c test to double check? How long have you been on a low carb diet? HbA1c shows average for the last few months so if the diet is fairly recent, that may be why there's a difference. And I'm supposed to be on metformin 500mg three times a day but they said to build it up slowly because a lot of people get side effects like stomach pain and nausea. If you keep having problems, you may need the slow release metformin which is supposed to be a bit easier on the stomach.

Hi @Flora123

Welcome to the forum. Great advice on here so it's great that you've found this forum.

To go straight onto that dose of Metformin is rather unusual, although I am also on that dose. It's more usual, as far as I understand, to begin by taking a much lower dose and then increasing it slowly. It's not unusual for Metformin to cause gastric upsets, pain etc and some people have said how they just haven't been able to tolerate it. Personally, I would be inclined to contact my GP, explain how you are suffering with this medication and tell him/her that you're prepared to take a much reduced dose for now or stop it altogether. Once things have settled down again then, probably the GP would be happy to have you gradually increase, in the hope you can tolerate it. It does, apparently, seem to be a good medication to be on.

As @Brie912 has mentioned, it would be interesting to know how long you have been on low carb foods in relation to when you had your HbA1c done. The big drop could be because of the low carb, if you've started it since the blood test. Alternatively, I would wonder what effect a 'brief run' of high carb foods in your diet may have caused your blood glucose to be particularly raised at that time, reflected in the HbA1c, identifying you as being diabetic but perhaps not as 'severely' as the GP has felt. In that case, when you have a check done, presumably in two or three months, it will be a lot lower.

Well done for realising the advice from the nurse re what foods to eat is not the best advice. Take it with a pinch of salt and continue with your low carb You're doing everything right, it would seem. Also, you've been given a meter and prescribed test strips! That's fantastic so make the most of that.

Sounds to me as if your GP maybe panicked a bit, initially. I've experienced a GP panicking when I had a random blood glucose checked, just off chance, and it was 19.6. I made an appt to see my GP the next morning and, as I was on steroids for Polymyalgia (for the past 3 months) he panicked, had me reduce the Prednisolone from 18mgs/day to zero over 10 days!!! It was not a nice experience, I have to say but I've survived

Anyway, keep posting, reading and asking lots of questions ...

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

Although your dosage is not unusual given your HbA1c people are normally told to take 1 tablet twice per day with meals for the first week then 2 tablets twice per day with meals thereafter.

To clarify, were you asked for a second blood draw which would be A1c tested for confirmation of diagnosis?

Flora123 said:

I do like eggs and have two boiled eggs for breakfast every day but have never liked dairy.

The doctor was shocked when she saw me as with such high readings she was expecting someone with a lot of weight to lose and unfit and not size 10. (Her words) I am struggling coming to terms with everything and can’t help torturing myself with the thought of what have I done to my body that is so awful to cause this. Keep being told it’s lifestyle but I really don’t see mine as that bad. My husband on the other hand.....! Have I abused my body or is it just bad luck?

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It really is just bad luck I think. There are many people walking around obese and abusing their bodies who won’t get diabetes. Then there’s people like you who aren’t the ‘stereotypical diabetic size’ who do. When I was diagnosed I spent a while trying to work out why? However I soon realised there was no point in looking back, I just needed to work with it going forwards.
I’m on Metformin 3 x 500mg/day. I started for a week on one tablet, the next week two and finally three. It gave me an upset stomach for a week or so but I tolerate it well now. It sounds from your levels that you’re doing really well. Keep it up!

@Flora123

Hello Flora 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 want 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 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.
  

Flora123 said:

I do like eggs and have two boiled eggs for breakfast every day but have never liked dairy.

The doctor was shocked when she saw me as with such high readings she was expecting someone with a lot of weight to lose and unfit and not size 10. (Her words) I am struggling coming to terms with everything and can’t help torturing myself with the thought of what have I done to my body that is so awful to cause this. Keep being told it’s lifestyle but I really don’t see mine as that bad. My husband on the other hand.....! Have I abused my body or is it just bad luck?

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I do sympathise. I don’t fit with preconceptions either - not being overweight and being apparently ‘young’ (41 now... but nice to be told that!). And my diet seemed ‘healthy’ - brown bread, veggies, fruit.

My GP does emphasise that diabetes happens to a broad swath of people, or at least he says he does. I was in the waiting room the other day though - the only person there - and he came out, looked around and went back again. He came out a few minutes later and saw me and said “Oh, I didn’t recognize you!”

I suspect he didn’t think I ‘look’ like a person he was about to discuss HBA1C results with...

I have known that my father's mother was diabetic for most of my life, but I just in the last week I have discovered that there are diabetics in my mother's family too - all type two, so I suppose that I was fairly well doomed to be unable to tolerate carbs in any amount. I knew that I needed to eat far fewer carbs than most people in order to control my weight, but that is a dangerous fad diet according to those who think they know about these things. I just hope that this is the last dying throes of that belief.

Resurgam said:

I have known that my father's mother was diabetic for most of my life, but I just in the last week I have discovered that there are diabetics in my mother's family too - all type two, so I suppose that I was fairly well doomed to be unable to tolerate carbs in any amount. I knew that I needed to eat far fewer carbs than most people in order to control my weight, but that is a dangerous fad diet according to those who think they know about these things. I just hope that this is the last dying throes of that belief.

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Was your father's mother T1 or T2? What has your GP done to rule out T1 in you?

EllieM said:

I think that's the normal "full" dosage for T2s, some can go on less. It is a surprise that you weren't told to gradually increase the dose to that level. I went "on" metformin for 2 years for a double blind trial to see whether it helps T1s with artery and eye issues, but was told to increase up to that dose over a period of a couple of weeks. (As it was a double blind trial, I never knew whether I was on metformin or a placebo, but the dosage advice was the same whichever you were on, as the nurse didn't know either.)

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Flora123 said:

I have never been told it can be faulty genetics and that my body can’t tolerate carbs any more. Just that it’s my lifestyle which makes me feel ashamed about this diagnosis. I haven’t told my siblings yet but I guess if it can be down to genetics then I should. Need time before that to come to terms with it myself.

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This article by the respected author Jenny Ruhl might cheer you:
"You Did NOT Eat Your Way to Diabetes!" http://www.phlaunt.com/diabetes/14046739.php

Flora123 said:

Yes that sounds like my experience. I don’t recognise myself at the moment as I’ve lost more weight. At my age 50, I can’t afford to lose too much ball the elasticity is going and I look drawn in the face. Feel my body is falling apart.

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I have unintentionally lot lots of weight, but now I have got used to my new face and even think it may be an improvement on the old one! But even if you can't plump up your face, you can stop your body from falling apart. Resistance training can do wonders for one's physique (I know!) and having more muscle is supposed to help against insulin resistance. Don't worry, the risk of ending up looking like Arnie is non-existent for females (and for non-steroid-dependant males.) Training with weights is also helpful against depression, as is aerobic exercise.