Confused With How To Diagnose T2

[gav_red]

Either I am missing something, which is probably the case, or the way t2 is diagnosed doesn't make sense!?

If for example I control my blood glucose through making good choices and get a good hba1c then my doctor would say I'm not diabetic anymore. Surely this is incorrect? My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later. Otherwise you are just measuring someones ability to control their blood glucose.

My apologies if that makes zero sense, still in the early stages of learning about this condition.

Gav

 

[Crocodile]

Either I am missing something, which is probably the case, or the way t2 is diagnosed doesn't make sense!?

If for example I control my blood glucose through making good choices and get a good hba1c then my doctor would say I'm not diabetic anymore. Surely this is incorrect? My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later. Otherwise you are just measuring someones ability to control their blood glucose.

My apologies if that makes zero sense, still in the early stages of learning about this condition.

Gav

It does make sense. Since the remedial protocol for T2 is dietary control and if the patient already does this while returning normal levels, no medical intervention is required until such time that a reading beyond the reference level is returned.

 

[urbanracer]

Either I am missing something, which is probably the case, or the way t2 is diagnosed doesn't make sense!?

If for example I control my blood glucose through making good choices and get a good hba1c then my doctor would say I'm not diabetic anymore. Surely this is incorrect? My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later. Otherwise you are just measuring someones ability to control their blood glucose.

My apologies if that makes zero sense, still in the early stages of learning about this condition.

Gav

I think that you are correct. The idea that one can cure diabetes crops up on the forums every now and then but I think most accept that once a person has become diabetic, reversal is merely a statement related to the level of control. The individual's disposition to return to the diabetic state remains unchanged - you can't go back to the old diet / lifestyle.

 

[kokhongw]

Either I am missing something, which is probably the case, or the way t2 is diagnosed doesn't make sense!?

If for example I control my blood glucose through making good choices and get a good hba1c then my doctor would say I'm not diabetic anymore. Surely this is incorrect? My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later. Otherwise you are just measuring someones ability to control their blood glucose.

My apologies if that makes zero sense, still in the early stages of learning about this condition.

Gav

That is because the current diagnosis guidelines for medical intervention is based on glucose levels, not insulin response or sensitivity.

Essentially the current T2D protocol is treatment to failure, implies increased intervention against progressive failures in glucose control...

 

[Rachox]

My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later.

What you describe here is a glucose tolerance test which some surgeries still use. My surgery only appears to use HbA1c which in my case has remained in the mid 30s since last September, so if a Dr saw my latest HbA1c result would assume I was non diabetic if he didn’t look at my history, present medication or diet.

 

[dbr10]

What you describe here is a glucose tolerance test which some surgeries still use. My surgery only appears to use HbA1c which in my case has remained in the mid 30s since last September, so if a Dr saw my latest HbA1c result would assume I was non diabetic if he didn’t look at my history, present medication or diet.

I was diagnosed with a OGTT. I thought that was definitive.

 

[Rachox]

I was diagnosed with a OGTT. I thought that was definitive.

Oh indeed, I think HbA1c (so long as your red blood cell count is normal) and the GTT are equally valid tests to diagnose.

 

[Bluetit1802]

Oh indeed, I think HbA1c (so long as your red blood cell count is normal) and the GTT are equally valid tests to diagnose.

The problem is, no-one knows how long our red blood cells live, so even on diagnosis the HbA1c can be skewed, and we see many people on here with anaemia and thyroid issues who still have the HbA1c rather than the alternatives.

 

[Rachox]

The problem is, no-one knows how long our red blood cells live, so even on diagnosis the HbA1c can be skewed, and we see many people on here with anaemia and thyroid issues who still have the HbA1c rather than the alternatives.

I think if my HbA1c had been borderline I may well have asked for further investigation, but with a diagnostic HbA1c of 70 and a normal haemoglobin count, I couldn’t really wriggle out of it!

 

[lindisfel]

You right, it doesn't make sense, because by the time your blood glucose rises beyond normal, metabolic syndrome is usually well developed and one's pancreas has cranked up its output so much its crying for mercy and has been for a long time.
Derek

Either I am missing something, which is probably the case, or the way t2 is diagnosed doesn't make sense!?

If for example I control my blood glucose through making good choices and get a good hba1c then my doctor would say I'm not diabetic anymore. Surely this is incorrect? My logic says the way to diagnose someone, regardless of their current hba1c, is to test insulin sensitivity. Perhaps give them a high carb meal and test 2 hours later. Otherwise you are just measuring someones ability to control their blood glucose.

My apologies if that makes zero sense, still in the early stages of learning about this condition.

Gav

 

[ringi]

What is needed is a full 'Kraft GTT' where a GTT is done with both BG inslin levels checked ever 15 mins for 5 hours. But it is costly and never done bymthe NHS for,type2.