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Confused

nicnak1

Member
Messages
5
Hi
3 weeks ago I did a fasting glucose test that came back at 14.3. My doctor rang me, asked me to come see him as a matter of urgency. So off I went, really worried. Doctor told me that he was sure I had type two, but wanted to do a glucose intolerance first. He gave me a glucose monitering kit, told me to test my blood every day, and make an appointment for the glucose intolerance test. I could not make an appointment until today (3 weeks later). I have been testing my blood every day, the lowest it has been is 12.9, the highest, 22. I am really worrried, as the doctor does not seem to be taking it seriously. Is this approach normal? is there anything I can do?
 
Well you won't know for sure until you get your test results, but it sounds to be that you've caught the old T2 diabetes. Welcome to the club.

I realise that it's not ideal, but when it comes down to it, it doesn't really matter if your Doctor is taking you seriously or not. If you want to get better (and stay better), it's going to be up to you to take control of your diabetes.

Once you are diagnosed, the following things will probably happen:
1) Your Doctor will stick you on Metformin, which will upset your stomach for a bit, and knock your BG levels by a point or two. Stick with it, Metformin isn't a magic bullet but it has lots of beneficial side effects.
2) You will ask your Doctor for a BG Testing Meter and strips and he will probably refuse and might even tell you that you shouldn't be testing. Ignore her (or him)* and go and buy one yourself and start testing. Understanding how what you eat influences your BG is the most important step in controlling your Diabetes.
3) (After several months) of waiting you will be sent to a dietician who will tell you to each lots of starchy carbs with every meal. Ignore him (or her)* and do your own research. Read this forum and (at least) books by Bernstein, Jenny Ruhl and Gary Taubes and work out which dietry approach is the best for you. It could be Low-Carb-High-Fat, it could be Moderate-Carb-Low-Fat, it could be Low-GI, the important thing is that you do your own research and come to your own conclusion.

*Obviously you should think very carefully before ignoring any medical advice, but reading around here will show you that the approach described in the default NHS advice is necessarily the easiest way to diabetic control.
 
Thanks for your quick reply
I have been lucky enough for my doctor to prescribe me a testing kit and strips etc....he said he wanted me to test myself everyday. What was worrying me was the high results! And to be honest, I could not see the point of doing a glucose intolerance test when my bs is that high anyway! The doctor I saw about my blood pressure said that if i loose a stone, it might make my bs come down naturally. In your experience does weight loss have that much impact?
 
Hi Nicnak1

Welcome to the forum. I have always found it a great place to be with members who can give support, knowledge and advice.

I am at a loss to understand why he referred you for a Glucose Tolerance Test (GTT) given your high fasting glucose result. I would have thought a confirmatory fasting blood glucose test would have been sufficient although I was diagnosed with just one fasting blood sugar test of only 12.1 Perhaps there are other reasons he felt a GTT was necessary as it is usual for it to be used only in cases of doubt, The following is from the Netdoctor website:

"How is a diagnosis made?
Type 2 traits

People with Type 2 diabetes often have:

a family history of diabetes
obesity
increased blood pressure
premature vascular problems such as heart attacks and stroke
raised level of triglyceride (a type of fat) in the blood
impotence (erectile dysfunction).

Glucose levels are measured in blood samples. This is done using the following tests:

random glucose test: glucose levels are taken at a random time on two occasions. Any figure above 11.1mmol/l is a diagnosis of diabetes
fasting glucose test: the glucose level is measured after an overnight fast and on two different days. Above 7.0mmol/l is a diagnosis of diabetes.

You may only need to give one blood sample if you have other symptoms of diabetes.
Glucose tolerance test

If the diagnosis is still unclear from these tests, a glucose tolerance test can be carried out."


On the weight loss issue, losing weight may have a beneficial effect on insulin sensitivity and improve your blood sugar readings.

Regards

Doug
 
Nic,

Then you've been luckier than most (and maybe your Doctor isn't a laissez-faire as you think).

Losing weight is always going to be good for your health and will help control your BG in the long term. However, losing weight is usually a very difficult a laborious process. Properly losing a stone or two is going to take you at least a few months.

In the short term you're going to have to get your BG level down by carb-counting. That doesn't necessarily mean "low-carbing", but you need to identify the carbohydrates in your diet and work out which ones you are prepared to cut out. Your meter will tell you how successfully you are doing this.

First step is getting your BG below 10mmol/l all of the time. Once you've done that, you can work out how to get them below 7mmol/l most of the time.

Whether you end up taking more drugs or not, you'll do yourself a big favour by putting a big dent in your BG readings by sorting out your diet.

Good luck. We'll be here to help you.
 
Thanks Borofergie for your rely

Although I know what your saying is true about watching the amount of carbs, I am still not convinced. The lowest bs reading I have had is 12.9 and that was when I hadn't eaten for 18 hours...night flight and a long journey back from the airport! If carbs play such an important part, why wasn't my bs reading lower? I am so confused, nothing makes sense
 
Osidge, your reply makes me even more concerned...
mum and grandma had diabetes
mum had cardiac arrest and died at 44 (I am 40)
dad had stroke and died at 58
I am 2 stone overweight
eeekkk. My doctor knows all this, and still no sense of urgency
 
Sorry to make you more concerned. You can have high blood sugar readings without carbs as your liver can dump glucose into your system when it detects that you are not getting it from diet. This often happens first thing in the morning but can happen at other times.

You will have had your GTT by now so the results should not be too long in being with your GP. In the meantime try to adopt a healthy diet and get some exercise. Both of those will help your blood sugars and vascular health in the long run.

When you next see your doctor, and given your family history, he will no doubt want to ensure that your cholesterol, triglycerides and blood pressure are OK. The drug metformin was mentioned earlier on. It is a usual first choice of medication and also has a beneficial effect on the heart ( http://en.wikipedia.org/wiki/Metformin ).

Above all, try not to worry and to keep your stress levels down.

Take care

Doug
 
Hi nicnak and welcome to the forum :) In case you're diagnosed with diabetes, here is some general information which will help you to look after your health. If you are not diabetic, in view of your family history, this information will still be useful to you to help you get your blood sugars down and to avoid progression to diabetes. This information was written for new members. Ask as many questions as you like as there is always someone here to help as you have already seen.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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.
 
nicnak1 said:
Although I know what your saying is true about watching the amount of carbs, I am still not convinced. The lowest bs reading I have had is 12.9 and that was when I hadn't eaten for 18 hours...night flight and a long journey back from the airport! If carbs play such an important part, why wasn't my bs reading lower? I am so confused, nothing makes sense

Because you are showing classic signs of insulin resistance: it takes a little while for your liver to respond to the carb restriction, and even longer before you clear the surplus glucose in your blood.

borofergie said:
When I was first diagnosed, it took me 12 days of low-carbing to get my levels down from 24.4 mmol/l to less than 7 mmol/l, and an additional 3 days before it stayed there for any period of time. (by low carb I mean <30g a day, although in the first week or so I was struggling to work out exactly what a carb was).

As Daisy says above, (almost) all carbohydrate turns to glucose in your blood, so reducing carbs is the most obvious way of getting your BG readings down.I'm not saying that you have to commit yourself to a low-carb diet forever (although you will probably will be stuck with "lower" carb diet), but things start to get a lot easier once you get your BG levels below 10mmol/l.

nicnak1 said:
Osidge, your reply makes me even more concerned...
mum and grandma had diabetes
mum had cardiac arrest and died at 44 (I am 40)
dad had stroke and died at 58
I am 2 stone overweight
eeekkk. My doctor knows all this, and still no sense of urgency

Well that should be your motivation, but when you get this under control, you don't have to worry about complications.
 
I think your doctor is taking you seriously by giving you a meter and asking you to test yourself; this is a very rare event! Hopefully with your reading and the GTT etc your GP will prescribe the appropriate tablets and as some one has suggested it will probably be Metformin to start with. If the standard Metformin gives stomach problems that don't go away then ask for Metformin SR, the slow release version. It is of course always possible that you have one of the diabetes variants and need a different approach but your GP should handle this with the readings. At my diagnosis 7 years back my BS was as high as yours and it did take several weeks to drop back, so give it time. Do take notice of the advice to keep your carbs under control but the good news is you can have fats and protein in sensible quantities with no problem; preferably unsaturated fats when you can.
 
Thankyou so much for all who have replied
I went to the Dr's today, and he put me on Metformin 500mg twice a day...also had high cholestoral so am now taking Simvastatin 40mg too!

Okay...so I am supposed to go on a diet. I was thinking I would follow a slimming world diet as I know what this entails and it has worked for me in the past.

Has anyone any advice regarding diet other than in the diet sheet the doctor gave me? What side effects may I expect from taking Metaformin?
 
Hi nicnak :) Metformin is well known for causing stomach cramps and upset. To avoid this you need to make sure you take your tablets with a meal, not before or after. If you still get these effects you can ask your doctor for the ER or SR (extended or slow release) which is usually kinder to the stomach. Metformin usually only lowers levels by 1-2 mmol/l but decreases insulin resistance.
 
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