Confusing test result

Ben2694 said:

Hi. I've had a confusing test result from the doctor and can't clarify it until Wed next week. Hoping for some guidance. I have been tested for pre-diabetes for around 10 years and have always been below the threshold. A week after my latest test, and not having been contacted by the GP, I called them. Was told result was Normal - No Action. I asked for the exact number and the receptionists seemed rather vague but intimated a figure of 48 which was shocking as I've never been pre-diabetic to this point. Checking the print out they gave me once more, there appears to be what I believe are 'references' ie the guidance relating to 'Diagnosis of Diabetes Mellitus' which is where the 48 comes from. There is a second section of 'Monitoring of Diabetes Mellitus' with targets etc.
I'm quite anxious about this - am I 'normal no action' or just into the Diabetic range at 48 mmol/mol. I'm wondering whether the actual number was left out in error (there is a random close brackets hanging around in space) or whether you need a deeper level of access to find the number which the receptionist couldn't access. Anybody had this experience? Do these doctor's 'report paths' always contain generic info like the above.

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They should be able to give you the figure and it will be on your records, if you can access them. My guess would be that "normal - no action" means you are still under 48 mmol/mol but your BG may still be far from "normal".

Round about eighteen years ago there was international agreement to standardise the diagnosis of T2 diabetes across health systems. The idea was that while T2 could be diagnosed earlier following symptoms, abnormal HbA1c etc. it was agreed that everyone would automatically classify an Hba1c of 48 or above as T2 diabetes. As I know only too well, you can have quite severe diabetic symptoms at levels well below 48.

48 just happens to equate nicely to 6.5 in the old percentage system and the clinical justification for 48 was that diabetic retinopathy is relatively rare (but not unknown) at levels below 48.

The issue for GPs in the UK is that detecting and diagnosing diabetes is linked to the 48 figure. In other words, the NHS system rewards GPs for diagnosing a patient following a test result of 48 or above, but does not reward a diagnosis of T2 at, say, 44 - even if the patient is symptomatic. The idea of "pre-diabetes" had to be invented to deal with people whose blood glucose was abnormal - that is, above 41 but not yet at 48.

In my opinion it's a good idea to avoid a formal T2 diagnosis if you can - it has an impact on things like insurances and there are all sorts of assumptions that follow. Once properly diagnosed, you can never be "non-diabetic" again. I've had normal blood glucose for six years now and while I've been re-coded as "showing no symptoms" I'm still recorded as being T2 diabetic and always will be.

you can see your test results on the NHS app
everything is displayed on that

Ben2694 said:

Thanks both. I'll wait till Wed to find out the actual 'number' whether 48 or not. I'm just surprised if the figure is 48, and I've never even been pre-diabetic before, that they can put on the test result 'normal - no action required'! But we will see...

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My surgery kept me from being diabetic by not repeating a flagged test for almost 10 years - by which time I was well and truly in the diabetes range.
I have never had any problem with the diagnosis altering anything to do with insurance, it did get me various checks and - had I been younger I would have qualified for free prescriptions.
As you know the problem now it should (with luck and a following wind) be fairly easy to lower your blood glucose and HbA1c to normal numbers with a few small changes, rather than waiting for them to go higher.