Contradictory blood results - told take metformin

[Coventina]

Hi! Told yesterday I am to be put on metformin - by a consultant who has not even bothered to meet me! I am so confused upset and depressed. Sorry for long post but has anyone else had similar experiences?
Nurses and docs at GP's have given me contradictory advice and diagnoses for last 18 months.
About a year ago - Nurses say I am Glucose intolerant: (fasting blood test then 2 hours later after glucose drink = 7.1 then 10.1)
Doc said, "You are diabetic".
Nurses said, "We don't think you are."
Doc rings to apologise - no you are not diabetic, there has only been one Hba1c that was over 7.1 so inconclusive.
Most recent fasting blood test (march 12) (after losing 1 stone since begin of Dec 11, and cutting back on wine) = 5.9 (3rd fasting glucose test within that normal range)
Dietician say - excellent - no treatment needed, that's within normal range, keep up with lifestyle changes. The glucose intolerance is well controlled by diet and lifestyle changes alone. Good chance you need not go on to become diabetic.
Nurses (when I went for routine BP check) - As soon as I walked in surgery, nurse pointed to my stomach and said "And you need to lose that"!) No acknoweldgemnt of any self help and positive impact . Was dimissed with the words "You are still glucose intolerant."
End of March 2012 - Hba1c comes back 54 ie 7.1 contradicting the previous week's fasting glucose result of 5.9.
Went to GP about back pain and Doc told me I am diabetic type 2 AND need to be out on medication. No prescription, information or explanation given, I walked out of surgery in a daze then went back and asked the nurses if I could speak to someone about what I had just been told. Nurse said, "NO!" I stood my ground and asked what was going on - after 18 months I want clarity. I was told an appointment would be made for me at the Diabetic clinic where I could speak with a consultant and discuss this in more detail and further tests may be done to find out what is reason for contradictory results.
Yesterday, dietican rang me and read letter from consultant (sent to doc not me!) saying, "That is the problem, trying to diagniose diabetes using different tests. Put her on metfomin 'just to be on safe side."
Dietican brought forward my routine appointment to Mid May. No prescription given and no discussion with me?!!!
I am so upset. And angry. I feel like I am invisible, reduced to a mere number. I have been told I have a potentially dangerous life long condition and told I will be out on meds for life - and dismissed when I ask for information and help! Any advice /views welcome...

 

[Grazer]

Few things here. Your fasting blood tests and the HbA1c aren't contradictory. They are different tests measuring different things. Your results suggest that perhaps you were pre-diabetic (what was called borderline diabetic) and have now tipped in to diabetic. The metformin is not a bad thing; a very safe drug that protects against future cardio vascular disease with no downside apart from perhaps tummy upset for a while until you get used to it. So don't worry about that; take the metformin. It also helps with weight loss. Please don't worry too much. I know it's scary, but it's not actually as bad as you might think!
I'm sure the consultant will clarify things for you. Good news is, that if you ARE diabetic, which it seems you are, it's been caught very early before progressing so you should be able to control it very well on diet and metformin only (without having to use the more complicated diabetic drugs) together with a bit of exercise.
Here's some general advice which might help you to control it:-

In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!

 

[daisy1]

Hi Coventina and welcome to the forum I'm very sorry that you've been messed around so much - it must have been very worrying but at least now you know and can get on with looking after yourself as well as possible. You will find plenty of people here on the forum who can help you through this.

This information should help you to get started:

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.
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Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

 

[Coventina]

Thank you both. I have had more information from you in the last 10 hours than I had from a plethora of primary health care workers in 18 months! Right now I am scared and sad but so relieved to have found this forum.

 

[MaryJ]

Coventina

take your time with it, read everything you can on here. It has a plethara of info and you're right you will learn more about YOUR condition here.

Have you got a meter? if your HCP's didn't give you one try and source one. It's the only way you can take control and know for sure how different foods affect you. It helped me come to terms with it as it was in my control. You get a hgh reading you reduce,eliminate that carb.

Ask as many questions as you like. there is no such thing as a silly question - I bet someone out there wants to know too. And believe me someone on here will have had some experience of it.

Mary