Could it of been diagnosed earlier?

[ElmoreGuy]

Hi All,

I know, it’s late but came home to a letter from my Neuro Consultant to be told I have Diabetes, with a blood count HbA1c of 77. Not sure what that means but I’m a little confused. I’ve recently been seeing a neurologist as it was deemed better than seeing an Endocrinologist for a diagnosis of Hypokalemia that I’ve had for 50 years. Every time I visit the hospital my bloods are taken, that’s 2 to 3 times a year. Is it possible to have this HbA1c indicator missed, it’s not like I’m “Mr Skinny” being 5’ 7” and weighing 196lbs? I imagine that one condition has probably masked the other as I take a diuretic to regulate my Potassium. Getting weak or paralysed is a condition of HypoKPP. Did notice the dry mouth symptom but put it down to snoring. Seeing GP on Friday to go over a diet plan and possible medication. Any suggestions what to ask him and should I ask to be referred back to the Endo Clinic? I’ll keep you posted…

Cheers, G

 

[Paul_]

Hi, welcome to the forum.

For more information on the hba1c test and what your results means, this site provides a good explainer:

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, testing frequency, limitations, control & conversion. How blood glucose levels link to A1c.

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, test frequency, limitations, control, conversion. How blood glucose levels link to A1c.

www.diabetes.co.uk

Your result is definitely diabetic, but comes in the "could be a lot better and needs to be reduced, but could be a lot worse" category in my opinion. Mine was 83 at diagnosis and I've seen accounts of people's being well over 100.

Beyond that, I don't have experience with your specific conditions beyond diabetes, so I'll leave the advice to others around here.

In terms of diabetes, it's possible your previous test results may have been overlooked or misinterpreted, many around here have experienced this. Are you UK based? If so, do you have access to your medical history on the NHS app? This will allow you to look back over every test result you've ever had and will let you see if anything has been missed/overlooked.

You mention dry mouth, however as for whether you should/could have noticed (which I think is what you were implying), maybe, but it's easy to miss and many symptoms are non-specific. Diabetes symptoms can be quite subtle, as yours were, right up until they're not. With the benefit of post-diagnosis hindsight, I had some symptoms for probably 1-2 years. Did I put these down to diabetes? No. Should I have done? Maybe, but they were quite subtle, happened in isolation, and were disconnected from each other over that timeline. It was only in the last 6-8 weeks prior to diagnosis that I had several symptoms hit, all in quick succession, and other explanations become quickly and increasingly improbable. Not everyone gets this path of symptoms though. In short, I wouldn't let it play on your mind. Assuming you're not a doctor yourself, there's little to nothing you personally could have done to spot it earlier.

 

[KennyA]

Hi and welcome.

The first question is when did your blood glucose levels go out of range. The normal range - that is the blood glucose values that almost all non-diabetic people have - is between 38 and 42. The attached graph shows this. Type 2 diabetes will (by fairly recent international agreement) "automatically" be diagnosed with an HbA1c of 48 or above.

The problem is that if your blood was being taken for other purposes nobody was looking at it to answer the question of whether you were diabetic or not. They might have assumed you knew already.

In my case I had a range of diabetic symptoms starting around 2009 or 2010. I went to the GP with them as they occurred - they were fairly classic diabetic symptoms, minus the frequent peeing - instead I had fluid retention because my kidneys wouldn't function. I was told firmly I wasn't diabetic because my blood sugar level wasn't high enough. I accepted that. No-one mentioned it was out of normal range. They on;ly "diagnosed " me as diabetic once I hit the 48 mmol/mol figure, by which time I'd had painful and unnecessary symptoms for about ten years.

Unfortunately the focus on the blood test figure means (in my opinion) that the system sometimes isn't looking at the patient, but at a test result, and missing things as a result.

The good news is that there are things you can do about it. Don't be worried about taking medication for a time, it does help some people enormously. In my casre shifting to a low carbohydrate way of eating reduced my blood glucose very quickly and as it fell my symptoms vanished almost entirely (I seem to have a bit of permanent damage but it's very mild). If you decide to try it there is lots of advice and recommendations on this forum. Have a look at the "Success Stories" section in particular.

Best of luck, ask about anything that isn't clear.