DAILY HOME BLOOD TESTS GOOD FOR 2 YEARS - LAST 2 WEEKS RESULTS MUCH HIGHER - NO CHANGE IN DIET ETC.

Hello All,

I know that the advice about something like this would always be - Ask your Doctor - but I am housebound - have had my Diabetes review blood tests only 2 weeks ago with a good result [45] - so no Doctors review / medication change necessary from that result.

Getting a home visit Doctors appointment is impossible from my Surgery unless you are judged to be seriously ill.

HERE IS MY SITUATION / QUESTIONS:

I was diagnosed with type 2 Diabetes in early 2022 - this was prompted by my Doctors Surgery reviewing blood test results from 2016 which showed that I was in the Pre-Diabetic range - apparently in about 2021 an NHS change in checking people who had previously been in the Pre-Diabetic range caused my Surgery to contact me and suggest that I have blood tests done to check whether I had graduated into the Diabetic range of blood glucose.

Those blood tests showed that I was well into the type 2 Diabetes range - 83 and 9.7% and I was diagnosed as such and prescribed Metformin 1g tablets.

I also drastically reduced my Carbohydrate intake and lost about 20 kilos of weight in about the next 4 months which was obviously good for my Diabetes.

I was given a Blood Glucose Home test kit and I have been using that to take daily blood glucose tests.

For the first year approximately those Home blood tests were almost all in the 4.5 - 5.5 range - and the yearly Diabetes review blood test showed 42 - a massive drop from 83 on the first test that showed that I was type 2 Diabetic.

For the next year / the last year the tests were almost all in the 5 - 5.5 range.

I had my Diabetes review blood tests carried out 14 days ago and the result was 45 - another good result although up from 42 last year - as Members will know that figure is for a different range from my Home Blood Glucose meter tests.

Here the situation that has developed in the last 16 days:

Every day for the last 16 days my Home Blood Glucose test results have been much higher than at any time during the last 2 years:

Here are the results in reverse order the first one being today: 6.2 - 6.6 - 6.6 - 6.6 - 7.2 - 5.9 - 6.4 - 6.9 -8.2 - 6.2 - 7.1 - 6.6 - 6.7 - 7.8 - 7.3 - 6.1.

I know that these are not massively high but they are much higher than the daily tests for about 2 years prior to 16 days ago when this started.

I have been eating the same meals every week for the last 2 years because after finding it quite difficult to decide on meals that I would like and were not as high in carbs as I had previously been eating I then stuck to eating the same ones every week.

I don`t drink alcohol and my sedentary / housebound lifestyle has not changed during the last 2 years.

Have any Members experienced a change / increase in blood glucose like this for seemingly no apparent reason ?

I am wondering whether to try taking a 1.5g dose of Metformin as a trial - assuming that because of the good result showing in the Diabetes review blood test 14 days ago that is what a Doctor would prescribe - I know that Members cannot suggest or agree to that on here.

Something that I noticed at various times during the last year which concerned me was that if I tested 2 hours after eating my dinner in the evening I would get perhaps a 5.2 or 5.5 result but if I then tested the next day before eating or drinking anything except for some water I could get a test result of 6.3 or 6.5 - that could be 15 hours after eating my dinner on the previous evening.

I thought that the highest my Blood glucose should be was at about 2 hours after eating - not 15 or more hours after eating ?

I would really appreciate any comments please.

My Regards,

Chris

Rachox said:

I agree with what @TheSecretCarbAddict above but in addition to that, can you not get a phone appt. with your GP? Also I really would check with your dr before raising the dose of any meds.

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Hello Rachox,

Thanks for your reply - please excuse this long message but I wanted to explain why I will definitely not be able to ask a Doctor about this:

When patients telephone my Doctors Surgery it is a normal situation to be anywhere from 20th to 35th in the queue.

Because of that the waiting time to be able to speak to Reception staff can be up to a ridiculous 2.5 hours - definitely over an hour at best - however very frequently people are cut off after about a hour which as I am sure you can imagine is very frustrating.

When people that I know have been able to get through and speak to the reception staff they have frequently been told that there are no appointments available - their systems do not allow bookings beyond a month into the future and the existing month`s appointments are nearly always fully booked up.

During about the last 4 years for various important reasons I have tried telephoning the Surgery and persevering but having the attitude - You have to wait as long as it takes - I have NEVER been able to even speak to the Reception staff let alone get a Doctors appointment.

During 2022 I was trying to arrange for a home visit to receive a Covid-19 vaccination - not being able to do this by telephoning the Surgery I had to try these forms of communications:

I sent 6 emails - submitted 4 online messages - sent 3 recorded delivery letters - sent 3 special delivery letters those were addressed to the Practice Manager and even submitted a complaint using an official Surgery complaint form addressed F.A.O. the Practice Manager - none of these including the official complaint form which was stated should be acknowledged within 3 working days were ever even acknowledged let alone replied to or my vaccination home visit arranged.

I had to contact my local Healthwatch organisation who then tried to contact the Surgery also without success.

Healthwatch then arranged with another NHS area Health Centre many miles away from where I live to send a member of a Covid-19 vaccination team to visit me at my home - they came from Essex - I live in SE London.

163 days after first contacting my Doctors Surgery I then received a home visit Covid-19 vaccination.

I have only been able to arrange appointments when I have previously been at the Medical Centre having blood tests done or Vaccinations and even then I have sometimes had to accept an appointment with a Physician because there were no Doctor appointments available at all.

Physicians at my Doctors Surgery can carry out Diabetes reviews but ridiculously cannot carry out medication reviews or change medication doses.

Thanks again for your reply.

Chris

TheSecretCarbAddict said:

Your BG can be affected by other factors than just your food intake - stress, sleeping patterns, etc. Is it a new batch of test strips? Maybe that has a different error compared to previous ones.

Has any of the foods you normally buy changed the recipe? I was looking at two identically looking stock cube packages from the same supermarket just now. Even though they are the same product, one had higher carb content than the other.

Higher morning reading could be related to dawn phenomenon where liver releases glucose to get you ready to face the day. This is not directly related to when you last ate, but it relies on energy stores within your liver that will be affected by your eating patterns.

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Hello TheSecretCarbAddict,

Thank you very much for your message and for the information.

I am definitely not trying to contradict anything that you wrote - I am sure that you are correct in some people`s circumstances.

I am almost certain that there have been no major ingredient changes in the food that I have been eating every week for the last 2 years - nothing that could cause quite a big increase in my daily Blood glucose test results.

Nearly all of my meals are meat and salad - for example: Roast gammon slices and a mixed salad - Roast chicken breast fillets and a mixed salad - small Beef Steak and a mixed salad - Omelette and a mixed salad - Roast Pork escollopes and a mixed salad.

The mixed salad is a box of prepared salad from Tesco - Tesco Simple salad - and although there is sometimes a slight change of ingredients that might just be something like the substitution sliced carrot for the sweetcorn - there is usually a small amount of sweetcorn in this salad but I am sure not enough to worry about regarding my blood glucose and I have been eating that most days for the last 2 years when I have been getting the good home blood glucose test results.

Because I am now retired and housebound I don`t have much to worry about except for my health - this situation for example - but I am definitely not under any stresss - I am quite a laid back methodical person who during my work career as an Engineer was used to regularly dealing with situations that could have been very stressful for some people - now that I am retired nothing causes me stress.

I know that this will be impossible to answer:

Regarding what you described about a persons liver releasing glucose to get them ready for the day ahead - I wonder why the ocassions that I mentioned when I had a quite high home test / early / late morning reading of 6.2 or 6.5 would have happened probably only about 30 times in a 2 year period - and far enough apart for me to consider them unusual ?

If my liver was releasing glucose to get me ready for the day would you have expected this to be happening far more frequently than about 30 times in a 2 year period ?

I use a Palmdoc 2 Blood Glucose test meter which I do check regularly with the Test fluid and include a change of needle in the pin prick device for the `check calibration` type test.

The test strips are well within date and I get a new supply regularly on repeat prescription.

Thanks again for your interest and information - I really appreciate it.

Chris

Rachox said:

Wow! What a terrible state of affairs. Sounds like a change of surgery is in order, is that a possibility?

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Hello again Rachox,

What I described is the normal state of affairs for every Surgery / Medical Centre in the Primary Care Trust that covers my area of SE London - I have seen exactly the same kind of complaints / comments on Surgery reviews - online newspaper articles - local area Forums etc.

There have been News articles recently on SE London online newspapers related to similar circumstances one of which where they described with a photo of the queue an example of patients getting so frustrated with the situation that I mentioned that over 40 people recently went and queued up outside Surgery from 7am to go into the Surgery as soon as it opened at 8am only to have only 3 people getting an appointment - "No more appointments available today - come and queue up again tomorrow"- with no doubt the same result !

It was acknowledged by the Surgery when contacted by the online newspaper reporter that the Surgery does not have enough Doctors or Reception / Admin staff so there are not enough appointments available for the patient demand.

So changing my Surgery is not really an option - I could easily be going from very bad to even worse.

Chris

TheSecretCarbAddict said:

@CHRISXX - I had to generalise as I didn't know all your circumstances. It was more - have you thought about these things? Look like you have! While T2 is a defined disease, it is also very individual.

In terms of the dawn phenomenon, I attach a couple of screenshots of my CGM results. Let's start with the one from 21/03. I didn't have any food that day until about 1pm, which represents the second spike. The first one is all liver dumping glucose. And as I had just started low carb then, there was a lot to dump. Let's assume something similar is happening with you. Your fingerprick test represents just one dot on this graph, and depending on timing, it would show very different results. For me, the levels were quite different between me opening my eyes and going downstairs to get some coffee.

Now, the second screenshot shows a more recent trend (don't ask about reds, that's for another post). I still have dawn phenomena, but it is less pronounced as I've cut out lots of carbs. The body still can generate new supplies of glucose to release from protein, for example, but has to work harder at this and therefore spikes less pronounced.
View attachment 67407View attachment 67408

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Hello again TheSecretCarbAddict,

Thanks for your message and for including screenshot showing how the dawn phenomenon affected your blood glucose at those times.

I am obviously much less concerned about the approximately 30 ocassions in the last 2 years that I described as it seeming strange to me to have quite a high morning blood glucose test result than I am about the seemingly unexplainable recent high test results - however those tests have also mainly been during the morning or afternoon and all tests were before eating and drinking except for drinking a glass of water.

This mornings test result at 10am was 6.9.

Because I am a retired Engineer and have been used to dealing with problems on a `cause and effect` basis when I started to get the higher blood test results knowing that there was no change in my diet, medication or lifestyle in general to have caused those higher blood glucose results I became worried.

The fact that the higher home blood test results only started 2 days before my Diabetes review blood tests has meant that because the official tests showed my 3 monthly average blood glucose as 45 there was no need for a Doctors appointment / telephone appointment to be arranged by the Surgery and because of that `official result` there was no need to change my Metformin dose from 1g.

I cannot imagine that the future results of my home blood glucose tests will just revert back to the 5 to 5.5 range that they were at for a year prior to 17 days ago.

There has to be a recent cause for this - I don`t claim to have any medical knowledge but looking at this logically if I am correct about what Metformin actually does my first guess is that the Metformin 1g dose is no longer regulating my insulin production to a level where that is regulating my blood glucose to within the 5 range when tested daily on my Palmdoc 2 blood glucose meter.

But would that possibly mean that my pancreas has stopped producing as much insulin as it has been producing for the previous 2 years and that my Diabetes is getting worse ?

As I described in a lot of detail in my messages replying to Member Rachox it is impossible to arrange Doctors appointments without actually going to the Surgery and that is not possible for me as I am housebound with a severe back problem and problems with both knees.

I was driven to the Medical Centre Blood Clinic 2 weeks ago by a friend who had his first weekday off work in 3 months - it could be another 3 months before his next weekday off - all of my other friends are either also working Monday to Friday / Saturday or are retired and no longer drive so actually being able to go to the Surgery to explain why I need to see or at least speak to a Doctor during a telephone appointment will not be possible.

Even getting a minicab to go there is not viable as because the Surgery / Medical Centre is next to an estate where there are lots of problems and criminal activity you cannot get minicabs to pick you up from there to travel home - the people who could not get cabs to come onto the estate started asking to be picked up from the Medical Centre then when there were problems with them the minicab companies refused to send cabs there which caused problems for legitimate Surgery patients like me who needed cabs.

Wait and return bookings are not really viable either unless you are prepared to pay as much or more than the actual fare for the waiting time because there is always a queue of lots of people waiting to see a receptionist - you could be queueing for reception staff for longer than it takes when you have an appointment - are waiting to see a Doctor and are in the room with them.

Sorry for the very long message.

I mentioned the additional details [more than I described to Member Rachox] about problems getting to see or speak to a Doctor so that Members could see that suggesting a Doctors appointment in my case cannot be achieved in the near future unless the blood glucose test results get worse and then I will have to try and arrange to go to the Surgery just to try and get an appointment and then have to arrange to be transported there again for the appointment unless it is a telephone consultation.


Thanks again for your interest and for your messages I really appreciate it.

Chris

JoKalsbeek said:

Hi Chris,

Pretty much everyone gets liver dumps in the morning, -diabetics and non-diabetics alike- the question is how much... Yours have been low throughout, and anything could cause a rise. Maybe you used a different hand soap and it skewed the results (some foamy soaps do). Maybe you had a nightmare, maybe you got up for a nightly wee, maybe you were on other medication... I mean, I know there's been shortages here, dunno about the UK, but sometimes I get a different brand than my usual, and even that can affect things, especially when its about steroids or statins etc. It doesn't have to be food or stress. It could even be a barely noticeable case of the sniffles. If none of that rings a bell, well... Maybe give yourself a little time to see whether the trend continues, or whether it backs down again. Two weeks, when possible culprits can take a while to abate, is a little short to draw conclusions from; you likely need more data.

And yeah, we always say see a GP or contact the nurse etc. Don't change anything on your own, you know the drill.

When it comes down to it though, it is your body. And you're testing sensibly, so if anything goes wrong, you'd know. Not a recommendation, just an observation. Not something I can advise within the parameters of our forum rules, but just something to, maybe, privately contemplate.... But again, whatever happens next, I personally would gather at least 2 weeks more data before any changes...

Good luck!
Jo

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Hello Jo,

Thanks for your message and for some suggestions.

Can you please also see my very long reply to Member TheSecretCarbAddict so that I don`t have to repeat stuff.

I really have thought about any changes that might have caused the recent higher blood glucose test results without anything except the Metformin 1g dose no longer being enough coming to mind.

But as I wrote in my previous message to Member TheSecretCarbAddict would that possibly mean that my pancreas has stopped producing as much insulin as it has been producing for the previous 2 years and that my Diabetes is getting worse ?

I am on a Statin 20mg dose but I have been taking them for about 15 years.

I do have to get up every night to use the toilet but that is because I have an undiagnosed dehydration problem - nothing to do with my Diabetes and not Diabetes Insipidus - blood and urine tests could not identify the problem which was so bad 2 years ago I was drinking 6 or 7 litres of water per day - I have reduced that to about 4 litres per 18 hour day to try and keep hydrated but that does mean I have to wake up frequently to use the toilet - that has been the situation for about 2.5 years so nothing new.

The Hand wash liquid that I use has been the same one for about 5 years and I do ensure that I rinse it off well just before doing the finger prick blood tests.

Thanks again for your interest and suggestions Jo I really appreciate it.

Chris

Hopeful34 said:

Hi @CHRISXX Is your surgery open late, ie till 6.30pm or 8pm any evening or any Saturday mornings, when one of your friends could go straight from work to your surgery and phone you when they are near the front of the queue to see the receptionist, and you could speak to the receptionist that way? Or early morning before they go to work?

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Hello Hopeful34,

Thanks for your message.

The Surgery is not open after 6pm and none of my friends get home from work until well after 7pm / 7:30pm and as most work in the Construction industry all over London and the surrounding counties most of them leave home not much after 6am depending upon how far away they are working.

On a Saturday morning they only see patients who have somehow managed to book `emergency appointments` - there is an intercom at the Medical Centre front door where patients who have a booked emergency appointment have to give their name to be checked on a list before being even let in the door.

It literally is the situation where if your name is not on the appointments list they will not let you in the front door whatever the reason for your visit - there is a sign on the door surround giving the telephone number for an `Out of hours Emergency Doctor Service` and they will point that out abruptly to people that they will not let in.

I have actually tried going there on a Saturday morning quite a while ago and experienced exactly that and have since heard the same thing from some of my neighbours who tried to just speak to the reception staff on a Saturday morning - "Your name is not on the appointments list so you cannot come in" - no exceptions made.

Thanks for your suggestion.

Chris

TheSecretCarbAddict said:

Metformin doesn't actually stimulate increased insulin production. What it does is reduce the amount of glucose released by the liver and improve how cells absorb glucose, improving efficiency of the insulin that is produced.

I'm on the opposite journey to you... until about 3 weeks ago, I was maxed out on all oral diabetes medication. By making quite radical lifestyle changes (going very low carb and doing time restricted eating / intrmittent fasting) over the last 8 weeks, I'm now off two diabetes meds and my blood pressure tablets. In due course, I am also hoping to get Metformin reduced or removed, but that will be the last to go if at all.

Also, while an increase in your normal levels can be worrying, this needs to also be looked in a wider context. One of my non-diabetic relatives wore CGM out of interest, and their average blood glucose level was 6.2mmol/L. I don't have their HbA1c to tell you how this translates, but I found it an interesting piece of information in terms of my own diabetes management.

But as I said above, T2 is quite individual, and you need to see what works for you.

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Hello again TheSecretCarbAddict,

Thanks for explaining about Metformin reducing the amount of glucose being produced by the liver - I don`t know how I got the idea that it worked by increasing insulin production from my pancreas - I wonder if my liver has started to produce more glucose than the Metformin 1g dose can reduce ?

When I had my Diabetes review blood tests I also had Full Blood Count tests which included liver function - that specific test showed `Normal` function / within the normal range - I wonder if a recent increase in glucose production just 2 days before the test would have shown up ?

I was able to view all of the Blood tests results using my Patient Access account - there were loads of items that I had no idea what they were but all of those and the main recognisable items such as Liver function were all within the normal ranges except for my Diabetes review blood test where my blood glucose over the previous 3 month period was above the normal range of up to 41 at 45.

Regarding changing diet etc. - when I was diagnosed with type 2 Diabetes in early 2022 I changed all of my meals to much lower carb dinners - I have always only eaten once a day - dinner in the evenings - but I had been eating 350+ grams of carbs per day and drinking 3 or 4 300ml mugs of Latte made from powdered latte sachets and skimmed milk probably adding up to another 150g of carbs per day = 500g !

Changing my meals to what I described in a previous message to you and changing the Latte to a lower carb version made with hot water instead of skimmed milk caused me to lose about 20 kilos in about 4 months which drastically reduced my next Diabetes review blood test result from 83 down to 42.

Thanks again for your interest, knowledge and messages - I know that I will not be able to get anywhere with this without actually consulting a Doctor but that is going to be a big problem for me.

Chris

P.S: I am not receiving any Forum reply notification emails when there are replies to this thread and I cannot see any `Settings` menu so that I can check whether that is enabled - do you or any other Members know how to enable the reply notification emails please ?

Rachox said:

First you need to click on your profile pic, circled in green here:

View attachment 67415

Then select preferences, circled here in red:

View attachment 67416

Then choose what you’d like here, circled in red:

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Hello again Rachox,

Thank you very much for taking me through the process to enable reply notification emails.

I cannot believe that I somehow missed the Preferences option when I did look at my Profile somehow I must not have seen the full list of options although just looking a moment ago I don`t know how that happened - Sorry.

I definitely did have these notification emails enabled when I was using the Forum in 2022 and I was receiving them for my threads / questions during that time - perhaps during my lack of activity on here there has been some kind of Forum update that automatically disabled them ?

Thanks again.

My Regards, Chris

JoKalsbeek said:

Well, as you've already found out, metformin doesn't do anything about your insulin-output. A T2 is usually high in insulin, just insensitive to it. Metformin makes you a little more sensitive to it and it tells your liver not to dump so much glucose. It's more likely your output is still the same, as you're not on any medication that forces your pancreas to put out more, which can eventually tire it out. It could be your sensitivity is impaired more than it was, the statin might be affecting your blood glucose more than it was. I mean, our bodies don't stay the same all the time, (in)sensitivities, hormones, our response to certain meds, things can vary over the years. I mean, 5 years ago I would've been rid of the comfort-eating kilo's I put on after my mom passed in no time flat, just by getting back on the low carb wagon. Now they're on, and they don't seem to be going anywhere. Thanks, menopause. So it could well be you might need to tweak your diet some to accommodate changes in your body as you age, or as you're on certain meds for a longer period of time. Leave the sweet corn for instance.

I appreciate it's next to impossible to get proper medical help these days, but for the moment, your blood sugars aren't dramatically worse from where they were. So a slight tweak might be all you need. You might not know exactly why things have changed, and whether that change is permanent, but you do know you can lower your carb intake further to accommodate whatever is happening elsewhere to make your blood glucose go up a bit. Don't look at the unknowns and things you can't do anything about, but tackle the stuff you can identify and tackle.

Good luck!
Jo

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Hello again Jo,

Thanks for your message and for describing some changes that happened to you in previous years.

I do know that our bodies can develop changes as we age and that some of our organs for example Liver, Thyroid, Pancreas and others can develop problems which could then affect things like glucose production - certain hormones production - insulin production and I am sure many other factors affecting the `ingredients` in our blood.

What has me concerned is that the rise in my blood glucose did not gradually rise up to the levels that I listed in my original message on this thread it was an instant situation - as if a switch had been turned on somehow releasing more glucose into my blood from 18 days ago onwards.

I know that as you mentioned most of the test results that I listed are not massively higher than the 5 - 5.5 daily averages that I described as having been the results for about a year prior to the 13th April - but some i.e. 8.2 - 7.8 - 7.2 & 6.9 are much higher than those in the 5 range and I wonder why the instant rise ?

My blood glucose test result today was 7.2 at about 12 noon - yesterday 6.9 at 10am.

Here are my results for the week begining Monday 1st April: 5.2 - 5.6 - 5.3 - 5.3 - 5.0 - 5.4 - 5.2

Here are my results for the week beginning Monday 8th April: 5.4 - 5.3 - 5.0 - 5.4 - 5.1 - 6.1 - 7.3

Here are my more recent higher blood glucose test results in reverse order starting Today:

7.2 - 6.9 - 6.2 - 6.6 - 6.6 - 6.6 - 7.2 - 5.9 - 6.4 - 6.9 -8.2 - 6.2 - 7.1 - 6.6 - 6.7 - 7.8

It is as if a switch was turned on on the 13th April causing something in my body to be changed which immediately raised the glucose level in my blood / caused my Diabetes to get worse ?

I really don`t know how I could have any different meals that were lower in carbs than those that I listed in a previous message - all meat and salad - when I mentioned the small amount of sweetcorn that is in the Tesco Simple salad - there would not be enough to heap fill a desert spoon and that amount gets divided roughly with half of the salad in the box for 2 meals.

Thanks again Jo for your interest and information / advice I really appreciate your very nice messages.

Chris