Diabetes for the second time

[gillytee31]

I was first diagnosed with diabetes in May 2012 and was almost immediately put on insulin as my diabetes was so badly out of control. Fast forward to October 2019 and my husband after a 1 year battle with stomach cancer. 2 months later I had my annual review at my GPs and bloods were taken. I was shocked to be told that my HbA1c was very low and I had to be taken off all diabetic medication immediately. From then I had no contact with anyone about the diabetews. I felt that there was something going wrong in March 2020 but I just could not get hold hold of my docotor or practice nurse because of the pandemic and because my situation was not considered urgent. Fast forward to May this year and started feeling quite unwell so got in touch with my GP who arranged for a blood test and lo and behold I have diabetes again and was immediately put back on metformin, but was told I did not need to regularly to check my BG levels. My eye specialist arranged for me to have my HbA1c tested at the hospital in July and it was 63. He said it was up to the GP to manage it. The practice nurse phoned me about a week later and said as my HbA1c was 63 which was just within the acceptable limit (apparently that is 63) I should carry on as I am doing. I still have some strips and needles so I can still check my blood levels and they are normally around 13. This is quite a lot higher than when I was on insulin and I do not know if this is anything to worry about. I am due for my annual review in December. Do you think I am safe to wait until then? Any advice or comments would be much appreciated.

 

[jjraak]

@gillytee31

63 HBA1c is high.
And well into diabetic range

& Running at 13 is high too.

A very odd tale, sounds like you may have been let down there.

I wonder if trying LCHF is something you tried before ?

it might be a good thing to try now, if not ..(and your able )

When I got DX (58) it didn't seem to be rush to get treatment started ...but maybe try asking for an earlier appointment & a chance to talk to your doctor about your concerns.

 

[HSSS]

I agree with the above that levels are too high and doing nothing isn’t a good option. 59mmol is usually the point at which they stop calling it well managed. You say 63 in July. What was it back in may? Most of us aim a lot lower than that unless we have specific situations making a higher level more appropriate. Metformin alone is highly unlikely to be enough as it’s a mild medication and it needs lifestyle stand diet changes. Insulin really isn’t the best option for type 2 unless they’ve actually tested to check that you are failing to make insulin (unusual) or there are good reasons other choices aren’t appropriate. Occasionally it’s used short term for very high levels but is then stepped back as control is gained.

What is your plan to manage it now? Are you aware of low carb eating to bring those levels back down?

A few things to note is that your strips are likely out of date and thus unreliable. You need new ones. Ignore the advice not to test as that’s mostly financially driven and they only issue strips to those on insulin and other hypos medications now. A non diabetic will have fingerprick readings under 6mmol fasted and under 7.8mmol at least 90mins after a meal. This is good to aim for ultimately but is likely to be higher until you get it under control.

You say diagnosed again. Once you have diabetes you have it for life. You may have been in remission (normal levels control by lifestyle alone) or maybe although you no longer needed insulin the lack of monitoring means you really have no idea what’s happened in the intervening years. It’s possible your low hba1c back then was artificially lowered by a lot of hypos caused by the insulin. These are reasons you should not be declared “cured” as you still need monitoring for exactly what’s happened to you. Can’t say I think a lot of the care your dr has provided.

 

[Mindini 1964]

Gosh, I agree 63 is high, I first started st 63 and my diabetes team were straight on it. My levels dropped 2 42 over a few years but I'm struggling 2 mainteen. Back up 2 56. I thi k different parts of the country have different views mine say lowest acceptable is 48 but iv read 58 is its confusing

 

[KennyA]

Gosh, I agree 63 is high, I first started st 63 and my diabetes team were straight on it. My levels dropped 2 42 over a few years but I'm struggling 2 mainteen. Back up 2 56. I thi k different parts of the country have different views mine say lowest acceptable is 48 but iv read 58 is its confusing

There's often confusion between what's recommended for T1 and what's appropriate for T2. "Normal", ie non-diabetic, A1c falls within the range 36 to 42 .

As I understand it (not being T1 myself) T1 people can be advised to run with a higher level of BG to avoid the risk of hypo. This is where the 48 figure comes in, and it is also the point at which a diagnosis of T2 would be made (although there is really nothing to stop a diagnosis being made earlier). I had a range of nasty diabetic symptoms well before my BGs reached 48 so I prefer to keep mine on the low side of "normal".

 

[Mindini 1964]

Gosh, I agree 63 is high, I first started st 63 and my diabetes team were straight on it. My levels dropped 2 42 over a few years but I'm struggling 2 mainteen. Back up 2 56. I thi k different parts of the country have different views mine say lowest acceptable is 48 but iv read 58 is its confusing

 

[HSSS]

Gosh, I agree 63 is high, I first started st 63 and my diabetes team were straight on it. My levels dropped 2 42 over a few years but I'm struggling 2 mainteen. Back up 2 56. I thi k different parts of the country have different views mine say lowest acceptable is 48 but iv read 58 is its confusing

48 is the diagnosis level. 58 is what they want you to stay under to be considered well controlled.

Many of us prefer to stay a lot lower than 58, ideally under 48 and even better under the prediabetic level of 42 if that’s possible.