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Diabetes T2 and blood clot/DVT/PE (history of)

IronLioness

Well-Known Member
Messages
299
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Routine
Hi all, 1wk into T2 diagnosis, and would be grateful of advice. Just been reading that diabetes increases the risk of blood clots due to thickness/viscosity.

My concern - I've already had a DVT and PEs in 2015, should I be asking my doc to be put back on blood thinners?


My diagnosis result was 49 and my doc said he believes I can get it back down into range with more exercise and diet. I flagged that I've had a blood clot before, I don't want it back, and I was concerned by T2 diagnosis, but he didn't really acknowledge it. I'm trying not to jump on worries, but the clot and PE experience was awful, I would be devastated if the diabetes caused another clot, or worse. I'm not on warfarin anymore - I smashed the blood clot by intense exercise regime in 2015. I don't want it back.

I just don't know how 'thick' the blood gets with diabetes. Just wondering if it might be a good idea to go back onto blood thinners until the 3mth review.....
 

I would definitely talk to your doctor again before making any changes particularly to medication. Hopefully your doctor was just having an off day & will give your concerns the proper attention. If not you could always seek a second opinion.
 
Safi said:
I would definitely talk to your doctor again before making any changes particularly to medication. Hopefully your doctor was just having an off day & will give your concerns the proper attention. If not you could always seek a second opinion.
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Thanks Safi. I had high hopes for my doc, but he was so vague about the specifics, he just kept asking me to ask the questions when I do the Desmond course day. But, I'm in at the surgery tomorrow for a fasted lipid blood test so I'll see if I can see someone then - as the course isn't until end of October and that's too far away.
 
It really is something you'll want to get squared away before you make any major changes. I may be wrong but I think that many of the veg recommended on a low carb diet can be high in Vitamin K (green veg in particular) which I believe needs limiting if you are on blood thinners. I'm really not that familiar with those types of meds & I am definitely not a doctor so I can only reiterate that you shouldn't make any major changes until your doctor has satisfactorily addressed the issue.
 
@IronLioness - It's certainly worth mentioning your concerns to your Doc, however my personal (and I stress the personal) take on such statements is that is it poorly controlled (for whatever reason) diabetes that leads to many of these increased risks. Getting your bloods back into shape really has an impact of reducing the risks of so many complications.

Is it fair to assume that your treatment/active management of your former DVT/PE has ceased, or are you still taking medication on a preventative basis?

I seem to recall @Bubbsie having had a recent clotting event, around the time of her diagnosis, but I could, of course, be misremembering. If she's around, she may have some wisdom to offer you.
 
Hi Iron.ioness I had a DVT way back in 2016 so I appreciate your concerns...it was accompanied by a bout of severe cellulitis...I have no idea which may have influenced which...my diabetes was diagnosed during a routine blood test approximately a month later...part of the problem is your GP may not know enough about blood clots or Warfarin use...that would need a referral to a haematologist...whether diabetes can provoke another DVT may be an issue I cannot say...speak to your GP outline your concerns which should be taken seriously...I take Warfain indefinitely...there is a blood test (sticky blood test) that can be done to assess the risk of a reoccurrence there's no reason why your GP cannot refer you for the test...it would certainly help to put your mind at rest...allay some of your concerns.
 
If you are on medication for a blood clot having too much vitamin K can affect your INR levels...whether it will affect those who are not using blood thinners is another matter & impossible for me to answer...I take Warfarin indefinitely so avoid green leafy vegetables & other foods that counter act with the meds...absolutely right your GP should be consulted before making any major changes...I would go further still & recommend she asks to be referred to a haematologist for a definitive answer.
 

Hi @IronLioness,

Please accept a big hug from me. I can entirely empathize with your concern. Like you, I suffered from DVT and PE in 2015. While in hospital, they also found I had T2 and my blood sugars then were then in 17 mmol plus range.

After having been diagnosed with DVT/PE, I was on blood thinning medication (Elliquis Apixaban) for two years. I have now been off this medication for one year and so far no problems in spite of diabetes. I agree with @DCUKMod that in my mind the danger of blood clots is much increased when your blood sugars are very high. If you keep your blood sugars in the normal range, this danger might not be much higher than for people without diabetes.

Did they test you for a genetic predisposition for thrombosis when they diagnosed you? If not, maybe you could ask for this test. It helped me a bit to put my mind to rest.

If I remember correctly, you said you also have a stressful job. Did you know that chronic stress and increased cortisol levels increase the risk of blood clots also? (A study on people with Cushings syndrome, a disorder where people produce too much cortisol, showed -- if I remember correctly -- that the risk of thrombosis is increased about tenfold) So, it might also help if you can reduce stress a bit (though I realize this is easier said than done.) I also exercise on an elliptical trainer daily, which might help to prevent blood clots from forming.

Other than this, I really think that @Bubbsie gave you some very good advice. Go and see a specialist to assess your risk of another thrombosis.

By the way, the blood thinner they prescribed for me is a little less cumbersome than warfarin. It also has no interaction with foods high in Vit. K2. It is more expensive though, so you might have to make a case for it. In my case, they went for the more expensive medication because of a busy job and irregular work hours.
 
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Thanks Safi. I'm not on any blood thinners anymore, I completely smashed it 9mths after the DVT & PEs were diagnosed. It was just when the doc called to say T2 diagnosis he explained it as "your blood is like sugar, thick and sticky" which immediately rang alarm bells for me, having had exactly that type of blood with the blood clot. I asked if I'm more at risk of them reoccurring, he said yes, but that all questions would be answered in the Desmond course thing ‍ - but, I've been back to Docs today for the lipid fasting blood test and I'm booked in to see him on Monday to ask about the clot danger/no danger.
 
I'm not on blood thinners anymore, thank goodness. But the experience of the original DVT and PEs was so traumatic I'm going to do whatever I need to do to get my blood back into range ASAP to reduce the risk.
 
That's a good idea about the sticky blood test! I'll ask him on Monday about that, if I don't get satisfactory advice I think I'll go back to the haematology team at King's in London. It's where I got myself referred initially as my own medical team (Inc hospital) were awful! Our healthcare patient pathway not quite up to par. This is same team that misdiagnosed my Dad's diabetic foot infection, and he ended up having half a foot amputated! Scary times, so I definitely need to get this right.
 
Hi @ziggy_w

Thanks for the info, and the hug


When I referred myself to King's College Denmark Hill thrombosis unit in London the Proff did a full check on predisposition, Factor V Leiden etc and all were negative, it was purely based on circumstances - higher oestrogen level during period of inactivity, and I was given the all clear 9mths on after dissolving them with warfarin and hardcore exercise.

I did look into Apixaban at the time but I stayed with warfarin (even though strict Vit K monitoring had to be done) I read the NICE clinical guidelines and felt it was my preferred option given the interactions/side effects/risks etc. I'm not a geek it may sound like, but I work for the health service so I know my way around clinical guidance and the system, when it's needed - but apparently I just can't get my own 'house' in order, doh! Although I'm taking this new diagnosis very seriously.

Thank you for the information on cortisol, this is a whole new world to me in terms of how it's potentially an antagonist to SO many conditions, as well as clots and diabetes. Mind blowing how stress can literally make you ill! My job environment is stressful and I think I *really* need to get a handle on it because in the lead up to diagnosis my anxiety was through the roof. It wouldn't surprise me if that played a big part in the diagnosis. I've got an appointment with my doctor on Monday, I'll have a frank conversation with him about the clotting concerns and take it from there. I'll also try and focus on my wellbeing, too, to reduce the stress and anxiety - the cortisol situation definitely needs to change ASAP.
 
If you control your BG levels then your blood should not be thick and sticky.
Being able to make a free choice from low carb veges might be better than taking a medication which is counter indicated because it has the same effect as all the leafy green veges.
 

Really well done on getting rid of the thrombosis within 9 months, @IronLioness. In my case, there are still some remnants (had three-tear DVT), but tests showed left and right legs are now functionally equivalent. I hope continuing the keto woe (-->way of life) combined with exercise will keep improving this.

What are the side effects of Apixaban? Tbh, I didn't know that there were any (other than the chance of excessive bleeding as with any blood thinners). It would definitely have been informative if they had told me.

Good luck with your doctor's appointment. Keeping my fingers crossed.
 
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Speak to your GP & ask for a referral is s/he is unsure...its the safest option.
 
TBH Lioness I wouldn't get too excited about the DESMOND course...I've done one and it was just dreadful...of course you may be one of the lucky ones who gets a 'facilitator' who doesn't follow the standard NHS advice...one that doesn't rely on the notorious 'eat well' plate...you are fortunate that you can come here and ask whatever question is necessary...but the DESMOND course did not deliver what if said on the tin...I started with BG's at 17.4...now I have reasonable management of my diabetes...one recommendation I can make is a book 'Type 2 Diabetes The First Year' by Gretchen Becker...it explains what diabetes is...how/why it develops...the genetic pre-disposition...advises on self monitoring our blood glucose (testing) & so much more...you can preview the book on Amazon before you make a decision to buy it...or you may be able to get it from your library...its the best book I have ever read on T2 diabetes...Gretchen Becker is a type 2 diabetic...like many of us there was little useful information available to her at her diagnosis...it really is well worth reading.
 
Thanks for this, appreciated. I'm just on diet and exercise management for T2 at the moment, hoping to stay off the meds for as long as possible. Good news about the blood viscosity, I know it sounds mad, but it really was a worry, especially as pre experience of the darned blood clot. I'm quite literally researching all low carb veges, and fruit.
 
@ziggy_w it was tough going for those 9mths but soon after diagnosis I researched treatment and then got myself referred to a specialist thrombo unit in London, no faith in my local team from initial treatment and mis-advice (I had a femoral DVT running mid thigh to ankle and also PEs in lungs), so I didn't want to wait around, clots and PEs are nasty things to get wrong.

With the Apixaban, at the time, I chose against it and Rivaroxaban as back then where I live they were 'new' on the market and there wasn't an effective way to stop excessive bleeding if it occurred, and that worried me (bleeding out) because of my job role - I work in events and usually on site so there's a higher risk of things dropping on me, cuts etc, so I chose to stay on Warfarin as wherever I was in the country if anything happened on site it could be handled. But I think that has officially changed now and is in the new guidelines for usage as there's more demand for Riva and Apix because of not needing to go for those darned weekly tests with the yellow book. That, and you can have a Vitamin K party on those thinners and not have worry about the INR count.
 
Thanks for this @Bubbsie I'll check out that book. So I got the Desmond course invite through - 31st October I'm booked in for, but given what you and a few other folk have said I think I'll go, but keep expectations low. To be honest, I've already learnt so much since diagnosis last week from all you fantastic folk on these forums, and the replies to my posts. I'm very grateful to everyone, these forums have been an invaluable resource for a newby! Even today when my Doc called me he didn't understand why I've bought my own BG kit, he said that "just coming back at 3 months would be fine and we'll deal with everything from there" - that blew my mind. In that, I know my diagnosis figure of 49 wasn't super high but in the next 3 months suuuurely a monitor would help a person understand foods, reactions, good bad effect of carbs to try and do what they can with an informed knowledge, rather than 'winging it' ? Seemed quite blasé to me, so I'm glad I got my own kit and I'm really appreciative of this site and the folks on it.
 
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