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

Bubbsie said:

I'm not surprised at your doctors comments Lioness...disappointed but not surprised...that is the usual response we get from our health care professionals...with the odd exception...yes you have to make your own mind up about the DESMOND course...with what you know about your diabetes you can compare how you're managing now with what they have to offer...it will be interesting to hear what you think of it...good luck.

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Thanks @Bubbsie I really appreciate your advice and info. So many things to take on board.

SimonCrox said:

Diabetes is a minor risk factor for DVT / PE, so I understand your worry, but I do not think that it is a great problem.
I am not sure if the risk relates to just having diabetes or the glucose control.
I feel that the real question is "Was it one episode of DVT / PE in 2015, or did you have one episode of one and after treatment had another episode?" One episode = one course of anticoagulant; several different episodes = keep on with the anticoagulant until thought to be more risky than good.
Re the new anticoagulants, apixaban is the safest if poor renal function and has good data showing that fewer new clots and fewer bleeds compared to warfarin.
If one bleeds on warfarin, it is easy to reverse with vitamin K. If one bleeds on a new anticoagulant, one would need to give fresh frozen plasma - this is not difficult and is what we used to do if bleeding on warfarin, but does need a drip and takes longer to give. There is an antidote to daba.... but it is expensive and has not been used extensively yet. The real catch is that one cannot measure how much a new anticoagulant is thinning the blood, ie if trying to reverse it, it is difficult to know where one is.
Both my father and grandfather died of PEs, so I have an interest in the topic
best wishes

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Hi @SimonCrox
It was just the one episode of PEs and the DVT, thank goodness. Circumstances. They checked for the usual and also if predisposed, but was all clear. The experience was awful, I'll avoid it again, if possible, at any cost. It was when the Doctor called with the diagnosis and mentioned "thick sugary blood", it set some warning bells off. I'm going to see the Doc again on Monday, armed with a bunch of questions, I'll include this with them as they won't D:dimer test unless there are symptoms. I guess until I'm back in normal glycaemic range I'm just being super cautious. I get the clots back again and it's blood thinners for life. Yikes!

Sorry to hear your Father and Grandfather passed from PEs.

kitedoc said:

I personally would object to a doctor saying blood clots are due to 'thick. sugary blood".
That is a cheap shot at trying to blame the patient for what has happened to them.

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Hiya Kitedoc, it wasnt the clots he was describing when he mentioned the thick sugary blood, it was the diabetes, but that then immediately made me on higher alert as its the same as the bloods when I had the DVT/PE.

SimonCrox said:

Thank you - you are very kind

The D-dimer is not straightforward - if it is negative, then highly unlikely got DVT/PE (but it is possible), and if positive, then may have DVT/PE, but may not. Not sure of your age and what one is taking as D-dimer cut-off; in past, 500 was cut off but it was found that if aged over 50, then age x 10 was better - numerous studies showed that this new higher cut-off did not miss DVT/PE. Anything will raise the d-dimer level, unfortunately.
I am sure that your approach to avoid again is totally sensible eg long flights or if immobile in hospital; I would never be patronising, but this is sensible, not super cautious. My father had one episode of PEs and 10 years later got breathless with nothing to find on examination or chest X-ray - so anyone would suspect and treat PEs, apart from the doctors looking after him. So pays to speak up.
Best wishes

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I definitely learnt my lesson to speak up, originally I knew something wasn't right in my calf and told the doctor that too, but was waved off with a "it's just a muscle pull from your gym work", I told them it was, but they didn't listen. Two weeks later it gets worse to a stabbing pain deep in my calf and I can't walk to the end of the platform after getting off a train (about 20 yards) without gasping for air badly, I knew something was up. I went to the docs had the blood test, went to work, got a call 4hrs later to get to the hospital ASAP. Went in, they scanned my leg, mahoosive femoral blood clot from mid thigh to ankle, lungs partially collapsed but were 'cloudy' on the x-ray so they didn't know the extent of PEs in there because of this *cloudy* nonsense. It was for that reason I researched a good thrombo unit and got myself referred down to London. I won't accept shoddy patient care because we only get once on this earth. I totally relate to your Father's experience, so sad they came back 10yrs on. PEs are horrific. I'm super careful on flights, wear the correct tightness medical stockings and probably a total pain for the person next to me as I wiggle and calf pump throughout the flight, doh! When the Doc told me about T2d diagnosis I did want some clarification on the risk between the two but I'm seeing him tomorrow armed with a bunch of questions, he's going to love that, ha!

SimonCrox said:

Thank you - you are very kind

The D-dimer is not straightforward - if it is negative, then highly unlikely got DVT/PE (but it is possible), and if positive, then may have DVT/PE, but may not. Not sure of your age and what one is taking as D-dimer cut-off; in past, 500 was cut off but it was found that if aged over 50, then age x 10 was better - numerous studies showed that this new higher cut-off did not miss DVT/PE. Anything will raise the d-dimer level, unfortunately.
I am sure that your approach to avoid again is totally sensible eg long flights or if immobile in hospital; I would never be patronising, but this is sensible, not super cautious. My father had one episode of PEs and 10 years later got breathless with nothing to find on examination or chest X-ray - so anyone would suspect and treat PEs, apart from the doctors looking after him. So pays to speak up.
Best wishes

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I definitely learnt my lesson to speak up, originally I knew something wasn't right in my calf and told the doctor that too, but was waved off with a "it's just a muscle pull from your gym work", I told them it wasn't, but they didn't listen. Two weeks later it gets worse to a stabbing pain deep in my calf and I can't walk to the end of the platform after getting off a train (about 20 yards) without gasping for air badly, I knew something was up. I went to the docs had the blood test, went to work, got a call 4hrs later to get to the hospital ASAP. Went in, they scanned my leg, mahoosive femoral blood clot from mid thigh to ankle, lungs partially collapsed but were 'cloudy' on the x-ray so they didn't know the extent of PEs in there because of this *cloudy* nonsense. It was for that reason I researched a good thrombo unit and got myself referred down to London. I won't accept shoddy patient care because we only get once on this earth. I totally relate to your Father's experience, so sad they came back 10yrs on. PEs are horrific. I'm super careful on flights, wear the correct tightness medical stockings and probably a total pain for the person next to me as I wiggle and calf pump throughout the flight, doh! When the Doc told me about T2d diagnosis I did want some clarification on the risk between the two but I'm seeing him tomorrow armed with a bunch of questions, he's going to love that, ha!

Mr_Pot said:

Just a word about thick sticky blood. The normal amount of glucose in the blood of a non diabetic is about 5 grams in the total 5 litres of blood. Imagine a teaspoon of sugar in 5 litres of water. If you are diabetic and have a blood glucose level of say 10mmol/l then that is 2 teaspoons of sugar in 5 litres of water, hardly thick and sticky.

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@Mr_Pot thank you for this! Appreciate it because I've been trying to figure out what actually constitutes as sticky. Good to know this, thank you.

Bluetit1802 said:

I thought a high platelet count is an indicator of blood that is more likely to clot.

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Ahh now that's basically my question to the Doctor tomorrow, I thought that too, but when I got the call with the diagnosis he said the diabetes makes the blood thicker than normal because of the glucose. I asked if that means there's a risk of clots returning and he said there was, eek... I've been reading up on it and I think I need to ask lots of questions tomorrow about this.

Bluetit1802 said:

Do you get print outs of your test results, or see them on-line? Your platelets will show on the full blood count section.

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No details at all, my Doctor called me and just dropped the bombshell, your blood test results came in, your blood count is 49 and that means you're in the clinical diagnosis for diabetes", that's it. I'm seeing him tomorrow, though, and will ask all the questions, and then some..

Bluetit1802 said:

You absolutely MUST ask for a print out of your test results, and at the same time ask if the surgery puts test results on line and how to register for this (if you are in England - all surgeries are supposed to do this.) Blood test results are sooooooo important, and we need to know all the numbers. Not just the odd one or two, or words of wisdom such as "fine" or "a bit high". If the surgery does not put test results on line, the print outs are the next best thing, and you are entitled to them.

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Thanks for this, this is good to know!! (I had no idea they could/should do that!)