Diabetic Or Not, That Is The Question?!!!

What was /is your hba1c value? Do you test your blood sugars?

If you were ‘just diabetic’ on diagnosis and you’ve been taking Metformin and losing weight you could well have lowered your HbA1c into the non diabetic range, but in my opinion you have potential to creep back into the diabetic range. As @Diakat says you need to find out your HbA1c results to really judge how you’re doing.
In May ‘17 I was well into the diabetic range on diagnosis. I took Metformin, lost weight on a low carbohydrate diet, which I maintain still and have kept my HbA1cs in a non diabetic range for a year, it doesn’t mean I’m not diabetic anymore though, just well controlled.

Hi @Katy Bear

Your initial hba1c result was confirmation you were just diabetic. Anything over 47 mmol/lol is classed as diabetic. I would ask you practice for confirmation of what your figure was and what were your hba1c results each year to see exactly what they were to give you a bigger pictures, especially your current one. Pre diabetes is between 42 and 47 mmol. So if you were only just diabetic (say 48 mmol for example) and are now 47 (in the prediabetic range) it's a fractional move. Although the gap could of course be much wider. Once diagnosed you go on a diabetic register. Once a year you have eye tests and feet examinations. Did you have these? Most Drs won't take you off this register and you would always be classed as diabetic for this reason, even if you get into non diabetic levels. They just class you as a well controlled diabetic. That said I do know a couple of doctors that have taken diabetics off the register (from reading this forum). But as @Rachox says it could creep back into the diabetic range quite easily.

Many of us on the forum have reduced our hba1c into non diabetic range and effectively put it into remission. You can see stats on people's journeys in their signature boxes under their comments. For example I was diagnosed at 62mmol. Last Dec. My latest result is 41 (this May) which is classed as non diabetic level. But I know if I introduce bread pasta rice potatoes cereal into my diet I would go back to square one. I refused medication at the outset and will continue to do so until I think it's necessary. I am hoping to always control it with diet. My monitor was my greatest investment. It tells me what spikes my blood sugar and then I can reduce or eliminate from my diet. You can get some free but have to pay for strips although some Drs will give to pts on metformin it's very rare. It was a massive learning curve and took me a good few months to get my head around it. I do have the odd treat but limit myself as I want to remain.medication free.

I wonder if you changed your diet at all? It may all be down to the metformin if you didn't. You have gone into the prediabetic range so that's great. If you aren't on a lower carb diet already this would help you get into non diabetic range very quickly in my opinion.

You really need to contact your surgery and ask for all your HbA1c results from when you were first diagnosed. Without this information, and because you chose to follow the (incorrect) advice of your first nurse not to test, you have been working blind for 5 years. Your surgery will give you these figures.

Katy Bear said:

I have never checked my blood sugar as the first practice nurse I saw in 2013, said I didn't need to!!!

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Not the best advice being handed out. That would mean that if you made changes to diet and/or exercise, you wouldn't have a clue about whether you were doing the right thing or not, until you had an HbA1c. That could be a whole year with poor BG control affecting everything that poor BG control affects. Almost any part of your body can be harmed by too much sugar. Damaged blood vessels cause problems such as:

• Kidney disease or kidney failure, requiring dialysis
• Strokes
• Heart attacks
• Vision loss or blindness
• Weakened immune system, with a greater risk of infections
• Erectile dysfunction
• Nerve damage, also called neuropathy, that causes tingling, pain, or less sensation in your feet, legs, and hands
• Poor circulation to the legs and feet
• Slow wound-healing and the potential for amputation in rare cases

Not to be taken lightly. I'm surprised that medical people don't see the logic behind monitoring BG. I wonder if it's to discourage people from asking for monitors and test strips on prescription.

I find it interesting to see what is no longer in the nice guidelines that used to be there such as

Self-monitoring of plasma glucose should
be available:
 to those on insulin treatment
 to those on oral glucose-lowering
medications to provide information on
hypoglycaemia
 to assess changes in glucose control
resulting from medications and
lifestyle changes

 to monitor changes during
intercurrent illness
 to ensure safety during activities,
including driving.

Katy Bear said:

I was diagnosed with Type 2 diabetes in August 2013 when the practice nurse told me I was 'just' diabetic!! Prescribed Metformin 500 mg tablets 3 times daily which I've taken since then. I had a blood test some 3 weeks ago for my yearly review, saw a new practice nurse on Tuesday and was told I didn't have diabetes but that I am actually pre-diabetic!! I'm just wondering how can this be??!! Was I ever diabetic or have I been taking these tablets for 5 years for nothing?!! I've lost a stone and a half in the last 18 months. Any advice gratefully received please?!! Thanks!!

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Valid good question. I was in same situation was I Diabetic or Pre??? was the question exactly.

Not a doc, just a suggestion box, based on fact, I had an error lab A1C that indicated Diabetic and told to convince myself I was diabetic,even though I argued /questioned there was discordant results asking for immediate second test,I only had one A1C which would have clarified my concerns as if two were on par over the cut off or over, it would have allowed label accordingly, and clarified discordant situation, it was refused, so, for 3 months I was under impression I was diabetic, finally after repeated requests, I got 2nd A1C, pre diabetic, search done same time my request first A1C test,and yes lab error typographic error resulting, I as not diabetic, was Pre Diabetic from onset, pre diabetic the 2nd A1C test.

perhaps depending on info you know about your diagnosis? why dont you go back to the date you were diagnosed as the nurse, doctor whoever, as they to indepth explanation, ask what the actual result level was if it was an A1C test you had, if you are not aware, they based diagnosed Diabetic that warranted immediate metformin?, also, you may wish to ask what the average equivalent sugars were on the result of A1C to see if any discordancy?

Current test, Ask nurse also to clarify, why there is a difference between first diagnosis, and new diagnosis? i.e. due to medications, or other, also ask if you dont know what the recent test A1C level was, that indicates difference of diagnosis, relating to her confidence stating "your not diabetic, by saying that is she indicating your first test may have been wrong, or meaning referring, Metformin has changed a diabetic status of first test, to now pre? there may be something on your records, unbeknown to yourself, that the nurse may be aware of shows, that could explain how is she in position to inform and know this? perhaps some direct questions asking to obtain, clear answers and information would help clarify your question overall hopefully.

Just a suggestion box idea, it depends how much info you have re your tests previous and level and differences of diagnosis of course, as well? Questions it seems definitely required to clarify situation for peace of mind?

Do not forget the cut off between diabetic and prediabetic is man made decided on by committee and arbitrary and I don't think nature makes such fine distinctions.

I was thinking, dangerous I know. Diabetic or pre-diabetic, would my actions, if I was now given either of those diagnoses, be any different? For me the answer is NO! I wish I'd had the opportunity to change my dietary regime at a pre diabetic diagnosis rather than 15+ years after a diagnosis of diabetic and being told not to cut my carbs. Especially as I had made a deliberate point of asking if I should cut my carbs. As Rod Stewart might say "I wish that I knew then, what I know now, now that I'm older".

Many years ago I attended a Herbalife talk and one of the speakers was talking about a lady who was "slightly" diabetic. I gave the speaker just a little bit of grief (Can you be slightly pregnant? Have a slightly broken leg?) You are either diabetic or you're not. I realise that "slightly" diabetic is now called pre-diabetic but it's still diabetes, just that it hasn't progressed. It is still a sign that something isn't quite what it should be. Maybe too much carbs for the body to cope with, maybe insulin resistance, possibly a pancreas not producing "normal" amounts of insulin.

Katy Bear said:

told I didn't have diabetes but that I am actually pre-diabetic!!

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Diabetic or not? A Sober alcoholic is still an alcoholic.

This term of pre-diabetic can be miss leading, in one country its this number and in another country it's that number and not all countries use the same number scale.

Diabetes is a long-term metabolic disorder which was thought of until recently as a progressive disorder. It could and would only get worse. In those terms pre-Diabetic is a cut of point that can be used to with hold medication or care. Not some scientific marker to describe if you are ill depending on which side of the line in the sand you are on.

Now days Pre-Diabetic can be though of as a warning sign of safety buffer instead of the pre cursor for the inevitable progression to Diabetes.

Just to add re self testing, I purchased my accu check when diagnosed 2 years ago and it came with a slip to give to GP for testing strips, lancets and sharps box. Mr GP added them to my very long list of prescriptions. I've had no trouble getting the items. My GP also told me LCHF was the way to go, I have a bliod test every three months, appointment to see GP in week following test, 6 monthly see the practice nurse for check up. Plus annual foot check and diabetic eye test all done in the surgery. Perhaps here in Norfolk our GPs are more up to date? It's not a new thing either as my late Mother was also type two and always got lancets and tests tips on prescription. She was diagnosed back in 1980.
Reading the comments feel very lucky to have excellent.GP!

I am surprised they just dumped you on that much Metformin, without, it appears, any decent follow-up.

For me, being pre-diabetic would mean that I'd prefer to change my diet rather than go on Metformin. When I was told I was pre-diabetic a few years ago there was no question of any drugs, just (very poor) advice about cutting down on sugar. And a suggestion that I should lose weight ... when I asked if I could have help with this as I knew I had an eating issue, my then GP said he didn't think it was helpful to use labels.
I cut out sugar for a few months, and (as I now know) went into remission for a while.

And then back to my old eating habits ...
So I'm now diabetic ... but thing have changed a little for the better. I'd discovered the lowcarb programme and told them I wanted to try that instead of dreugs and my GP was happy to let me try for 4-6 months before looking again at the drugs (well my GP was, the DN said she was surprised he hadn't given me Metformin and was about to flag it up until I refused),
and I got a referral to IAPT to talk about my relationship with food.
I'm back in remission, but know sugar will always be my enemy so I'm still on lowcarb and I still test every week..

DavidGrahamJones said:

Many years ago I attended a Herbalife talk and one of the speakers was talking about a lady who was "slightly" diabetic.

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The French call it "une petite diabète". I can't generalise, but the ones with whom I have discussed it consider that it is nothing to worry about, just carry on as normal and eventually perhaps you will need "une petite piqure" (or two) which will sort it out.

Hello Kate Bear, you probably never were diabetic and hopefully never will be.Up to to the age of 65 years old i had excellent treatment .Then it all went downhill.I went to the doctor just before i retired in 2010 about the pain in my left hip .He said you have wear and tear in your hip ,but i shall not send you for an x-ray because i want to keep you away from the surgeons.I only wanted a sick note at the time.That gave me an insight into the treatment or lack of it in future.Since the the treatment at this malpractice has been appalling.These medics want to get as many people on the diabetic register as possible because they get paid extra for it..I was told i was diabetic in 2014/15.Although despite having routine 6 monthly fasting blood tests and blood pressure tests.They knew about it for at least 6 years.I was told at the time not to buy a meter and test my blood sugar .How will i know if i'm eating the right food to control my blood sugar.She said well i can'r prescribe test strips .so i bought a meter and test strips myself.Certain drugs including statins can cause the onset of type 2 diabetes .There was a study in September 2006 about old types of beta blocker blood pressure drugs causing the onset of type 2 diabetes especially mentioning Atenolol .By 2015 i had been taking 100mg of atenolol daily for at least 25 years the doctor refused to take me off them I got the impression she wanted to make my diabetes worse.So i weaned myself off them.Later on i went on an alternate 24 hour fasting diet as i was getting all sorts of complications.none healing ulcers on my lower legs .dizzy spells ,blackouts .I developed a squeaky voice as if i had been eating too many Haribos.I have been diabetic free for at least 18 months now .All my complications have cleared up.

Many of the issues raised on this thread are still kicking around on similar threads
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