Diagnosed three weeks ago

Kiteslady

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I have been diagnosed for three weeks from a fasting glucose level of 26.3 and hba1c of 122!! My doctors have just given me a blood sugar monitor and stuck me on 2g o metformin a day for which I am suffering greatly. After banging the desk, literally, I have finally got a review appointment tomorrow but wonder what I should be asking or demanding?
 
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daisy1

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@Kiteslady

Here is the information we give to new members and I hope you will find it helps you before your appointment. Reducing the carbs in your diet should help you to lower your levels. Ask as many questions on here as you like and someone will be able to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

Liam1955

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@Kiteslady - Hello and Welcome to the Forum. :) You should think about asking for the Metformin Slow Release which is much kinder on your stomach.
 

TorqPenderloin

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1,599
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Type 1
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but wonder what I should be asking or demanding?
With levels that high you should be demanding a c-peptide and GAD-65 antibody test. Those are the tests that help rule out the possibility that you might be type 1.

Levels that high don't just show up overnight except under very unusual circumstances (like your pancreas no longer producing insulin).

There's no reason to be scared or worried (although if you feel that way, it's okay), but your primary concern at this point should be making sure you have the correct diagnosis and then start trying to soak up as much information as you can.
 

Pinkorchid

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Type of diabetes
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Diet only
Yes I agree those levels are high but can be controlled and lowered but as Torq said maybe more blood tests are needed. Off topic but your lovely little dog looks a lot like mine is it a Shih Tzu
 

Kiteslady

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With levels that high you should be demanding a c-peptide and GAD-65 antibody test. Those are the tests that help rule out the possibility that you might be type 1.

Levels that high don't just show up overnight except under very unusual circumstances (like your pancreas no longer producing insulin).

There's no reason to be scared or worried (although if you feel that way, it's okay), but your primary concern at this point should be making sure you have the correct diagnosis and then start trying to soak up as much information as you can.
Thanks, I have made a note of what yo ask for. This is why I have posted, as you guys obviously know much more than me!
 

Kiteslady

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Yes I agree those levels are high but can be controlled and lowered but as Torq said maybe more blood tests are needed. Off topic but your lovely little dog looks a lot like mine is it a Shih Tzu
Yes, I have two, this one is nine yrs old, the other is white, blind and eleven. I rescued them a year ago from dreadful conditions.
 

Kiteslady

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T
@Kiteslady - Hello and Welcome to the Forum. :) You should think about asking for the Metformin Slow Release which is much kinder on your stomach.
Thanks! Didn't know that existed, another note to ask tomorrow
 

Pinkorchid

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Yes, I have two, this one is nine yrs old, the other is white, blind and eleven. I rescued them a year ago from dreadful conditions.
It is the only other one I have seen who is so similar in colour to my Shih Tzu everyone says how unusual her colour is and she licks her nose exactly like yours is doing . How lovely that you have given them a loving home.
 

Kiteslady

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It is the only other one I have seen who is so similar in colour to my Shih Tzu everyone says how unusual her colour is and she licks her nose exactly like yours is doing . How lovely that you have given them a loving home.
Thank you. He is such a sweetie I take him into a local Alzheimer's care home to spend time with the old folk. They also keep me active as they love their walks!
 

Kiteslady

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Thank you for your advice, I have now been prescribed slow release metformin, much higher dose statins and am on three, yes three diabetes education sessions. I also have retinopathy and podiatry booked, got cream for my split heels, cream for my dry skin and the direct dial number of our diabetes lead nurse practitioner. I asked all the questions I needed, she gave me over half an hour and I feel at last I am getting somewhere! More blood tests in eight weeks, then they will decide what extra or different medication to give me.
 
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Liam1955

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@Kiteslady - Hi. :) How are you doing now on the slow release Metformin? Has your blood sugar levels started to come down?
 

Kiteslady

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@Kiteslady - Hi. :) How are you doing now on the slow release Metformin? Has your blood sugar levels started to come down?
My tummy problems seem to be less now thanks, although I am now on 40mg daily of statins which I am getting used to as well! This diabetes thing is complicated... I have managed to get my blood sugar own to an average of 8 and have another lot of blood tests scheduled for the end of next month.
 
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Liam1955

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@Kiteslady - Was the 8 a fasting (morning) reading? Do you test before meals and then 2 hours after eating? Also what diet do you follow if any? Metformin takes time to build up in your system and you might begin to see a slight effect. But, it can take up to couple of months to reach it's full effect. :)
 

Kiteslady

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@Kiteslady - Was the 8 a fasting (morning) reading? Do you test before meals and then 2 hours after eating? Also what diet do you follow if any? Metformin takes time to build up in your system and you might begin to see a slight effect. But, it can take up to couple of months to reach it's full effect. :)
Yes, I have been told to do both readings. The after eating readings are usually between 10 and 12. I have been following a high protein, complex carb diet with not too much fruit, but am going to a couple of education sessions in the next two weeks. I hope the metformin will build up, but not the side effects, I have been very 'explosive'!
 

Liam1955

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@Kiteslady - Good results of 8 & 9 compared to 3 weeks ago! A lot of forum members follow the LCHF Diet (Low Carb High Fat) and have lost weight and also lowered their HBA1C. If you go to the top of this page and click on Forums, then scroll down to FOOD and NUTRITION there you will see various diets. Also it helps to keep a food and blood sugar result diary. Note down what foods you eat, your blood sugar reading before and then 2 hours after - in doing this you will be able to see which foods gives you spikes = high sugars.
 

Kiteslady

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@Kiteslady - Good results of 8 & 9 compared to 3 weeks ago! A lot of forum members follow the LCHF Diet (Low Carb High Fat) and have lost weight and also lowered their HBA1C. If you go to the top of this page and click on Forums, then scroll down to FOOD and NUTRITION there you will see various diets. Also it helps to keep a food and blood sugar result diary. Note down what foods you eat, your blood sugar reading before and then 2 hours after - in doing this you will be able to see which foods gives you spikes = high sugars.
Thanks, I shall have a good look at the food diets. I have an app on my iPad for the diary, it is very useful and I have already identified some foods which give me spikes. It seems the slow release metformin is not as harsh as the other, but I wonder whether it brings down my sugars as effectively? I have noticed that when I do a lot of exercise, such as the heavy digging for my potato patch, my sugars dump to about 4 so am learning to top up when I feel strange.
 
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Liam1955

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@Kiteslady - Excercise/Activity does help to lower blood sugars and is recommended along with Diet. Metformin lowers the amount of sugar created by the Liver, and decreases the amount of sugar absorbed by the intestines. It may also help Type 2 Diabetic's lose weight as it lowers appetite.:)
 

Kiteslady

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Another question, which may seem very silly. When you see sugar content in grass on tins and packets, what does it relate to? Can it be converted into spoonfuls for the less educated like me? I have no idea whether to eat anything or not...