In denial….?

[Canarsie13L]

I am confused!

My doctor is telling me that I am diabetic (type 2) on the basis of a fasting glucose test of 7.3. I have been self testing for a few months, just to establish what my true blood glucose level is, and it seems to vary quite a lot. About 7.5 is the maximum, but I frequently measure 4.2 when I test 2 hours after eating. The level seems to vary during the day between these two levels, (4.2 to 7.3). Based on the GP's diagnosis, and the fact that my fasting blood sugar level is above current NHS guidelines I am following a low-carb diet regime, and increasing my exercise to lose some weight (BMI 27.5). I think it best to deal with a possible problem and not be in denial.

However, one thing that puzzles me is the lack of consistency in my blood glucose readings. It seems higher when I go to the surgery than when I self test, and it also seems to change quite erratically during the day, but never seems to get much above 7.0. I would like to know what test results I should be seeing before eating, and after meals, and how often I should be testing, without becoming paranoid!

 

[Lazybones]

Dear Canarsie13L,
Daisy will no doubt be posting what are the general guidelines for Blood Glucose levels for the various types of diabetes. I would however mention that unlike a body temperature. Blood Glucose levels aren't constant and can go up and down considerably depending on a great number of things, the food we eat, stress, exercise etc:
Your doctor in order to confirm if you have diabetes will usually take your morning Blood/Glucose measurment (after fasting 12 hours) and if your B/G is 7.0 mmol/L (Plasma) or more on two closley related tests, then that is usually enough to say that someone has diabetes. The early morning readings are frequently higher than those of the rest of the day which is quite normal, but being anxious over the visit to the Dr. and the Blood Test itself can also give rise to a slight increase in what would otherwise be a lower reading.
Most modern Blood Glucose meters will give a good approximation to what the value of the individuals B/G is, but they use 'Full Blood Anaylasis' and not 'Plasma Blood Anaylasis' as would be done by your doctor and the testing laboratory. If your test meter is like mine, it's worth checking to see if your meter has these dual settings in which case you should set your meter to 'Plasma' so that the results shown will relate to those of the Blood test done at your doctors.
There is also a Blood test that your Dr. may instigate at the same time, it's the HbA1c test which will also show if you have diabetes, and at the same time show what were your 'average' Blood/Glucose levels in the 120 days that preceeded the sample being taken.
The aim of controlling blood glucose is simply to maintain you B/G within a recognised safety band, ideally for all of the time, but this I have yet to acheive myself.

 

[Canarsie13L]

Dear Lazybones,

thanks for your reply! I guess my testing regime is also a bit complicated by the fact that my tester (which I bought when working in the Middle East), is calibrated in "mg/dl". So, if I get a figure of, say. 93, that converts to 5.16 in mmol/l. I normally just divide the figure by 18 to get an answer. I did't realise the difference in readings between the Full Blood Analysis from a home meter self-test and the Plasma test that the doctor would be looking at, so thanks for advising me about that! I guess I'll buy a more sophisticated tester which can give me the option of the "Plasma' setting, and give an answer in mmol/l units.

I really do wonder why there are so many differing measuring systems and units (mmol/l, Mg/dl etc.), as this seems to lead to confusion, at least it does with me!

 

[daisy1]

Hi Canarsie13L and welcome to the forum

Here is the information we give to new members and I think you will find it helpful. Ask as many questions 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 well over 70,000 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 ... rains.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

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 blood glucose 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.

 

[Lazybones]

It's all a bit confusing when you are first told that you are diabetic, but take things one stage at a time and you'll soon be conversant with this diabetic thing.
The may be no immediate need to rush out a buy a new B/G meter just because your meter gives a readout in mmol/dl and you have to do the conversion by dividing the result by 18 to get the answer in our Uk measurment of mmol/L as in the end its the actual level that you are intrested in whether its in mmol/dl or mmol/L.
If you can search the web for the manufacturer of your meter, and download the instruction manual, you might find a means of setting the meter to the mmol/L setting that we use here in the Uk and there may be the option to also set the meter so that the resultant display is for (Plasma) rather than full blood samples.
Most modern meters don't have the plasma/full blood settings options and are manufactured so that they display 'Plasma' results so as to match those obtained from that of your Dr, or Pathology Testing Laboratory.
If you decide on a new meter I'm sure someone this site can reccomend a good one, bearing in mind that the NHS are reluctant to issue FREE test strips and once purchased you are then committed to use the manufacturer's test strips, the price of which can be expensive and is controlled by them.

 

[sugartoohigh]

All good advice above Canarsie13L , don't worry it gets easier.

 

[Ali B]

Hi Canarsie13L and welcome to the forum

Here is the information we give to new members and I think you will find it helpful. Ask as many questions 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 well over 70,000 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 ... rains.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

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 blood glucose 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.

I find this so very interesting and simple to understand.,Ill be returning to this post....thank you for the explanation

 

[mikegresty]

there are no particular set test results to expect apart from a normal range between 4-7 before a meal and. 7-9 after. so many factors can affect levels such as alcohol, excercise, stress levels and more predominantly at this time of year the cold but as complex as this all seems it soon all becomes second nature with practice and regular monitoring x

 

[alwaysquestion]

I am confused!

My doctor is telling me that I am diabetic (type 2) on the basis of a fasting glucose test of 7.3. I have been self testing for a few months, just to establish what my true blood glucose level is, and it seems to vary quite a lot. About 7.5 is the maximum, but I frequently measure 4.2 when I test 2 hours after eating. The level seems to vary during the day between these two levels, (4.2 to 7.3). Based on the GP's diagnosis, and the fact that my fasting blood sugar level is above current NHS guidelines I am following a low-carb diet regime, and increasing my exercise to lose some weight (BMI 27.5). I think it best to deal with a possible problem and not be in denial.

However, one thing that puzzles me is the lack of consistency in my blood glucose readings. It seems higher when I go to the surgery than when I self test, and it also seems to change quite erratically during the day, but never seems to get much above 7.0. I would like to know what test results I should be seeing before eating, and after meals, and how often I should be testing, without becoming paranoid!

-------------------------------------------------

Hi Mike, have just joined, as type 2, so if this is sent to anyone by mistake, my apologies

USA median levels are 5.5.mmol/L. Usually, I am told that 'normal' well functioning persons should settle around 3.8 to 4.2 in a period after fasting. Then when such lucky persons eat, it should rise to around 7 and then decline again to around 4.

For diabetics this range should characteristically be up to 7.5 - 7.8 if they are under control... below 8 is Ok but is an orange light... .... but after all the problem varies across a wide range with individuals, often with a complex of other difficulties.

I was diagnosed with 12.2 HBa1c last July - rather high.... This test is for the general past three months. Your daily test is more or less for the last hour or so. There is a big difference. Your test is probably mmol/L The difference in measures can be found on a convenient chart free to download from Diabtes.co.uk. Don't expect 'consistency' in your readings only a range. Your liver will supply sugar at times if you don't folow a regular meal plan... so you might think ... 'should be low now.. I didn't eat since breakfast'... but the liver has other ideas and supplies the body with sugar! You need the energy..!

I am thin, not overweight at all...and went on the usual diet , cutting out most carbs except prridge ( water) for breakfast, and a quarter plate of low GI carbs for lunch. I got it down to 6.9 . I lost weight from 74 kl to 68 kl... not a good idea really.... This is a problem that is less usual since diabetes is so closely associated.

We should be able to maintain a quasi normal state with a careful diet within the range of spot readings that I have indicated, but what we can't forget is that now we arn't functioning on automatic any more ( homeostasis) and the pilot has to keep control

Cheers