Incorrect diagnosis?

[Flu strength Darren]

At a yearly blood check i was called by tbe doctor and told I had a HB1aC of 52.

He told me I was diabetic, and needed to take metaformin, this was 6 weeks ago I'm now on 2000mg a day.

I was called by the nurse saying I needed to go for an eye and foot check, but had no follow up, that was it, nothing more, no advice on how to manage etc, no appointments for the eye check.

So ive been self managing, cutting carbs, eating protein Fibre etc.

I got a CGM early on and started noting what spiked, how long it took to return etc

So 6 weeks of readings across 3 libre 2s estimate my hb1ac at 36.

Overnight its a steady low 4, when I have a white bread sandwich its up to 10 ish and back to 6 in a couple of hours, everything I m seeing, nothing is screaming out at me, even beer doesn't raise by much.

How long does meatafirmin take, is the above down to the tablets allready?

I am skeptical as 3 weeks ago diagnosed with quite bad iron anemia, sounds like due to long term lansoprazole use.

Apparently this causes red blood cells to hang around longer and so gather more sugar and this is what the test is based on..

So the question is, would metaformin have stabilized me in just a week or 2?

 

[Antje77]

So the question is, would metaformin have stabilized me in just a week or 2?

Not necessarily, but you also cut the carbs, which may well be doing the trick.
An hba1c of 52 corresponds with an average blood glucose of around 8.4. If you've significantly cut the carbs you'll likely spend a lot less time close to 10 than you used to.

Dou you occasionally double check the sensor with a fingerprick?
Mine always read a bit lower than blood which means my predicted hba1c is always a little lower than the lab one (a consistent 8 mmol/mol for years, but this is very different between people.

I am skeptical as 3 weeks ago diagnosed with quite bad iron anemia, sounds like due to long term lansoprazole use.

Apparently this causes red blood cells to hang around longer and so gather more sugar and this is what the test is based on..

I would have my doubts on my initial test as well if I had anemia.
An alternative is a fructosamine test, and it's worth asking for it if you have reason the hba1c is not trustworthy in your case.

Fructosamine spans a shorter time than hba1c so it'll reflect your recent numbers and won't tell you if your initial diagnosis was correct.

 

[Antje77]

Oh, and welcome to the forum of course, @Flu strength Darren !

 

[Mrs Redboots]

This is exactly what happened to me - after my annual health check, I had a call out of the blue from one of the doctors at my local health centre saying my HbA1C was through the roof, and I needed to go on metformin immediately, if not sooner. I refused at first - I had absolutely no symptoms, and, not knowing about the HbA1C test, pointed out that it had been a hot afternoon and I'd been eating ice cream. Anyway, the doctor more-or-less told me I'd die if I didn't start taking Metformin that very day - and that was all the advice I ever got! Ever.

They do check my feet at my annual health check, and I get called for a retinopathy screening every so often (you'll probably get a letter telling you when and where to report), but that's about it. Oh, and they check my HbA1C once a year, after my health check (which includes a blood test); the past couple of year's it's been pre-diabetic and/or normal! I haven't changed my diet that much, but take the line of "Everything in moderation", which seems to work for me (please note, it doesn't work for everybody!), but then, I don't really have a very sweet tooth!

 

[Flu strength Darren]

Not necessarily, but you also cut the carbs, which may well be doing the trick.
An hba1c of 52 corresponds with an average blood glucose of around 8.4. If you've significantly cut the carbs you'll likely spend a lot less time close to 10 than you used to.

Dou you occasionally double check the sensor with a fingerprick?
Mine always read a bit lower than blood which means my predicted hba1c is always a little lower than the lab one (a consistent 8 mmol/mol for years, but this is very different between people.


I would have my doubts on my initial test as well if I had anemia.
An alternative is a fructosamine test, and it's worth asking for it if you have reason the hba1c is not trustworthy in your case.

Fructosamine spans a shorter time than hba1c so it'll reflect your recent numbers and won't tell you if your initial diagnosis was correct.

AI tells me my level of Anemia is chronic, the specific term it used was "my iron tank is empty" and is highly likely my H b1 was elevated, with it being 52 and my CGM behavior I'm almost convinced I'm taking metaformin for nothing, and i hate taking drugs for no reason, when I asked the doctor about the iron I asked if it could be down to 25 years of lansoprazole and hes asked me why I had been taking it so long??? *** he and his cronies have been prescribing it for this length of time?????
As soon as I sort my iron I'm gonna make him look into this.

 

[lovinglife]

Are you also on semaglutide @Mrs Redboots? That will also make a difference to your numbers - the OP is on Metformin only which is different from your situation

 

[Flu strength Darren]

This is exactly what happened to me - after my annual health check, I had a call out of the blue from one of the doctors at my local health centre saying my HbA1C was through the roof, and I needed to go on metformin immediately, if not sooner. I refused at first - I had absolutely no symptoms, and, not knowing about the HbA1C test, pointed out that it had been a hot afternoon and I'd been eating ice cream. Anyway, the doctor more-or-less told me I'd die if I didn't start taking Metformin that very day - and that was all the advice I ever got! Ever.

They do check my feet at my annual health check, and I get called for a retinopathy screening every so often (you'll probably get a letter telling you when and where to report), but that's about it. Oh, and they check my HbA1C once a year, after my health check (which includes a blood test); the past couple of year's it's been pre-diabetic and/or normal! I haven't changed my diet that much, but take the line of "Everything in moderation", which seems to work for me (please note, it doesn't work for everybody!), but then, I don't really have a very sweet tooth!

Well I'm about 7 weeks after being told I would have the eye and foot check, nothing yet. I'm sure a lot of GP surgerys are the same but mines shocking, still waiting after 3 weeks for a fit test through the post!

 

[lovinglife]

Foot check you should be able to get at your GP, but the eye test needs to be done by a specialist which will have a waiting list, if you are worried about your eyes you can get a test at the opticians (but still go for the NHS one when you get it) now you have a diagnosis of diabetes eye tests at the optician are free every two years

Don’t be tempted to buy glasses if you need them. You need to give your eyes time to settle down because BG affect your eyes and they will change as you BG comes down

 

[Flu strength Darren]

Foot check you should be able to get at your GP, but the eye test needs to be done by a specialist which will have a waiting list, if you are worried about your eyes you can get a test at the opticians (but still go for the NHS one when you get it) now you have a diagnosis of diabetes eye tests at the optician are free every two years

Don’t be tempted to buy glasses if you need them. You need to give your eyes time to settle down because BG affect your eyes and they will change as you BG comes down

Eyes are fine, feet also.
Didn't know eye tests were free?, like I said above, apart from a brief phone call saying take this tablet twice a day ive had nothing, I'm told their is a form to get for free prescriptions by a work colleague?
He got appointment with specialist nurse same week as diagnosis, diet advice, dos and donts etc. Different surgery obviously.

 

[Antje77]

I'm almost convinced I'm taking metaformin for nothing, and i hate taking drugs for no reason

You have a say in what medications you choose to accept or not accept.
With an hba1c of 52 you were just over the diabetes threshold. Some people prefer the help of medication, others prefer to try to treat their diabetes with diet only first, and 52 is not a number where opting for diet only is unreasonable.

 

[lovinglife]

Eyes are fine, feet also.
Didn't know eye tests were free?, like I said above, apart from a brief phone call saying take this tablet twice a day ive had nothing, I'm told their is a form to get for free prescriptions by a work colleague?
He got appointment with specialist nurse same week as diagnosis, diet advice, dos and donts etc. Different surgery obviously.

Because at the moment your on Metformin all prescriptions (even ones that are nothing to do with your diabetes) are free but your colleague is correct to need to fill a form at your surgery & get the GP to sign it. If you stop taking the Metformin or don’t take any diabetic meds then you can’t get free prescriptions

 

[Flu strength Darren]

You have a say in what medications you choose to accept or not accept.
With an hba1c of 52 you were just over the diabetes threshold. Some people prefer the help of medication, others prefer to try to treat their diabetes with diet only first, and 52 is not a number where opting for diet only is unreasonable.

I followed doctors advice.

 

[Flu strength Darren]

Because at the moment your on Metformin all prescriptions (even ones that are nothing to do with your diabetes) are free but your colleague is correct to need to fill a form at your surgery & get the GP to sign it. If you stop taking the Metformin or don’t take any diabetic meds then you can’t get free prescriptions

Yes, the point i was making was i wasnt advised this by medical staff, only by a work collegue.

 

[lovinglife]

Yes, the point i was making was i wasnt advised this by medical staff, only by a work collegue.

Fair enough only trying to help give you the correct information, I wasn’t given it by my GP either, it was the pharmacist that advised me.

 

[Flu strength Darren]

Fair enough only trying to help give you the correct information, I wasn’t given it by my GP either, it was the pharmacist that advised me.

Yes, I think there is a clear gap here, most medical issues you are diagnosed and given a course of treatment/ care to help with it, there's something missing in the aftermath of diabetes diagnosis, not everyone can drop onto Google and AI and just do the best they can.

 

[Mrs Redboots]

Are you also on semaglutide @Mrs Redboots? That will also make a difference to your numbers - the OP is on Metformin only which is different from your situation

I am now, but only since last September (Ascend Plus Trial); my 2025 HbAC1 was, so I am told, pre-diabetic! "Keep on doing what you're doing!" said my GP, so I did! And then got invited on the trial, which I accepted!