Newly Diagnosed and confused

Hi Margaret

In some ways you are right - the HBA1C is the best tool to use to see how you are managing your diabetes in the longer term. For your information, an A1C of 7.7% indicates that your average BG readings (if you were to test with a meter) are in the region of 8-9 which is too high.

We can't take A1Cs all the time, though, so BG readings and fasting levels do help.

I am furious that your doctor has said you have "mild" diabetes. There is no such thing. You either have it, or you don't and you do. This leaves you at risk of complications the same as any other diabetic, and without a meter and a prescription for test strips you are being left helpless to help yourself. Have a look at this advice which indicates some handy things to point out to a GP reluctant to hand out strips (basically, the national institute for clinical excellence advises that all diabetics should test). Also read "Jennifer's Advice". http://www.diabetes-support.org.uk/testing.html

You are right to say that high carb low fat is daft for a T2. T2 means you have developed resistance to insulin. Insulin allows your body to absorb the glucose in your diet. Most of the glucose in your diet is from carbohydrate. Therefore, advocating a high-carb diet is clearly non-sensical.

Losing weight and some gentle exercise will greatly help your insulin resistance. Cutting back on carbs will do the same. On that basis you will be able to lower your BG and hopefully also your cholesterol.

Good luck!

Hi Margaret,
Welcome to our forum, although there must be better circumstances in which to meet?
I'd agree with the points LadyJ made, although I think 7.7%HbA1c is actually equivalent to a blood glucose reading of over 10mmol/l. Too high in other words.
The dietary advice given to you is utterly nonsensical, as you rightly point out. The crucial point is that you must lower your body's need for insulin, which will in turn lower your insulin resistance and assist your efforts to lose weight. In order to reduce insulin demand, you must reduce carbohydrates in the diet.
Your point about cholesterol is also well made. The largest epidemiological trial yet carried out involved thousands of Parisian women, who appear to live longer if they have higher cholesterol levels!
I think your HDL is a little low, and your LDL a little higher than ideal. Once again, however, both of these measurements will improve if your serum insulin levels drop.
As I'm sure you've already guessed, a low carbohydrate diet is just the ticket!

All the best,

fergus

Lady J and Fergus

I think Margaret said her fasting was 7.7 and her hba1c is 6.2 which isn't that bad. I wish I could get mine to be that lol.
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I am sure Margaret that if you cut back on the snacks and eat smaller meals involving carbohydrate, then you will be able to do just fine as you will lose some weight and also your blood glucose will also drop so dont worry too much.

Your GP should give you a prescription every month for about 50 test strips and give you a blood glucose testing meter so that you can see if what you are doing diet wise is working to reduce your blood glucose levels. Urine test strips will only detect glucose levels of about 10 or above so you should really have a blood glucose meter and try to aim to be no higher than 6 or 7. You should try to test twice a day - morning and before you eat your evening meal. Usually with type 2's the blood glucose level will rise up from lunchtime onwards so it is important that you do cut back on the amount of carb that you eat throughout the day. Everything will then even out.

Take Care

The last post is good advice re testing.

If you have a spreadsheet application, Excel, Lotus or the free open source Open Office version, key in the date(row 1), both data streams, (rows 2 and 3) calculate an average (row 4). Then use the software to plot both streams, the average and to calculate and plot the trend for each stream. Set and shade the 4-6 level on your graph. If the trend lines are heading towards the target its good news. If the trend moves away from the target you need to do something. Once you have sufficient data you can plot the results for all data, last 7 days, last 30 days and last 60 days - or whatever you fancy. This lets you see how you are progressing rather than reacting to one of readings. When the trend line for the last 30/60 days flattens out, hopefully within the target area, you've made it.

Easy peasy. Don't let out spikes freak you. There are bad days along the way.

Apologies, Margaret

It looks as if LadyJ and I mis-read your post -

I think Margaret said her fasting was 7.7 and her hba1c is 6.2 which isn't that bad. I wish I could get mine to be that lol.

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I think the most reliable conversion of HbA1c to blood sugar level is the one devised by Richard Bernstein. His years of measurement of many many patients and non-diabetics lead him to conclude that an HbA1c of 5% equated to an average blood sugar of 100mg/dl, or 5.5mmol/l.
Every 1% above that adds 40mg/dl, or 2.2mmol/l to the blood sugar level. That would turn your 6.2% into an average blood sugar of around 8.1mmol/l.
It also turns the NHS safe limit of 7% into a blood sugar of 10mmol/l, roughly twice that of a non-diabetic! Not so safe then.

All the best,

fergus

Hi Margaret,

The NHS is a fantastic institution and one we should be very proud of. Not faultless by any means, but hey ho.
They are somewhat off the way as far as diabetes treatment is concerned, particularly with regard to diet. If you take a look at the 'Know your rights!' thread you'll see that they are fully aware that carb reduction is a highly successful aproach to normalising blood sugars and reducing insulin resistance. Nevertheless, they consistently fail to inform patients about it, and often give advice in clear contradiction of the BNF requirement.
The best thing in these circumstances is to inform ourselves so we are able to avoid the misdirection which seriously harms our health. Lots of forum members have made an enormous difference to their health by doing just that.
Stick around!

All the best,

fergus

Hi Margaret! First Ignore the low fat, high carb rubbish. It will make the condition wose if you follow this advice and they will be making their prediction , that Diabetes is ALWAYS progressive, come true. Low carb is the way to go. this needn't be extreme Atkins, even though that wouldn't hurt you, but reduce bread, potatoes, pasta, rice, cakes and biscuits. Try to get rid of sugar particularly. You can drop them completely, perfectly safely, but TINY portions may be OK. You'll need to find out. they are meant to let you have enough test strips to find out what suits you, but you may well have to fight for them.
As to exercise; It doesn't have to be power walking. Just walking where ever you need to go will do. Speed isn't critical. I can't walk fast, but wear my pedometer and try to do my 10,000 steps a day. I use my bus pass in prefernce to my car( it's cheaper anyway ) and I walk to bus stops. It all adds up. Fasting BG 7.7 and HbA1cseem not bad. If you're lucky, you'll be able to get that down a bit quite easily.

Reduce the carbs. My godmother was Italian and I love plain pasta with olive oil, black pepper, anchovies and a nice glass of heavy red but have not had my weekly fix of pasta in the 14 months since diagnosis. I keep taking the heavy red! Cut out sugar completely; try green or white tea (no milk) and espresso made with good quality freshly ground coffee; you will find that they have a natural sweetness. Avoid fruits which have a particularly high sugar content, grapes for example. Don't eat biscuits or for that matter anything that contains trans fats. Reduce portion sizes, except fro green veg. And test twice a day until the statistics show that you have hit the target, then randomly monitor your morning glucose levels.

If someone is diagnosed with alcoholic related liver disease they are asked to avoid alcohol or face the consequences. If you are diagnosed as T2 diabetic you either make the choice of not overly indulging in the things that elevate blood sugar levels - or face the consequences. Its not that difficult - or if it is, simply reduce the intake of what you know is not doing you any favours. Bite the bullet and see life improve.