Oh Well.....

[DaveNN]

Hello again,
SO...my hedonistic lifestyle has caught up with me somehow.
The results are back in (from between Xmas and new year)- and whilst I have another consultation booked for this week- the results from the receptionist don't look that brilliant.

1) Col 6.1.... too many potato pies on tea cakes
2) "Fasting" Glucose 8.6. It wasn't fasting as such, as I was dragged back for a test a few hours a visit to sort out my cough (I simply asked for my 'proper' tests to be clarified ..like my butter...and I'm so glad that I did).
3)HBA1C...this one has thrown me a little, as I was given a score of 78. Apparently this is about 50% above where it needs to be BUT I've yet to work out if this figure is really BAD!

However, I've since lost 4lb and am noticeably 'slimmer'....but at 5' 7" and now 'only' 15 stone; I'm hardly borderline anorexic yet

What really pees me off is that (like so many posters on here, I imagine) is that it takes a 'crisis' to flaming well do what I should have done 10 years back when the weight started to pile on!

Anyway, I have BUPA as part of my company benefit package and I'm going to see just what they can offer..I've paid enough in over the years.

Any advice etc would be appreciated and thanks for reading!

 

[Yorksman]

I know what you mean about wanting to kick yourself. I was sailing close the the wind for years but when I stopped smoking, too many sweets and chocolate bars tipped me over. In a routine blood test I got a fasting score of 9.8 and was promptly sent off on Christmas Eve for another test. This time, because I had started to cut down, my fasting test was down to 7.6 but my hba1c was like yours in the 70s. The result of mint imperials, licorice and aniseed, kop kops and a host of other goodies. I got a meter and cut out all sweets, chocolate bars, buns and biscuits. And this over Christmas! I missed the mince pies most. But what used to be BG levels between 9 to 11s went down to 7 to 9s and are now down to 5 to 7s. I've also lost 7Kg. The GP, who normally likes to hand out pills, agreed that it was best to wait and see until I get a new set of red blood cells in about 3 months time. This time they shouldn't have aniseed balls attached to them.

 

[Dennis]

Hi DaveNN

To answer a couple of your questions:

2) "Fasting" Glucose 8.6. It wasn't fasting as such, as I was dragged back for a test a few hours a visit to sort out my cough (I simply asked for my 'proper' tests to be clarified ..like my butter...and I'm so glad that I did).
3)HBA1C...this one has thrown me a little, as I was given a score of 78. Apparently this is about 50% above where it needs to be BUT I've yet to work out if this figure is really BAD!

In the new HBA1c measurements 78 equates to an "old style" reading of 9.25%, which in turn converts into an average actual mmol/mol of 12. In other words your own blood tests (if you are doing them) may be higher or lower than 12 but will be an average of 12. This is around double what it should be, not 50% higher.

I have BUPA as part of my company benefit package and I'm going to see just what they can offer..I've paid enough in over the years.

I would certainly recommend that you use your BUPA and get yourself referred to a specialist diabetologist or endocrinologist. Your GP may have a reasonable knowledge of diabetes (unfortunately many don't) but the specialists will have forgotten more about diabetes than your GP ever learned! Of course you can always get referred to a consultant under the NHS, but their advice is restricted to whatever the current government guidelines are, regardless of how inappropriate those guidelines may be to a diabetic. A private consultant isn't so restricted so will recommend what is good for you rather that what a panel of government advisors thinks ought to be good for you.

Good luck in your journey through the wonders of diabetes!

Dennis

 

[DaveNN]

Thanks guys!

I appreciate the responses and advice!

 

[daisy1]

Hi Dave and welcome to the forum

This information that we give to new members should be useful to you. Ask all the questions you like and someone will 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 30,000 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.

 

[DaveNN]

Thanks for this info.
I've been back to the docs today- only to be told that I have to repeat the tests again.
The doc is a bit of a arrogant young thing and is very keen on offering lectures... And is still convinced that I will come back as diabetic and then he wills out me on tablets ( his words).
He dismissed BUPA immediately, questioning what they could offer?
My response of a " more mature bedside manner" went down like a bucket of cold sick.... But by this time he was getting on my nerves.
It seems as if he did ask for a fasting glucose test... But asked me to come in the same day as the original consultation!
I've promised myself an expensive toy IF I can get the weight down by about 10lbs in the next 3 weeks and based on my assumption that I'm "pre diabetes" afterall.

If I am diabetic, then I'm not on my own...which is of some comfort and consultation.

 

[Yorksman]

My response of a " more mature bedside manner" went down like a bucket of cold sick.... But by this time he was getting on my nerves.

Ha ha, I know what you mean. My GP is a pill pusher and told me, as he had done on previous unrelated matters, that 'statistically you will live longer if you take them'. I told him I would prefer a specific medical reason and not a statistical chance. The stats argument is circular. If you give people pills who don't need the pills, you skew the stats.

So he weighed me, measured my waist and said lets see what the blood tests show in 3 months with a sort of 'there'll be no improvement' type sneer. I have yet to tell him that he hasn't actually told me what type of diabetes I have, just that I have it. It's real tick box healthcare, you've got diabetes, here's the information pack, sign this form and take these pills. Next please.

 

[Yorksman]

Fleetwood Mac 1969, written by Peter Green, marvellous stuff !

:thumbup:

 

[DaveNN]

Fleetwood whom?
The last time that I saw that Mick was on the Brits.... Wasn't he the best?

Anyway, I've just done my first test with the iBG Star...2 hours after a meal of butternut squash soup and half a large tortilla.
I've come in at 8.8mmol/L.
Now, I appreciate that this figure is meaningless ( as I have zero idea just how accurate this piece of kit is) - but if it has a tolerance of +\- 10% then it's promising.
However, I will do two tests when I have another fasting glucose test in a few weeks.
At least I will have something to compare to and may be able to gauge how repeatable the readings are.

If anyone has done a comparative test ( that is a test during a consultation etc) I would be interested in the findings.

 

[Yorksman]

I had a test on Christmas Eve around 11.15 am at the local hospital. I chose a later time because it was my birthday the day before and I took my family out for a meal. I had a good meal but stayed away from the BBQ Spare Ribs in sticky sauce and Roast Duck in plum sauce, but had a fair amount of carbs. Just missed the sweet stuff.

Before my appointment I was 8.8 and when I got home I was 8.0. The actual blood test came in at a reading of 7.6 whereas the mean of my readings would suggest 8.4. My wife works in the labs and tells me even their blood analysers have ranges and are not consistent. Having run control fluid with my meter the lower range of the control, which is 2.4 to 4.1 gave a result of 3.6, so reading above the mean of 3.2. For the upper range control, between 8.0 and 10.8, I came in at 10.2, quite a lot higher than the mean of 9.4.

You should also expect sudden changes for no apparent reason. At 8am today my reading was 6.5. At 11am it was 8.2 and at 1.30pm it was 6.3. I only had water, not even coffee. It was as if my body realised that I was up and about and my liver thought I may need an extra shot of glucose to be getting on with. The important thing is am getting more 6s and more 7s and fewer 8s as time goes by. I now start to see, occasionally, a couple of 5s and on one occasion even in the 4s.

 

[DaveNN]

Cheers for this sir!
Whilst tolerances are expected, it would appear that a shop bought meter or even a result from a lab can "condemn" someone to being classed as diabetic.....when the figures are on the cusp.The more that I learn about this condition ( considering that my aged mum and her late dad are/were diabetic) the more I believe that it is a black art!
I've been reading a review on my meter earlier, the reviewer ( who had 1st dibs on a unit prior to release) suggest that it can be as much as 20% out! that is frightening! That said, the readings were always on the high side- which for me is ok( so far)- but could be a 'mare for an insulin user.
I'm doing a 14 hour fasting test tomorrow morning, lets see what it comes up with.

 

[Yorksman]

In the meter manual it says not to be worried by the odd reading in the 11s and only if this was regular should I consult the GP. The practice nurse told me to come and tell them if it went up into the 15s and 16s. Well after cutting out anything sweet, ie probably a good percentage of my diet and having lost weight, I'm 6s and 7s most days. Hopefully as I lose more weight that will come down.

 

[DaveNN]

Mmmm..
Well I have just done a 12 hour fast test.
The first result came in at exactly the figure from yesterday.This did not add up, so I re did it and I have come in at 5.3mmol/L.
I'm running on 1400 ( or so) kcal a day, with only 3 tortillas as my main source of carb. I've been there with the Atkins ( lost 8 lb in week one) and promptly piled in all back on ( some 2 stone) in next to no time!
No exercise due to an awful chest infection.
You know, even if ( with sensible eating) the doc doesn't diagnose me with DM, this forum and my meter could be the best thing that has happened to me this year.... Open goal here!

 

[Yorksman]

Hi Dave. It takes some time to get to know how to use the meter properly and little mistakes such as not changing the pricker needle can and do affect results. Mine were all over the place to begin with, pressing the drop onto the strip rather than letting it flow etc. Anyway, you get there in the end.

The GP should really make a diagnosis from your HBa1c as this is a record of the last three or so months and, as an average, it omits short temporary spikes. Glucose attaches itself to your red blood cells. Your blood cells are replaced continuously and they have all been changed at around 3 months. Counting the HBa1c then gives a record of what has been happening over that three months.

You are right though, the experience prompts you into doing those things you know you should have been doing before. Why didn't I do this earlier? Well, better late than never.

 

[kellyfell]

What really pees me off is that (like so many posters on here, I imagine) is that it takes a 'crisis' to flaming well do what I should have done 10 years back when the weight started to pile on! :wave:

 

[DaveNN]

After showing a 12 hour fast of 5.3 mmoll the other morning- I woke up at 6 am today with a lovely 9.2!
As I only had mussels- with a couple of lumps of brown bread ( that might be a clue) my post meal ( 2 hours) was 8.4!

I am becoming resigned to the fact that I will be shown to have some form of DM ( hopefully the strips will be on prescription!) but.... I do appear to have a greater spring to my step- even though I can't really exercise yet.... Due to this ruddy chest infection!

But, I'm losing just over a lb every other day...so that must be doing some good!

I'm still very new to this but I get the impression that my liver is dumping glucose in my system, to compensate for the reduction in calorie intake ( 1200 to 1600 a day) BUT I'm not producing enough insulin to cope....

As a member put to me.... Welcome to the wonders of diabetes!

 

[Yorksman]

But, I'm losing just over a lb every other day...so that must be doing some good!

That's just as important as BG readings.

I used to get some 9s and then some 8s but I'm all 6s and 7s now but with oddities, 5.8 last night, 6.7 this morning. The act of losing weight messes with your blood chemistry as fat breaks down. If you are losing 3 1/2 lbs a week, that's roughly 7 packs of lard being broken down and transported by your blood. Some of this is glucose so, even if you haven't eaten any, your body puts it in your blood. Hence most people tell you that you should exercise when you diet, and drink lots of water, to help it on its way. With exercise, you are aiming to get an improvement in your blood circulation more than burning calories.

 

[DaveNN]

I do appreciate the advice and it does tally with my thoughts.
The gym in the guest room has been neglected but won't be from tonight..... I might dust it and check the pulleys!

The weight thing is frightening, especially when it's put into context, though some on this initial loss will be muscle.

I'm going to try to convince the doc ( as you will understand) to give me 3 months to see if I can fix this but to give me a prescription for the strips, as it will be cheaper than any mess- I reckon.
I had my tester in the car and it looks like they got a tad cold, with a few error 6's, so I must have wasted a slack handful.

 

[Yorksman]

Hi Dave,
Just wondered how you were getting on.

 

[DaveNN]

Hi YM...

Well... I am literally just back from the Drs..armed with a couple of boxes of metformin.
Whilst my fasting levels are normal, my hba1c levels are definitely not...69 down from the high 70's in a matter of weeks.
Not off the scale by any means though!
I have fallen off the wagon a few times recently (chocolate) and whilst my figs didn't go above 12, they took an age ( days) to get back down to the mid 6's.
My GP had to refer to the Internet again and has come to the conclusion that metformin would be helpful in my case.
He said that if I had see him 6 months back with the same figs, he would have just gone down the diet and lifestyle route.
Now, they are more proactive.
We had a long chat on this, including me showing him my iPad diabetes app, with all my figures ( including carbs, BP, weight loss etc)
He'd never seen it and it became quite clear to him that I'm no mug and am taking this very seriously.
We had a dispute about getting strips on prescription.
He said that that the practice would not do this, so we discussed what NICE say.
He's referring me to the DN.
She'll be giving me a free meter anyway...so this appears to be a bit of a contradiction.
The doc was much more open and professional this time, which is good.
We've fired off statins etc for the moment and he wanted to out me on BP meds.
I suggested that metformin would help in both these aspects...what didn't help was me presenting a 143/93 and then a 128/84 in a matter of a few minutes.
He did state that in his opinion type 2 is more serious than 1....in respect to the fact that it doesn't present much in the way of real symptoms ( thrush and jock itch in my case!)... But it can create real and lasting damage.
I went for an eye test yesterday and all is fine.
There is zero problems with the retinas, nor any noticeable swelling with the lens'.
He won't out me on SR metformin immediately though.
I explained that my job meant hours of travelling, meetings etc.
What I didn't want to have to do was bring a commode ( or a plastic bag) into a board room, in case I suddenly had to evacuate myself.
Anyway, I've agreed to stick with them for a week and see what happens.
I'm on 500mg a day, with an increase in 2 weeks...assuming that my car or a meeting room does not end up resembling a scene from the Somme in the meantime.
However, I'm going to see how 500mg goes first- and if my figures stay in the 5 mark- I will stick at that.

So..there're we have it...I am now ( according to my doc) officially type 2.

I may just tell H.R and our fleet management people, in time.
As for life insurance, it's part of my 'package' so there is zero problems there.

Lets now see what difference metformin makes to my life and underpants drawer!



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