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Please may I have some advise?

lisa00769

Active Member
Messages
37
Location
devon
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Negativity
Hi.
Please bear with me im new to this. xxx
I had a HCA1c blood test done and the results came back at 49. Because of this I had a GTT last wednesday and the results were 8.7 before the drink and 14ml after. I have to go and see the practice nurse tomorrow and im really worried about it. Will I have to have medication for this level or do you think I could get them down through diet? Also will I need to test my blood regularly at home? I don't know much about diabetes and any advise would be so helpful.
Thankyou
xxxxx
 
Don't worry, DN's are mostly harmless.

You will almost certainly get pills. Everyone seems to get Metformin and if she wants to give you other pills she will.

You can certainly improve matters with your diet but don't make the fundamental error of thinking it's a slimming diet. You may have to do that as well if you are overweight but what I mean by diet is more a rearrangement of what you eat rather than how much of it.

NHS is stingey with meters and more so with test strips without which the meter will not work. You may have to buy one of your own but don't try getting along without one. It is close to impossible.

Good luck with your appointment. I would be nosey enough to ask you to let us know how you got on.
 
Thank you so much for your reply. Are those levels which came back quite high or are they just borderline? I would really like to see if i could do without any medication and it would be good to go to the appointment at least armed with a little bit of knowledge. x Thank you again
Lisa
 
Both readings are a little high but not disastrous at all. High enough to attract the attention of the practice nurse obviously.

I should give up the idea that you are going to get away without medication.
 
I don't know about GTT results but at 49 your HBA1C is only slightly above "normal" range which has an upper target of 42. For people with diabetes the target range starts at 48. I would be very surprised if you are given meds and in your position would want to try managing without meds but modifying diet etc for a period of at least 3 months to allow time for a repeat test which would show the impact of dietary changes etc
 
badcat said:
I don't know about GTT results

I just stole this from Wikepedia.

Fasting plasma glucose (measured before the OGTT begins) should be below 6.1 mmol/L (110 mg/dL). Fasting levels between 6.1 and 7.0 mmol/L (110 and 125 mg/dL) are borderline ("impaired fasting glycaemia"), and fasting levels repeatedly at or above 7.0 mmol/L (126 mg/dL) are diagnostic of diabetes.

A 2 hour OGTT glucose level below 7.8 mmol/L (140 mg/dL) is normal, whereas higher glucose levels indicate hyperglycemia. Blood plasma glucose between 7.8 mmol/L (140 mg/dL) and 11.1 mmol/L (200 mg/dL) indicate "impaired glucose tolerance", and levels above 11.1 mmol/L (200 mg/dL) at 2 hours confirms a diagnosis of diabetes.
 
Hi. Your HBa1C is only slightly elevated at 6.6% in old money. I agree with Badcat that your nurse may well decide not to give you meds at this stage and rely on diet only. If you are a bit overweight then the right diet should bring your blood sugar down into the mid-range and no meds or other treatment needed. If the nurse tells you to have starchy carbs with every meal (NHS poor advice)then politely ignore that and follow guidance on this forum. That means reducing your carb intake and having low-GI carbs. You don't need to have carbs with every meal. You probably won't be offered a meter but you may want to get one anyway as a meter can help guide you in which foods and quantity work for you.
 
Thank you so much for your replys. I shall go armed with this knowledge and see if I can just work on my diet. x You have been really helpful. I shall let you know how I get on tomorrow afternoon.
Thanks again
Lisa
x
 
Daibell said:
If the nurse tells you to have starchy carbs with every meal (NHS poor advice)then politely ignore that and follow guidance on this forum.

Sorry to cloud the waters here Lisa but Diabells advice above is just an opinion and a wrong opinion in my opinion :D .

The NHS diet advise is not all bad but seems to be misinterpreted by some. Despite what some may say the NHS diet advise is based on fact and scientific research unlike opinions which are based on repeating inaccurate anecdotes.

Go to see your diabetic nurse with an open mind and listen to their advise, at your level they may or may not prescribe medication depending on the thinking at your particular GP surgery, some like to introduce medication early in the hope of avoiding any damaging high levels while some will like for you to try to reduce your blood glucose levels by dieting alone at first, both trains of thought have their pros and cons and most doctors/nurses will be happy to let you try dieting if thats what you want to try.

Once you get a definite diagnosis come back and read the information for newly diagnosed diabetics that is regularly posted here by Daisy, it is sound advice that should set you on the road to good control.
 
Hi Lisa and welcome to the forum.

This is the advice that Sid mentioned which we give to new members. 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.
 
Hi Sid. I thought my advice was very much in line with your own approach in your signature? You suggest 'reduced' carb and 'low-GI' which is what I recommended and agree with. You also say 'portion control' which I agree with although I didn't mention. You well know that there is no science that says you have to have carbs with every meal and many posters on this forum have been told this by the NHS (also a work colleague of mine). I have no idea what proportion of patients are given the poor 'starchy carb' info but the many posters suggest it's worth being aware of as a newly diagnosed. Have another read of my post?
 
Hi. Just wanted to update you. I had my appointment yesterday and the dn has started me on 500 of metformin once a day and to increase to 3 times a day over 2 weeks. Also on statins once a day. She is seeing me again in 2 weeks and will teach me to check my own levels then and give me a monitor and testing strips. She also checked urine sample and gave me lots of advice on diet and was really helpful.
 
You're going to make us all jealous. Getting a monitor and test strips eh. Maybe the NHS is having a change of heart.
 
Hiya. I must say I was pretty surprised myself, I didn't even ask for them. I think I amjust one of the lucky ones. But truly thankful for the advise on here, and the nursesaid that any questions I have she is on the end of the phone. X
 
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