Probably a silly question!

[squishychickfi]

Hi

I was diagnosed with T2 last summer and was put on metformin which was increased to 1g SR morning and night.
The diabetic nurse at the practice left and there is no-one taking on the role at the moment although a GP is quite interested in new medications.
Thought I would have my bloods checked every 3 months but was told it would only need to be once a year.
Long story short - was feeling not too well about 8 weeks ago and went and insisted on a test and it came back high (9) which was higher than the first one on the meds!
Saw the GP and he has now put me on januvia sp?? as well. But no more blood tests for 8 weeks.

Still not feeling great and have read a lot of different posts from others - can anyone tell me if I should insist on testing my blood more regularly - I was surprised he prescribed as I had heard that NHS was saying it was too expensive - but don't feel I am managing very well at the moment.

I am sure someone will post that everyone is individual but I feel that I am missing something and not sure what to do!

Many thanks

 

[sugarless sue]

It may be better to get referred to a hospital Diabetic clinic or find a new doctor as they don't seem too knowledgable on diabetes.

Here is the information we usually give to newly diagnosed Diabetics. I hope some of it helps you to get control of your blood sugar levels.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!
If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l. ( Type 2)

2hrs after meals....... no more than 9 mmol/l (Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.

 

[squishychickfi]

Thanks for your reply

I had already posted - but my message must have got lost in cyberspace!

I am happy with my own GP (but didn't see her as saw the one that was supposed to be interested in diabetes!) so don't want to change if I don't have to!

How do you get to see a hospital diabetic nurse? Do you have to have really high glucose levels? My levels don't seem as high as some people on here and I would hate to waste their time or take up a place for someone who needs it.

 

[k9kitty]

Hi there, sorry you have not been too well.
Are you able to buy a meter and test your own blood glucose. Your local pharmacy should have a starter pack of meter and strips. Self testing and keeping a note of results and symptoms whilst waiting for your next formal blood test might reassure you a bit and help you feel more in control. I find it very useful in sorting out my highs form my lows.
Your GP may be willing to give a prescription for the strips if she can see how testing will help you control your symptoms better.

I am not sure how you get to see the hospital diabetic nurse but I have to go to my hospital eye clinic for another problem and to save me faffing around at another clinic they have agreed to do my diabetic eye screening. You could ask you GP to refer you for a second opinion because you have been feeling so poorly.

 

[squishychickfi]

Having spoken to my hubby about this - he agrees that I should see the doc! She is happy for us to check up on symptoms etc on internet and knows that we are sensible and will weed out the silly stuff that is on the internet so I think she may well agree to me testing. As hubby said you will be able to keep a better control of it and therefore not be a burden to NHS
So tomorrow I am going to ring and make an appt. If after that she says no - I may well get a test kit and do mine just to see if it is fluctuating!

Thank you for your advice

 

[ellenc]

Please buy a meter (or you should be provided with one free at your surgery, my brother was two months ago) and get strips on NHS and test yourself as often as you like, I test two times a day morning and before evening meal. Try and help yourself with what you eat and take exercise, I find that if I only walk round the shops in the afternoon my level falls. I agree that if you find that you levels dont come down after self help then kick up a fuss untill someone takes notice.

 

[squishychickfi]

Thank you - I am going to be more proactive - I hope - it is the summer hols so I can do a lot more cooking and be more sensible with food - therefore can get into a better routine for when I start back at school!

I rang the docs - she is away for a bit - but have an appt with a nurse so will get her to have a look at my results and see if she is able to prescribe! If not will wait for doc to come back!

 

[sawyatt]

Hiya

Not a silly question at all. When you are new to diabetes everything is very confusing! You should be having an HbA1c blood test every 3 months, especially as your levels are not yet under control or stable. This will give you an idea of your average readings over the previous 3 months so testing every 3 months keeps you in the picture. Your aim, at this stage, should be to get your hba1c down to 7 or below. Don't panic about this - just be sensible.

One way to lower bs is to exercise and walking is probably the easiest to start with. Also try not to eat too much too late in the day. My GP said to have evening meal by 6pm if poss (though difficult if you work and are not home til later). Urine strip testing is only of value if your blood glucose level is above 10 as any lower will not usually register and 8 or 9 would still be too much, so I dont find that very useful - just a guide. The best thing I did was to buy a blood testing monitor - no pain to speak of and easier than peeing on a stick and counting to 30! These are available on NHS but my GP was reluctant so I got my own to prove I was serious and I'm hoping he'll prescribe the strips for me now.

I do think, however, that the hba1c test, in conjunction with home blood monitoring is the best practice. If you do not have a diabetic nurse at your practice your GP should be looking after you until they get a replacement. As diabetics we are encouraged to look after ourselves and become 'expert patients' so you need to have all the tools available to do this and regular monitoring by your GP is vital - if your diabetes is under good control there will be less of a strain on the NHS in the future you could point that out! Also ask whether there is a DESMOND course available in your area yet - these are being rolled out across the country at the moment and you will find this day course invaluable. All the best!

 

[squishychickfi]

Think the sooner I make an appointment with GP the better! Was told only needed testing once a year (sugar levels were at 9 last one!) and take meds - think I want to be in control myself - so will ask them about a meter!