Process of diagnosis

[LittleGreyCat]

My friend is currently going through the process of diagnosis.

(1) Blood check as part of other general treatment - reading in the high teens (16-18 IIRC).

Warned that he was probably diabetic.

(2) Fasting blood glucose test - value of 9.

Warned that he was probably diabetic.

Also scheduled for another fasting BG test in 2 weeks time as "this is the way it is done".

Now I thought that once you had a non-fasting spike in the teens and a fasting level above 7.0 then they had you bang to rights.

See for instance
http://en.wikipedia.org/wiki/Type_2_diabetes_mellitus
and scroll down to the "Diagnosis" bit where there is a table.

Now I think that if I coached my friend in extreme low carbing for two weeks that we might be able to get the fasting BG down below 7 (I know I can do this for myself at least some of the time) but what would that prove, apart from that low carbing works for him?

So why the second fasting BG test?

I am dredging through my memory (always a painful task) and I think I may have had more than one fasting BG test.
This is supported by the memory that I fasted for my first HbA1C then felt a right pillock when I realised I didn't need to.
However I can't quite see the logic of the second test, unless it is because people don't always fast as they should (but then why would they do it for the second test?).

Anyway, posting to ask the newly diagnosed what process they went through.

Chers

LGC

 

[daisy1]

I don't know what the usual procedure is but I had my first fasting test which came out at 8.6 and so he said "you're diabetic". I refused to believe him so that's why I had another fasting test!

 

[LittleGreyCat]

Thanks - disbelief is not an issue here (one benefit of having a previously diagnosed friend).

 

[viviennem]

I had one high fasting BG test, then another fasting test + HbA1c - those came out at 9 and 6.5 respectively.

I think it's usual to re-check the first fasting just in case it's a one-off or a freak (infection, stress, etc).

Viv 8)

 

[borofergie]

I self tested @ 24.4 mmol/l (just before getting on a week long business trip).
Spent a long week trying to low-carb and rolled up a week later at the Doctors to say "I'm Diabetic" (BG down to 9ish).

Sent me for a (single) fasting blood test and HbA1C, both of which had me bang to rights as a T2 diabetic.

 

[anna29]

Hi, With myself having an underactive thyroid, I requested to be tested in case it had 'bombed' again? as had been feeling so drained,weary, tired out for quite some time.
Was tested and it had 'bombed' my GP unusually then wanted a full fasting bloods and lipids test as my cholesterol was 'high' too.
2 weeks later returned home to message left on landline to vist GP asap etc...
Went on the 30th dec 2009 and he sat me down and explained all the results in, were too high and I also was 'diabetic too' :shock: it totally ruined my new year as I was 'gobsmacked' and couldnt take it in, it knocked me sideways to be very honest.
Took me couple of months for it all to sink in...
I did get superb support from my GP and PN [practice nurse] they swiftly arranged appts and full screening tests with my feet and eyes and follow up aftercare.
So in answer to your question it took 2 full blood and lipid fasting tests, to reveal an Hba1c of 9.7% . :shock: plus a bombed thyroid gland again!
Hope this helps? Anna.x

 

[phoenix]

However I can't quite see the logic of the second test, unless it is because people don't always fast as they should (but then why would they do it for the second test?).

Anyway, posting to ask the newly diagnosed what process they went through.

I think it's to confirm,
' with no symptoms diagnosis should not be based on a single glucose'
There can be lab errors, a one off because of an infection etc . It's an International criteria. For anyone a diagnosis of diabetes can be devastating it can also in some countries have major ramifications on the availbilty of medical insurance. It's important there is no doubt.
I believe that in the UK they may be starting to use an HbA1c for diagnosis . http://www.diabetes.org.uk/About_us/New ... -diabetes/
The WHO recommendation says

An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes.
A value less than 6.5% does not exclude diabetes diagnosed using glucose tests.

http://www.diabetes.org.uk/Documents/Ab ... c_2011.pdf
Edit : you asked about the recently diagnosed should have read better!

 

[Daibell]

To put some context on this, when I saw my GP with all the symptoms for diabetes he dipped a urine stick in my sample and said 'Yes, you have diabetes' and 'I'm the practice diabetes doctor' and that was it! He gave me some diet sheets and that was it for 3 months when I must have been at least in the teens of mmol. Good to hear that your friend's GP is trying to do things the right way.

 

[Ann19]

I had no symptoms, was seeing the GP about something else. He was looking through previous history as he was a new Doctor and said 'Oh, you're Diabetic' I said no I wasn't and he replied that a test done a couple of years ago said that I was. I said that I didn't know that I had ever been tested and that I hadn't been informed about the result so he arranged a fasting test. This came back at 7.7 so that was me diagnosed, type 2. No more test done. I questioned another doctor about the previous test and was told that it wasn't a fasting test so different results and didn't show diabetes.

I think that I was lucky about his mistake as it caught it early and hopefully I can keep it in control.

Ann

 

[Osidge]

Hi

I had a full blood screening as part of the ASCOT study of blood pressure treatments and statins versus coronary outcomes. The fasting blood glucose was 12.1 and I was informed by mobile by one of the study doctors that I was diabetic and should visit my GP. It was a bit of a shock but my partner and I just continued on our journey to Tesco to do the weekly shop (fortunately I was not driving!).

 

[viviennem]

Incidentally, what's the point of "coaching" in extreme low-carbing to get iBGs down before diagnosis? There's no point giving your friend a false sense of security. Much better, having had high numbers, even if s/he is NOT diabetic, to presume diabetes and act accordingly, so s/he never gets it!

IMHO :wink:

Viv 8)

 

[goldfish_21]

I also had two fasting tests, but not both at the GP's.

I had done a self test using a family members machine to rule out diabetes as the cause of my foot problems as I had been having trouble getting the doctors to take me seriously about the pain in my feet and had been basically told there was nothing wrong, go away.

Anyway, the self test (which we were expecting to be normal) read 28 then 26. Bought my own meter and tested for a week as couldn't get in to see a doctor till then. Readings were between 14 first thing to mid twenties after eating.

Doc took one look at my page of readigns and booked me in for a fasting blood test the following day.

The results came through the day after that (17)and both the doc and the practice nurse rang my mobile in a panic to say I'm probably diabetic and that they had booked me an urgent appointment at the diabetes centre at the hospital.

I went there the following day (the doc even rang when I was there to make sure I'd gone and that they'd fitted in an appointment for me! She was a trainee doc and I think they take their patients more seriously). They did another fasting test - still in the high teens- and I was given a dianosis straight away of Type 2 and put on lots of metaformin.

So, in short, they did do a 2nd blood test for me, but the time scale between first seeing a doctor and being diagnosed/starting treatment seems to have been much, much quicker than in your friend's circumstances. I understand the need to be thorough in diagnosing, but I'm sure the wait cant be doing your friend much good.

Vicky

 

[didie]

My high sugar levels were picked up by the Neurology Department when I was found to have had a stroke on a long-haul flight (despite flight socks, aspirin and lots of moving round the plane).

My GP repeated the bloods and then did the hideous glucose test which confirmed the diagnosis and the thought is that the undiagnosed diabetes may have caused the stroke as all my other tests were normal.

My HbA1c was 8.0.

In the first instance I'm using diet and exercise to try and bring my levels down. There is nothing like having a stroke at the age of 53 to make you stop eating rubbish and start exercising. I really don't want to have medication because I am already going to be on a Statin and anti-clotting drug for the rest of my life because of the stroke.

I'm lucky because having had the stroke I've been given a blood glucose monitor which are not routinely given out to Type II diabetics.

 

[Grazer]

If in doubt, the glucose tolerance test is given. If a reading of over 11 is achieved, you're deemed diabetic. So your friends reading in high teens, regardless of whatever may have been eaten, (won't be as bad as pure glucose) should say diabetic without any other tests as far as I can see.

 

[sailorpip]

I was admitted to the Omani Armed Forces Hospital in Muscat earlier this year with suspected cellulitis in my leg. I had bloods, ultrasound, xrays, and told "you are diabetic" I said no I'm not - but I was still put on a diabetic diet (grilled fish or meat without oil - rice - salad & fruit) & I/V penicillin (for 10 days) for my leg, I was there a week before being med-evaced home with an RAF Nurse and taken to the RCDM (Royal Centre for Defence Medicine)Queen Elizabeth hospital in B'ham. While there my leg was ulcerated, but untreated other than dressings. I had a Blood fasting test - (but no sweet drink & retest) No mention of diabetes, but my GP notes instructed him to do a 'BG tolerance' test.
I had a biopsy @ Liverpool School of Trop Med as it was thought I had Leishmanisis (a disease caused by a sand fly bite) not true as it happened. - but they (LSTM) genuinely thought I was diabetic even without a blood fast..
The blood fast was not done for several weeks as my ulcers were being treated by compression bandages. On them healing I had my fasting test and sweet drink. The result was I was informed I was T2.
The Omanis knew straight away, and I shed almost a stone in a week on their diabetic diet, And LSTM knew I was Diabetic both without Blood fasting - So It really was a case of "its a fair cop gov" but still left me devastated, as I have had little reason to visit doctors throughout my life
Hope some of this might help someone.