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Pros and cons of official diagnosis?

Discussion in 'Prediabetes' started by Happyhomelands, Feb 15, 2018.

  1. Happyhomelands

    Happyhomelands · Well-Known Member

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    I'm a bit confused by my gp appointment. Having had fasting glucose in the 8s and an Hb1ac of 50 the practice nurse told me that I have type 2 diabetes. She advised me to make an appointment with my GP. I have been low carbing with pleasing glucose levels. I can see a steady reduction from January.
    My GP says that as my current levels are good then I'm not diabetic. He will retest Hb1ac in a couple of months. If there are 2 concurrent highs then I am diabetic. I'm hoping that by the time of the test my test will indeed be in normal range.
    My question is "does the diagnosis make any practical difference?" I know from my cheat days I will need to continue low carbing, that's not the issue. The reason I initially tested was that I was experiencing eye pain and blurry vision. If I'm not diagnosed I won't get the full diabetic support./ investigations. There may be other issues I don't know.
    Does anybody have any views on the value of an official diagnosis if I intend to look after my diet?
    Many thanks for picking through my rambling question.
     
  2. archersuz

    archersuz Type 2 · Well-Known Member

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    If diagnosed you will get annual eye screening, a free annual eye test with a high street optician, an annual review including checks on your feet from the diabetic nurse. If you work then your employer has to make 'reasonable adjustments' if required. I feel there can be a stigma attached to having a 'label' of diabetes but although I have reduced my HbA1c to 35 I am happy to keep that label and the regular screening.
     
  3. walnut_face

    walnut_face Type 2 · Well-Known Member

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    Pros:
    You will get a retinopathy screening each year
    You will get a blood test at least once a year

    Cons:
    You will have to tell every insurer (Vehicle and Travel)

    Officially diagnosed or not I would say that you may already have insulin resistance and will have to be very careful and keep a close eye going forward
     
  4. Guzzler

    Guzzler Type 2 · Master

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    Any doctor who thinks that an initial A1c of 50 and a couple of months later of, let's say, 38 no longer has Type 2 Diabetes is wrong in my opinion.

    You will have had two HbA1c tests to confirm the initial diagnosis and (again, in my opinion) you will always be Diabetic even if you are considered in Remission or Reversal or have been given the tag of Resolved.

    I would advise you to carry on monitoring your bg levels and striving for good management of the condition and at your next review go armed with the knowledge that there is no 'Cure'.... yet.

    Edited to add.
    Even though 50 could be considered borderline Pre Diabetes/Type 2 Diabetes my thoughts are the same, though other people may have differing opinions. Read up and then make your own mind up. Good luck.
     
    • Agree Agree x 2
  5. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    With an HbA1c of 50 and a FBG of above 7, that is enough for a diagnosis of T2. Sometimes a second test is done within 2 weeks of the first, to confirm the HbA1c. Your nurse was satisfied this wasn't necessary. However, your GP should have done the second test within 2 weeks of the first if he wanted to confirm it. As he didn't you can assume you are T2. It should be on your records already. Are you in England? If so your surgery is supposed to put your records on line, and this should include any diagnosis. If you ask your surgery how to register for test results on-line you will be able to see all your test results and diagnosis.

    If subsequent tests come back with normal levels, you are still diabetic, but in remission/well controlled/ whatever you want to call it.
     
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  6. Happyhomelands

    Happyhomelands · Well-Known Member

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    Thanks, I'm less worried about stigma than missing something medical. On the other hand I don't want to waste NHS money if tests aren't medically justified. I am less worried about my eyes now that I have read about mechanisms for blurry vision whilst glucose levels are changing. Lots to think about.
     
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  7. Happyhomelands

    Happyhomelands · Well-Known Member

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    Yes definitely have insulin resistance and will need to keep a close eye.
    If I keep glucose levels low perhaps I don't need a retinopathy screen?
    Do insurers put restrictions on type 2s?
    Thankyou for the info.
     
  8. Happyhomelands

    Happyhomelands · Well-Known Member

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    To be fair to the gp my printer wasn't working so the levels I showed him were not well presented.
    I agree with you, the results look like type 2 and that means to me that a good future result means type 2 under control.
    Let's hope the low carbing is a permanent solution.
    Thanks for the advise, really helpful.
     
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  9. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Whatever the GP labels you, you are still diabetic. Your HbA1c and FBG show this. Any slip up in your low carb eating is highly likely to raise your levels back to where you started. You aren't cured. Carbs are still danger foods for you.

    You may find more advantageous life insurance policies because they don't expect us to live as long! I certainly found this when I took out an annuity.
     
  10. Happyhomelands

    Happyhomelands · Well-Known Member

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    Thanks. I was really pleased and surprised that he didn't suggest medication. I didn't understand the implications of the second test. I have been occasionally monitored since gestational diabetes 17 years ago. 2 years ago I failed the glucose tolerance test but didn't know the significance. I'll definitely go and get my test results now as I think I'll understand them much better thanks to this forum.
    The GP is very nice, I'm sure he will listen to me. It would be funny if the diagnosis is in my records already.
     
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  11. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Most GPs will leave medication alone with an HbA1c of only 50 and give you 3 months to try and lower it with diet. My HbA1c was 53 (FBG 7) Medication was never mentioned, and hasn't been since.
     
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  12. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Are you sure that a diet controlled diabetic needs to tell insurance firms?
    The DVLA isn't interested.
     
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  13. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    You do when first applying. I also told my car insurance people but they weren't interested.
     
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  14. archersuz

    archersuz Type 2 · Well-Known Member

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    I told me car insurer and they weren't interested - said I only need to inform them if I have to inform DVLA and/or my GP says I am not fit to drive
     
    • Agree Agree x 2
  15. Happyhomelands

    Happyhomelands · Well-Known Member

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    Does the DVLA need to be notified?
     
  16. archersuz

    archersuz Type 2 · Well-Known Member

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    In my opinion it's still worth having the annual screening. The HbA1c is an average over 2-3 months and may not show up any spikes, and it's the spikes that can cause damage.
     
  17. paulus1

    paulus1 Type 2 · Well-Known Member

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    as others have said your diabetic. sorry. the good news is its pretty low so not likely to have done any harm. if you can maintain your diet you should remain in the none diabetic range. this does not mean your healed just well controlled. trust me the nhs is saving money testing and preventing complications. a poorly controlled diabetic is a massive drain on the nhs. it makes cost sense for them to keep you healthy.
     
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  18. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    Congrats on the hba1c reduction, the diet you are following that has got you these results is basically how you will need to keep living to maintain good control. It can be a bit tough eating out and finding low carb choices, but it's not impossible. Just remind yourself you want to keep that 35 when tempted.
     
  19. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Have I missed something? The poster said his HbA1c was 50.
     
  20. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    No, they are only interested if you are on insulin or certain other drugs that might cause a hypo.

    https://www.gov.uk/diabetes-driving
     
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