Puzzled

[AR54]

Recently diagnosed type 2 diabetic.... prescribed metformin why does the doctor say I have no need to check my blood sugars? ... doesn't make sense.

 

[AM1874]

Hi @AR54 .. and welcome
The "no need to test" line from your doctor is, sadly, the experience of many people. There are many so-called reasons for this, including: "you're on metformin so you won't have a hypo", " you won't be able to understand the readings", "metformin keeps your blood sugar down" .. all of which are nonsense. The reality is that your Doc (along with thousands of other HCPs) is either following a particular interpretation of the NICE guidelines, or trying to save money for his/her surgery .. or both

But putting that to one side for now, you have certainly made a good move coming here. I was diagnosed T2 in early Feb and, like many people, I was a bit shell-shocked with little information and no real idea of what was happening to me. Since joining this forum, though, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

The key point to take on board is that managing and controlling your diabetes (or pre-diabetes) through exercise, diet and testing your Blood Glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I have tagged @daisy1 for you and I suggest that you read up on the Low Carb Program in the information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. and the following Diet Doctor websites ...
Low Carb Intro and Information
Low Carbs in 60 Seconds

It is a top priority that you get yourself a test meter and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

Unless you are prescribed test strips by your doctor (unlikely), the costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on the cost of your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £38.45
10 packs x 50 use code: 975833 .. cost is £76.90
For the TEE 2, the strips are £7.75 for a pack of 50 .. there are no discount codes currently available for bulk buys
I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I know what my BG levels are .. and I can now manage them

Hope this helps

 

[leslie10152]

Recently diagnosed type 2 diabetic.... prescribed metformin why does the doctor say I have no need to check my blood sugars? ... doesn't make sense.

Welcome to the forum @AR54. You need to test prior to meals and two hours after to ensure you are on track.

 

[daisy1]

@AR54

Hello AR54 and welcome to the Forum Here is the Basic Information we give to new members and I hope it will be useful to you. Ask as many questions as you need to and someone will be able to 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 245,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

 

[Phoenix55]

Welcome @AR54 It does not make sense to not test but it takes time and determination to interpret the results. I bought a meter and some test strips and kept a record of waking bg and two hours after each meal combined with a food diary and exercise taken. I learnt more about my diabetes in a few days than I did from any HCP. The key to getting back in control was to limit carbohydrates, not just sugars, and to avoid grain products. Some people can tolerate grains, some can't, some can tolerate some carbohydrate others can't. Your meter will tell you what is right for you. The advice on here is to buy a meter that has cheaper strips, they are the on-going expense and various kinds are available through the shop. If you do decide to go down the low carb route there are several recipe books that are probably available through your local library to give you some ideas.
Enough information for now, it is a steep learning curve at the beginning, but it does get easier. Good luck.

 

[AR54]

Thanks for all the info I’m only getting these messages now! Haven’t being on much I don’t know if it’s just me but feeling really nausea and having dull aching pain under my right rib area a lot.....n the tiredness is something else! Just got the energy to go to work come home good days make dinner n do little house work ....bad days just make it through door n have to lie down n sleep n I feel the cold a lot too .. haven’t returned to doctors as my doctor off on maternity leave and the rest ..... well let’s say I be better going to a vet!

 

[Resurgam]

Ah - that might possibly be gall stones - if you have been eating low fat foods your gall bladder doesn't empty and stones can form - then when you eat anything oily or fatty and it tries to work again - it hurts.
I had some really painful episodes going back to Atkins in the past - my doctors were always putting me on diets which caused weight gain, and pains in my gall bladder. They did pass, though. Permanent pain could be a bad sign, that the stones are too big to be expelled.
It could be dangerous to remain stoical about it.

 

[Grateful]

I am sorry you aren't feeling well.

Concerning the blood glucose testing, those who are suggesting you do it are giving good advice.

It is not the only option however. I do not self-test, so rely entirely on the HbA1c test at the clinic every three months or so. Because I don't test, I have to rely on a basic list of "foods to avoid or restrict heavily." This is a simpler alternative and it happens to work very well for me, in part because I am fairly anxious by personality and worry that daily testing would just add to the stress.

I am not trying to dissuade you from testing, but just wanted to give my perspective on how a good result can be obtained by some of us even without testing (see signature below for details).

 

[AR54]

Ah - that might possibly be gall stones - if you have been eating low fat foods your gall bladder doesn't empty and stones can form - then when you eat anything oily or fatty and it tries to work again - it hurts.
I had some really painful episodes going back to Atkins in the past - my doctors were always putting me on diets which caused weight gain, and pains in my gall bladder. They did pass, though. Permanent pain could be a bad sign, that the stones are too big to be expelled.
It could be dangerous to remain stoical about it.

I had a scan Resurgam. done in June time .. I and the doctor thinking gall stones ...scan come back clear for stones but showed fatty liver that’s when the whole diabetes thing raised its ugly head. It comes and goes I would call it a ache just there most of the time and I do think it’s brought on by not eating enough ... and sometimes if I go off road and eat chips or something classed as fatty. I’ve a app to see nurse at the end of the month and I shall tell her about it ...

 

[AR54]

I am sorry you aren't feeling well.

Concerning the blood glucose testing, those who are suggesting you do it are giving good advice.

It is not the only option however. I do not self-test, so rely entirely on the HbA1c test at the clinic every three months or so. Because I don't test, I have to rely on a basic list of "foods to avoid or restrict heavily." This is a simpler alternative and it happens to work very well for me, in part because I am fairly anxious by personality and worry that daily testing would just add to the stress.

I am not trying to dissuade you from testing, but just wanted to give my perspective on how a good result can be obtained by some of us even without testing (see signature below for details).

Hi grateful I find I keep on track better if I test... it keeps me on the diet better. Because I found when I wasn’t testing I kind of kidded myself I was “A ok “ and fell of the band wagon sort of speak. Couple biscuits here, few sweets there at break time with the rest of the team at break times....

 

[AR54]

Hi @AR54 .. and welcome
The "no need to test" line from your doctor is, sadly, the experience of many people. There are many so-called reasons for this, including: "you're on metformin so you won't have a hypo", " you won't be able to understand the readings", "metformin keeps your blood sugar down" .. all of which are nonsense. The reality is that your Doc (along with thousands of other HCPs) is either following a particular interpretation of the NICE guidelines, or trying to save money for his/her surgery .. or both

But putting that to one side for now, you have certainly made a good move coming here. I was diagnosed T2 in early Feb and, like many people, I was a bit shell-shocked with little information and no real idea of what was happening to me. Since joining this forum, though, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

The key point to take on board is that managing and controlling your diabetes (or pre-diabetes) through exercise, diet and testing your Blood Glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I have tagged @daisy1 for you and I suggest that you read up on the Low Carb Program in the information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. and the following Diet Doctor websites ...
Low Carb Intro and Information
Low Carbs in 60 Seconds

It is a top priority that you get yourself a test meter and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

Unless you are prescribed test strips by your doctor (unlikely), the costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on the cost of your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £38.45
10 packs x 50 use code: 975833 .. cost is £76.90
For the TEE 2, the strips are £7.75 for a pack of 50 .. there are no discount codes currently available for bulk buys
I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I know what my BG levels are .. and I can now manage them

Hope this helps

Thanks for all this info AM1874 at the moment I have a monitor which is more expensive to keep running.I shall look into purchasing these ones