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Questionable GP Knowledge & Advice

Gadget_man

Well-Known Member
Messages
73
Type of diabetes
Prefer not to say
Treatment type
I do not have diabetes
I've not been officially diagnosed as of right now, but having tested my own fasting blood for the last 9 days it would seem that there is an issue, i.e. the lowest reading I've had is 6.2 and the highest 7.3, which I am led to believe are outside the "normal range" for a non-diabetic.

On the basis of the readings I've taken I made an appointment to see my GP to discuss what happens next. Normally I've found this GP very good, helpful, good listener and has provided very good care. Anyway, I went there today and was a bit gobsmacked by what I heard.

I explained why I'd been testing my fasting levels and showed her the results that I'd printed out and was told that levels of up 6.0 are considered "normal". Whereas I have found evidence, on this forum and elsewhere that indicates my position is nearer correct similar to those I've copied into here as seen below.

A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test.
Diabetes Tests and diagnosis - Mayo Clinic
www.mayoclinic.org/diseases-conditions/diabetes/basics/tests-diagnosis/con-20033091

Fasting test results
The results of a fasting test with respect to glucose levels in the body are as follows:

  • Normal: 3.9 to 5.5 mmols/l (70 to 100 mg/dl)
  • Prediabetes or Impaired Glucose Tolerance: 5.6 to 7.0 mmol/l (101 to 126 mg/dl)
  • Diagnosis of diabetes: more than 7.0 mmol/l (126 mg/dl)
I understand that the levels that are discussed in these excerpts are from lab blood tests and not "user meter" tests, but there has to be some correlation surely?

I was then told that my meter, an Accu-Chek Mobile, that is less than 2 weeks old, is probably inaccurate by up to 1.0 high, as most meters read higher than they should and, " you need to check your meter against the diabetes nurse's meter, as their's are accurate".

When I challenged this statement about the readings always being high and inaccurate by up to 1.0 by saying, in that case diabetics would over compensate themselves with too much insulin, I was told, "the readings mean something different for them, the readings for you mean something else and can't be relied upon". When I asked why they meant different things dependent on your diabetic / non-diabetic status, I was given some half-hearted waffle which didn't make much sense but ended with, "it's complicated". I decided not to go any further along this discussion path as I felt that the BS (pardon the pun) level was getting way too high.

Anyway, she's decided to send me for a "real" test, as she described it, and I have to await the results.

What are the experiences or comments on this from others?

P.S.
I'm making an appointment to see the diabetes nurse and check my meter against their 'accurate' one to see what the deviation really is between two meters. Not accurate I know, but still......!
 
Well it's good that she is sending you for a 'real' test if that is a full HbA1c blood test as that is the only one that can determine if you are diabetic.
I use an Accu Chek Mobile and find it is fairly accurate. If anything it probably gives a lower reading than is indicated by my HbA1c test - see my figures below.
Others on here say their Accu Chek Mobiles also tend to give a lower reading than their other meters.
 
Hi, blood glucose monitors are not accurate!
Testing your your blood glucose levels is an important part of treatment, especially on a non medicated, diet only T2!
We use a monitor to test foods that we may have a tolerance to.
The usual suspects are carbs, sugar and starchy vegetables.
We use the monitor to see trends as we gather the information on what we are eating and how much as well. A food diary is essential is using the monitor as a tool.
The instant blood glucose reading is just a snapshot of your blood glucose levels.
The timing is important. We recommend pre meal and two hours after first bite.
If a food or combination of foods gives you a reading of more than two mmols higher than your pre meal reading, then that meal needs adjustment or eliminating from your diet.
A fasting reading can be skewed by dawn phenomenon, this is because your liver gives you a boost to get you out bed in the morning!

Your GP is getting your bloods done to see if you have diabetic levels, this is called a hba1c test, it is to see your percentage of glucose in your blood.

The figures you quote are a guideline not set in concrete, because individually, we all have different normal range levels. Also some diabetics can live comfortably fit and healthy above and below those guidelines.

If you start reducing your carbs and sugars, you could address the higher figures you are getting from your monitor.

Welcome to the forum.
I'm tagging @daisy1 to give you the newcomers welcome information.

Best wishes.
 
In my experience, I find the accucheck mobile to be the most accurate of meters I have tried and my fasting numbers correlated with a venous blood sample analysed in a lab. 6.7 fasting on meter and 6.7 on lab test.

On the other hand, my Sd codefree is always 0.5-1.0 higher than the accucheck.

I was also told I'm not diabetic based on an hba1c of 5.6 (38) by my gp and that they would test again in 12 months. No amount of protesting changed the doctors mind. I think they just see me as a hypochondriac.

What is very clear though is that despite my doctors insistence, I do have glucose tolerance issues, just not at full blown T2 levels yet.

I have made significant inroads to my fasting numbers with LCHF and now sit between 5.0-5.5 most mornings, however if I fast for 12 hours or more it will always rise to over 6 and sometimes closer to 7.

I have accepted what my do tor has said but applied my own due diligence and applied lifestyle changes before it becomes a bigger problem as through talking to people they are all very happy to confidently say don't worry you're aren't diabetic and then allow you to carry on as normal and then drop the bomb in subsequent annual tests without ever mentioning that you are higher than normal and need to pay attention.
 
Well it's good that she is sending you for a 'real' test if that is a full HbA1c blood test as that is the only one that can determine if you are diabetic.
I use an Accu Chek Mobile and find it is fairly accurate. If anything it probably gives a lower reading than is indicated by my HbA1c test - see my figures below.
Others on here say their Accu Chek Mobiles also tend to give a lower reading than their other meters.

I use an accu chek mobile alongside Libre and I find it accurate too.

I wish I was surprised by your experience with your GP...
 
Hi, blood glucose monitors are not accurate!
Testing your your blood glucose levels is an important part of treatment, especially on a non medicated, diet only T2!
We use a monitor to test foods that we may have a tolerance to.
The usual suspects are carbs, sugar and starchy vegetables.
We use the monitor to see trends as we gather the information on what we are eating and how much as well. A food diary is essential is using the monitor as a tool.
The instant blood glucose reading is just a snapshot of your blood glucose levels.
The timing is important. We recommend pre meal and two hours after first bite.
If a food or combination of foods gives you a reading of more than two mmols higher than your pre meal reading, then that meal needs adjustment or eliminating from your diet.
A fasting reading can be skewed by dawn phenomenon, this is because your liver gives you a boost to get you out bed in the morning!

Your GP is getting your bloods done to see if you have diabetic levels, this is called a hba1c test, it is to see your percentage of glucose in your blood.

The figures you quote are a guideline not set in concrete, because individually, we all have different normal range levels. Also some diabetics can live comfortably fit and healthy above and below those guidelines.

If you start reducing your carbs and sugars, you could address the higher figures you are getting from your monitor.

Welcome to the forum.
I'm tagging @daisy1 to give you the newcomers welcome information.

Best wishes.

Thanks for your reply. Interesting what you say, I'll have to research that liver phenomena.

Daisy has already been in touch thanks.
 
Well it's good that she is sending you for a 'real' test if that is a full HbA1c blood test as that is the only one that can determine if you are diabetic.
I use an Accu Chek Mobile and find it is fairly accurate. If anything it probably gives a lower reading than is indicated by my HbA1c test - see my figures below.
Others on here say their Accu Chek Mobiles also tend to give a lower reading than their other meters.


Thanks for your input.
 
Thanks for that.

I gather that there may be a lot more people unsurprised by my GP visit and discussion.
A GP told me that over 80% of diagnosis for any condition are usually made at A&E consultation these days. All GPs seem to do is treat symptoms these days and have little time to actually do thorough investigative work.

When all is said and done, they will never show the same level of concern for their patients that we feel and in my experience will always leave me feeling let down by their input.

Do your own due diligence, they won't do it for you, that is as clear as night and day.
 
I think the numbers you quote are the US numbers, slightly different, if it matters at all. From this website:

upload_2017-1-25_13-34-28.png
My GP also dismisses my fasting levels of 6.5-7.00 (sometimes over 7) and insists on just using the HBA1C number. I'm seeing them next Monday about something else so will ask again about (1) fasting level and (2) perhaps an OGTT
It will be interesting to see which meter the nurse uses, ours uses OneTouch Ultra 2, which are supposed to be pretty inaccurate. I had a spell using one and it read low all the time)
 
Have a look at the numbers here.

http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

What symptoms did you have that made you start testing?
Thanks for your reply.

I wasn't aware I had any symptoms to start me checking.

A friend asked me to join a 'health and fitness plan' he runs, which I know is a euphemism for selling high priced food supplements, but I watched a video his group had produced which made a rather startling claim that EVERYONE needs a sugar boost to get them going in a morning , plus of course their supplements.

I had other reasons to obtain an Accu-Chek monitor but having got one I decided to see if their claims were true or not as I disputed their claim on the basis that diabetics really wouldn't want to take a sugar hit first thing in a morning.

Anyway, I got going and was surprised by my results. Chatting with a very close friend who has considerable knowledge on this subject convinced me things aren't right and the rest you know.

Having said I wasn't aware of any symptoms before I checked myself, I can now see that when I do get low (and I do get below 4.0 during the day for some reason despite eating properly) I get shaky, irritable and anxious. Whether that's now a self-fulfilling thing or not I'm not sure, but for now the readings are enough to convince me something is wrong.
 
A GP told me that over 80% of diagnosis for any condition are usually made at A&E consultation these days. All GPs seem to do is treat symptoms these days and have little time to actually do thorough investigative work.

When all is said and done, they will never show the same level of concern for their patients that we feel and in my experience will always leave me feeling let down by their input.

Do your own due diligence, they won't do it for you, that is as clear as night and day.

Thanks for that.

I agree with you in all respects, but would add that it's OK doing your own due diligence, BUT the GP is the doorkeeper to official help and support.
 

It's good that you managed to get a HbA1c test sorted - fingers crossed the results are OK.
Thanks again.

Even if the results appear OK, a single test at a random point in time isn't going to alieve my concerns and I'll be continuing to look to either get 'OFFICIAL' support or work out how to help myself.
 
Thanks for your reply.

I wasn't aware I had any symptoms to start me checking.

A friend asked me to join a 'health and fitness plan' he runs, which I know is a euphemism for selling high priced food supplements, but I watched a video his group had produced which made a rather startling claim that EVERYONE needs a sugar boost to get them going in a morning , plus of course their supplements.

I had other reasons to obtain an Accu-Chek monitor but having got one I decided to see if their claims were true or not as I disputed their claim on the basis that diabetics really wouldn't want to take a sugar hit first thing in a morning.

Anyway, I got going and was surprised by my results. Chatting with a very close friend who has considerable knowledge on this subject convinced me things aren't right and the rest you know.

Having said I wasn't aware of any symptoms before I checked myself, I can now see that when I do get low (and I do get below 4.0 during the day for some reason despite eating properly) I get shaky, irritable and anxious. Whether that's now a self-fulfilling thing or not I'm not sure, but for now the readings are enough to convince me something is wrong.

I get below 4 in the day, and feel bad.
I can also have a really bad nights sleep and wake up over 6.
It can drop to below 5 by the time I've walked around for a bit though.
But if I calorie control my diet, I can wake up with 4's.
There is definitely a difference between finger tip testing, and core BG that needs to be accounted for as well.

I would scrutinise what I eat, (after the test), and make some changes though, even so.
 
Thanks again.

Even if the results appear OK, a single test at a random point in time isn't going to alieve my concerns and I'll be continuing to look to either get 'OFFICIAL' support or work out how to help myself.

If it's a good result, it'll mean you aren't diabetic, or pre diabetic, so there isn't going to be a lot official support can offer though.
If you just want to reduce your BG, assuming your BMI is ok, and you're exercising etc, just don't eat carbs.
 
Thanks for that.

I agree with you in all respects, but would add that it's OK doing your own due diligence, BUT the GP is the doorkeeper to official help and support.
Absolutely, but even then, they can let you down badly.

If I could offer any advice, it would be to make the necessary changes to diet regardless right now and await the results of the official doctors test.

By adopting a low carb lifestyle you can only be doing yourself and your health good in the long run and should a diagnosis come at some point then further changes would not be such a culture shock and a lot easier to cope with.
 
Absolutely, but even then, they can let you down badly.

If I could offer any advice, it would be to make the necessary changes to diet regardless right now and await the results of the official doctors test.

By adopting a low carb lifestyle you can only be doing yourself and your health good in the long run and should a diagnosis come at some point then further changes would not be such a culture shock and a lot easier to cope with.

Changing now will affect any result of a future test..
 
Changing now will affect any result of a future test..
Only an hba1c which would be a positive thing. If you go for an OGTT you would be instructed to carb load in the days preceding the test anyway.

We all handle things differently, from my perspective I have identified that I have some insulin resistance and have made the changes before it becomes a bigger issue down the road when I get my next test in June.

Ultimately, if you have insulin resistance it will only get worst if left. A normal hba1c will not offer any reassurance that you're are no longer at risk of diabetes if you carry on as normal.

I think what I'm trying to say is why let a problem become a bigger one once you have a head start and an opportunity to attempt a reversal sooner rather than later.
 
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