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Questions about my BG results 1 and 2 hours after my meal

 
Here I am, back from spending a day on the M20 while a lorry burned down.

I have been reading a great deal about the controversy over the NICE recommendation for dispensing statins. It is obvious that large parts of the medical profession disagree with it. viz.

http://www.bmj.com/content/348/bmj.g3937

It is NICE that make the recommendations and not the GP's and nurses.
 


You'd be surprised at the level of poor advice casually metered out and of the number of clinical incidents in a single hospital in a single day. Wherever people are involved, mistakes are made, procedures not followed and short cuts taken, jobs rushed and poorly done and people simply not paying attention to either the patient or to what they are doing. It's the way people go about their jobs.

And orthodoxies do set in, even if bad ones. Below is Prof Roy Taylor's criticism of the NHS approach in the journal Practical Diabetes:

"It must be recorded that many individuals expressed frustration at the routine manner in which their doctor, nurse or dietitian regarded the diagnosis of type 2 diabetes. This conflicted with the cataclysmic blow which they personally felt. They were told that the diagnosis was clear and therefore the guidelines will be rolled out. Lose some weight and take this metformin. Get used to it."

I got a sneer when I refused the metformin and a snarl when I mentioned Roy Taylor. After 40 years in the job my GP had just become complacent.

Below is typical of what goes on:

"This blood test costs us £6000 and it will tell us nothing because it has nothing to do with condition under investigation."

"Yes, but the consultant dosen't understand what the test means but I haven't the time to explain it to him so just do it and avoid any fuss."
 
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Maybe we should charge them for our time in explaining what T2 diabetes is like and how best to deal with it.

I appreciate that GPs are in a cleft stick regarding NICE and the legal position of them departing from the guidance, but with T2 being prominent on their radar screens at the moment you would think that at least one GP/DN per practice would take the time to research more, independently of NICE. And start from a position of what the body can do for itself rather than pushing pills being the default start point.
 

In principle I like the idea of a central authority dictating doctrine and especially if it has Care Excellence in the title. This kind of thing prevents local variations of care and stops strange potions being dispensed because a HCP has an arrangement with strange practices.

That works fine until you put the fox in charge of the hen coop and the doctrine gets so bad that even the other HCP's notice.
 
Please remember guys the guidelines do not consider any patients to be well motivated intelligent individuals who want to manage their own diabetes. They are written for the masses who believe doctor/nurse knows best. Sadly there is not enough time in the system to educate the masses, it's up to we 'few' here preaching the message on cyberspace!
Derek
 
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lindisfel said:
Please remember guys the guidelines do not consider any patients to be well motivated intelligent individuals who want to manage their own diabetes. They are written for the masses who believe doctor/nurse knows best.
Click to expand...

All the more reason for it to be right then, surely?
 
Today's readings
Fasting at 6.30am 5.2
Breakfast at 9.30 2 eggs, 3 rashers, sausage.
10.30am 6.2
11.30am 5.7
13.30 post 3 mile walk 4.9
17.50 4.3

Football again later will post after eating. After liver dumps at waking and post exercise 5.2 and 4.9 respectively


Sent from the Diabetes Forum App
 
I'm confused gaz. Are you suggesting liver dumps are reducing your blood scores to 5.2 and 4.9, or raising them to that?
 
I think what I am saying considering I am new to all this is that when you first wake there is a liver dump of glucose so my 5.2 fasting is actually quite low or dare I say normal? Also post exercise, during which there may well have been liver dump and immediately after exercise 4.9. Again quite low?


Sent from the Diabetes Forum App
 
Question is as a comparison what would these reading be in someone of my age 46 that is healthy and does not have T2?


Sent from the Diabetes Forum App
 
Hi,

We don't all have a morning liver dump. It happens when your background insulin production is out of wack (for whatever reason).

To find out if you have one, test last thing at night, and in the middle of the night.
If your morning reading is higher than those readings, then you have a Dawn Phenomenon (aka liver dump).

Likewise, the liver only dumps after strenuous exercise - strenuous enough for it to think you are running out of fuel for your muscles... A 3 mile walk could do that - but only if very strenuous. I'm not sure it would for me, and I'm not even medium-fit. Is your avatar pic your muscles? If so I would be amazed if you would liver dump from anything less than an intense workout.

Also, I think (but am not 100% certain) that low carbing reduces your chance of liver dumping, simply because there is less glycogen stored, so there is less glucose available to dump... Anyone else have an opinion on this? Please correct me if I'm wrong!
 
That's speculation. Not everyone has liver dumps on waking - healthy or diabetic. Some people have them sometimes, and some almost, always. Only overnight testing would give you an insight as to where you really are, but I'd suggest that would be OTT, at this stage.

Your fasting and post exercise are good. I wouldn't say they are in any way low. I find after walking, my scores drop, not rise, but many report a rise, then drop. As I say, we're all individuals.

As for your next post; who knows. They're all different too. Indicative non-diabetic levels are shown here: http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html.
 
gaz tred said:
Question is as a comparison what would these reading be in someone of my age 46 that is healthy and does not have T2?


Sent from the Diabetes Forum App
Click to expand...

There's a link in my signature to a website called bloodsugar101.

It's packed with info for (type2) diabetics, and has a section on normal BG levels and what happens when our glucose tolerance detereriorates.
 
I say you are very lucky to be getting strips if you are type 2.... Where I live my GP refuses to give strips and does not advocate testing at all in between the HBA1c tests.... they say the strips are too expensive to prescribe. I am under the hospital for my control as its not very stable and gets effected by all kinds of things and then behaves for a while without reason... my specialist insists on strips as I am on gliclazide which can cause hypos.... I get hypo symptoms at readings of (old) 4.5 . so the consultant emailed my GP and insisted they give strips... they still refused... that went on for 18 months... I now have found a doctor in the practice who says " just see me, i'll sort it".... but what an effort... So if you are getting enough strips to test four times every meal, well done... I have 50 and they want me to make them last as long as possible... at least a month. My argument is, on here the type 2 testing programme is advocated, and I know it helps me control as when I test regularly I get better control... so why is it there is a charge to register on the programme is its been proved testing gives better control and the NHS want to cut down on costs ... better control = less complications - less hospital costs.... make the testing scheme free to everyone .. I can't afford to pay to go on the scheme...
 
Tonight 2 hours after dinner I was 7.4 so that's in the normal range for a non diabetic according to this website:
http://healthiack.com/health/what-is-normal-blood-sugar-level

Is that website right? What BG should I be aiming to be under to avoid experiencing the terrible neuropathy I had and to avoid risk of a heart attack which I read is a complications of type 2 diabetes. I've been going by that website and I'm not sure if it's correct.

Also I am testing first thing in the morning and 2 hours after dinner. Is it really important to test 1 hour after meals as well to get the peak? And if the peak is high does that mean that meal should be excluded even if it comes down to say 7.4 at 2 hours? Also the other day at 1 hour post dinner my BG was 9 is this doing damage to me even though it came down an hour later (2 hrs post dinner) to 7.6?

Another question is it really damaging to have a treat now and again and just have a takeaway and not worry about the BG? Or is that going to do my body damage in the long run?

For those who don't know I suffered terrible terrible neuropathy for months before being diagnosed. Tingling pins and needles like a billion ants crawling on my feet and up my legs. On my hands and arms. My groin and eventually my face. I also suffered non stop muscle twitches, blurred vision, I was very snappy. Eventually one day my legs were tingling so bad it was like an intense buzzing like they were gonna take off! The next day the side of each leg was numb and they remain numb still but the tingling has gone.

I hope someone can answer my questions as I'm really trying to learn and I don't want to be having a blowout every few weeks only to discover down the line I'm damaging my body even more. I'd also like to keep my BG at safe levels 2 hrs post meal and I'd like to know what you guys think I should aim to be under.
 
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As you
As you say the..Few........that is exactly it.The NHS will not change their guidelines on what a minority think is the best way to manage diabetes diet wise because it has not yet been proven so they can't officially recommend it It takes years of research and testing before a new drug becomes available to use and it will be the same with the diabetic diet they will not change their guidelines until they can prove if it is right or not to tell diabetics to do a LCHF diet....a lot of HCP's may think it is ok but cannot officially say so
 
Sounds like your levels are fine the 2 hours post meals guideline is under 8.5 I think most people only do the pre meal and 2 hours after tests
 
Of cour

Of course there will always be mistakes made it would be pretty unrealistic to believe otherwise humans are not infallible but on the whole we have to be able to trust that our GP's and HCP's do give us the right advice otherwise who else is there for us when we are ill
 
I get kind of confused by all this too, but on top of this there is also gluconeogenesis by the liver and this also appears to be disordered in some people and not sure if it's related to the amount of stored glycogen or not. I will get readings in the 4's after a walk, but a few hours of fasting later, I can be in the 7's. I get totally confused by what my own body is doing for no apparent reason I can discern
 
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