Really confused newly diagnosed

[Sarahlou360]

Hi!
I don't know where to start so forgive me if I ramble on..
I saw my doc for a different issue and she requested bloods. Not fasting and I was told they were not looking at sugars so I went about my normal eating/drinking habits. Had a couple of biscuits with milk the night before and a bowl of crunchy nut for breakfast, test was at 11am.
Anyway, they did do my sugars and it came back at 10.
I have had fasting and past tests that have come back at 6 or 6.6 so at the higher end of ok but still OK I thought.
So my doc took great joy in telling me I was diabetic and dangerously so that I needed meds (Metaformin) asap and that was my only option. So for 4 weeks she has me on:
Week 1- evening meal only x1
Week 2- morning and evening meal x1
Week 3- morning x1 and evening x2
Week 4- morning x2 and evening x2

I have discussed with others and they are all very shocked at the amount I have been told to take in a short space of time or with a number of 10?
I hadn't seen this doc before and felt very bombarded with scary facts and shoved a booklet and prick machine and that was it. I don't know what to do! Is this right? Should I get a second opinion?

 

[Deleted member 475901]

Some GPs have not kept up with the changes in treatment fro T2 diabetes. Reading around here will offer a few choices other than pills if you want to try dietary changes instead.
I turned down metformin and went low carb immediately - and reached remission within weeks. The nurses who monitor T2 at the surgery were amazed as they'd never recommended low carb - it is now one of the options with support offered by the NHS

 

[Antje77]

I have discussed with others and they are all very shocked at the amount I have been told to take in a short space of time or with a number of 10?

This way of increasing metformin isn't very unusual.
Metformin is the mildest diabetes medication, although the side effects can be anything but mild for some. That's why it's increased over a couple of weeks, often it's better tolerated that way.
Not always though, for some it means diarrhea no matter how slowly thay increase the dose, but others are perfectly fine on it.

What is unusual is that he seems to have diagnosed you without a hba1c test, which tells you something about your average blood glucose over the past 3 months.
Did you get a blood draw which was sent to the lab as well?
I'd definitely make sure to find out what your hba1c is, that's your starting point.

they did do my sugars and it came back at 10.
I have had fasting and past tests that have come back at 6 or 6.6 so at the higher end of ok but still OK I thought.

Maybe not completely OK, but not super high either!
With those numbers there is no telling if you have diabetes or pre-diabetes without a hba1c.
And like @TriciaWs said, many of our members have gotten their numbers nicely back in the non diabetic range with some dietary changes.

 

[HSSS]

I’m not at all sure which tests you’ve had done (and they might not all be the same test) or on what basis they have diagnosed you.

blood glucose in the uk is measured in mmol/L (mg/dl in some other places). This is how much sugar (glucose) is in your blood right now. That should ideally be between 4 and 5.5 fasted and under 7.8mmol at least 2 hrs after eating/drinking or under 11 if done randomly as yours was. This can be a pin prick or from a vein.

hba1c in the uk is most often measured in mmol/mol and would be under 48 to be classed as non diabetic. However some uk drs and the USA for example measure this in % and would confusingly be in the upper single digits too and are often mixed up with bgl in mmol. It should be under 6.5%. This test shows the effect on your red blood cells glucose has had over their life span which is an average of 12 weeks being made all the time. This is almost always done from a vein although there are some machines that can do it from a pin prick in some drs offices etc (not nhs as far as I know)

So first question is which actual tests have been done and in what units? If you are in England you are entitled to get online test result access via the nhs app. You will need to ask your surgery to turn it on though. Even without this you are entitled to the accurate details of all tests you have had including the name, result units measured in and normal range. Usually this means a printout. They can only charge a reasonable photocopy fee, no more. Other locations have similar systems.

It’s very strange and against NICE policy that a person should be diagnosed on a blood glucose test, especially a single one not repeated. And 10mmol/L for a non fasted test is not a diagnostic level anyway. https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

Diagnosis is normally done with an hba1c and if that is borderline or without symptoms should also be repeated.

 

[catinahat]

Welcome @Sarahlou360
Yes it can be quite a shock when we are first diagnosed, I remember thinking that they must have made some mistake, how could I be diabetic?
After the disbelief came self blame, despair, anxiety, a whole bag full of emotions before I accepted the diagnosis.
Setting aside the confusion of what tests you have had done and what units the results are in.
No one here can interpret your results and give you a diagnosis, that is your Dr's job.
With an estimated 5 million people living with diabetes in the UK, 90% of them T2, its not exactly a rare condition that your Dr has never before encountered.
She/he will have diagnosed and treated diabetes many times throughout their time as a Dr.

So my doc took great joy in telling me I was diabetic and dangerously so that I needed meds (Metaformin) asap and that was my only option.

I hadn't seen this doc before and felt very bombarded with scary facts and shoved a booklet and prick machine and that was it.

I think the shock of your diagnosis has somehow coloured your view of your meeting.
Why would your Dr take "great joy" in your diagnosis?
And what you call being bombarded with scary facts, I would describe as the Dr trying to impress on you the seriousness of a T2 diagnosis. And to be honest for a Dr to put you straight on to medication, and give you a glucose meter, your test results must have been quite concerning, most of us have to buy our own meters.
If I were you I would skip right past denial, blame and all the other emotions, and get to the most important stage.
The what can I do to keep healthy?

 

[Mrs HJG]

Oh @Sarahlou360 doctors and nurses try their best and don't necessarily convey their findings and/or assumptions in the best way - before I was diagnosed, the nurse asked me which type of diabetic I was, when she did a urine dip! (I now know a +++++ result will do that!). She hadn't even taken my blood yet

The Metformin increase is normal, and great if you aren't having unpleasant side effects - I have LADA and my BG is in non-diabetic range but I still take 2 Metformin a day, my endo (and my own research) backs they they have other good protective benefits that it doesn't hurt to maintain.

Was this one BG reading of 10, or the HbA1c result of 10%? Crunchy Nut will definitely do that for anyone, diabetic or not for a one-off finger prick, but as an HbA1c result the day's breakfast would make no difference - but if that's your everyday breakfast it would be starting your day on a high carb BG high. What are you current BG readings?

If you were previously 6/6.6 I am suspecting that was % and therefore if you were 6-6.4% that was pre-diabetes. NB. this is a slightly different range to the finger prick results.

If you and your surgery are registered with NHS online you should be able to see your recent results. It sounds like you Doctor is on the ball, even if their social skills need work.

 

[EllieM]

Welcome to the forums @Sarahlou360

I agree with the others that you should get clarification as to what those results are. An hba1c of 10% combined with previous tests of 6% or 6.5% would make more sense of the doctor's comments.

And a diabetes diagnosis without an hba1c seems a little premature to me. Having said that, hba1cs in the UK have been measured in mmol/mol for years (with a level of 48 mmol/mol or 6,5% being the diagnostic level for diabetes) so if your GP is giving you figures in those units they seem a little behind the times.

Once more, welcome.

 

[coops86]

Hi!
I don't know where to start so forgive me if I ramble on..
I saw my doc for a different issue and she requested bloods. Not fasting and I was told they were not looking at sugars so I went about my normal eating/drinking habits. Had a couple of biscuits with milk the night before and a bowl of crunchy nut for breakfast, test was at 11am.
Anyway, they did do my sugars and it came back at 10.
I have had fasting and past tests that have come back at 6 or 6.6 so at the higher end of ok but still OK I thought.
So my doc took great joy in telling me I was diabetic and dangerously so that I needed meds (Metaformin) asap and that was my only option. So for 4 weeks she has me on:
Week 1- evening meal only x1
Week 2- morning and evening meal x1
Week 3- morning x1 and evening x2
Week 4- morning x2 and evening x2

I have discussed with others and they are all very shocked at the amount I have been told to take in a short space of time or with a number of 10?
I hadn't seen this doc before and felt very bombarded with scary facts and shoved a booklet and prick machine and that was it. I don't know what to do! Is this right? Should I get a second opinion?

Sorry to hear that SarahLou, all the best with managing going forwards.

Intermittent fasting has worked wonders for me, if you google Dr Fung Diabetes he explains in detail how fasting can help with Insulin resistance. The meds only help with the symptoms not actual issue which for type 2 can be insulin resistance not high blood sugar.

Low carb all the way and you will be able to manage your blood sugar levels fine, my weakness was pasta but I found this substitute and I won't lie and say its the same as pasta but with a sauce on top its the closest I have found; Edamame & Mung Bean Fettuccine whole box only has 21 grams of carbs literally a third of normal pasta.