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Recently diagnosed for diabetes, but need some advice

Thanks for your very quick reply . My another question is:

I m not quite happy with my current diabetes nurse. But don't know where to find a good diabetes nurse? Should I go to private diabetes clinic? Please recommend what should I do?

Also do you think nurse has given correct prescriptions for diabetes to take 2 metaform now and then she will gradually increase to 4 a day.

Regards
Biren

I'm going to go into lecturing mode and make a lot of assumptions which may well be wrong, however......

I think you are still very much in denial about your diabetes, shown especially by your desire to find another diabetes nurse because you don't like what you are being told. This is not unusual; most people spend some time in denial before accepting a diagnosis and looking to the future and working out what is best for them.

First point; general practice.

Your GP is a diagnostician. this is the key role. Once diagnosis has taken place it is either a short term fix (infection, take antibiotics for 2 weeks) or a longer term problem such as a chronic (this just means long term) disease such as diabetes. Or it can be something urgent which requires hospitalisation. The GP is focused on preventing immediate harms.

After the initial diagnosis the long term care is usually handed over to a specialist member of staff whose job is to work with you, give advice, monitor progress. In your case the specialist diabetes nurse.

So far you seem to have been treated as one would expect.

Second point; treatment of T2 diabetes


There are recognised stages in treating diabetes, though they should always be tailored for the individual.

Commonly, if the blood glucose (BG) levels don't look too bad the patient is given advice about possible life style changes and is given a chance to bring BG under control through diet and exercise.

If this is not successful, the next stage is to prescribe Metformin to see if this works alongside diet and exercise.

If good BG control still cannot be achieved then more powerful drugs which stimulate insulin production by the pancreas can be prescribed. The end game is prescribing insulin as your own insulin production is no longer working adequately. If BG control looks really bad the first few steps may be skipped. Some people go directly onto insulin.

So far you seem to have been given a couple of years to take control of your BG but it isn't working. Metformin seems the next reasonable and logical step.

T1 suggestion

Diabetes specialist staff should also be very aware that first diagnosis is not always 100% accurate. There are others here who have not been correctly diagnosed initially.

From what you say your diabetes nurse has said something along the lines that as you are not a typical T2 (80%+ are overweight or obese on diagnosis) then there is a chance that you might in fact be a slow and late onset T1. Sounds like your nurse is being very sensible. Now the possibility has been raised your GP (the diagnostician) should be involved again to take a view, and possibly order further tests to confirm your diabetes type.

As I said at the top, it is quite possible that you are having good care but you just can't see that because you are frightened by the diagnosis. You have already indicated that you are scared of the prospect of taking Metformin, you are scared of the prospect of being diagnosed T1, and also that you have not been testing to monitor your BG levels to help you take control of your diet. You seem to know relatively little about diabetes.

Anyway, you have come to the right place.

You will get plenty of good advice about diet, exercise and medication although you should always check with your medical team when you change aspects of your life style.

Your first step is to get a BG monitor; advice on this can be found elsewhere on the site but the first obvious step is to ask your surgery. If they are diabetes friendly they may well have a free sample of a meter and prescribe you the test strips. That is what happened for me when I was first diagnosed (although that was a while back).

Your second step should be to tell us what you eat each day, and how much exercise you take. This will help us suggest areas where you might be able to improve your diet and exercise regime.

Oh, and your height and waist measurement; these are more important than your weight.

The main thing, though, is to take a deep breath and accept that you have to take control. Ask loads of questions and you will get loads of helpful answers (although they may not always agree with each other).
 
@biren1973

Hello Brian 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 more questions when 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.
 
Hi. First it's good that your nurse has even considered the possibility that you might be T1. My diabetes GP knew nothing about Late onset T1 and said I couldn't possibly be T1 despite being very slim but my own c-peptide test proved I was very low on insulin. Whilst not all T2s are overweight I've read that about 80% are and of the slim T2s some will be mis-diagnosed T1s and various other diabetic conditions. You need a c-peptide test to determine your natural insulin level. Your HBa1C isn't yet high enough to make it worth doing yet as a cost to the NHS. If your HBa1C continues to rise despite low-carbing and several of the diabetes tablets then T1 comes onto the agenda as it did for me.
 
I don't like to infer people's background from such limited evidence as just their name but Biren to me suggests possibly a Indian one maybe (at least in part)? The relevance here is that people with T2 diabetes with an Indian sub continent ethnicity are more often not overweight compared with those with a European one where it is 20% or so. Only a proper set of tests can determine the type.
 
My question is: I agree that I m diabetes, but can a person who is normal weight become type1?

Welcome to the forum an excellent place to hear other people's experiences and hopefully learn more about this very confusing disease.

The simple answer to your first question is: Yes. Worth mentioning that Theresa May was only diagnosed Type I a few years ago.

I heard type1 is very bad and extreme type of diabetes and life treating.

Neither types of diabetes are good and both can be very bad if not taken seriously. They can be life threatening, but that doesn't have to be the way it goes.

I don't have any symptoms of diabetes neither type1 or type2 , then how can she judge I may be type1.

Type I symptoms (not a complete list)
  • Increased thirst
  • Frequent urination
  • Bedwetting in children who previously didn't wet the bed during the night
  • Extreme hunger
  • Unintended weight loss
  • Irritability and other mood changes
  • Fatigue and weakness
  • Blurred vision
Type II symptoms (not a complete list)
  • Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. ...
  • Increased hunger. ...
  • Weight loss. ...
  • Fatigue. ...
  • Blurred vision. ...
  • Slow-healing sores or frequent infections. ...
  • Areas of darkened skin.
As already mentioned additional blood tests are required. The c-peptide will show how much insulin your pancreas is producing. Maybe your nurse should keep her opinions quiet until she can back them up with the relevant tests.

I have lots of expectations and hope for this forum. Hope someone help please.

This is a forum where everybody is allowed to contribute experiences because we're all so different although tied with a diagnosis of type I, type II, Pre-Diabetic, Gestational Diabetes . . . . . . . there's others.

You mention diet control but that's a vague term, did you control calories, carbs, both? Controlling carbs seems to help most people on this forum, exercise can make a difference if you're able.

I see you've mentioned a BG meter, good move, you can see what's happening on a daily basis, rather than waiting 3 months (at least). I get my HbA1c annually, others will have them more often.

All the best.
 
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