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slightly confused "diagnosis?" criteria

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whompa73

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I was diagnosed last week with type 2 since then I have been on this forum trying to gleen as much info as I can . I have seen posts that say when daiagoned there should be a whole host of tests to ddetermine whether you have diabetes or not and indeed which type. One person said it could not be diagnosed buy just one test. Yet my doctor seems to have done that very thing. I had one test for diabetes & 1 for liver and kidney function. The one for diabetes wasnt even the h?? 1c or what ever its called they did that this week when I saw the nurse. It wasnt even a fasting test (athough because it was first thing in the morning I hadn't eaten for 12 hours and had only drakn water so I suppose it ended up a fasting test but they did not know this) ok my "fasting " bg was 14 to 14.5 which is highish I know . I asked about other tests at the nurses appointment. like the is it glucose tolerance test? (Is there any need for this test apart from prognosis or dose it give infomation i need) And was told that this is only carried out when someone is borderline for diagnosis and I was (test was ) conclusively diabetic. Who is right .may I have been misdiagnosed? (I dont think I have) but given the way the docs have treated me so far I have so little confidence in them that it wouldn't surprise me if they told me to go see a vet coz they thought I was a cat ok maybe a pony alright a small (ish ) hippopotamus. But all joking aside They have been so usless I have to consider if it is intensional (because type 2 is self infliced isn't it! ! )( or so people see it that way). Should I have been so readily diagnosed ? Or is this just another cant be ars ed with you attitude form my doctor. Or are some of the people on the for misinformed? Or indeed how did your prognosis take place? Just to see the diffrences
All the best james
 
Re: slightly confused "diagnosis?" criteria

Hi James, there are many here that have the exact same problem. Assumed T2, later discovered T1 or LADA. The HbA1C test is nothing to do with diagnosis, it's just an average of your last 3 months BG levels.
The tests which would help determine what type you are would be a GAD antibody test or C-Peptide test. For some reason ( probably cost ), many sufferers are not offered these tests. The medical profession as a whole seem to be going away from T1 and T2 and prefer insulin dependant or non insulin dependant. I guess, what does it matter if you are T1 or T2 ? If the treatment is the same !
I would ask your docs for these tests but you may have to persevere ! Good luck !
Mo


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Hi, yup doctors suck lol, I have learned 100% of what I know from here and the net, you do not need to fast for hba1c, the 14s sound like you weren't misdiagnosed I'm afraid, try to read as much as you can and educate yourself on what you need to do and what you should be asking the docs to, the only problem with this is when sitting with doc or Dsn you will prolly be saying to yourself " that's stooped, that makes no sense, I'm not doing that" I know I do, then I smile, say Thankyou and leave grateful they give me testing strips, if they didn't they may have a bigger problem with me because I'd have no reason to not rock the boat. :) anyway good luck


Edit: ironic the the auto correct turns Dsn into Disney
 
I had a very similar experience, but am lucky enough to have an excellent DSN who explained to me why I haven't had to have the rucks of tests that others go through.
My first blood glucose finger prick test was 19.1.. which was conclusive in itself. I then had one set of full blood tests and was referred on to the DSN... haven't had to see a GP, just straight on with the DSN. My initial pre-metformin tests were all 11-13.5, and that was on the strict panic diet I put myself on after realising that life was about to change.
She explained that we could do the tests and spend time waiting for the results, but with consistently high results she felt that we would only be wasting time (and yes, it's no doubt probably money related). I was moved straight on to the metformin regime, and any other tests I've had have been related to my high blood pressure.
In a way, I feel glad to have evaded a lot of tests, if for nothing else that I've avoiding having to take time out of work for this disease (which invades life enough as it is without spending time at my local hospital).

OP, one thing I think is very wrong with the way you have been treated, is the way you have been made to feel about your diabetes. I know from what I've been through with my recent diagnosis, that us T2's spend a lot of time as it is thinking "what did I do wrong?", "could I have done this better?", without having half-assed medical professionals enforcing that idea. So if that's their attitude, then take it with a pinch of salt, and after each appointment always remember to log on to the forum for a bit of positivity and encouragement!
 
James,

I don't see that you have been particularly badly treated.
Your BG test was conclusive for diabetes so there is no need for further tests to confirm (although I agree that it should have been specified as a fasting test).

Sadly your practice may have seen a lot of diabetics being diagnosed and so you were "business as usual" and they would be focusing on the treatment while you were still in denial, asking "Are you sure? Shouldn't you be doing some of these other tests to confirm it?"

They could have spent more time reassuring you but I think this is a general issue with the cost reduced NHS.

What you should get next (which will really show if your GP practice is on the ball or just not geared for diabetics) is the full range of diabetic checks, including feet, and you should be scheduled for an eye (retinopathy) check within the first year.

Ask when this is due - they tend to do a rolling schedule based on your birthday, date of diagnosis or surname or similar - and if it is a long way off consider going to an optician for an eye check. Most opticians are very diabetes aware these days and they can give the backs of your eyes a thorough going over. I think this should also be free if you have been diagnosed as diabetic.

You should also get dietary advice from a dietitian, and there should be a course available for newly diagnosed diabetics so you can get more information.

If you are lucky there should be brochures, and perhaps even the offer of a testing kit.

Take a deep breath and come to terms with the fact that you are diabetic.

Once you have calmed down, make sure you get the proper treatment and all the help available.

If the practice isn't geared to this, find one that is and vote with your feet.

Cheers

LGC
 
LittleGreyCat said:
James,

I don't see that you have been particularly badly treated.
Your BG test was conclusive for diabetes so there is no need for further tests to confirm (although I agree that it should have been specified as a fasting test).

Sadly your practice may have seen a lot of diabetics being diagnosed and so you were "business as usual" and they would be focusing on the treatment while you were still in denial, asking "Are you sure? Shouldn't you be doing some of these other tests to confirm it?"

They could have spent more time reassuring you but I think this is a general issue with the cost reduced NHS.

What you should get next (which will really show if your GP practice is on the ball or just not geared for diabetics) is the full range of diabetic checks, including feet, and you should be scheduled for an eye (retinopathy) check within the first year.

Ask when this is due - they tend to do a rolling schedule based on your birthday, date of diagnosis or surname or similar - and if it is a long way off consider going to an optician for an eye check. Most opticians are very diabetes aware these days and they can give the backs of your eyes a thorough going over. I think this should also be free if you have been diagnosed as diabetic.

You should also get dietary advice from a dietitian, and there should be a course available for newly diagnosed diabetics so you can get more information.

If you are lucky there should be brochures, and perhaps even the offer of a testing kit.

Take a deep breath and come to terms with the fact that you are diabetic.

Once you have calmed down, make sure you get the proper treatment and all the help available.

If the practice isn't geared to this, find one that is and vote with your feet.

Cheers

LGC
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The reasons I have a problem with my surgery is not because I am having trouble accepting. I had been ill for so long but like most blokes I dont go to the docs till somthing is falling off. I was releived with the diagnosis because I was starting to think maybe prostate canser or something like that. I also knew before I wss officially told because some friends with diabetes did bg tests one came back as 24.9. I tryed ringing my doctors to talk to someone and was told dn was not in till tomorrow I said can I talk to the doc then I was told no because the dr dosnt realy know anything about diabetes I then said I had had a reading of 24.9 or at least tryed to I was stopped half way through and told that numbers mean nothing to her and ring back 08.50 tomorrow. I had been feeling realy ill for days and still getting worse eventhough i had stopped suggar and wsd truing to eat healthy but didnt real know what healthy was for a diabetic diet still probably dont. next day my bg was 13.2 in the morning I had 1 1/2 small brow muffins with a tbl spoon and a half of baked beans on each. 2 hours later my bg was 21.9. I rang the surgery at specifyed time and wad told nurs not avalible but would ring me back to be honist at this point i wanted to come in rarther than just a phone call. By 11 I had not heared ftom them so rand surgery again and wss told she would not call I had to make and appointment and could have one in a month. I siad I had an appointment for next tuesday but did they think it appropriate that someone newly diabetic with very high blood suggers should be made to wait for a month to be seen. She said it nothing to do with her so I said I wanted to complain Offically she said she tryed to put me through to the practice manager but they were buissy and would ring me back ( ye right).at this point I wad feeling verry rough and stressed so I rsng the local hospital and told them my story the said to ring 111 so I did and told them the nurse from 111 went nuts and said she wanted me seen or atleast talked to in the next 2 hours or go to hospital I asked if she would ring as I had been fighting all morning for that very thing wiyh absolutely no joy she said she would next tjing I get a call from the surgery saying I will get a call from the nurse at 12.55 but would not be receiving call from practice manager. 2 mins later I got a call from the 111 nurse saying she had spoke to the and I would be getting a call but thay had said they had already told me that so I said that the call was as soon as dhe put the fone down .I ended up hsving a 30min over the phone consultation insted of quick vist to the surgery. I think I only got the offer of the call initially because the manager didnt want any hassle and would have been quickly fobbed off if it wasnt for the 111nurse who had rang and given them a yalking to. I was put straight on to metformin and given a meter ( even though i had alresdy bought one and theirs was such poor quality i have gone back to useing mine) immediately as a consequence of the call. There is more I could mention but I think this post is probably long enough lol
 
Hi. Bearing in mind I was diagnosed 10 years ago by my specialist diabetes GP with a urine stick you at least had a fasting test! I wouldn't get too stressed out about all this. Your fasting test reading does indicate you have diabetes. Many (the majority) then guess the type i.e. T1 or T2 like mine did. The reasons include the costs of GAD and c-peptide tests, lack of knowledge of the tests, the statement 'that the treatment process is the same' etc. You should be given an HBa1C within 3 months; if not ask for one. This will confirm the diabetes anyway and the severity. You may well be started on Metformin. Further meds can be added later (I was on three-level tablets before insulin). If you are overweight you can assume insulin resistant T2 as an initial diagnosis. If you lost weight before diagnosis and are normal BMI and young then there is a possibility of LADA (T1.5) so keep measuring your blood with your own meter. GAD and c-peptide can be done later if your sugars continue to rise. Good luck and come back with further questions
 
Daibell said:
Hi. Bearing in mind I was diagnosed 10 years ago by my specialist diabetes GP with a urine stick you at least had a fasting test! I wouldn't get too stressed out about all this. Your fasting test reading does indicate you have diabetes. Many (the majority) then guess the type i.e. T1 or T2 like mine did. The reasons include the costs of GAD and c-peptide tests, lack of knowledge of the tests, the statement 'that the treatment process is the same' etc. You should be given an HBa1C within 3 months; if not ask for one. This will confirm the diabetes anyway and the severity. You may well be started on Metformin. Further meds can be added later (I was on three-level tablets before insulin). If you are overweight you can assume insulin resistant T2 as an initial diagnosis. If you lost weight before diagnosis and are normal BMI and young then there is a possibility of LADA (T1.5) so keep measuring your blood with your own meter. GAD and c-peptide can be done later if your sugars continue to rise. Good luck and come back with further questions
Click to expand...

I beleive I probably started with symptoms atleast 12 months ago but didnt realise what they were. Last year I weighed under 14.5 st and swam 40 lenghts 3/5 times a week as well as working 60 hours a week 12 hour shifts 6 of wich were out patrolling I may have been considered overweight but I was also very fit and well muscled. I had a resting hart rate of 56 I asked the doc about it he said it was usual for someone who exercised as I did to have a lower than usual hart rate because of fitness. Then I lost all motivation and get up and go. I seemed constantly hungry and tiered. I started to put weight on had over fist and probably got up to over 20 st I have over the last few weeks came down to arround 18 1/2 st but it hasnt realy been doing it as i was realy not well at all for the past 8 weeks. Its only the last week or so that I have been dieting. I must admit with cutting out sugar and only eating between 30/60 gm of carbs a day and the metformin I feel better than I have in months I even managed to go swimming the other day although I only did 30 lengths and a lot slower than I used to but I will stick at it and get back to nornal.
 
Insulin resistance can cause some Type 2s to get fat. Because the muscle cells resist the action of insulin trying to give them glucose to use for energy, the insulin stuffs the glucose into the fat cells instead (very simplistic but I hope you see what I mean).
The muscle cells aren't getting enough fuel which makes us tired and listless; meanwhile we gain weight.

Don't lose hope! You are going the right way about it by reducing carb intake, which gives your pancreas a rest from straining to produce enough insulin to deal with all the excess glucose in your blood. A good proportion of your later weight gain may well be due to internal fat, which clogs up the pancreas and liver in particular and stops them from working properly. Your weight loss from low carbing will probably come from losing this internal fat first.

Reducing your carbs seems already to have made you feel good and given you extra energy. The exercise will really help - sadly, I can't do much these days! Go on as you are and you should see a great improvement. :D

If by any chance your BGs don't improve enough on your present regime, follow Daibell's advice and start hassling your GP :wink: .

Viv 8)
 
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