Sort of Newly Diagnosed - NODAT

Wolfman Bob · May 10, 2012

Hi

Posted a few months ago when I was told that I had diabetes. I assumed it was type 2 as I had only fairly recently started having issues with glucose, and because of potential kidney complications my GP put me on to Gliclazide.

Initial HbA1C was 8.5% (December 2011) - now 7.1% (March 2012) (in "old" money )

However, a couple of weeks ago my renal consultant informed my that my diabetes type was NODAT - New Onset Diabetes After Transplant. I was aware that Tacrolimus and steroids (anti-rejection drugs) both adversely impacted on glucose levels, but nobody had actually mentioned anything about this apparently pretty common consequence of solid organ transplants!

Anyway, I am basically posting to see if anybody else on this forum has this condition, and is aware of how it differs from slightly more mainstream diabetes (pretty similar, better, worse?). I have researched a bit on the 'net, but that is not really a substitute for hearing from somebody who has been thus diagnosed and is familiar with any differences/additional risks that it would be useful to be aware of. Any information would be appreciated

On a separate note, my previous GP recently retired. On my first visit to my new one I was informed that all glucose tests were a waste of time apart from the HbA1C and that he was stopping my prescription for strips/lancets (although he did say if I felt I really needed them to ask him in the future). Not a very encouraging first appointment, and I must admit I was rather disheartened and perhaps less careful afterwards with my diet than I should have been

Still, I am now trying to get back on to the straight and narrow - as a matter of interest though, is there an average period between HbA1C tests? Mine seem to be set at 6 monthly intervals, although my renal consultant suggests that in my situation 3 monthly ones would be more prudent.

Anyway - thanks for reading

Best Regards

MaryJ · May 11, 2012

Hi Bob,

Can't answer your NODAT question but can stick my twopennorth worth in re the HBA1c and testing.

I think the frequency does differ from 3/6/12 months. So far, I have just arranged an appt with the nurse every 3 months. Your renal consultant has advised the 3 monthly HBA1c so that is how often you should have it.

I think you should go and tell the new GP that yes, you would like the testing strips again. You could always try prove to your gp how your meter is helping your control by producing your stats and explain what food caused the spikes.

Mary x

daisy1 · May 11, 2012

Hi Bob and welcome to the forum
I am not sure that there are any members on the forum with NODAT as I have just done a search and not found anything. Maybe someone has something similar without mentioning the name. I hope this information which we give to new members will be helpful to you. I posted this for you a while ago but thought it could refresh your memory. Ask as many questions as you like as there is always someone here to help.

BASIC INFORMATION FOR NEW MEMBERS

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 30,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.
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Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

Wolfman Bob · May 11, 2012

Thanks for the responses. I did join this forum around Christmas time and have picked up much helpful information and various people have been kind enough to answer my earlier questions regarding diabetes in general.

With regard to NODAT - not entirely surprised that there has not yet been a positive response from somebody similarly diagnosed - I must admit it was a totally new one on me!

I suppose I was being lazy - usually I am pretty good about researching things on the 'net that pertain to my various medical conditions (PKD, transplants, angioplasty etc.) but I thought that if somebody had already done the work I could "borrow" the information off them

heh heh - looks as though it is going to have to be up to me then...

If I find anything especially pertinent as to how it varies (if at all!) from type 2 I will post it here - then if anybody else finds themself in the same situation in the future there will at least be a little detail available.

Thanks once again and best regards.

Wolfman Bob · May 12, 2012

Had a look to see what was out there on the 'net with regard to NODAT (and preferably also its relationship with type 2) - sadly not a great deal that is not overwhelmingly opaque to the lay-person (at least in my opinion)! :?

However, the most useful link I could find is to an American Diabetic site - at least I could understand some of it!

http://care.diabetesjournals.org/content/35/1/181.full

Anyway, probably not of much interest to most people here - but at least if a transplanted diabetic does come along there will be something for them to look at.

Best Wishes

Sort of Newly Diagnosed - NODAT

Wolfman Bob

Member

MaryJ

Well-Known Member

daisy1

Legend

Wolfman Bob

Member

Wolfman Bob

Member

Sort of Newly Diagnosed - NODAT

Wolfman Bob

Member

MaryJ

Well-Known Member

daisy1

Legend

Wolfman Bob

Member

Wolfman Bob

Member

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