Was I Pre-Diabetic before I was Dignosed as Type 2

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[Squire Fulwood]

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My thoughts are that if it was a Fasting Blood Glucose test then it was an indicator of Diabetes and I should have been tested again. If it was a non fasting Blood Glucose test (a random blood glucose test) then I feel I should have been diagnosed Pre-Diabetic, however, I'm wondering if the Practice Nurse had taken into consideration I may have eaten breakfast just prior to the test?

I believe that a speculative blood test has to over 11 before you are invited back. In this way your nurse did account for the fact that it was not a fasting test.

 

[Squire Fulwood]

I take your point and can understand your worry. I suppose you could always visit your GP and ask him/her for a more conclusive test.

One comment I would like to make is that a random blood test is an extremely coarse test and a reading of 8.3 under these circumstances is not high. However, although it does not rule pre-diabetes in it does not completely rule it out either.

Go back and ask for a test. I presume your practice could afford an Oral Glucose Tolerance Test at the very least.

Good luck.

 

[lindisfel]

Hi Nomistheman,
It was more than a little remiss they did not do a Hba1c test, or a proper BG tolerance test if they were checking for diabetes last year?
Casting around with possible dodgy b.g. meters seems far from a scientific method.

However, tests get overlooked and you appear have been 'off the chart' at over 13% and no doubt any doctor would put you on medication straight away to get your blood sugar down.

Your wise choosing a reasonable target and it sounds as if your more controlled now whatever method your using.
best wishes
Derek
Ps. Hi Squire fullwood,
According to Nomis... new figures his Hba1c has been c.100!!!
I find this astronomical figure hard to compute?

 

[Squire Fulwood]

Ps. Hi Squire fullwood,
According to Nomis... new figures his Hba1c has been c.100!!!
I find this astronomical figure hard to compute?

Yes it's certainly a big number. 13.5 in old money. Apparently no doubt about diabetes now.

 

[LittleWolf]

I'm beginning to think not enough people are diagnosed with pre diabetes to stop it in its tracks. Like they want you to sit there and wait until you are full blown. What do you have to do to get action taken, go into a coma in front of them??!

Sorry if you feel not enough was done to warn you, OP


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[Finzi]

I have to say, if the original test was measuring your cholesterol, it would very likely have been a fasting test. That's how cholesterol is normally measured (unlike Hba1c, which doesn't need to be fasting). So I do think its very possible that you've had diabetes for longer than you think. I sympathise because I'm in the same position - was diagnosed in jan 2013, but had a random BM in March 2012 of 14, that was never followed up. Mine was within an hour or so of breakfast but even so, shouldn't have been that high.

I think the way to look at it is that there is no point dwelling on the past. There is nothing can be done about it now, but what can be done is to keep your levels normal now, and for the rest of your life, and that's far more long reaching and important than a few undiagnosed months. Also, keep it in perspective - lots of diagnosed and treated type 2's are walking round with fasting blood sugars worse than that. And because they're eating the wrong things, they'll be that way or worse permanently.

Re your liver, obviously discuss it with your own gp to reassure you but I honestly wouldn't worry too much about an isolated, mildly raised liver enzyme. That rise is very small, and unlikely to mean anything significant at all.

 

[Thommothebear]

I'm beginning to think not enough people are diagnosed with pre diabetes to stop it in its tracks. Like they want you to sit there and wait until you are full blown.


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Even when you are diagnosed prediabetic, the advice you get is dreadful. I went though my diet with them and was told it was already a good diet and I did not really need to change. Trouble is that it was a high carb low fat diet and it was almost certainly the problem and should have been changed. I did change it myself after things started to get worse and moved to the low GI diet, but that didn't really seem to help that much either. It's only when i reduced carbs down to less than 130g daily (and frequently much less) that I started to get control of my ever increasing BG levels.

My previous average bg was over 10mmol, now it's 5.9mmol and is trending lower, i have the energy to exercise hard and I'm losing weight too.

Now, I'm a pretty focussed and determined individual (some would say driven) and I believe in taking responsibility for myself, if I had known then what I know now about carbs and diabetes then I would certainly have changed my diet right at initial diagnosis of prediabetes and may have avoided the final diagnosis of type 2 in March this year.

That being said, it is what it is and I'm just grateful to my friend who introduced me to this site where I finally got some decent dietary advice


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[stuffedolive]

My experience too Thommothebear.
When I was told that I was pre-diabetic I was told that my diet (lowish GI but definitely carb heavy) was 'model' and my exercise levels 'fantastic', even though I was a little 'porky' but didn't realise it, and I was told that I would probably be pre-diabetic all my life and never develop T2. B*st*rd liars!
I now realise my diet was far from the best it could be and sure enough I progressed to T2, albeit slowly, and have kept medication at bay, but has been down to the exercise keeping the weight off.
Now I'm low carbing and hoping to get back to those pre-diabetic levels. Had I known about low carbing back then I may well have been able to stave off T2 completely.

 

[Thommothebear]

It took around 7 years for me to go from pre diabetic to diabetic. It was suggested to me that in my case it was likely not going to be anything to do with my diet but probably due to genetics, seeing as both my parents and 3 of my grandparents were also diabetic, although like me none of them developed it until they were in their late 50's

i'm not so sure though, i still think the right diet applied early enough may have led to a different outcome for me,



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[phoenix]

According to Wikipedia my results were in the Pre-Diabetic range even taking into account that I'd eaten breakfast. Admittedly, only just but, surely it should have been checked further at the time? Perhaps it's the human element of discretion?

If it had been a fasting reading, then you should have had a second reading to confirm diabetes. (It was above 7mmol/l) If it was random then it was not at any particular trigger point. There is no trigger point for a random test below the 11.1 . This level is only used for a diagnosis of diabetes if there are other symptoms, otherwise another test is required. I can't find any mention of using a random test to suggest pre diabetes... except in the wiki article.
I don't know where the writer of the article got the levels from. The references are to lab tests online which describes the blood test and a reference which it claims ' hints at random glucose levels'. This is the ADA page to which it refers.http://www.diabetes.org/diabetes-basics/diagnosis/ There are charts for a HbA1c, fasting glucose and an OGTT Absolutely no mention of the use of a random ie non fasting test to diagnose pre diabetes.

The 'official' WHO document for the diagnosis of 'pre' or as it calls it Intermediate diabetes uses either fasting or OGTT levels. (since then they have updated to include HbA1c) http://whqlibdoc.who.int/publications/2 ... 34_eng.pdf
The levels are:
Impaired Glucose Tolerance (IGT)
Fasting plasma glucose <7.0mmol/l (126mg/dl)
2–h plasma glucose*≥7.8 and <11.1mmol/l
Impaired fasting glucose : fasting levels are between 6.1 to 6.9mmol/l.

The level of greater than 7.8mmol/l is only for blood glucose tested two hours after a glucose challenge , not at an indeterminate time after an unknown amount of carbs. So your nurse was right, with the tests you had. Nevertheless, If you had other indications of potential diabetes then she might have suggested coming back for a fasting test.
It's a really vague area, in most cases T2 doesn't arise out of the blue, people have had gradually rising levels for some time before diagnosis, so yes you would have had pre diabetes. On the other hand many people with pre diabetic levels never progress to diabetes.

 

[Stormylady]

Hi Nomistheman

From having my son who will be 33 in August, I suffered with low sugar symptoms a lot. I mentioned it to numerous Dr's over the years but none of them made anything of it. Now 3 years after diagnosis I read more and more about pre-diabetic. I do believe if I'd been helped earlier I may never have become full blown diabetic, or at least been a lot older before I developed it. Now my son occasionally suffers with it, he saw a Dr once was told he must have a virus causing it, so because he was so easily fobbed off he refuses to go back to the Dr's now
I have recently had full heart tests so am not concerned about any effect there, my U & E's are OK, looks like I've been quite lucky and got away with it, but the next patient may not be. Dr's need to sit up and take notice of people and their symptoms.

 

[Libbaloo]

My doctor phoned after a routine blood test but I suspect it was the second time they had included a blood sugar test within the test options. When she told me, she didn't mention the term pre diabetes but just said I was a bit borderline and needed to lose weight and my level would be checked with another new fasting test in the new year... Adding that it would be good to see what the level would be after the Christmas period... Perhaps she was expecting me to have feasted thought the festive season and it might have tipped into type two. She didn't explain anything or mention diet or invite me in to talk.

I wonder how long in have been lingering in the pre diabetes range. Glad I know now and like you, very relieved t have found this forum.

All the best as you go forward armed with info and support.