What do my results mean?

I don't intend to offer "medical" advice but as a T2 diagnosed just over a year ago I will tell you what I feel sure caused my diabetes.
I have always been of normal weight since adulthood but I had for years had far too little sleep, had a stressful job and ate erratically and not always what I should have and did have a sweet tooth. I went for my free NHS health check and was gobsmacked when I got my results; glucose 18.6 and HbA1c 10.4. A glucose of 9 MAY be abnormal depending on when and what you had eaten but it would be a good idea to moderate your diet by cutting carbs and eating more green vegetables etc. If you can avoid becoming a T2 diabetic that would be great.

I hate not being able to eat all the things I like and having to watch everyone else tucking in. Christmas and family meals out are particularly bad so do avoid it if you can, good luck and I hope you remain non diabetic.

Hi and welcome,

I wouldn't panic with those test results, but to have peace of mind I would ask for an HbA1c when you have your next lot of tests. In the meantime there is no harm in following this forum, asking questions, and tweaking your diet to one suitable for diabetics. You seem to have learnt that reducing carbs is the way to go, particularly potatoes, rice, bread, pasta, cereals and things made with flour. By doing this you will keep your blood sugar levels under control and also lose the weight you need to lose. You could also consider buying a blood glucose meter and do some testing at home to help you learn which carb foods your body can tolerate, and which it can't.

Good luck!

ruthytoothy said:

I have a range of blood tests annually to monitor various medication, and on 1st October I asked them to include a random plasma glucose for the first time. The result came back as 9, so the GP requested an OGTT on 13th Oct, which came back as Fasting 4.9 and 2 hrs later 8.3. When I phoned reception for the results I was told that the GP doesn't want to see me about the results, but wants to retest in 3 mths. Looking at the info on this website it looks like my 2 hrs result is indicative of Prediabetes, but the random and fasting results are normal. So am I "normal" or prediabetic? Is one of these results more important than the other?

I'm 37 yrs old, my BMI is 34, and the bulk of my weight is carried around my belly, which I understand to be a risk factor. My Consultant made a change in my medication at the start of the year, and in the following 6 months I put on 1.5 stone - when I raised this with my Consultant last month he told me that a side effect of that new tablet was it prevented the satiety signals reaching my brain, so at my request I have been taken off this medication.

My blood pressure was on the high side of normal, but all of my other blood tests and my ECG were fine.

For a number of years I have had hypoglycaemia-like symptoms if I don't eat meals on time, and sucking a barley sugar seems to alleviate these symptoms.

I'm concerned that I seem to be headed for Type 2, and may be missing a crucial opportunity to begin improving my chances of avoiding complications.

Should I be asking for further testing asap, eg HbA1c? Should I buy a testing machine and start recording daily results? Before these tests were done I was planning on rejoining Slimming World to try to get my weight back under control, but on this forum I've been reading that SW isn't a good choice for diabetics, so should I go on a low carb diet instead?

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Hi @ruthytoothy
A couple of questions, if you don't mind.
Why or what are you seeing a consultant?
Was it a two hour OGTT?
How quick did you spike? Did you record the readings they took?
What was the change in medication?
What meds are you on now?
What is your hba1c?
How low and what circumstances did your Hypoglycaemic episodes occur?

I've tagged @daisy1 to give you the newcomers welcome information.

@ruthytoothy

Hello Ruthy and welcome to the forum Here is the information we give to new members and I hope you will find it useful. I hope it will help you to avoid becoming T2.

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 over 150,000 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-and-whole-grains.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 bloodglucose 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.

Hi again, Did you eat after the test was done? Ask for a hba1c test to be done, as suggested by @Bluetit1802.
I think you do need one, you are probably prediabetic and with your meds, your blood glucose levels will be a bit whacky, your steroids for your asthma can do this!
You have already recognised and as suggested low carb will really help.
If you do get diagnosed as prediabetic, then a blood glucose monitor will help you understand what happens when you eat carbs and sugars.
Have a look around the low carb forum for ideas and recipes.

Have a read around the forum and ask any questions about anything, someone knowledgeable will help you!

ruthytoothy said:

Thanks again @nosher8355. I didn't eat until after the 2nd test, at which point I had a bowl of breakfast cereal, followed by lunch an hour or so later. Even after lunch I was still shaky for a further 40mins or so, although I do wonder whether that could have been partly psychological.

Do you think I should push for the hba1c now, or wait until they call me back in Jan?

I'm not on regular steroids for my asthma, as it is well controlled by antihistamines, but I do know that Venlafaxine can cause weight gain so depending on the mechanism, I guess this may be affecting my blood glucose.

I've eaten wholemeal/brown versions of bread, pasta and rice for many years, and we don't eat many spuds, hence thinking I'll need to go low carb since I'm already eating "healthier" carbs.

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The 'healthier or complex card's are for 'normal' people! (But who is normal?)
I'm not, I'm weird!
It is better to eat those carbs but reducing your carbs and having alternatives to them, is what works for prediabetic!
Carbs and sugars turn to glucose in your body, the 'healthier' the slower it works. But to control your blood glucose levels, and reduce them, then reducing your carbs even more, will do this.
And if you need to lose weight, then the less carbs you have, the weight will gradually come off! Low carbing is not really a diet but a lifestyle change.
Other factors obviously come into it like exercise and plate size, but if I can and have to do it anybody can!
Best wishes.

Have a look at this thread if you are interested in going low carb. http://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/ It may help you.

.

I would believe that they would do this before giving you glucose!
You might have a fasting hba1c result from your two hour OGTT
But if you need to know ask your GP, it is just giving blood!

You can only ask and your doctor might know already!

There is no harm in asking now, or indeed waiting 3 months. It won't make any difference if you intend to start your new eating plan now, and I suggest you do. No time to lose!

ruthytoothy said:

So the GP wouldn't start me on any medication then? In that case I'll save my energy for greater battles, and just ask for the Hba1c in Jan. And in the meantime I'll definitely be trying LCHF - tonight's job will be menu planning and placing a giant Tesco order!

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Medication is rarely given to newly diagnosed with an HbA1c of 53 or under (48 is the figure at which you are diagnosed diabetic). Many doctors allow 3 months on diet and exercise, and then reconsider at the next test. There are exceptions of course. Metformin is the first medication and is of limited effect in reducing BS levels, but is an appetite suppressant so works better on people with more weight to lose. Diet is the key, not Metformin.

If your doctor offers you Metformin then do discuss it with him after reading up about it. I don't mean to discourage you from taking it, I'm not a doctor, but it won't help reduce post meal spikes. It doesn't work on the pancreas, it works on the liver and helps to a small extent in reducing the amount of glucose the liver produces naturally.

My HbA1c on diagnosis was 53. I was allowed 3 months diet and exercise, and as I got my levels down this way and have kept them down, I have never needed any meds. Hopefully this will continue as long as possible.

ruthytoothy said:

I have a range of blood tests annually to monitor various medication, and on 1st October I asked them to include a random plasma glucose for the first time. The result came back as 9, so the GP requested an OGTT on 13th Oct, which came back as Fasting 4.9 and 2 hrs later 8.3. When I phoned reception for the results I was told that the GP doesn't want to see me about the results, but wants to retest in 3 mths. Looking at the info on this website it looks like my 2 hrs result is indicative of Prediabetes, but the random and fasting results are normal. So am I "normal" or prediabetic? Is one of these results more important than the other?

I'm 37 yrs old, my BMI is 34, and the bulk of my weight is carried around my belly, which I understand to be a risk factor. My Consultant made a change in my medication at the start of the year, and in the following 6 months I put on 1.5 stone - when I raised this with my Consultant last month he told me that a side effect of that new tablet was it prevented the satiety signals reaching my brain, so at my request I have been taken off this medication.

My blood pressure was on the high side of normal, but all of my other blood tests and my ECG were fine.

For a number of years I have had hypoglycaemia-like symptoms if I don't eat meals on time, and sucking a barley sugar seems to alleviate these symptoms.

I'm concerned that I seem to be headed for Type 2, and may be missing a crucial opportunity to begin improving my chances of avoiding complications.

Should I be asking for further testing asap, eg HbA1c? Should I buy a testing machine and start recording daily results? Before these tests were done I was planning on rejoining Slimming World to try to get my weight back under control, but on this forum I've been reading that SW isn't a good choice for diabetics, so should I go on a low carb diet instead?

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Your Doctor is obviously taking a calm approach to all of this, and it makes sense for you to try to adopt the same, although that can be easier said than done.

You have identified a few risk factors in yourself already - your raised BMI, carrying your weight around your mid section and slightly elevated BP, as well as the single blood glucose level.

I think it's probably safe to say that your overall health could improve a notch or two if you were able to lose a few pounds, and provided the means of achieving that meant reduced sugar and probably carbohydrate intake, there is likely to be a positive knock-on impact to your blood glucose numbers; whatever they are. Clearly stopping taking a drug that may have had a part to play in your recent weight gain also seems, from the outside, looking in, from a lay perspective, like another positive move.

So, I would say you could be summing matters up pretty well, in suggesting you may have a bit of a golden window of opportunity to make improvements before crossing the line to any diagnosis. I think many of us probably envy you that chance.

Good luck with it all.

ruthytoothy said:

3 - Not sure what you mean by this. The test was as follows:- blood sample taken after 11 hrs fasting, then given lucozade to drink and sent home. Returned to surgery 2 hrs later and blood sample taken again. So the only readings were from these 2 blood samples, which were sent to the lab - they didn't use a monitor at the time.

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You are not supposed to be moving around during OGTT as this makes the reading unreliable and probably too low.

I think you should press for HbA1c to be done as soon as possible, before you change anything in your diet. I was diagnosed diabetic after OGTT of 13.8 but soon got my HbA1c down to 33 on LCHF.