White Coat Syndrome causing High Readings

[tazuk]

Hi - Please forgive my first post for being rather long !! About three years ago I was diagnosed with impaired glucose after a GTT.

I recently started to monitor my blood glucose and as my fasting sugars were in the high 6's I took steps through diet (low carbing), supplements and exercise to bring them down which I sucessfully did into the low 6's and now into the 5's.

However I am absolutely terrified of doctors and hospitals and just going near them brings about panic the likes of which seem ridiculous to the casual observer - I will actually stress out for days before a doctors appointment and once during a hospital stay the doctors had to remote monitor me as just a doctor coming near me sent my pulse sky high. I was prescribed beta blockers which I believe may be part of the problem in terms of my blood sugars.

The doctor recently did a fasting glucose test which came back at 7.4 - my reading before leaving home for the doctors was 5.9! I tested int he waiting room and was actually showing 8 - back home again and my blood sugar is in the low 6's.

Naturally the doctor wants to repeat the test in a couple of weeks time, and I am worried I am going to get a diagnosis of diabetes - even though my fasting blood sugar this morning was 5.5 and post prandial readings about 6.5.

Any ideas on what I can do ? Thanks for your time

 

[sugarless sue]

Hi,Tazuk,and welcome to the forum.
There's no doubt that stress puts up your Bg and your BP! As to what you can do about it.Do you know why you have this fear of doctors/hospitals?
If you are testing regularly at home I suggest that you make a chart or ,if you have the software download the results onto a chart and show the doctors what you are like when not under stress.
There are many that suffer 'white coat' syndrome ,you are not alone there.

 

[pip]

Would you be better if a nurse was to visit you at home ?
My mum has this phobia and she finds this helpful, I am sure this could be arranged under the circumstances

 

[tubolard]

I agree with Sue, another consideration is could your meter be reporting a whole blood glucose reading and the tests are reporting a plasma blood glucose. Plasma Blood Glucose is 10%-15% higher than Whole Blood Glucose (my meter uses 12% to calculate a Plasma Blood Glucose reading). Given that there is also a 10% error margin this could help explain some of the differences you're reporting.

Regards, Tubs.

 

[tazuk]

Thanks for all your replies

I think this phobia is rooted in the fact my mum died of cancer when I was very young and I guess i made some scary connections with hospitals/doctors and death back then. I was relatively OK with my old doctor as he had known me and my family for years, but since changing to this new doctor when he retired my anxiety around anything medical has really spiralled out of control. Im not sure that even a nurse coming to the house would solve it - I have even been known to panic over taking my own blood glucose! Im looking into the possibility of hypnotherapy.

I have made a chart over the past few days which shows fasting glucose between 5.5 and 6.3 -which I will show to the doctor.

Tubs thanks for that info - I didnt realise there was a difference between the whole blood and the plasma readings (Im still very new to all of this). My monitor does read whole blood. Im not sure whether the docs test was plasma or not - it was drawn from the arm and took a few days to come back if that is any help. Do they still use the 7.0 mmo/l cut off point to diagnose diabetes with plasma or do they adjust it somewhat?

Thanks for all your help - Im desperately trying to get my head round whether Im going to get the D diagnosis - my anxiety is soaring!

 

[tubolard]

Most lab tests will return a plasma reading. AFAIK, a fasting plasma blood glucose reading of 7.0 mmol/L (whole blood glucose reading of 6.1 mmol/L) or above indicates diabetes.

Regards, Tubs.

 

[tazuk]

Thanks for that info

 

[Dennis]

Hi Tazuk,

Another test you could ask to have done is an HBA1C. For this they take a sample of your blood and send it to a lab for analysis. The results that come back a few days later show what your blood sugar levels have been over the previous 3 months, rather than what they happen to be at the single moment in time that the blood sample is taken. In your case this may show a more accurate picture than a test taken while you are stressed by the presence of a doctor.

 

[tazuk]

Thanks I will ask the doc about having that done

Thanks to you all for taking the time to reply - its much appreciated