Yet another newbie..

[_pixie_]

Hi all,

I have just got back from the docs, my hba1c was 9.8, and my other number which I didnt understand was 48. The doc says that because it is 48 that indicates a t2 diagnosis...but I thought the 9.8 was the more significant number so I am a bit confused why she didn't really comment on that at all.

I was given the option of Metformin but am unsure whether I want to take it so have been asked to go back in 2 weeks with my decision. I have been prescribed Ramipril for high blood pressure, and she has asked me to have an ECG and liver function and cholestral bloods next week.

She suggested that my pancreas was damaged during a gall bladder/pancreas infection in 2016 and as a result of 2 years of keto diet. Unsure about that personally....I never felt better and only stopped because of the gall bladder surgery and never getting back to it.

What do you think about the diagnosis? Surely 48 is barely borderline and doesn't need meds? Would it have been higher if I had breakfast on the morning of the test? I hadn't eaten for 14 hours beforehand....Or should I be more focussed on the 9.8?

Thanks all
Pixie

 

[Daibell]

Hi and welcome. It's slightly confusing. The 9.8 could be your HBa1C measure in % which is fairly high and needs meds however the 48 could also be your HBa1C in the new mmol measure and these two numbers are in conflict. It's also possible the 9.8 was fasting blood sugar test in mmol and largely irrelevant. I think you need to check these numbers with the surgery. If you have online access to your medical records have a look. If you don't have access do ask the surgery to give you access and to your medical records for test results. I'm surprised at the need for an ECG? Did the GP say why because he/she should have said why as it's not directly related to diabetes.. Liver function and Cholesterol checks are normal for us but do check that the cholesterol test is a full 'lipids profile' so you can check your various LDL/HDL etc ratios. You need these to determine whether statins are considered. I'm amazed that the GP said the keto diet could have caused any problem as there is no evidence that I'm aware of for that unless you are an exception. Metformin is a very safe drug and helps a bit with blood sugar so don't worry about taking it; many of us do.

 

[JoKalsbeek]

Hi all,

I have just got back from the docs, my hga1c was 9.8, and my other number which I didnt understand was 48. The doc says that because it is 48 that indicates a t2 diagnosis...but I thought the 9.8 was the more significant number so I am a bit confused why she didn't really comment on that at all.

I was given the option of Metformin but am unsure whether I want to take it so have been asked to go back in 2 weeks with my decision. I have been prescribed Ramipril for high blood pressure, and she has asked me to have an ECG and liver function and cholestral bloods next week.

She suggested that my pancreas was damaged during a gall bladder/pancreas infection in 2016 and as a result of 2 years of keto diet. Unsure about that personally....I never felt better and only stopped because of the gall bladder surgery and never getting back to it.

What do you think about the diagnosis? Surely 48 is barely borderline and doesn't need meds? Would it have been higher if I had breakfast on the morning of the test? I hadn't eaten for 14 hours beforehand....Or should I be more focussed on the 9.8?

Thanks all
Pixie

Hi Pixie, and welcome,

I think you might have your numbers mixed up? I think the 9.8 was a mmol/l fasting blood glucose, and the 48 was your HbA1c, the average of 3 months. (So no, fasting or eating wouldn't have made one iota of a difference) That is just on the cusp of a diabetic number, so yeah, you should, if you are diagnosed a T2, get your numbers back into the normal range quickly and without medication, should you choose to. That said, you do mention having had pancreatitis. For some people that means they don't produce enough insulin anymore. While T2 is more a problem of producing a whole lot of insulin and not being sensitive to it, T3c is more a matter of not making sufficient insulin anymore... And I don't know enough about T3c to say much. Our cat had it, but that was after a severe bout of pancreatitis that left him unable to produce any insulin at all, overnight. I don't know whether a relatively mild one could have a slow onset or whatever, but after three years i would've expected more dramatic numbers. Still, Not my area, so something I will shut up about and hope someone else'll pop in.

What I do know is that since you've done keto before, you'll be more likely to roll right back into it: It doesn't ruin your pancreas, so I don't know where on earth she got that from... But it will get your blood glucose numbers back down into the non-diabetic range, if you truly are a T2 rather than a T3c. Also, be prepared for some more diagnosis when the cholesterol, liver function etc comes back. Type 2 is part of something called Metabolic Syndrome, consisting of diabetes, high blood pressure, high cholesterol, non alcoholic fatty liver disease, (morbid) obesity, you know, the usual suspects. They all feed into one another, so just try and take it in stride: the solution to all of them is pretty much the same, and when you tackle one, you tackle all. I had them except for high blood pressure, and switching to a low carb diet pretty much solved everything. My fatty liver's fine, my cholesterol doesn't require statins anymore, I dropped 20 or 25 kilo's, dunno how much because I quit weighing myself when I hit 102 kilo's, down to the low '80's now. And my blood sugars are in the normal range. Even with a few sneaky holiday-centred binges. So... I have a feeling you're going to be okay. You've been down the keto path before, you can follow it again. One more thing: If there is any question about what type you are, ask for additional testing. A C-Peptide test should let the pro's know whether you're still making insulin or no.

Good luck!
Jo

 

[_pixie_]

Hi both

Thank you for replying, you are right...my mistake...I just rang to check and she said that hb1ac was 48 and the fbg was 9.8. She has diagnosed T2 this morning.

I think the ECG is just because of a family history of premature heart attack so probably more a precaution. She was quite a helpful doctor other than suggesting that I control it by reducing portion control (which I knew wasn't the way forward)

 

[bulkbiker]

and as a result of 2 years of keto diet.

Your Doc has no idea about a keto diet... as you say you felt great on it and it probably kept your T2 at bay for a while.
Might be an idea to get back to it.
Maybe slowly increase the fats as without a gall bladder too much fat too fast can cause problems but as many of us have found keto can put T2 into remission and fairly quickly.

 

[bulkbiker]

just got back from the docs

Sounds a bit like this

 

[HSSS]

Definitely ask for the cpeptide. Surprised she isn’t doing that already as the pancreatitis is a suspect (type 3c) rather than common or garden type 2. Short term treatment might look similar but long term quite likely not. You need to know if you overproduce insulin and are resistant or simply can’t make it in any reasonable quantities. Keto helps both but might not be enough on its own in the case of 3c.

 

[JoKalsbeek]

Hi both

Thank you for replying, you are right...my mistake...I just rang to check and she said that hb1ac was 48 and the fbg was 9.8. She has diagnosed T2 this morning.

I think the ECG is just because of a family history of premature heart attack so probably more a precaution. She was quite a helpful doctor other than suggesting that I control it by reducing portion control (which I knew wasn't the way forward)

It takes some getting used to, the terminology, the numbers, everything... You're not the first to mix 'em up, and you won't be the last either. As for the ECG, I had one when I was first diagnosed, as well as an eye check, foot check, blood pressure check etc... Dunno if that's par for the course where you are, but in the Netherlands, you're supposed to get all that checked. establish a baseline, so to speak, and see what needs treating and what's fine. Mind you, you're probably at a point where it's easy to get the bloodsugars under control still, and not likely to have a whole lot of complications. Do your research, so you know what to ask and what the answers mean. You might want to read Dr. Jason Fung's The Diabetes Code. Also, it's pretty standard to give newly diagnosed diabetics statins. Which is a bit backwards as statins can increase bloodsugars and in some people, cause T2 to begin with. But they just come out with all guns blazing, I suppose. There was only one kind I could take because of my faulty thyroid, but the side effects... It aggravated the rheumatism too much. Now I'm glad I quit it, I have my cholesterol ratio's perfectly under control. And that's with eating loads of eggs, goat's cheese and bacon and whatnot. So... Learn, ask questions, here and from the pro's, and you'll have this licked in no time. (Though I'd still try and get a C-pep test done!!!)
Jo