Went to my doctor yesterday

[Jacinta (Australian)]

Hello lovelies , so yesterday I went to see my doctor to talk to her about a number of things , and I did tell her I’m doing the low carb diet and she was 100% all for it (I was worried she wasn’t all for it ) and now I have an appointment in a few days to do a care plan with a nurse to see a dietician because she said that seeing a dietician will also put me on the right track and see where I am at with it as it can cause kidney problems and eye problems ???. What I would love to know is your hbcA (sorry if I got that wrong) level 3 months or 6 months ???? Cause my doctor thinks it’s 6 months , I thought it was 3 ??!!, she also said she would put me on metroform (again sorry for mispelling), but she doesn’t know what type I am so that’s why she hasn’t started me on anything yet . So I have been doing it diet and exercise, which I feel so much better and I mean a lot better , I’m not tired , I eat breakfast then I’m not hungry til like 12-12:30-1pm then I eat lunch and not hungry til like 5-5:30pm then I’m good for the rest of the night til morning again. . I also asked my doctor IF I’m type 2 if I could do it with just diet and exercise and she basically said no , appranetly I need the medication aswell as diet and exercise , any advice on that ????.

 

[mage 1]

What is your hba1c my doctor said 6 months ask nurse to change it to 3 months as most people have theirs 3 months on this Forum

 

[Jacinta (Australian)]

What is your hba1c my doctor said 6 months ask nurse to change it to 3 months as most people have theirs 3 months on this Forum

Mines the old way of doing it , 12% , how can they change it to 3 months ???? I’ll have to when I see her next couple of days

 

[Leadinglights]

When first diagnosed it is a good idea to repeat the test after 3 months as the HbA1C is a measure of the average blood glucose over a 90-120 day period so that gives a good indication if the measures somebody has adopted are being successful. But leaving it as long as 6 months means if they have not then it is much longer for people to be running with high levels. However once better control has been achieved then a longer gap is probably acceptable to keep a eye on how things are going.

 

[Jacinta (Australian)]

When first diagnosed it is a good idea to repeat the test after 3 months as the HbA1C is a measure of the average blood glucose over a 90-120 day period so that gives a good indication if the measures somebody has adopted are being successful. But leaving it as long as 6 months means if they have not then it is much longer for people to be running with high levels. However once better control has been achieved then a longer gap is probably acceptable to keep a eye on how things are going.

Ahhh Thankyou for that information leadinglights , I do appericate any advice I can get . I’ll defianetly will once I’ve established which type I am . And make it my goal to lower my blood sugar , how bad is it to loose weight ?? Like I weighed 83kgs and I weighed myself today cause I was curious and I’m now weighing 80kgs but I been doing the low carb and more intense exercise for like 4 weeks , is that an okay weight ???

 

[helli]

What is your hba1c my doctor said 6 months ask nurse to change it to 3 months as most people have theirs 3 months on this Forum

I believe you would be incredibly lucky to get HbA1c every 3 months.
In a good “year“, I get mine measured every 13 months for my “annual review”.

There may be some confusion because HbA1C gives an indication of blood sugar levels over the last 3 months. This does not mean it is typically measured every 3 months.

 

[Lucyr]

What is your hba1c my doctor said 6 months ask nurse to change it to 3 months as most people have theirs 3 months on this Forum
I have my hba1c once a year normally

 

[Leadinglights]

I believe you would be incredibly lucky to get HbA1c every 3 months.
In a good “year“, I get mine measured every 13 months for my “annual review”.

There may be some confusion because HbA1C gives an indication of blood sugar levels over the last 3 months. This does not mean it is typically measured every 3 months.

When I was diagnosed last June I was given a blood form for 3 months hence and then asked for one after 6 months which was given with no problem, I then decided to leave it for 5 months and again it was given with no issue. This was obviously worthwhile as it revealed a couple of other issues, high potassium and low folate.
Always worth asking, they can only say no.

 

[rebrascora]

My second test was done 5 weeks after diagnosis because my levels were so high and not responding to treatment and dietary changes. I saw the consultant approx 6 monthly after that so blood tests were done each time before my appointment. My last one was Nov and I have my next appointment next month, but obviously as a Type 1 that may be a bit different than a Type 2, although I would say that in the early stages of diagnosis, it makes sense to keep a closer check on things to ensure that whatever treatment or management strategy (ie diet and exercise) is having a beneficial effect.
So I would say, negotiate for a 3 month test after your initial diagnosis, particularly if you are aiming for management solely through changes in lifestyle..... and yes this is possible for many Type 2 diabetics, so don't let your Health Care Professionals discourage you. To a large extent it depends on your HbA1c result though and your 12% or 108mmols/mol is very high, so it is understandable that they are keen to start you on medication and Metformin is the first one they go to.

It is great to hear that your lifestyle changes so far are making you feel better. Are you self testing your BG levels? If so and you are seeing the numbers reduce then I would go to your appointment with the nurse armed with your readings alongside your food diary and make a case for a review of your HbA1c in 3 months and a hiatus on medication until then because you can clearly show that the changes you have made are having a positive impact. If you are not self testing then you will have a less strong case to support your aims and as always, be prepared to listen to their arguments and find a compromise. There is no reason why you can't come off the medication at a later date when your HbA1c is down to less dangerous levels.

 

[helli]

When I was diagnosed last June I was given a blood form for 3 months hence and then asked for one after 6 months which was given with no problem, I then decided to leave it for 5 months and again it was given with no issue. This was obviously worthwhile as it revealed a couple of other issues, high potassium and low folate.
Always worth asking, they can only say no.

After a few years of similar numbers, i am reasonably happy to save time off work for another visit to the docs on top of the blood test for the annual review, annual review, retinal scan, dentist, opticians, flu jab, ....

 

[trophywench]

I don't understand why, now everything is recorded under our NHS numbers, GP surgeries still are required to do all the same blood tests as the ones the hospital diabetes clinic do. The reason always given was because it required the GP to log out of the GP system and back into the hospital one to access them and if they happen to be 6 months apart, well OK, but when they're relatively close together the path lab won't do the second one if it's for the GP cos THEIR records show last time THEY did them (same path lab)

 

[Lilian]

I find that very often the hospital require a blood test the same time as the GP so I go and get them done the same time. One form for the hospital and one for the doctor. It has always been done twice. There was one time when they both asked for a TSH test. Fortunately I always asked for a copy of the results. I noticed that the results to the consultant were different to the ones to the doctor. I understand two different machines maybe different but both readings should show high (if I am high) or lowo (if I am low). However one showed I was low and consultant said my medication should be increased whereas the other one (showing high), my GP refused to increase it. What was more worrying is that when I mentioned to my GP the difference in the results he did not care. When I mentioned it to the consultant, again did not care. A few weeks later I contacted the lab to inform them. Nobody had told them. It also took me 10 minutes of explaining for them to understand what I was getting at. They kept saying that two different machines would be calibrated differently, but did not understand that they should at least both show high or both show low. Same bloood, taken at same time, and even tested at same time. Not sure she was going to do anything about it. I wonder how many people have been misdiagnosed or treated wrongly because of this. She did ask me if I wanted to be tested again. I gave up when I asked what machine she was going to do it on, and there wasn't a flicker of understanding my joke.

 

[SB2015]

I know that the hospital won’t repeat an HbA1c within three months, and for us it is usually done every 6 months.

I work with both GP requirements and Consultant requests. To access them online I want the GP to have the results, so
- mid year I get just HbA1c done by GP (primary care pay for that)
- full year I get the full tests done (HbA1c, cholesterol, ....) using a form from Consultant (secondary care pays for them) but take urine sample and have the blood taken at GP. They then add a note on the form to ask for results to be notified to Practice as well.
That suits everyone.

 

[Drummer]

I had a second Hba1c test so as to have the results at the last 'education' session, which was taken around 80 days from diagnosis, then one at 6 months and after that annually until the pandemic.
There were 5 dreadful weeks of medication, but I went from Hba1c 91 to 41 in 6 months just eating low carb after I stopped taking the tablets.
I did not consciously increase exercise but as I felt so much better I did do a lot more.
My weight reduced - but I did not try for that either.

 

[Jodee]

Hi Jacinta.

My experience is if your blood glucose level are high initially (not controlled) you will be retested in 3 months (it will depend how high your Hba1c is, if still high after 3 months the medication dose of metformin will be increased, reduce carbs, exercise regularly watch the sweet treats and retested again in 6 months by which time blood glucose levels should have reduced and medication can be reduced depending on what your current HbA1c level is.

Once HbA1c levels are stable (in control) its then an annual check.

If you blood glucose levels are high ie heading toward 70s, 80s or higher you won't get levels down with exercise and diet alone, you will need the medication to help get the levels back down to a safer level.

This has been my own experience.

You need to know what type you are. the Diabetic clinic at the hospital should know this, ask if you can attend a online course once you know what type you are.

 

[Jacinta (Australian)]

Hello everyone , Thankyou for the response , I didn’t realise that 12% was so high like I’m in shock to be quite honest , while I haven’t been on medication I’m dieting and exercising aswell until I know what type I am. Because in Australia what % is a safe % that I should be looking at so I can set myself a goal to reach it??? And I haven’t been self testing as I have no idea where to get one or even the cost of one and I’m embarrassed to even go about getting one .

 

[Docb]

Here is a graphic showing a comparison between % and mmol/mol when it comes to HbA1c. 12% is equivalent to 105mmolmol and is something we would consider needs attention a bit sharpish. In UK, 48 mmol/ mol (around 7%) gets you a diabetes diagnosis.

As for a blood glucose monitor, you can get one anywhere - pharmacy (local or on line), Amazon, or where ever. They consist of a reader in which you plug a test strip every time you do a test. That means you have to buy pots of test strips so there is an on going cost.

With a 12% HbA1c you would expect to see readings in the high teens most of the time. The brilliant thing about a test meter is that you can monitor progress and see if any changes you have made brings your general levels down.

 

[Jacinta (Australian)]

View attachment 17017

Here is a graphic showing a comparison between % and mmol/mol when it comes to HbA1c. 12% is equivalent to 105mmolmol and is something we would consider needs attention a bit sharpish. In UK, 48 mmol/ mol (around 7%) gets you a diabetes diagnosis.

As for a blood glucose monitor, you can get one anywhere - pharmacy (local or on line), Amazon, or where ever. They consist of a reader in which you plug a test strip every time you do a test. That means you have to buy pots of test strips so there is an on going cost.

With a 12% HbA1c you would expect to see readings in the high teens most of the time. The brilliant thing about a test meter is that you can monitor progress and see if any changes you have made brings your general levels down.

Hey Docb , can you please explain something to me , cause now I’m confused . If my blood sugar is that high wouldn’t I feel like c**p ??? like thirsty , sleepy all the time or breathe less and what ever else???
Cause I wasn’t any of those at all , the only thing I copped was consist utis , I wasn’t breathe less , or sleepy or constantly thirsty at all . And I’m still not . I don’t understand how my blood sugar was so high ???? I’ll admit my diet was all over the place, like it was 70% healthy to 20% - 30% c**p , I still exercised , I was still drinking water . I did drink sugary stuff and a lot of carbs only cause I loved my bread , pasta and rice . I didn’t realise carbs was the main culprit , if I had of known this I would of done something about it and I’m only 29 years old , I should of known better . My other one is I love fruit it didn’t matter what kind of fruit I would eat it and yet no one told me that not all fruit is good for you especially the sugary ones , I didn’t even know fruit had other sugar in it , I know I can’t keep dwelling in the past and punish myself for everything I have done wrong or didn’t know , but god dam . Even I didn’t know about not all vegetables are good either . Why am I only learning this now and not in school like there suppose to teach you everything .
Sorry for the rant , just still slightly upset about the hole thing still

 

[Ljc]

;I didn’t have any symptoms at all and my Hb1ac was much higher than yours , if I remember correctly (it’s a long time ago now lol) , 15% ,

 

[Docb]

Hi @Jacinta. Just so you know, the Doc is justified but my doctorate is not medical so anything I say must be looked at with that in mind.

From what I can see, having high blood glucose does not always result in symptoms, just like Ljc. Read through the forum and you will find lots of anecdotal reports of it. Just like them, my highest was around 10% (in your units) and it was only after it was found that I began to piece together what was going on.

One of the problems with sorting out T2 is that it encompasses a whole lot of stuff. Is it due to a dodgy pancreas? Is it due to ineffective glucose absorption in muscles? Is it due to excess body fat clogging up the system? Is it due to the way the gut processes carbohydrate in to glucose? Is it due to the rate at which glucose is absorbed from the gut into the blood stream? Is it due to other glucose generation processes in the body? Is it due to a combination of some or all of these things? Goodness knows, certainly not your GP who only uses a couple of simple tests which give you the what but not the why. They just guess and if you are lucky, they might be right. Anyway, having all these potential causes is the reason why there is a lot of individuality in the way people react to elevated glucose levels. If you look for a simple answer, you will just get confused.

There are two stand out things which apply to most people with high blood glucose levels, even if they do not show immediate symptoms.

First is that prolonged high blood glucose increases the risk of diabetes complications further down the line. And that is risk, not certainty. The sensible thing is to do something now to cut down that risk.

Second is that the one thing that can be done to reduce blood glucose is to focus on reducing carbohydrate intake because for most people that is the one thing you can control and for most people carbohydrate intake is the major source of blood glucose.

In my mind, talking about sugar as if it is something peculiar is unhelpful. There are many different sugars and in my simple world they are all best thought of as just another carbohydrate, along with all the other carbohydrates - which incidentally we used to call starches. Anything which is sweet and juicy, like the fruit you buy in the supermarket, will have a lot of carbohydrate. Not only that, but they will be simple carbohydrates (note I don't call them sugars) which are easy to convert and absorb.

What am I getting at? T2 diabetes is not a simple thing with a magic answer applicable to all, despite the claims you see. Far better is not to look for magic but to get to understand your system and then work out what is best for you. I suggest it is best to take your time and go through the process you are going through now until you get that understanding. In my opinion, that is the best way work out a way forward. Express your frustration in any way you want, the members will see past that and help you get there.

Anecdote warning. On the subject of fruit. I have found that for me (might not be for all) that apples from the supermarket gave me a big jump in blood glucose but apples and pears picked from my fruit trees did not. Go figure.