Newbie

[Nishikoi]

Hi all I'm new to using forums. I was diagnosed with type 2 in December my a1c reading was 67 and now on metformin slow release and reading is down to 56 I was told by gp that was OK and only need a test again in 12 months wondered if this was normal or should testing be done a bit more regular in the beginning. My only contact is my gp I'm not under a diabetic team or nurse I was told gp would manage it in house. I joined this forum because if I have questions I have nobody to ask and I think I can learn things from you genuine people who know the condition. Thanks

 

[Vonny]

Hi @Nishikoi and welcome from one Newbie to another. I was diagnosed in April this year, and had further bloods after 6 weeks. I'm due back for more in September, but that is under a diabetic nurse based at our GP practice. My Hba1c was 76 to start with, and had reduced via diet and metformin to 54. Hopefully it will have reduced by September to under 50.

I think each practice is probably different. I know our GP surgery does follow-ups regularly because it did with my son 3 years ago when he was diagnosed with T2, and they have seen me 3 times during lockdown. I can't speak for anyone else, but my nurse wanted to see me down to <48 in September before she put me onto longer between blood tests. It may be overkill for all I know!

Hope this helps x

 

[Deleted member 27171]

Hi @Nishikoi
Welcome to forum.
Annual HbA1c is the minimum you can expect - some practices may offer it more regularly as standard. You can request one at any time, so if you feel you start experiencing an increase in symptoms or you are concerned at any point that do ask your GP to test again. Did they give any indication of what HbA1c they had as ‘ideal’ for you? 56 is a bit higher than the often desired 48, but it is individual and there may be good reason the GP is happy with 56. That result since December is certainly an improvement and if you continue towards your weight loss goal this will help even further.
Do you test your levels at home? If not, it might be worth some consideration so that you have an idea of how it’s all going In the meantime.

 

[Ralph-YK]

Welcome to the forum Nishikoi.
With me, they went to yearly HbA1c quite quickly, with no comment from HCP. I was also passed to the practice nurse straight away. The only time I've had any involvement of a GP for my diabetes is when I started marking a fuss at my last practice.
The generaly advice here is to do self testing. Testing before and after eating, so you can see the affect food has on your blood glucose (BG) levels. Along with any changes you make.
Keep a food diary, along with a record of your levels. Hopefully after a couple of weeks you'll start to see a pattern.

 

[Ditto]

Hello and welcome. 🙂

 

[everydayupsanddowns]

Welcome to the forum @Nishikoi

And congratulations on your excellent HbA1c reduction so far.

As others have suggested, you may find it helpful to monitor your own BG around different meals if you are unsure how your diabetes management is progressing. The really tricky thing is that blood glucose responses to various foods are highly individual, and it can be impossible to say which types and amounts of carbohydrate will ‘spike’ your BG without checking for yourself.

While there are obvious things like cakes, biscuits, sweets and sugary drinks that you will be wanting to cut out straight away, you might be surprised how much *all* carbohydrate affects your BG levels, including potatoes, rice, pasta, bread, pastry, grains, cereals and many fruits.

Checking your BG before and 2 hours after eating can really help you identify any sources or amounts of carbs that your body is struggling with. Then you can try reducing portion sizes of the carb elements in meals, or swapping for alternative types (eg seedy or low carb bread, or switch to something like ryvita if all breads seem problematic)

It is likely that you may need to self fund your BG meter. These are available over the counter at pharmacies, but if it becomes a regular part of your diabetes management toolkit, choosing one with relatively modest strip costs is very helpful. The most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 which both have test strips at around £8 for 50. Some other brands cost as much as £30 for a pot of strips!

Good luck and keep asking questions 🙂

 

[ianf0ster]

Hi @Nishiko1,
Your GP may be happy with your HBA1C being at 56, but since anything over 47 is diabetic and anything above 41 but below 48 is pre-diabetic the question is - Are you happy with an HbA1C of 56.

I was only at 53 when diagnosed and given a talk about risks from high Blood Glucose: Neuropathy , Retinopathy, Heart disease.

 

[everydayupsanddowns]

Hi @Nishiko1,
Your GP may be happy with your HBA1C being at 56, but since anything over 47 is diabetic and anything above 41 but below 48 is pre-diabetic the question is - Are you happy with an HbA1C of 56.

I was only at 53 when diagnosed and given a talk about risks from high Blood Glucose: Neuropathy , Retinopathy, Heart disease.

While there is additional risk at 56 vs 48, personally I don’t think it’s overly helpful to sound the bells of doom over someone newly diagnosed and give the impression that diabetes complications are going to crash down on them like a ton of bricks immediately. I think the stern talk you were given Ian was perhaps if not misplaced, then certainly somewhat alarmist.

I was part of the T1 guideline development group as one of the lay members, and the Drs on the group thought long and hard over moving the guideline from 58 (7.5%) where it had been for years to 48 (6.5%) because while there was evidence of reduced risks, notably in retinopathy, many of the DCCT graphs are flattening out in a ‘hockey stick’ style, and the risk reductions are more modest at that end.

So not so long ago 58 would have been the target for T1s and would have been recommended for pretty low risk of development of long-term complications (and most likely reduced exposure to hypoglycaemia).

So while 56 (7.3%) could be improved with careful management and the support of the forum, I think it’s important that @Nishikoi recognises that there is time to make the adjustments carefully and gradually (rapid changes in BG are harder on the eyes and fine blood vessels than a more staged approach) 🙂

 

[Nishikoi]

Hi @Nishikoi and welcome from one Newbie to another. I was diagnosed in April this year, and had further bloods after 6 weeks. I'm due back for more in September, but that is under a diabetic nurse based at our GP practice. My Hba1c was 76 to start with, and had reduced via diet and metformin to 54. Hopefully it will have reduced by September to under 50.

I think each practice is probably different. I know our GP surgery does follow-ups regularly because it did with my son 3 years ago when he was diagnosed with T2, and they have seen me 3 times during lockdown. I can't speak for anyone else, but my nurse wanted to see me down to <48 in September before she put me onto longer between blood tests. It may be overkill for all I know!

Hope this helps x

Thankyou for your help

 

[Nishikoi]

Welcome to the forum @Nishikoi

And congratulations on your excellent HbA1c reduction so far.

As others have suggested, you may find it helpful to monitor your own BG around different meals if you are unsure how your diabetes management is progressing. The really tricky thing is that blood glucose responses to various foods are highly individual, and it can be impossible to say which types and amounts of carbohydrate will ‘spike’ your BG without checking for yourself.

While there are obvious things like cakes, biscuits, sweets and sugary drinks that you will be wanting to cut out straight away, you might be surprised how much *all* carbohydrate affects your BG levels, including potatoes, rice, pasta, bread, pastry, grains, cereals and many fruits.

Checking your BG before and 2 hours after eating can really help you identify any sources or amounts of carbs that your body is struggling with. Then you can try reducing portion sizes of the carb elements in meals, or swapping for alternative types (eg seedy or low carb bread, or switch to something like ryvita if all breads seem problematic)

It is likely that you may need to self fund your BG meter. These are available over the counter at pharmacies, but if it becomes a regular part of your diabetes management toolkit, choosing one with relatively modest strip costs is very helpful. The most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 which both have test strips at around £8 for 50. Some other brands cost as much as £30 for a pot of strips!

Good luck and keep asking questions 🙂

Thanks for your advice

 

[Nishikoi]

Hi @Nishiko1,
Your GP may be happy with your HBA1C being at 56, but since anything over 47 is diabetic and anything above 41 but below 48 is pre-diabetic the question is - Are you happy with an HbA1C of 56.

I was only at 53 when diagnosed and given a talk about risks from high Blood Glucose: Neuropathy , Retinopathy, Heart disease.

I'm not really happy I think it's still too high I've requested another test

 

[Nishikoi]

While there is additional risk at 56 vs 48, personally I don’t think it’s overly helpful to sound the bells of doom over someone newly diagnosed and give the impression that diabetes complications are going to crash down on them like a ton of bricks immediately. I think the stern talk you were given Ian was perhaps if not misplaced, then certainly somewhat alarmist.

I was part of the T1 guideline development group as one of the lay members, and the Drs on the group thought long and hard over moving the guideline from 58 (7.5%) where it had been for years to 48 (6.5%) because while there was evidence of reduced risks, notably in retinopathy, many of the DCCT graphs are flattening out in a ‘hockey stick’ style, and the risk reductions are more modest at that end.

So not so long ago 58 would have been the target for T1s and would have been recommended for pretty low risk of development of long-term complications (and most likely reduced exposure to hypoglycaemia).

So while 56 (7.3%) could be improved with careful management and the support of the forum, I think it’s important that @Nishikoi recognises that there is time to make the adjustments carefully and gradually (rapid changes in BG are harder on the eyes and fine blood vessels than a more staged approach) 🙂

Thankyou so much for your information

 

[Nishikoi]

Thankyou for your help

Thankyou

 

[Martin9]

Welcome to the forum @Nishikoi

And congratulations on your excellent HbA1c reduction so far.

As others have suggested, you may find it helpful to monitor your own BG around different meals if you are unsure how your diabetes management is progressing. The really tricky thing is that blood glucose responses to various foods are highly individual, and it can be impossible to say which types and amounts of carbohydrate will ‘spike’ your BG without checking for yourself.

While there are obvious things like cakes, biscuits, sweets and sugary drinks that you will be wanting to cut out straight away, you might be surprised how much *all* carbohydrate affects your BG levels, including potatoes, rice, pasta, bread, pastry, grains, cereals and many fruits.

Checking your BG before and 2 hours after eating can really help you identify any sources or amounts of carbs that your body is struggling with. Then you can try reducing portion sizes of the carb elements in meals, or swapping for alternative types (eg seedy or low carb bread, or switch to something like ryvita if all breads seem problematic)

It is likely that you may need to self fund your BG meter. These are available over the counter at pharmacies, but if it becomes a regular part of your diabetes management toolkit, choosing one with relatively modest strip costs is very helpful. The most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 which both have test strips at around £8 for 50. Some other brands cost as much as £30 for a pot of strips!

Good luck and keep asking questions 🙂

Nice to see the new Gluco Navii mentioned, i see the SD Codefree still getting recommendations on other posts