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A little confused

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Raconteur

Raconteur

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Relationship to Diabetes
Type 2
Hello All, I was diagnosed as being prediabetic in October 2013. Unfortunately it seems i have now progressed to being Type 2 (diagnosed this past week), despite making a lot of lifestyle changes, e.g. much increased exercise regime, stopping smoking, and changes to diet. This was obviously not enough.
I had tests done just before Xmas and the results of the HbA1c were 48 mmol/mol. In the weeks prior to this I wasn't feeling as bright as I should have been, so I started testing with my test unit on waking and my readings were always around the 8.5 mark, hence the visit to the doctor.
My immediate concern is, the doctor has put me on metformin 500mg, one a day for a week and then to increase to 2 per day. However, I got a call from the surgery on Friday saying that I have to come in for more tests on Monday. I am confused about this, as what changes could be found after a week?
 
Once you're on Metformin, they like to keep an eye on your kidney and liver function, so maybe it's that. Also, do you normally have cholesterol checks? That's something they keep an eye on once you're diagnosed.
 
Yes, I do, i had his tested at the same time and it came out at 5.5, which is better than it was 12 months ago when i was 6.2 mmol/l. I was also put on statins.
 
Hi and welcome Paul - I to am new so of little or no help at all! :D
 
Paul Barry McCreadie said:
Hello All, I was diagnosed as being prediabetic in October 2013. Unfortunately it seems i have now progressed to being Type 2 (diagnosed this past week), despite making a lot of lifestyle changes, e.g. much increased exercise regime, stopping smoking, and changes to diet. This was obviously not enough.
I had tests done just before Xmas and the results of the HbA1c were 48 mmol/mol. In the weeks prior to this I wasn't feeling as bright as I should have been, so I started testing with my test unit on waking and my readings were always around the 8.5 mark, hence the visit to the doctor.
My immediate concern is, the doctor has put me on metformin 500mg, one a day for a week and then to increase to 2 per day. However, I got a call from the surgery on Friday saying that I have to come in for more tests on Monday. I am confused about this, as what changes could be found after a week?
Click to expand...

Hi Paul - I would try not to be too anxious about this (do as I say, not as I do, eh? 😉 ).

As I understand it, with an HbA1c score of 48 (which is the lowest diabetic threshold score), they often like to have a second test, timed fairly closely to confirm their findings.

To be honest, with your fasting tests, I wouldn't be surprised if the second test (assuming it is that) did indeed confirm it, but it isn't the end of the world.

Diabetes knowledge is advancing all the time, and there are some newer views that some of the advice we may have been given in recent years may not have been as great as thought at the time. I'm thinking of things like "go low-fat" and "plenty carbs at every meal".

I'm fairly surprised you have gone straight onto medication with an HbA1c score of 48, but that was probably influenced by your feeling unwell, plus elevated fasting scores. However, with tweeks, I would think it likely you can reduce this number - ideally below diabetic numbers. My HbA1c at diagnosis was 73, and I have managed to reduce it substantially (numbers in my signature), without medication. To be fair, I don't have any other health issues and I consider myself to be one of the "lucky" diabetics who seems to have been caught early (as you have), and to have worked out a way forward, without too many problems.

As I say; don't worry too much about more tests. Worry won't change anything, and reality is usually much less serious than our imaginations can throw at us! At the point of diagnosis there are so many things they have to check - bloods, feet, eyes, diet and so on.

Good luck with it all.
 
Hi and welcome to the forum. As others have said I wouldn't worry too much about the extra blood tests. Good luck with them though. My HbA1c was 127 when I was diagnosed. It's coming down slowly. But getting there.
 
Thanks for the feedback. The main reason for choosing to go on the medication is work related. I travel frequently to mine sites and, generally, food choices and the ability to exercise can be very limited. Nevertheless, within days of starting the medication my levels (measured with Bayer Contour) have dropped remarkably to around 5 and my lethargy has all but gone away. On a related matter (I think), my urine was very dark, and has been for a number of years, became more like the colour one would expect (in other words, became much lighter) after commencing the medication. Maybe the elevated sugar levels were affecting the functionality of kidneys? Just a guess!
 
The elevated sugar levels cause the kidneys to work harder since they have to pee out all the excess sugar. However because the filters in the kidney aren't the right shape or size normally to actually let 'sugar' molecules in, in larger quantities, this causes problems.

I liken it to a sieve - if you try and force gravel through a sieve eventually you will make an actual hole which will let the smaller bits through. However, with that sized hole - all sorts of other things can get through - eg insects. So there's yer kidney - letting in bugs and Lor' knows what, causing UTIs (and what's the first sign my mother always told me to watch out for? - darker than usual urine!) and eventually, untreated long enough and worse than your levels - causing real damage to your kidneys.

At the mo - your sieves have just had a few holes stretched a bit, no actual holes yet! - and by getting your BG on track pretty pronto you have very likely prevented any real lasting damage to be caused.

High blood glucose = overtime for the kidneys every time!
 
I think the darker urine was probably more down to you being dehydrated. Basically, if your blood glucose levels were too high, your kidneys would have been working hard to remove the excess and this would have meant you losing more water. If you weren't compensating by drinking more than normal, then you'd be a little dehydrated and the urine would be darker. Now that you are on medication, the bg levels should be coming down, the kidneys can rest a little, you are less dehydrated again and the colour of the urine should lighten.

Welcome to the forum, by the way! 🙂
 
Great Feedback, thanks.
It turns out that the tests order by the Doctor relate to Full Blood Count, Liver Function Tests and a Kidney Test. I presume these have all been requested to act as a benchmark for future results to be compared against?
 
Paul Barry McCreadie said:
Great Feedback, thanks.
It turns out that the tests order by the Doctor relate to Full Blood Count, Liver Function Tests and a Kidney Test. I presume these have all been requested to act as a benchmark for future results to be compared against?
Click to expand...
Yes, they are all standard tests 🙂
 
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