Am I Diabetic or Not - Nobody Seems to Know!!

[Zosema]

Hi everyone, went to see the diabetic GP at my practice this evening as I told to by another GP (at the same practice) to discuss the pains I have been having in my legs with him.

The diabetic GP said there is no sign of neuropathy; the other GP said it was definitely this and was going to get worse!

Then, the diabetic GP reviewed my blood test results and said that I may NOT be diabetic after all, I might have impaired glucose tolerance!! He's given me a form to have a further blood test done, along with a glucose drink in order to ascertain how I handle glucose.

I am now completely confused and bl**dy irate to have been told I am diabetic by one GP, only to have another one say I might not be. Who should I believe? Should I believe anyone, as nobody seems to be agreeing with each other in that practice, 3 different GPs there have told me different things now.

My original fasting blood test came back as 7.1, the re-test was 6.3 and then, once I'd started Metformin, the result was 6.1.

My mother has Type 2 diabetes, so I know that increases my risk.

The only good thing that came out of tonight's consultation was that I have managed to lose 8 kg in the last 7 weeks or so.

Aarrghh - rant over, thanks for listening.

Zosema, otherwise known as "Confused of Reading"

 

[Robster65]

Hi Zosema.

We have come up against this confusion as well.

Some GPs see BGs up to 10 or 11 as 'normal' while others will be more cautious and see the 7.1 as being an early sign of type 2.

I'm not sure why there is such a range of opinion but it certainly doesn't make it easy for you to know what you should do. I would say that 6.8 is still high as a fasting BG but I presume they'll give you a glucose tolerance test to see how high you go 'under stress' and you can be categorised officially. Which doesn't really change anything for you. You still need to be careful of carbs and exercise will still do you more good than not.🙂

Rob

 

[Northerner]

...My original fasting blood test came back as 7.1, the re-test was 6.3 and then, once I'd started Metformin, the result was 6.1....

I think the normal criteria for diagnosis is two fingerprick tests over 7 or one if there are other significant symptoms present (like excessive thirst, urination etc.). I imagine when you only just about meet the criteria it can be difficult to give a firm diagnosis since, as suggested, it may not be diabetes but impaired glucose tolerance.

However, whatever the case your levels are higher than would be expected from someone who had good natural blood sugar control, so the best thing is to follow the prinicples of a diet and lifestyle suitable for a person with diabetes - which is, of course, suitable for everyone so you have nothing to lose! 🙂 Hopefully, the glucose tolerance test will clarify things for you 🙂

 

[Mark T]

Interesting that they want to test you whilst you are on Metformin, my DSN said to me that if I wanted to have a oral glucose tolerance test then I'd first have to come off the Metformin because it will disturb the results.

I didn't bother doing the test as I didn't think it would tell me much. Self testing had already shown that I can hit double figures eating the right (wrong?) combinations of foods.

Although, I would wonder if your GP would think that I'm diabetic

Are those leg pains a recent thing? I've occasionally had leg pains when I've been loosing weight (and still do if I push things a bit). I took it as a sign that I was dropping too much off too quickly.

 

[Northerner]

A lot of people suffer from transient neuropathy when they begin treatment, as the blood sugar levels reduce to a level that the nerves are less familiar with - I still get the occasional pain if my levels run higher for a while.

 

[Copepod]

Plus, WHO (World Health Organisation) and international diabetes associations have been known to change their minds about whether to diagnose diabetes with HbA1c or Glucose Tolerance Test or random or fasting finger prick tests AND which levels indicate diabetes or impaired glucose tolerance with each test.

 

[lauraw1983]

How frustrating for you. However your levels looks good, so look on the bright side there. I wish mine were as good!

I hope they can clarify things for you soon, can you see a diabetes Dr or a clinic you could chat to a DSN about things? some GP's are very frustrating, and as they are not specialised in anything I think they can often confuse things.

I hope the GTT answers things for you x

 

[HelenM]

until recently these were the official guidelines

Methods and criteria for diagnosing diabetes mellitus
1. Diabetes symptoms (ie polyuria, polydipsia and unexplained weight loss) plus

a random venous plasma glucose concentration > 11.1 mmol/l
or a fasting plasma glucose concentration > 7.0 mmol/l (whole blood > 6.1mmol/l)
or
two hour plasma glucose concentration > 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).

2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting or random values are not diagnostic the two hour value should be used

fingerpricks shouldn't normally be used unless there are symptoms and a fasting test is over the threshold. Otherwise lab test confirmation is necessary.
recently the WHO and then the UK have agreed that the HbA1c test can be used (again lab done, not fingerprick)

An HbA1c of 48 mmol/mol (6.5%) is recommended as the cut point for diagnosing diabetes. A value of less than 48 mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests.

http://www.diabetes.org.uk/About_us...ations/New_diagnostic_criteria_for_diabetes_/

The important thing to realise though is that there is very little difference between a glucose level that just above the threshold or just below it. At that level whether it's called impaired fasting glucose/ impaired glucose tolerance or diabetes, glucose levels are higher than normal. It may be that losing weight, diet and exercise will help the person achieve more normal glucose levels but some doctors prefer to use metformin even at 'pre diabetic' levels.

 

[Zosema]

Hi everyone, just had a call from my diabetic GP. He explained to me the changing criteria used to diagnose diabetes and said I definitely need the glucose tolerance test. I think he'd spoken with my original GP and they realised they'd managed to completely confuse me! So, that is me tomorrow - 2 hours hanging around the hospital. Can't wait, hahaha!!!

 

[Northerner]

Hi everyone, just had a call from my diabetic GP. He explained to me the changing criteria used to diagnose diabetes and said I definitely need the glucose tolerance test. I think he'd spoken with my original GP and they realised they'd managed to completely confuse me! So, that is me tomorrow - 2 hours hanging around the hospital. Can't wait, hahaha!!!

Good to hear that they called you up to explain, take a good book with you! 🙂

 

[Zosema]

Well, I had my oral glucose tolerance test and the result was normal. My GP (the one who originally told me I was diabetic) has told me that this, therefore, means that I have impaired glucose tolerance because I still had the one high fasting blood glucose result.

I'm still confused, should I continue to take the Metformin or not? I haven't been able to see or speak to the diabetic GP at all, so have no idea what I should be doing now! I haven't taken any Metformin since Monday morning this week, because of having the glucose tolerance test.

The GP I saw yesterday said I need to view this as a big wake up call and my body giving me a warning shot that all is not well and that I will end up diabetic for sure if I don't lose weight. I have about another 9 stone to go on that front!

Does anyone here know what I should do with regards to the Metformin etc?

Thanks!
Zosema

 

[cherrypie]

Hi,
Have you actually been told that you are pre diabetic?

If this is the case then the Metformin will not do you any harm and will likely benefit you because it will improve your insulin resistance. Speak to your G.P. to clarify if he wants you to keep taking it.
http://www.pre-diabetes.com/info/treatment.html

 

[Pumper_Sue]

Hi Zosema,
well at least your GP was honest with you so you now know what you need to do.

Ring your surgery and ask to speak to the Dr dealing with diabetes or your own GP and ask about the met. Explain to the receptionist there is confusion over the medication you were prescribed.

If you haven't been told to stop it my guess would be you carry on as Met from what I understand is also a great help with weight loss.

It's only a guess and only your medical team can answer yes or no.

 

[Zosema]

Hi,
Have you actually been told that you are pre diabetic?

If this is the case then the Metformin will not do you any harm and will likely benefit you because it will improve your insulin resistance. Speak to your G.P. to clarify if he wants you to keep taking it.
http://www.pre-diabetes.com/info/treatment.html

Hi, he told me that its likely I could become diabetic if I don't heed the warning that my body is giving me - my mother is Type 2 diabetic, so there is that link too.

I am losing weight - I've lost 8 kg in the last 7/8 weeks, I just have quite a long way to go until I reach my target weight. At least it's a start though.

Also, I felt mentally sharper once I'd started the Metformin and like I had a bit more physical energy, why would that be if I just have impaired glucose tolerance?

Apologies for so many questions! I think I've received much better advice on this forum than I have at my doctor's surgery - nobody there seems to talk to anyone. Rather disturbing actually!

Many thanks
Zosema

 

[ypauly]

Apologies for so many questions! I think I've received much better advice on this forum than I have at my doctor's surgery - nobody there seems to talk to anyone. Rather disturbing actually!

Don't appologise ask any question you feel like, it can be a mind bogling condition. many of us found more info here than from the medical proffessionals whan we were diagnosed, there are some wonderfully clever people here who love to help.

 

[GlucoseGary]

Also, I felt mentally sharper once I'd started the Metformin and like I had a bit more physical energy, why would that be if I just have impaired glucose tolerance?

I think the thing I've realised now (too late ) is that there's no such thing as "just" impaired glucose. You either have working control or not, and if (like me) you have that combination of family history and excess weight, doing as Northerner suggested and starting to think like a diabetic now cannot possibly hurt (but you can still risk a few treats too!).

I recently read that by the time you hit the diagnosis thresholds and get symptoms, up to 80% of your insulin-producing cells may already be impaired or dead. Avoidance is better than treatment.

 

[Robster65]

I think the thing I've realised now (too late ) is that there's no such thing as "just" impaired glucose. You either have working control or not, and if (like me) you have that combination of family history and excess weight, doing as Northerner suggested and starting to think like a diabetic now cannot possibly hurt (but you can still risk a few treats too!).

I recently read that by the time you hit the diagnosis thresholds and get symptoms, up to 80% of your insulin-producing cells may already be impaired or dead. Avoidance is better than treatment.

Agree with Gary. It's just a matter of how severe the symptoms are. For IGT they're not as bad as for diagnosed T2. But the treatment is much the same, with or without meds.🙂

Rob

 

[am64]

when i was first dx they used an HbAlc reading of anyone above 7.2 after fasting blood test ...now i believe they have reduced it to 6.4 i think