Hello and Newbie questions

[richardbarnes]

Hi all,

I just wanted to say hello and I have some newbie questions!

I’ve not been diagnosed as diabetic (yet), I recently had a high HB1AC test result, which has come as a surprise as I exercise (running & powerlifting) regularly, my BMI is in the heathy range and my body fat is below 10%.

I eat heathy, although admit my sugar intake increase during lockdown whilst working from home. More bread, Gin & Tonic, sweets & biscuits.

I've been running marathons and Ultra's for years (I am 48) so thought (probably wrongly) I was just burning it off.

My 1st HB1AC result was 13.8%, my Doc wanted another reading a week and a half later that came back as 13%.

After the first high reading I bought a meter and my first fasted readings were 16-22mmol/l, so I started to cut out all sugar and only eat small amounts of complex, non-starchy carbs. 3 weeks in and it’s started to drop to a fasted reading of 9-10mmol/l.

Newbie questions (potentially daft):

• I’ve found if I take two blood readings right after each over (different strips and lancets) it can change by 2-3mmol either up or down, is that normal?
• After a run it drops significantly, for example, I had a post 12mile run of 6.8 and post-6.5 mile run of 5.5. If it drops that much I must be processing or burning the sugar in my blood at least whilst exercising, is that normal?
• My only symptoms are mild thirst and blurred vision, yet if I wear my glasses my sight isn’t blurred, if it was diabetes related would my vision be blurred even with glasses? Presume the glasses are correcting the effect of the high sugar.

I am still waiting for the Doctor’s to respond to my test results but I thought I’d take action anyway!

I do feel a bit cheated, there is no history of diabetes in the family. My wife thinks it’d due to all the running has made me sensitive to glucose.

Appreciate your thoughts and if anyone else is in a similar situation.

Richard

 

[adrian1der]

I can help with some of these:

The meters are not very accurate so you will see variations. I think the allowed error is around 15%

Gentle exercise will lower your BG while I, and many others, find that really vigorous exercise raises BG

 

[richardbarnes]

Thanks Adrian, I'll use the meter as a guide rather then an absolute representation in that case.

 

[adrian1der]

No problem - the other advice is to wash your hands well before you test. A bit of something sugary on your fingers can throw your readings way off. You've done the right thing in cutting down on starchy things as well as sugary things. One tip is to test just before you eat and then again two hours later. Ideally you are looking for a rise of no more than 2 or at most 3 in the post prandial reading. If you keep a food diary and a record of your readings you will soon work out what you can tolerate and what you can't. I know it seems like a lot of tests but you will soon get to grips with what you can eat.

 

[rebrascora]

Hi and welcome from me too

Thanks for all the info you provided in your opening post. So helpful to get a picture of your situation. Unfortunately your 2 HbA1c results are both well into the diabetic zone and that scores you a diabetes diagnosis! What Type of diabetes is another matter.... Can I ask what prompted the first blood test? Were you suffering symptoms and if so, did they come on suddenly? Have you lost any weight unintentionally?

Have they stared you on any medication yet and do you have an appointment for speaking to the GP or nurse about your results? For your information GPs can sometimes be lacking in knowledge about diabetes and there is sometimes a practice nurse who has received some training from the specialist diabetes clinic, who may be more knowledgeable and oversee the treatment of diabetics at the practice. That said, in your case I would be pushing for a referral to the specialist diabetes clinic as your circumstances suggest you might be Type1 rather than Type 2.

Adrian has addressed the meter accuracy issue. Don't be put off by that as testing is an incredibly helpful means of managing your diabetes and showing you trends. Running or walking/cycling/swimming involves the biggest muscles of the body using up their stores of glucose and then sucking the glucose out of your blood stream to replace it, so yes, it will drop your levels. Weight training will often involve putting the body under stress which will trigger the liver to produce and release glucose into the blood stream and increase your BG levels in the short term, but the increase in muscle mass will allow more storage of glucose, so the muscles will usually soak up the surplus glucose from the blood later.... and more. Exercise will affect (decrease) your BG levels for up to 48 hours afterwards and it may be that your exercise is "keeping a lid" on your diabetes and preventing it going off the scale rather the other way around as your wife thinks.

I hope you get some input from your medical professionals soon and do ask for a referral as you clearly don't fit the Type 2 diabetic profile and more testing might be appropriate to see how much insulin you are able to produce and look for Type 1 antibodies.... These tests are called C-peptide and GAD antibody tests and would usually be sanctioned by a consultant.

It might be worth while investing in a pot of Ketostix which you can buy over the counter at any pharmacy for about £5. They will enable you to test your urine for ketones when your BG levels go too high (mid teens and above). At high BG levels, ketones can turn your blood acidic and become toxic and lead to what is known as Diabetic Ketoacidosis (DKA) which is very serious and warrants immediate hospital care. Type 2 diabetics are extremely unlikely to suffer this, but if you are Type 1 then it is a real possibility, so whilst your GP or nurse (when you speak to them) may be on the ball and prescribe them, it is worth getting a supply in the meantime to keep an eye on things as DKA can come on quite quickly if your pancreas suddenly becomes overwhelmed. Signs to look out for would be abdominal pain, respiratory difficulty and breath smelling like pear drops, but hopefully the Ketostix would warn you before it got to that stage.

 

[Docb]

Yes, when it comes to using a meter you have to take into account that the number after the decimal point does not have much meaning. I reckon there is a decent case for banning meters from displaying it. After doing ten tests in quick sucession on all 10 fingers and thumbs I vowed from then on only ever to report readings to the nearest whole number. Even then I would put an error of +/- 1 on the result.

This does not invalidate the use of a meter, far from it. Used wisely and with understanding they provide the best way of getting rapid feedback on the effect of what you have eaten and to work out the patterns of how your system is reacting to different food stuffs. From that you can make dietry changes and see very quickly the effect of the changes. Ideal if your aim is to adjust your diet to get your levels down and infinitely superior to waiting 6 months for an HbA1c test. They are also good for looking for long term trends to see whether overall, your levels are going up, going down or going nowhere.

What you must not do is to bodge away haphazardly and then fret about odd readings being different by one or two units.

 

[helli]

@richardbarnes given your fitness, I would be requesting Type 1 to be considered.
It is a completely different condition to the more common type 2 and may explain the sudden onset.
There is a myth that only children are diagnosed with Type1. This is not the case, more than half of us are diagnosed as adults.
The idea of injecting insulin may be scary but, for me, the choice being taken out of the equation, made it easier to accept. It has made very little difference to my life - I have not missed out on doing, eating, travelling, exercising anything I want to do since my diagnosis in my mid-30s. I have just had to consider a few extra things along the way.

Regarding your questions
- our meter are not 100% accurate. They can be 15% out. So, depending on your readings, 2 mmol/l difference is possible within the accuracy tolerance of a normal meter with numbers in double figures.
- cardio exercise makes our body more efficient at using insulin. So a run can cause our levels to drop. Unfortunately, it is never as easy as that as stress can make our levels rise so running up a steep hill against the wind during a rain storm may cause levels to go up. Likewise short spurts can cause a rise to HIIT may result in a rise. And resistance training usually causes a rise. But we are all different.
- blurred vision is due to the change in the focal length of tears. When we have diabetes, our body tries to get rid of the sugar through urine, sweat, saliva, tears, ... any way it can. As a result, our tears become sugary (I remember getting my partner to taste mine when I was first diagnosed because it was so weird). Our eyes gradually adjust to the sugary tears so when our levels start to come down, they need to adjust again.

Managing diabetes is a marathon not a sprint so give yourself and your body time to adjust and learn. After more than 15 years I am still learning.

 

[EmmaL76]

Hi there. Welcome. Im 44 diagnosed last year. Originally as type 2 but altered to type 1 as I was gad positive. Although my cpeptide also show insulin resistance, this can happen with late onset apparently. I just want to tell you how important it is to get the right diagnosis. Your a1c is definitely diabetic. I like you was very fit and I’m really slim. I was running every day and actually felt pretty good not knowing I was diabetic. Originally I was told to cut the carbs, which obviously lead to more weight loss. I eventually cut them so much I didn’t need insulin which led me believe I was a type 2 all along and hopes of remission started to fill my mind. Problem is it’s not sustainable and I fear my literally zero carb diet is actually masking an underperforming pancreas. Interestingly my DN (diabetic nurse ) feels that my extreme exercise may have been a contributing factor. Not sure of the connection there but she has a guy on her books that fell ill with undiagnosed diabetes after running a marathon maybe coincidence. Please ask for more tests as confusion and possible misdiagnosis can lead to you being unnecessarily strict on yourself and will take a toll on your energy levels unless you get the balance right.
P.s no diabetes in my immediate family either, I was asked this constantly in hospital.

 

[richardbarnes]

Thanks everyone for the advice. I have an appointment (well telephone call) with the diabetes nurse on the 29th. I will definitely ask for further tests and a referral. To be honest I would have thought with a test result that high the doctor would have been more proactive 🙄.

This was picked up in a yearly health check blood test, I had no idea it was that high. Been feeling fine otherwise but now looking out for the complications mainly thanks to Dr Google 🙂

It's great to hear from people first hand, so thanks again!

 

[everydayupsanddowns]

Welcome to the forum @richardbarnes

Blurriness of vision can be due to changes in the shape of the eyeballs with differences in pressure because the consistency of fluids can change in the presence of high blood glucose.

These changes can take a few weeks to settle back down, but hopefully will resolve themselves as your blood glucose levels begin to come back into range.

Hope you get some clarity around your diagnosis and diabetes type, and an effective treatment and management plan.

 

[richardbarnes]

Thank you, I'll post an update when I have it.

 

[richardbarnes]

Hi all, just wanted to provide an update.

I've been referred to the specialist diabetes team, I have an appointment next week to have further blood tests to test for Type 1 LADA. They are not really sure if it's type 1 or 2 at the moment. Seems like a few people here I might be an anomaly!

In the interim they have prescribed that I take one 40mg Gliclazide before eating (& include carbs in that meal). They are also supplying a blood and Keto meter.

I have to say they have been really good and called me within an hour of referral from the GP's.

My low carb diet is going well and I've been tracking well below 10mmol first and last thing. Exercising still drops my blood sugar to normal range but climbs over the day (still under 10).

I am pretty upbeat about it all to be honest and lots of people worse off then me. I'll update on progress!

 

[EmmaL76]

Ahh well done. Hope you get your answers. Please update with results… as a fellow anomaly I’m always keen to hear similar stories/outcomes. You seem to be taking it well and being productive. So pleased your medics are responsive it helps no end to be heard

 

[richardbarnes]

Ahh well done. Hope you get your answers. Please update with results… as a fellow anomaly I’m always keen to hear similar stories/outcomes. You seem to be taking it well and being productive. So pleased your medics are responsive it helps no end to be heard

Thanks. I was already to insist on further tests after your advice but seems no need!

 

[richardbarnes]

Hi all, just thought I'd provide an update. My antibody tests have come back:

GAD 311 u/mL (normal range 1-9)
IA2 67.2 u/mL (normal range 0-10)

Quite high, so looks like LADA or T1.5 for me and not T2. I have an appointment with a consultant 2nd week of December.

Low carb diet going well and I've managed to keep in a 4-8mmol range most of the time!

 

[EmmaL76]

Hi all, just thought I'd provide an update. My antibody tests have come back:

GAD 311 u/mL (normal range 1-9)
IA2 67.2 u/mL (normal range 0-10)

Quite high, so looks like LADA or T1.5 for me and not T2. I have an appointment with a consultant 2nd week of December.

Low carb diet going well and I've managed to keep in a 4-8mmol range most of the time!

Well that leaves little doubt. How do you feel about it ? Really well done for staying in that range. Must of been quite difficult x

 

[richardbarnes]

Thanks 🙂 I'd rather know and it makes sense now, like you I've been active and had a heathy diet so T2 just didn't make sense before.
It's not been too bad, lo-dough pizza bases and cauliflower rice have made it easier (lots of red wine seems to help 🙂)

 

[EmmaL76]

I tried that lo dough stuff, reminded me of a piece of kitchen roll lol. However have you tried edamame noodles? Really low in carbs and great for stir fry. Totally with you on the wine front tho x

 

[richardbarnes]

It is a bit, reminds me of thin cardboard although with the right toppings its not too bad. I haven't tried edamame noodles, I will do though as had a small quantity of regular noodles last week in a stir fry and it had a distinct effect on my BG! (I shouldn't be surprised really). I think red wine should be available on prescription! 😉

 

[EmmaL76]

These are the ones I have and they have very little effect on my BGs. You get 4 boxes, when I got mine they were £12 but I noticed they are now £6. You get 4 individual meals out of each box. Obviously the wine to go with it bumps the bill up !