Hello, new (first) test done this morning

[LisaB0151]

Hi there, just had the non-fasting test this am as high risk but both T1 and T2 in the family. How do you know which one you’re high risk for or is it just whatever comes back in the results? I’m so confused? Also, how do you know if you’re “pre”? As I see from this site I could be “pre” rather than have diabetes. Thanks.

 

[adrian1der]

The first thing is to have an HbA1c test. This measures the sugar bound to blood cells and as blood cells live for two to three months the test measures your average blood glucose over that period. 42 and above and you are classified as at risk of diabetes or pre-diabetic. 48 and above and you will be diagnosed as diabetic. There are then other tests that can be done to determine T1 or T2. In many cases these are not done. For example, I was very overweight, diagnosed as T2 and started on the relevant medication. Some people will be diagnosed as T2 and not respond in a normal manner to the medication and will be subsequently re-diagnosed as T1. I'll call in @rebrascora who went down this route. I'm sure Barbara can tell you more 🙂

 

[SB2015]

Hi Lisa, Welcome to the forum.

With T2 the body does not produce enough insulin, or is not able to use the insulin sufficiently to balance the glucose that is in the blood. The glucose comes from the carbohydrates that we eat. This may be controlled through dietary changes and a more active lifestyle and/or medications which make the pancreas produce more insulin, or make the insulin available work better.

With T1 the body sets some antibodies going, and these gradually destroy the beta cells that are in the pancreas and make insulin. Eventually once these have all gone there is no insulin produced and we have to inject it instead.

Some of the symptoms are common for both, hence the misdiagnosis for people sometimes. The HbA1c will tell you an average levels of glucose in your blood, which will be high for either type. The additional tests for T1 measure the output of insulin (c-peptide) and/or the GAD antibody test which looks for the presence of those pests that are destroying the beta cells.

I hope that all makes sense. Let us know how you get on, and do ask what tests have been done and what your levels are.

 

[rebrascora]

Hi and welcome.

Was this a test at your GP surgery or was this some private test? How was the test done? ie was it a finger prick test or was blood taken from your arm? Was it done by a nurse/doctor or one of these automated machines?

Numbers and the measurement units are important when talking about diabetes, so if you don't know the actual numerical result then ask? And ask what the test was? Ie an HbA1c test or a Blood Glucose test. Also when you had breakfast relative to the test ie how long after eating and what you had to eat and drink is relevant to understanding the result.

The "at risk of diabetes" or "prediabetes" labels just tells you that your body is starting to have problems metabolizing carbohydrates. The diagnostic test is the same as for diabetes in that it is an HbA1c test, usually involving blood from your arm sent off to the lab but I believe there are automated machines in some hospitals and very large GP practices which can give an almost instant HbA1c result from a finger prick. An HbA1c result of under 42 is normal, 42-47 is "Prediabetes" or "at risk of diabetes" and 48+ gets you a diabetes diagnosis.

If you had a high finger prick Blood Glucose (BG) reading, that might indicate that you were likely to have diabetes but they would do an HbA1c test to check, and I could imagine a nurse or doctor saying that a high BG reading could mean a high risk of diabetes, ie that there is a high risk that a proper HbA1c test would show that you are diabetic and I would very much hope they would obtain some blood from your arm to send off and check that. Once you get that HbA1c blood test result, then you and the doctors will know if you are diabetic or at risk of diabetes... or not diabetic at all....... So that HbA1c test is really important and I am hoping you will say that they took some blood from your arm to test???

After you get a diabetes diagnosis with a result of 48+, then you still could be either Type 1 or Type 2. Most doctors look at you and assess from what they see and know about you as to which type but it isn't always clear cut. There is no specific test for Type 2 and Type 1 testing is a bit more complicated and expensive so they tend to make an assumption that you are type 2 particularly if you are a mature adult and if you are carrying a bit too much weight or have a poor diet and are relatively inactive. These assessments are not by any means always accurate and quite a number of us where misdiagnosed as Type 2 when we were later found to be Type 1...... but no point in going into more detail until you have the result of an HbA1c test as that will tell you if you are diabetic or not.

 

[adrian1der]

They tend to make an assumption that you are type 2 particularly if you are a mature adult and if you are carrying a bit too much weight or have a poor diet and are relatively inactive.

Sums me up at diagnosis beautifully 🙂

 

[rebrascora]

Sums me up at diagnosis beautifully 🙂

Yes but the truly amazing thing is that in the short time since then, you have massively changed most of those parameters and the one that you can't change has probably also been impacted in that I bet you feel younger even if you can't chip a few years off the actual score.

 

[adrian1der]

Yes but the truly amazing thing is that in the short time since then, you have massively changed most of those parameters and the one that you can't change has probably also been impacted in that I bet you feel younger even if you can't chip a few years off the actual score.

Too true 🙂

I think that is the "good thing" about a T2 diagnosis. Everything you need to do and change is under your control while I'm amazed at what you T1s have to go through to try and get a handle on things. And you're right - having made changes I do feel so much better although looking after a 4 month old baby I currently feel 156 not 56 (bad night last night as he is not sleeping well in the heat).

 

[LisaB0151]

The first thing is to have an HbA1c test. This measures the sugar bound to blood cells and as blood cells live for two to three months the test measures your average blood glucose over that period. 42 and above and you are classified as at risk of diabetes or pre-diabetic. 48 and above and you will be diagnosed as diabetic. There are then other tests that can be done to determine T1 or T2. In many cases these are not done. For example, I was very overweight, diagnosed as T2 and started on the relevant medication. Some people will be diagnosed as T2 and not respond in a normal manner to the medication and will be subsequently re-diagnosed as T1. I'll call in @rebrascora who went down this route. I'm sure Barbara can tell you more 🙂

Thank you that’s great. I’m 53, overweight by about 4 stone as I was always about 10. They did an HB1 test and loads of other tests this am kidneys, thyroid etc. So it’s helpful to know all this. My dad and nephew and aunts/uncles are diabetic with a mix of both types. No gestational in our fam that I’m aware of. Not sure if that makes any difference or not. Thank you for your helpful reply

 

[LisaB0151]

The first thing is to have an HbA1c test. This measures the sugar bound to blood cells and as blood cells live for two to three months the test measures your average blood glucose over that period. 42 and above and you are classified as at risk of diabetes or pre-diabetic. 48 and above and you will be diagnosed as diabetic. There are then other tests that can be done to determine T1 or T2. In many cases these are not done. For example, I was very overweight, diagnosed as T2 and started on the relevant medication. Some people will be diagnosed as T2 and not respond in a normal manner to the medication and will be subsequently re-diagnosed as T1. I'll call in @rebrascora who went down this route. I'm sure Barbara can tell you more 🙂

Sorry it was a nurse at the practice. I didn’t have breakfast only coffee I don’t usually eat early on so it would just be one cup of coffee with milk no sugar? The test was the HB1 she said? They took various vials as my thyroid, kidneys, bones and liver are all being tested but this is the one I’m concerned about as I’m assuming this counters any other issues if managed correctly. I’m already on a restricted gluten free low fat high fibre diet having just been diagnosed with diverticula disease and don’t eat meat or fish either. This will be a challenge for me I think.

 

[rebrascora]

Good to hear they have taken blood for an HbA1c and yes they will do a raft of other tests too. When you get your result back in a day or 3, do make a note of the reading because this is the starting point on your diabetes journey, even if it is hopefully in the pre diabetes (or at risk) range.
Being over weight and older do make Type 2 more likely but with diabetes no rules are set in stone. If Type 2 management strategies don't work (ie dietary changes and increased exercise and oral meds) then you might consider asking for Type 1 testing but I would imagine that initially Type 2 treatment will be the route they take and hopefully it will be right.

Unfortunately your diet will be more challenging with not eating meat and fish. Hopefully you are good with eggs. Gluten intolerance and diabetes are fine together as gluten mostly comes from grains and grains are carbohydrate so avoiding grains will help both. High fibre is also good for diabetes. Low fat is a hot topic as it is standard NHS advice for any and every ailment or otherwise without a great deal of modern science behind it and many of us disregard it when it comes to diabetes... but that will be your choice to investigate and make your own decision about.

Good luck. Hopefully your HbA1c comes back as quite low and some small to moderate changes in lifestyle will be enough.

 

[LisaB0151]

Good to hear they have taken blood for an HbA1c and yes they will do a raft of other tests too. When you get your result back in a day or 3, do make a note of the reading because this is the starting point on your diabetes journey, even if it is hopefully in the pre diabetes (or at risk) range.
Being over weight and older do make Type 2 more likely but with diabetes no rules are set in stone. If Type 2 management strategies don't work (ie dietary changes and increased exercise and oral meds) then you might consider asking for Type 1 testing but I would imagine that initially Type 2 treatment will be the route they take and hopefully it will be right.

Unfortunately your diet will be more challenging with not eating meat and fish. Hopefully you are good with eggs. Gluten intolerance and diabetes are fine together as gluten mostly comes from grains and grains are carbohydrate so avoiding grains will help both. High fibre is also good for diabetes. Low fat is a hot topic as it is standard NHS advice for any and every ailment or otherwise without a great deal of modern science behind it and many of us disregard it when it comes to diabetes... but that will be your choice to investigate and make your own decision about.

Good luck. Hopefully your HbA1c comes back as quite low and some small to moderate changes in lifestyle will be enough.

Thanks Barbara that sounds fairly straightforward planning wise thank you

 

[rebrascora]

If you are able to instigate a daily walk into your routine, that can help significantly and actually lowers your levels more than going to the gym at least in real time, so don't feel you have to do anything overly exertive. Walking after meals can be particularly helpful, so something else for you to perhaps look at planning.

 

[LisaB0151]

Hi Lisa, Welcome to the forum.

With T2 the body does not produce enough insulin, or is not able to use the insulin sufficiently to balance the glucose that is in the blood. The glucose comes from the carbohydrates that we eat. This may be controlled through dietary changes and a more active lifestyle and/or medications which make the pancreas produce more insulin, or make the insulin available work better.

With T1 the body sets some antibodies going, and these gradually destroy the beta cells that are in the pancreas and make insulin. Eventually once these have all gone there is no insulin produced and we have to inject it instead.

Some of the symptoms are common for both, hence the misdiagnosis for people sometimes. The HbA1c will tell you an average levels of glucose in your blood, which will be high for either type. The additional tests for T1 measure the output of insulin (c-peptide) and/or the GAD antibody test which looks for the presence of those pests that are destroying the beta cells.

I hope that all makes sense. Let us know how you get on, and do ask what tests have been done and what your levels are.

Hi that’s great thank you for this information. I’ve read and read on it but it wasn’t making sense! Thanks again and will update in about three days when hopefully my results are in

 

[LisaB0151]

If you are able to instigate a daily walk into your routine, that can help significantly and actually lowers your levels more than going to the gym at least in real time, so don't feel you have to do anything overly exertive. Walking after meals can be particularly helpful, so something else for you to perhaps look at planning.

Thanks I agree. I’ve actually lost a stone just by walking the last 12 months. Walking at pace I mean. This has been helpful in lots of ways. I get bored and am not keen on the gym

 

[LisaB0151]

Too true 🙂

I think that is the "good thing" about a T2 diagnosis. Everything you need to do and change is under your control while I'm amazed at what you T1s have to go through to try and get a handle on things. And you're right - having made changes I do feel so much better although looking after a 4 month old baby I currently feel 156 not 56 (bad night last night as he is not sleeping well in the heat).

I’ve just nosed at your stats there Barb I hope you don’t mind as your roughly similar to me but I note your BMI has dramatically decreased? How did you do that if you don’t mind me asking was it your “diabetic” dietary changes combined with new/increased exercise? Sorry for the impertinent questions but I’d love to decrease my BMI like that

 

[rebrascora]

Thanks I agree. I’ve actually lost a stone just by walking the last 12 months. Walking at pace I mean. This has been helpful in lots of ways. I get bored and am not keen on the gym

That comment is interesting in 2 respects.... Firstly that you have been more active in the last 12 months. It is usually inactivity in the time preceding diagnosis which triggers Type 2 and weight loss is sometimes an indicator of Type 1, whereas weight gain usually precedes Type 2 diagnosis. So the fact that you have been more active and lost weight recently might tip the scales a little more towards Type 1 which can have a slower onset in mature adults.
It will be worth keeping an open mind on the Type of your diabetes in view of that additional info.

Were you symptomatic? Just wondering what prompted the blood test or was it just a routine health check?

 

[LisaB0151]

Hi and welcome.

Was this a test at your GP surgery or was this some private test? How was the test done? ie was it a finger prick test or was blood taken from your arm? Was it done by a nurse/doctor or one of these automated machines?

Numbers and the measurement units are important when talking about diabetes, so if you don't know the actual numerical result then ask? And ask what the test was? Ie an HbA1c test or a Blood Glucose test. Also when you had breakfast relative to the test ie how long after eating and what you had to eat and drink is relevant to understanding the result.

The "at risk of diabetes" or "prediabetes" labels just tells you that your body is starting to have problems metabolizing carbohydrates. The diagnostic test is the same as for diabetes in that it is an HbA1c test, usually involving blood from your arm sent off to the lab but I believe there are automated machines in some hospitals and very large GP practices which can give an almost instant HbA1c result from a finger prick. An HbA1c result of under 42 is normal, 42-47 is "Prediabetes" or "at risk of diabetes" and 48+ gets you a diabetes diagnosis.

If you had a high finger prick Blood Glucose (BG) reading, that might indicate that you were likely to have diabetes but they would do an HbA1c test to check, and I could imagine a nurse or doctor saying that a high BG reading could mean a high risk of diabetes, ie that there is a high risk that a proper HbA1c test would show that you are diabetic and I would very much hope they would obtain some blood from your arm to send off and check that. Once you get that HbA1c blood test result, then you and the doctors will know if you are diabetic or at risk of diabetes... or not diabetic at all....... So that HbA1c test is really important and I am hoping you will say that they took some blood from your arm to test???

After you get a diabetes diagnosis with a result of 48+, then you still could be either Type 1 or Type 2. Most doctors look at you and assess from what they see and know about you as to which type but it isn't always clear cut. There is no specific test for Type 2 and Type 1 testing is a bit more complicated and expensive so they tend to make an assumption that you are type 2 particularly if you are a mature adult and if you are carrying a bit too much weight or have a poor diet and are relatively inactive. These assessments are not by any means always accurate and quite a number of us where misdiagnosed as Type 2 when we were later found to be Type 1...... but no point in going into more detail until you have the result of an HbA1c test as that will tell you if you are diabetic or not.

Yes they took three or four vials I was a bit alarmed as I only thought I was having a diabetic test so assumed they’d only need one!

 

[rebrascora]

I’ve just nosed at your stats there Barb I hope you don’t mind as your roughly similar to me but I note your BMI has dramatically decreased? How did you do that if you don’t mind me asking was it your “diabetic” dietary changes combined with new/increased exercise? Sorry for the impertinent questions but I’d love to decrease my BMI like that

Lisa, I think you may be confusing @adrian!der with myself rebrascora (Barbara). Adrian has lost an amazing amount of weight since his diagnosis, through diet change and regular walking and exercise bike I believe. His stats are amazing but what are even more amazing are his daily menus.... it's gormet food at his house every night a la Adrian. We are so jealous of his wife and son!

 

[LisaB0151]

That comment is interesting in 2 respects.... Firstly that you have been more active in the last 12 months. It is usually inactivity in the time preceding diagnosis which triggers Type 2 and weight loss is sometimes an indicator of Type 1, whereas weight gain usually precedes Type 2 diagnosis. So the fact that you have been more active and lost weight recently might tip the scales a little more towards Type 1 which can have a slower onset in mature adults.
It will be worth keeping an open mind on the Type of your diabetes in view of that additional info.

Were you symptomatic? Just wondering what prompted the blood test or was it just a routine health check?

Thank you as the weight issues in the symptoms lists confused me no end! I’ve been totally assuming T2 though I must admit and at no time really considered T1. I think because my dad is T2? I’ve had massive thirst every day, morning through to evening and it’s resulted in my logging my water intake as it was around 7 litres a day! Terrible sleeps, swelling and pins and needles in my hands and feet. Dizziness and I seem to be literally hungry all the time. I can’t eat early on though as it makes me feel nauseous and it always has but that has got slightly worse the nausea I’m not sure if that’s a symptom or not?

 

[LisaB0151]

O

Lisa, I think you may be confusing @adrian!der with myself rebrascora (Barbara). Adrian has lost an amazing amount of weight since his diagnosis, through diet change and regular walking and exercise bike I believe. His stats are amazing but what are even more amazing are his daily menus.... it's gormet food at his house every night a la Adrian. We are so jealous of his wife and son!

Oh I’m really sorry I’ve lost track of who’s who already! Wow well done Adrian then I’ll be keeping my eye out for the menus too! Lovely thank you