Is it usual to wait so long after diagnosis to start medication?

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mat

mat

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Hello all

After a blood test I was diagnosed with T2 last Friday. Although I have had confirmation by letter of my diagnosis the letter simply states that the surgery will be in contact in around a week to book me an appointment with the diabetic nurse. This means I could possibly be 2-3 weeks post-diagnosis without seeing anyone or obtaining medication.

I have started my own diet and eating much healthier but of course, using my Mothers testing kit, I am still getting readings of 8.0-14.0 daily which shows I obviously need medication.

I do know that I have probably been living like this for many months but now the diagnosis is formal do you think waiting longer is dangerous and I should ask the surgery to see me as I am concerned or simply wait it out? Symptoms wise I don't feel worse but still have frequent urination, blurred vision and excessive thirst.

Thank you
 
mat said:
Hello all

After a blood test I was diagnosed with T2 last Friday. Although I have had confirmation by letter of my diagnosis the letter simply states that the surgery will be in contact in around a week to book me an appointment with the diabetic nurse. This means I could possibly be 2-3 weeks post-diagnosis without seeing anyone or obtaining medication.

I have started my own diet and eating much healthier but of course, using my Mothers testing kit, I am still getting readings of 8.0-14.0 daily which shows I obviously need medication.

I do know that I have probably been living like this for many months but now the diagnosis is formal do you think waiting longer is dangerous and I should ask the surgery to see me as I am concerned or simply wait it out? Symptoms wise I don't feel worse but still have frequent urination, blurred vision and excessive thirst.

Thank you
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When I was diagnosed I saw thw nurse quite quickly - just before my planned holiday : she told me to enjoy my holiday and see her again afterwards. The gap helped me to come to terms with the diagnosis, to do a bit pf reading and - crucially - make a list of questions,
 
Diet? Have you cut sugary food and drinks together with carbs like cereals, bread, biscuits, potatoes and rice? Snacks?
Was your HbA1c result closer to 50 or 100?
Dr Unwin recommends most of his patients to diet instead of taking medication.

Have a look at this presentation:

The nuts & bolts of drug free T2 diabetes remission by Dr David Unwin​

 
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Hi @mat No, I don’t think waiting is dangerous at those numbers. While you’re waiting for your appointment, you could read up about Type 2 and maybe make a list of questions to ask.
 
In my case it took around six weeks from my first high HbA1c result to get to the level of medication I'm on at present. The medication helps matters certainly, but lifestyle changes that you can rapidly implement yourself can make a big difference for very many people. It's something you can control yourself. Dr. Unwin who appears in the video linked in the previous post is one of the 'heroes' of the low-carbohydrate diet as a means to manage T2 diabetes. Prof. Taylor, who appears in this video, advocates for a rapid weight-loss approach. Combining both approaches is as much as anyone can do in the beginning, though the kind of diet that appeals most to you and that you can stick with, in the context of your living situation and thus how much control you have over your diet, will probably be the determining factor as to what action is feasible for you personally.

Very best of luck
 
mat said:
Hello all

After a blood test I was diagnosed with T2 last Friday. Although I have had confirmation by letter of my diagnosis the letter simply states that the surgery will be in contact in around a week to book me an appointment with the diabetic nurse. This means I could possibly be 2-3 weeks post-diagnosis without seeing anyone or obtaining medication.

I have started my own diet and eating much healthier but of course, using my Mothers testing kit, I am still getting readings of 8.0-14.0 daily which shows I obviously need medication.

I do know that I have probably been living like this for many months but now the diagnosis is formal do you think waiting longer is dangerous and I should ask the surgery to see me as I am concerned or simply wait it out? Symptoms wise I don't feel worse but still have frequent urination, blurred vision and excessive thirst.

Thank you
Click to expand...
Need medication? Are you sure?
I started off with readings in the high teens but at the next test I was no longer diabetic, and at 6 months my HbA1c was 41.
If you are already reducing the carbs in your meals you should see your numbers going down as you get the amount right for your particular requirements.
I tried to take the tablets, Metformin and Atorvastatin, but they made me so dreadfully ill I stopped them. That was over 7 years ago now and I've had no problem doing without them.
 
JITR said:
Yes he does, though his key message today is to lose the weight by any means.
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He does, and it's highly likely that the means of weight loss (diet wise) has no bearing on the outcome. Nobody has done the MRI scans on people who have lost the weight on a low carb diet to prove it conclusively, but it's (very) highly likely.

So long as a person loses the necessary weight (15Kg or 15% of body weight, whichever is larger) as soon as reasonably possible after diagnosis then I don't think it matters to the likelihood of achieving remission or how robust that remission might be whether you choose one diet style over another.
 
PerSpinasAdAstra said:
He does, and it's highly likely that the means of weight loss (diet wise) has no bearing on the outcome. Nobody has done the MRI scans on people who have lost the weight on a low carb diet to prove it conclusively, but it's (very) highly likely.

So long as a person loses the necessary weight (15Kg or 15% of body weight, whichever is larger) as soon as reasonably possible after diagnosis then I don't think it matters to the likelihood of achieving remission or how robust that remission might be whether you choose one diet style over another.
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I agree with you. Even so, given the numbers of people involved, it would be worth doing the MRI scans to find out what happens in the first four weeks on higher, but still low, calorie diets with reformulated shakes. That's when most of the fat comes out of the liver. Another approach would be to use the current shakes for the four weeks followed by real food for 3-6 months. Maybe the New Dawn project will be looking into the question to inform future managed and self-managed programmes.
 
I never got medication. I depends also on when you take your readings. Directly after food today I was 10.8. But it goes down 2 hours after food and that’s the reading that’s important fur t2 As others have said you can cut the mealtime readings by cutting down sugary and carb foods. I am in remission. I’m not an expert but your readings aren’t too high with what you’ve said and you might be advised by medical practitioner to manage it by yourself with diet. There’s a lot of help in the learning zone on this website to give you a guide.
 
JITR said:
I agree with you. Even so, given the numbers of people involved, it would be worth doing the MRI scans to find out what happens in the first four weeks on higher, but still low, calorie diets with reformulated shakes. That's when most of the fat comes out of the liver. Another approach would be to use the current shakes for the four weeks followed by real food for 3-6 months. Maybe the New Dawn project will be looking into the question to inform future managed and self-managed programmes.
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MRI scans? You can hardly see a doctor these days never mind getting an MRI scan! I mean that with respect
 
JITR said:
Diet? Have you cut sugary food and drinks together with carbs like cereals, bread, biscuits, potatoes and rice? Snacks?
Was your HbA1c result closer to 50 or 100?
Dr Unwin recommends most of his patients to diet instead of taking medication.

Have a look at this presentation:

The nuts & bolts of drug free T2 diabetes remission by Dr David Unwin​

Click to expand...
If they haven’t seen the nurse they’re unlikely to know their Hba1 c I am in remission drug free
 
mat said:
Hello all

After a blood test I was diagnosed with T2 last Friday. Although I have had confirmation by letter of my diagnosis the letter simply states that the surgery will be in contact in around a week to book me an appointment with the diabetic nurse. This means I could possibly be 2-3 weeks post-diagnosis without seeing anyone or obtaining medication.

I have started my own diet and eating much healthier but of course, using my Mothers testing kit, I am still getting readings of 8.0-14.0 daily which shows I obviously need medication.

I do know that I have probably been living like this for many months but now the diagnosis is formal do you think waiting longer is dangerous and I should ask the surgery to see me as I am concerned or simply wait it out? Symptoms wise I don't feel worse but still have frequent urination, blurred vision and excessive thirst.

Thank you
Click to expand...
It is good you have access to a monitor so you can keep a track of the changes you are making. However having a strategy for testing will be more useful than random readings together with a food diary so you can record what you eat and drink with an estimate of the total carbs which you can use to modify your diet. Testing before you eat and after 2 hours when you aim to keep the increase to be no more than 2-3mmol/l or once your levels come down no more than 8-8.5 mmol/l 2 hours post meal.
Many find that a low carb approach successful for reducing blood glucose and losing weight if you need to. Have a look at this link for some ideas for modifying your diet. https://lowcarbfreshwell.com/
If you are prescribed medication then if metformin then that approach should be suitable but if it is any other medication you would need to check that low carb would be OK.
However there is good explanation which may prompt you with some questions for your appointment.
 
JITR said:
I agree with you. Even so, given the numbers of people involved, it would be worth doing the MRI scans to find out what happens in the first four weeks on higher, but still low, calorie diets with reformulated shakes. That's when most of the fat comes out of the liver. Another approach would be to use the current shakes for the four weeks followed by real food for 3-6 months. Maybe the New Dawn project will be looking into the question to inform future managed and self-managed programmes.
Click to expand...
I absolutely agree that more research is needed in this area. In my case, right now I'm keenly interested in the best action to take after losing Roy Taylor's 'magic' 15Kg of body weight. Is there an optimum diet and/or medication approach after a significant amount of fat comes out of the pancreas in order to help dysfunctional (insulin producing) beta cells recover? Nobody knows.

All I have to go on is Google University and advice from a consultant diabetologist/endocrinologist I saw earlier this week. He advised staying on my current medication and continuing to lose more weight. He offered to prescribe me Trulicity or Ozempic on top of the Metformin and Dapagliflozin I'm already on if I felt it would help me lose more weight and keep it off. My last HbA1c in January was 39 mmol/mol - I thought he'd be reducing my meds, not offering to increase them. I'm staying on my current meds and am going to follow doctor's orders, but I very much wish there was more information available based on solid research as to the optimum path or paths to the possibility of a robust remission.
 
Wow, so much information. I did post this in my very first thread but to clarify:

https://forum.diabetes.org.uk/boards/threads/newbie-possible-t2-in-waiting.110707/#post-1329724

This is the letter I received from my practice the other day (personal info deleted):

Dear Mr XXXXXX

We have recently received your blood test results and these results have shown an increased Blood Glucose level indicating a diagnosis of Type 2 Diabetes.

The results are included below:

HbA1c: 67

Type 2 Diabetes is most commonly associated when your pancreas is not producing enough Insulin and to prevent any complications from this, it is important to ensure your blood glucose levels are controlled.

As a newly diagnosed Diabetic patient, we will be inviting you to attend a new group session at XXXXXXX Medical Centre. Address below:

XXXXXXXX
XXXXXXXX
XXXXXXXX

These sessions will involve other newly diagnosed patients so this will give you the opportunity to meet people in the same situation.

I will be contacting you shortly to book you in for this. If you would not like to attend a group session, please let me know when I phone you and I will book you in for an individual appointment. Please be aware there may be a delay with providing you with an individual appointment due to capacity.

I look forward to speaking to you.

Yours sincerely,
XXXXXXX
 
Hi Mat
Try not to worry. I am not medically trained but from experience, an hba1c of 67 does not warrant an urgent appointment. Between now and your appointment, I would keep a food diary (with times) and record your bg before each meal and 2 hrs after each meal. This will really help you and your dsn to figure out what's going on with your levels as it's different for everyone.
 
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