Newly diagnosed - advise required please

[VH2024]

Hello, I’m looking for some advice please. Being potentially diagnosed with type 2 is a bit overwhelming and confusing at the same time. A bit of background history, I was diagnosed with gestational diabetes just in my third pregnancy but right at the very end not long before I actually gave birth to my son who is now 18 months old. So there wasn’t really any treatment management as the doctors etc said that it usually disappears post partum and said to have a follow up test. The follow up test was normal and was told that I require an annual diabetes check going forward.

My first hba1c was 41
My second hba1c almost a year later (May 24) was now 48.

I was fully aware that a test of 48 was confirmed diabetes. The nurse at my GP practice called to say we will repeat the test again in four weeks time. If it’s still elevated then you have type 2 diabetes. In the four weeks I made sure I was quite strict with food and sugar intake. Fast forward four weeks and the repeat hbac1 test has risen even higher to 55. I was absolutely shocked. I didn’t expect it to go from 48-55 in four weeks not with the changes I have made. So after another call to my GP about the score I was advised to have another test in four weeks time and a urine test. That’s four weeks from now.

My issue is when I went for the second test which was 55 I actually had coronavirus which I didn’t know at the time but have been really unwell since spiking temperatures etc. Could the fact I had Covid at the time of the second test make it shoot up that much in such a short time (from 48-55)?

Also is it normal for my GP to repeat the hbac1 after just four weeks? I thought it’s an average reading of the previous three months? Why would a test just four weeks later show any difference? So it’s currently at 55 and how accurate is it going to be in four weeks time when I have had covid? Plus I also want to make some further adjustments to my diet and lifestyle for the number to come down below the original number of 48. Is the Nurse wrong to repeat the test in just four weeks? I’m not sure what to do.

Sorry if this is long winded, trying to remember all my pointers. Thank you for anyone that listens or offers an advice.

 

[victorhamesse]

I guess that they want to see if the upwards trend continues. As I read your post, your score/timeline goes : 48 > 4weeks > 55 > 4weeks > ???. An upward trend might indicate something needs to be looked at quickly. Do you take finger prick tests ? What might they be saying ?

 

[Inka]

Welcome @VH2024 🙂 I’d recommend getting your own blood glucose meter so you can keep an eye on things. I know at least three women who developed Type 1 diabetes in pregnancy. They were assumed to have Gestational Diabetes. One showed obvious Type 1 some weeks after giving birth but the others took longer to be diagnosed as the Type 1 came on more slowly. One woman was diagnosed almost 2 yrs after giving birth. It’s worth keeping an eye on.

If you do have Type 2, then a meter will be useful anyway as it will help you adjust your diet.

 

[rebrascora]

When levels are not too high and the patient doesn't have symptoms then it is usual for a second confirmatory test, although I would have thought that your Gestational diabetes result might be considered the first test and therefore you have now technically had 3 results above 47.
Out of curiosity, do you know your HbA1c result from your pregnancy? Just wondering how high it was?

As regards Covid, then yes, it can inflate HbA1c readings in a diabetic but shouldn't impact a non-diabetic who is able to produce enough insulin to cope with the raised output of glucose from the liver in response to the infection. If you are diabetic, then yes it could increase your HbA1c but not really over a couple of days at the start of an infection before you develop symptoms because as you know the HbA1c represents a sort of 3 month average, so a couple of days of higher levels would be unlikely to have that much impact.

Do you have any risk factors for Type 2.... I imagine you are pretty active with having young children but are you carrying any spare weight particularly around your upper waist?
Is there any family history of Type 2 or Type 1 or any other Autoimmune conditions in the family?
What sort of things were you typically eating for breakfast lunch and evening meal when you changed your diet during that 4 week period and have you lost or gained any weight recently?

As regards testing again in 4 weeks.... if you haven't already made an appointment then you might want to leave it a bit longer.... especially if you have had Covid and it has been a nasty or prolonged bout of it. In the meantime I would recommend you get yourself a BG testing kit and extra test strips, if you don't already have one, and start testing your levels just before and 2 hours after meals, to see how you are responding to what you eat. At this stage it is possible that you are Type 1 or Type 2 and whilst health care professionals will usually assume Type 2, it is important to keep an open mind, especially when your levels have increased in a short space of time despite making significant dietary changes. If you are developing Type 1, and it can come on more gradually in adults, then the Covid may hurry the process along, so it would be useful to be able to monitor your levels and detect if there is a significant deterioration happening as much as anything to keep yourself safe, but if it is Type 2 the Covid will almost certainly impact your next test too.

If you decide that you want to try some home testing, the test kits which are most frequently recommended here on the forum for reliability and economy of use are the Spirit Healthcare TEE2 and the Gluco Navii. Both can be bought online and you would be well advised to get a couple of pots of extra test strips as the kit just comes with 10 test strips and 10 lancets. Many of us reuse the lancets, providing we are only using them on ourselves although they are supposed to be single use, but the test strips cannot be reused so you definitely need extra of those as 10 won't go very far.

 

[rebrascora]

@Inka types faster and more succinctly than I do, but obviously thinking on the same lines....

 

[Drummer]

@VH2024 That is a rather rapid increase in HbA1c - but I noted that you are restricting sugar these days - that might not be all that helpful if you are not also watching the amount of carbohydrate in general as starches contribute to high blood glucose just as much as sugars - in fact they are pushed as a 'healthy ' option, particularly whole grain of brown versions - I was diagnosed type 2 and almost spherical after decades of such advice, even when protesting that it made me feel ill to eat like that.
If you start to feel increasingly unwell you should get medical advice quickly, even if it means going to a walk in clinic or even A & E over the weekend - call me overly suspicious once you feel better, but better safe than sorry.

 

[Leadinglights]

For making some dietary changes if you do get confirmed as Type 2 or you are just below the diagnostic threshold which it would still be worth doing then have a look at this link for a low carb approach https://lowcarbfreshwell.com/
Of course be guided by your result but I would support the advice to get a home monitor so you can be testing at home to keep a regular check so there will be no surprises.