Not sure I qualify

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SueinFrance

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Hello all🙂
Mt story is long and complicated and I'm currently getting no professional help at all so I thought I'd see what you lot think. I've been following you for a while and you all seem so supportive.
Family history: Brother, aunt cousin Type 1, mother Type 2 on insulin
My history, gestational diabetes on insulin 21 years ago which lingered for a year then no treatment.Now having fasting BGs between 6-7 all the time and PPs 8-12 but I feel like my Dr thinks I am obsessed
Advice please:confused:
 
Hi Susie and a warm welcome to the forum,I would say your BS at 6-7 all the time is preety much bang on, why do you say you think your GP thinks your obsessed?
 
Welcome to the forums SueinFrance 🙂

Fasting BG's between 6 and 7 are definitely good for a diabetic. Some of your post-prandials are a little high for me.

What you you like help with? What have you been given help with?
 
Hi Sueinfrance, welcome to the forum.🙂
 
Hi Sue, is your question because you are not officialy diabetic, so you are wondering if those readings are ok or if you actually have diabetes?

As others have said, fasting appears fine. How long after eating were your other readings? I think non-diabetic people do get elevated readings after eating but I'm not sure by what time it should be back to normal. How about if you asked your GP for a glucose tolerance test to settle the issue one way or another? Or an HBA1c test to see how your avegare BG is.

Have you tried urine testing? I understand that non-diabetics should not have sugar in their urine so that might give you a bit more reassurance.

Hope you can get to the bottom of it.
 
Pigeon said:
As others have said, fasting appears fine. How long after eating were your other readings? I think non-diabetic people do get elevated readings after eating but I'm not sure by what time it should be back to normal. How about if you asked your GP for a glucose tolerance test to settle the issue one way or another? Or an HBA1c test to see how your avegare BG is.
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Hey! Hold on a second!

The blood glucose level in a non-diabetic is about 4 mmol/L and although it has been suggested that a non-diabetic could go above 7 mmol/L after a particularly high carbohydrate meal, I understand that to be a significant amount of carbs to do that (entire pizza, chips, full-sugar soft drink, etc). 6-8 is not 4, and 8-12 is not 7. I'm not a GP and therefore can't make a diagnosis - but I would want those numbers investigated if it was me.

I'd agree pushing for a HbA1c and possibly a GTT too.
 
_My GP thinks I'm obsessed because I think I NEED to monitor BS!
Yes 6-7 is fine for a diabetic but I'm not and as Pidgeon sussed out that is the problem.
My fastings do occassionally go over 7. I'm not overweight BMI 22. PP yesterday was 11.4 2 hours after high grain sandwich and yogourt.
I suppose what I want is to have test strips prescribed because at 25 euros for 50 I'll probably not continue and as I've read prediabetes is as much of a risk for CVD as type 2 I want recognition!!
PS;HbA1c 5.8 I get quite a few hypos- does this average out the high ones?
As Mark pointed out and as I've read the info advised for newbies a real normal FBS is lower than 6.
Thanks all
 
Well everything I've ever read says non-diabetic range is 4 to 7. Except sometimes (eg whilst doing something heavy like mowing a large lawn) they'll get a 3 point summat.

My husband is always 5 or low 5 whenever I test him. He's not diabetic.

In UK after gestational, you would these days get an HBA1c done - is it every year? or 2 years?

I expect you could have it done if you paid for it?

Or do a DIY OGTT and take the reults to your doc?
 
I wonder if you can convince your GP to keep on testing you more regularly (say every 3 months) for your HbA1c.

I'd try justifying it on the basis that you do have a significant family history of diabetes and that your BMI is 22 and thus you don't meet the usual criteria for Type 2.

Remember, you can get Type 1 at any age and there are slow forms of it where your pancreas slowly gives out rather then just stopping all of a sudden. It's not impossible that your pancreas is spluttering a bit.

What sort of hypos are you getting? into the 2's and 3's? Or just feeling hypo?

Oh, I've measured my wife in the 4's - even after she has eaten a large slice of chocolate cake.
 
Mark T said:
I'd try justifying it on the basis that you do have a significant family history of diabetes and that your BMI is 22 and thus you don't meet the usual criteria for Type 2.

Remember, you can get Type 1 at any age and there are slow forms of it where your pancreas slowly gives out rather then just stopping all of a sudden. It's not impossible that your pancreas is spluttering a bit.

What sort of hypos are you getting? into the 2's and 3's? Or just feeling hypo?

Oh, I've measured my wife in the 4's - even after she has eaten a large slice of chocolate cake.
Click to expand...

When I last saw an endocrinologist (have autoimmune thyroiditis) she did say that WHEN I developed diabetes it would be type 1 but I don't understand why.
I feel hypos at about 3.5
🙂
 
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SueinFrance said:
When I last saw an endocrinologist (have autoimmune thyroiditis) she did say that WHEN I developed diabetes it would be type 1 but I don't understand why. I feel at hypos at about 3.5
🙂
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Hi Sue.

I would imagine because T2 isn't autoimmune, whereas T1 is. Either way, you sound as though you're on the verge of something. The problem is, GPs don't see a need to act until seomthing is wrong. The precursors of that wrongness (word? 🙄) are not of concern to them. I presume it's the same, if not worse, in France.

In fairness, they would probably advise lowering your carb intake to see if that helped as a first measure, so maybe you could do that yourself and test occasionally to see if it makes a difference?

Rob
 
Hi Rob,
thanks you've summed it up. I suppose I'm wanting something to be done NOW but have to wait until the scale tips over into pathological.
It's just the same as my brother, T1, who had a stroke recently at 54. Now he's having lots of tests what a pity he didn't have them before...My Mum had to have gangrene before anyone looked at her feet. What has happened to "prevention is better than cure"

Sue
 
Mark T said:
Hey! Hold on a second!

The blood glucose level in a non-diabetic is about 4 mmol/L and although it has been suggested that a non-diabetic could go above 7 mmol/L after a particularly high carbohydrate meal, I understand that to be a significant amount of carbs to do that (entire pizza, chips, full-sugar soft drink, etc). 6-8 is not 4, and 8-12 is not 7. I'm not a GP and therefore can't make a diagnosis - but I would want those numbers investigated if it was me.

I'd agree pushing for a HbA1c and possibly a GTT too.
Click to expand...

I am confused now Mark because a while back I posted about my husband having a reading well below 4 after a long run, and also a reading above 8 but the answer I got back was that he was fine. I don't recall it being after a heavy carb meal either?
 
I wouldn't like to speculate Lucy 🙂

However, I've seen several discussions on here that have talked about non-diabetic numbers.

Most of the studies and various numbers relate to the diagnosis of diabetes. But I don't believe that you simply become a diabetic because your HbA1c changed from 6.4% to 6.5% (or stop being diabetic just because you dropped below).

The WHO actually says that anyone above 6.0% needs to be monitored and in the same paper the ADA are stated as suggesting 5.8% as the lower limit. But that's average limits and not specific values, so doesn't help you.

There was a good presentation that was posted up by HelenM which showed cgm traces for non (diagnosed) diabetics. Unfortunately I can't find it right now. That study shows that, generally, the human body, tightly controls the blood glucose level. So yes, sometimes it might go below 4 or above 7, but hitting those values all of the time isn't necessary normal.
 
I suspect that some GPs see the occsional highs and lows that can appear in a series of readings as normal. What they fail to act on are the random highs or lows that continue to appear, indicating a constant out of range BG.

If they were to act on them, they would be spending their budget in advance of any definite diagnosis. If they send you home, they rely on a very slow onset of complications so that they can't be connected with them in any way and the hope that someone else's budget will pay to put them right. Maybe.

I'm sure there's also a large dose of "I've seen it all before and there's a lot of hyperchondriacs who have nothing really wrong" along with "I'm too busy with patients who need constant attention for serious medical problems".

Just my opinion of course. 🙂

Rob
 
Hi Sue in France,
We are also in France and our GP recognised my husband as Diabetic/preDiabetic 6 years ago although he only only started prescribing meds a year ago as my husband wasn't reducing his levels enough with diet alone.
Our GP is great for preventative medicines. He's been testing me for Diabetes for nearly 10 years since I went to him initialy with 'menopause' symptoms which were similar to Diabetes symptoms. The last time I was tested was a few months ago; it seems to be standard if we have any sort of blood test it just gets added together with cholesterol. I'm supprised that your GP hasn't picked up on your brother's stroke or your mum's gagrine. My GP asked all about my family history then sent me for tests. Thankfully they all came back 'low/no risk'. He seems to be the one obsessed with Diabetes and cholesterol in our case.
The treatment here though is very different to the UK. I keep urging my husband (he's T2) to get a blood testing monitor as he feels 'unwell' farly often and we don't know if it's Diabetes, stress, general fatigue, going down with a bug etc. The GP hasn't offered him anything except regular blood tests and consultations; every three months now. That surprises me really as in France in general you are treated with an attitude of respect and have so much more control over your own health; keeping your own records, xray photos, receiving a copy of test results direct from the laboratory etc., choosing when and where you want to go into hospital and choosing the surgeon so not to be given a monitor is surprising.
Our GP strongly suggested that we get a blood pressure monitor and check our blood pressure once a month and send him the results. 3times X 3times a day X 3days to get 27 readings then average them to get a truer reading than one in the surgery. We did it a few times then lapsed.
I think that like in England different GPs have different agenders and interests. Perhaps you may need to speak to local people and find one that is more sypathetic.
Where abouts are you? We are in Brittany. Do you need a GP who speaks English?
 
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Hi Cakemaker thanks for that.
I do admit that you can't complain about the French system, I'd much rather be ill here than in the UK as rapid access to care is great. My only gripe is that they don't seem to take on board Prediabetes. Care protocoles are sometimes amazingly different within EU countries and an example can be seen that U100 insulin only came into use here in the 90s whereas it was used in the 70s in the UK. Also as you say, self monitoring is not encouraged for T2 blood sugars and thats a pity. I live in Grenoble and French is fine.
My GP infact says that she doesn't know anything about high post meal BS with normal fasting so I'm just glad that I do see an endocrinologist even if it is only once a year.
My plan is to insist on getting test strips on precription, I bought my own machine in the UK last year. (Boots ?18- maybe that would be good for your husband too?
 
Welcome,
I agree with cakemaker that you could ask around and look for a more sympathetic GP. Perhaps you could get an appointment with your endocrinologist for some more expert advice. You could go without a referral though you would get a lower reimbursement.
Unfortunately you are unlikely to be prescribed strips. The French authorities have in the last year cut back on what they will reimburse.The maximum that T2s not on insulin will get is 200 per year.(and those on diet and exercise or just metformin may not get any)
http://www.ameli.fr/professionnels-...lettes-d-8217-autosurveillance-glycemique.php
 
Thanks Helen,
I can now see why,even if a doctor thinks it would be interesting to self test, they cannot recommend it and not prescribe strips. I will therefore continue to do my own thing ie buy the strips and show the results to my endocrinologist. I suppose what happens in the future is for the moment in my own hands.
 
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