Support for newly diagnosed- HbA1c 120

Status
Not open for further replies.
Franarama_

Franarama_

Member
Pronouns
She/Her
Hi all,
I’m after some advice. I had a HbA1c as part of investigations for an unrelated issue. I’d mentioned I’d had unintentional weight loss, but with increased hunger.
My HbA1c returned at 120 - which I know is high!
My GP has started me on Gliclazide 80mg, twice a day.

I am a nurse by background. My field is respiratory, so apart from general diabetic knowledge, I am clueless.

I have moved to low carb diet, I am making a conscious effort to track my food intake, focusing on my carbs and fibre intake and trying to find trends in my BG readings.
I’m sticking to a 12 hour eating window.
Blood glucose is ranging from as high as 26.5mmols/L and my ‘lower end’ is around 15.8mmols/L. Higher readings are usually in the mornings, pre-breakfast.
I am taking the Gliclazide 30mins before meals.

I was only told about this 6 days ago. To say I’m overwhelmed is an understatement. I am on day 6 of the Gliclazide treatment also. Other than prescribing the tablets, I haven’t really been given any advice from my GP on the best way to manage this. He was rather frantic when contacting me with the results.

I’m 33, BMI is in overweight category at 28. I am actively trying to reduce my weight to the healthy category.
I’m usually fit and well, apart from the last 3 months where I’ve had ongoing gynae issues which I am awaiting surgery. This has had an impact on my physical activity levels as I’m suffering with rather severe pain. There is no family history of type one diabetes, I have no autoimmune conditions.

My GP said there is a possibility this could be LADA. I’ve had a full antibody screen sent and currently awaiting the results. I wasn’t even aware of this condition a few days ago.

I was wondering how long does it take to see results with the Gliclazide? - in terms of improved blood glucose control. I completely get I will not see overnight results.

Even though I’m from a healthcare background, I’m finding it extremely hard to be objective currently.

Is there any tips and tricks that helped you when just diagnosed?

Is there anything else I can do to try and help promote better blood glucose control?

I feel a little bit lost.

Any help or advice would be greatly appreciated.

Thank you for taking the time to read this long, slightly panicked post!
 
Hi @Franarama_ welcome to the forum. I was diagnosed in January so still learning myself, but you’ve definitely come to the right place for some great advice from people who have loads of experience. Hopefully they’ll be along soon.
 
Hi @Franarama, and welcome from me too. My HbA1c was almost as high at diagnosis and I was also in the overweight category with a BMI of 29.6 but I managed to turn things around by fully embracing a low carb diet, which I am still doing almost 5 years on. Others have done the same. Strange that I was prescribed Metformin, whereas you get Gliclazide. Now if I'd seen your GP and you'd seen mine..........??? Hopefully your antibody tests will rule out anything more than T2.

No surprise that you got no advice on managing your diabetes. That comment comes up time and time again from newbies. However, you'll get all the advice and help you need from the forum and it will be coming from members who are managing their diabetes day-by-day, so if you have any questions about anything at all just ask.
 
@Franarama_ Unintentional weight loss is a symptom of Type 1 (LADA is a slower-onset form of Type 1). It’s good you’ve had the antibodies test. However, the results do take a while to come through.

Have you been given the means to test for ketones? This is very important if you might be Type 1/LADA.

If you do turn out to be Type 1, then Gliclazide isn’t a good idea as it will exhaust your remaining beta cells. You’d be better off on insulin.

9 out of 10 people diagnosed with Type 1 do not have a close relative with it. I’d be seeking further medical input personally. If you’re suspected to be Type 1, you need insulin - especially with blood sugars that high.
 
Inka said:
@Franarama_ Unintentional weight loss is a symptom of Type 1 (LADA is a slower-onset form of Type 1). It’s good you’ve had the antibodies test. However, the results do take a while to come through.

Have you been given the means to test for ketones? This is very important if you might be Type 1/LADA.

If you do turn out to be Type 1, then Gliclazide isn’t a good idea as it will exhaust your remaining beta cells. You’d be better off on insulin.

9 out of 10 people diagnosed with Type 1 do not have a close relative with it. I’d be seeking further medical input personally. If you’re suspected to be Type 1, you need insulin - especially with blood sugars that high.
Click to expand...
Thanks so much for taking the time to respond Inka!

I was able to check my ketones at work. Urine was positive (one below most positive). Blood ketones were 0.4.

I was looking into home ketones meters. I ended up with a bit of analysis paralysis from my research.

Thank you for your advice regarding insulin, I thought this might be the case given how high my sugars have been. Would it usually be a combination of long acting and fast acting? Or one of these only? - sorry I know this is probably variable from person to person.

Thanks for your information regarding LADA also.

Thanks again for your help!
 
Martin.A said:
Hi @Franarama, and welcome from me too. My HbA1c was almost as high at diagnosis and I was also in the overweight category with a BMI of 29.6 but I managed to turn things around by fully embracing a low carb diet, which I am still doing almost 5 years on. Others have done the same. Strange that I was prescribed Metformin, whereas you get Gliclazide. Now if I'd seen your GP and you'd seen mine..........??? Hopefully your antibody tests will rule out anything more than T2.

No surprise that you got no advice on managing your diabetes. That comment comes up time and time again from newbies. However, you'll get all the advice and help you need from the forum and it will be coming from members who are managing their diabetes day-by-day, so if you have any questions about anything at all just ask.
Click to expand...
Hi Martin,
Thank you for your reply. I have previously done low carb a few years ago, but due to erratic working schedules I fell off the band wagon with it! I’m glad it’s worked for you, that’s really positive! I have been back following a low carb diet since I was advised about my result. I’m hoping to see some improvement in my sugars soon!

To be honest, I was quite surprised when the GP prescribed Glicazide. I thought Metformin would be a first line treatment.

How frequently did you have your HbA1c checked? And what sort of timeframe did you see an improvement?

Thanks for your help!
 
Suzie72 said:
Hi @Franarama_ welcome to the forum. I was diagnosed in January so still learning myself, but you’ve definitely come to the right place for some great advice from people who have loads of experience. Hopefully they’ll be along soon.
Click to expand...
Thanks for your reply Suzie.

I’ve just noticed your HbA1c results, 88 to 43 in 3 months is great! How did you find changing your routine/diet?

Thanks for your help!
 
Franarama_ said:
Thanks so much for taking the time to respond Inka!

I was able to check my ketones at work. Urine was positive (one below most positive). Blood ketones were 0.4.

I was looking into home ketones meters. I ended up with a bit of analysis paralysis from my research.

Thank you for your advice regarding insulin, I thought this might be the case given how high my sugars have been. Would it usually be a combination of long acting and fast acting? Or one of these only? - sorry I know this is probably variable from person to person.

Thanks for your information regarding LADA also.

Thanks again for your help!
Click to expand...

It varies - not just from person to person but depending on who’s treating you. Your GP sounds on the ball. Some HCPs still seem to think that Type 1 is just a childhood disease when, in fact, just as many adults as children are diagnosed with it. In adults, it’s not infrequently assumed to be Type 2.

My thoughts, as a Type 1 not as a medical professional, is that it’s better for a person to have both types of insulin even if in small quantities. This allows far more flexibility and usually better control. Slow/basal insulin is supposed to be used as a background insulin, keeping blood sugar steady in the absence of food. It’s not supposed to deal with meals. Fast/bolus insulin deals with meals. So, as an example, even if someone only needed small amounts of insulin, it would be better to have 3 units of basal insulin, then bolus insulin for meals as needed (let’s say the person needs 5 units in total of that) than to have 8 units of basal insulin, trying to make the basal cover the food when that’s not its job.
 
Thanks so much for your help and advice! You’ve really helped!

I’m going to speak to the GP this week and discuss my blood sugar diary that I’ve been keeping.

I’m also hoping I will get some readings below 15 in the coming week!
Take care!
 
As well as your blood sugars, it would be helpful to list your meals too, along with the times you ate. That way your blood sugars can be related to your carb intake. Obviously it’s more of a concern if someone is eating very few carbs and still getting high sugars.
 
Welcome to the forum from another late starter with T1 ( diagnosed with LADA at age 53)
I am gald to read that your GP is on the ball and considering T1/LADA. For so many this is not even considered in adults, but as @Inkahas said there are a lot of us around.

The idea of keeping a diary of what you are eating, alongside your BG, is really useful, with a particular focus on the amounts of carbohydrates in the meals. This will be useful information whichever type of diabetes you have. All those carbs we eat get converted into glucose once inside us, and our bodies need to process that using insulin, whether it be our own or injected.

Most T1s are now given two separate insulins, a background insulin (basal) to deal with the glucose that our liver delivers to keep us ticking over, and the quick acting insulin (bolus) to deal with the glucose from what we chose to eat. This makes life a lot more flexible than the older mixed insulins, where you then had to eat to match your injections (Timing and amounts of glucose).

It is a lot to get your head round at the start but it does get a lot easier and much of what we do day to day becomes automatic. Keep the questions coming. Nothing is considered silly on here. Just ask.
 
One proviso with the low carb approach is that with gliclazide there is a possibility of hypos however as you have a monitor you can keep a check for that. You can get ketone urine dip sticks from the pharmacy fairly cheaply.
This link may give you some ideas for low carb meals and which foods to avoid and which should be OK. https://lowcarbfreshwell.com/
Obviously if you get a diagnosis other than Type 2 then your dietary approach would be different.
 
Hi and welcome from me too, another late starter with Type 1 at 55yrs.

My HbA1c was 114 at diagnosis. I was started on Metformin and Gliclazide and went low carb. It took me 4 weeks of whittling my carbs down to the very bare essentials to get my BG under 10 and my breakfast porridge was the last to go giving me my first BG in range ie 7 but my HbA1c was tested again and came back at 116, so I was started on both basal and bolus insulin 6 weeks from diagnosis. I had C-peptide and GAD antibody tests a month later after I saw the consultant and whilst C-pep was borderline low end of normal, my GAD came back positive (took 6 weeks).
Do keep a close eye on your ketone levels when you are persistently mid teens. The urine dip sticks were all that I had and indeed still have, not that I have needed them since.

It is hugely overwhelming at first so the feelings you have are completely normal and if anything even more so when/if you start on insulin as it is a very steep learning curve and you may well need some time off work to get your head around it, if you aren't already off with the gynae issue.
Just to mention, we had someone recently who had a pelvic infection as a result of really high BG levels at diagnosis and that was how their diabetes came to light. They were admitted to hospital I believe with low abdominal pain and that was when they got both diagnoses..
 
Inka said:
As well as your blood sugars, it would be helpful to list your meals too, along with the times you ate. That way your blood sugars can be related to your carb intake. Obviously it’s more of a concern if someone is eating very few carbs and still getting high sugars.
Click to expand...
Thank you! Yeah I am logging everything!
 
I also wanted to say that it does get easier and gradually becomes your new normal, but there is a period of mental adjustment needed and it can be very much like grieving, so it is important to give yourself time to come to terms with the diagnosis. I was OK until I was started on insulin. Up to that point I was determined that I was going to push it into remission if I had to eat cardboard. Had a few tears in the car park of the GP surgery when I came out from getting started on insulin. Nearly 5 years down the line I am slimmer and fitter and healthier than I have been for maybe 20 years, so there have been some positives to come out of it.
 
Hi @Franarama_ , hate to say this cos I assume you're already aware - no way should anyone be sticking you under general anaesthetic and taking a scalpel to you, with blood glucose at that sort of level - therefore the sooner you can get yours down to a better level, the sooner you'd be safe to operate on. Only thing is - whatever else is wrong - eg the gynae prob - will also be increasing your BG, cos that's what happens when the dear ole body produces antibodies to help it deal with and heal whatever else is up with it - vicious circle.

If whatever it is needs dealing with sooner rather than later - please don't try to stop them starting you on insulin pre-op either if they suggest that! Even if you do land up as a bog standard Type 2 and can easily treat that with Diet and/or tablets - get the op done and your body to get itself healed (cos any op is traumatic for your body even if you're looking forward to getting it sorted so not traumatic on the face of it to you personally at all)
 
Franarama_ said:
How frequently did you have your HbA1c checked? And what sort of timeframe did you see an improvement?
Click to expand...
I had my second HbA1c 3 months after diagnosis, and it had dropped to 56. By that stage my DN said that I could try managing without the Metformin. I managed just fine as the next one three months later was 41, and the next one six months after that was 35.
 
Last edited:
Franarama_ said:
I was wondering how long does it take to see results with the Gliclazide? - in terms of improved blood glucose control. I completely get I will not see overnight results.
Click to expand...

I believe glic works very quickly, as experimental evidence shows it reaches its peak in the body 30 minutes after taking it and if taken 30 minutes before a meal, it has the greatest effect on lowering post meal levels.
 
harbottle said:
I believe glic works very quickly, as experimental evidence shows it reaches its peak in the body 30 minutes after taking it and if taken 30 minutes before a meal, it has the greatest effect on lowering post meal levels.
Click to expand...
Is that from day 1 of taking it?
 
Status
Not open for further replies.
Back
Top