Totally confused - help!

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Me1971

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Type 2
I’m 49 yr old female bmi 40+. My mother is an insulin dependant diabetic. I had gestational diabetes in my last 3 pregnancies (as did my mother) and after feeling ‘off’ for the last year I requested bloods (previous practice used to do it annually.).
So today I was on the phone to the doctor as I have another UTI and asked if the bloods were back.

fasting bloods 9.7
Hc1a or something is 51

I was wondering if anyone had similar levels and did they go straight on to Metformin or do you have an attempt to control it with diet? What is the criteria for the VLCD option?

So many questions xx
 
HbA1c is what you are trying to remember - anything over 48 gets you the diagnosis of diabetes, usually. Sounds like you have probably had higher blood glucose for a while though, as you say 'another' UTI - and they are really common when the person has too high blood glucose.

The major criterion for a low carb diet is whether you are prepared to do it and stick at it - if you are - then do it! It is actually a misnomer saying 'High' fat because that's not a brilliant idea when you have a fair amount of weight to lose. It should be 'Lower carb normal fat' really.
 
trophywench said:
HbA1c is what you are trying to remember - anything over 48 gets you the diagnosis of diabetes, usually. Sounds like you have probably had higher blood glucose for a while though, as you say 'another' UTI - and they are really common when the person has too high blood glucose.

The major criterion for a low carb diet is whether you are prepared to do it and stick at it - if you are - then do it! It is actually a misnomer saying 'High' fat because that's not a brilliant idea when you have a fair amount of weight to lose. It should be 'Lower carb normal fat' really.
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Thank you for replying I am just a little overwhelmed. I have spent so long burying my head in the sand that when someone digs it up and slaps you around the face your first reaction isn’t always ‘it’s alright here’ if that makes sense
 
Hi @Me1971 and welcome to the forum.

HbA1c of 51 puts you just into diabetic territory so no need to panic but doing something to get it down now avoids problems for later. It is probable that the key is to lose a chunk of weight and to get your BMI much closer to normal levels. Many members have been in that position and successfully got their HbA1c back down by losing weight. Read around the forum, especially the weight loss section, and you will find out how they have gone about it. There are different approaches and you need to find one that suits you.

You will find that there are lots of us who are more than happy to share their experiences to help you along the way. So ask questions and we will do our best to give you honest and helpful answers.
 
Thank you. I was kind of thinking that if it was extremely serious I would have an appointment with the doctor rather than the diabetic nurse. I think I’m the back of my mind is my mum who had her leg amputated at 52 and is now bed bound with a catheter and a bed sore which will not heal (she has now had it 3 1/2 years x
 
Me1971 said:
Thank you. I was kind of thinking that if it was extremely serious I would have an appointment with the doctor rather than the diabetic nurse. I think I’m the back of my mind is my mum who had her leg amputated at 52 and is now bed bound with a catheter and a bed sore which will not heal (she has now had it 3 1/2 years x
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I have never seen a GP for my Diabetes in over 16 years, I see the Diabetes Nurse, she does the checks and prescribes medication. It is a much longer appointment.
 
Welcome to the forum @Me1971

Don’t feel fobbed off by seeing the nurse rather than the doctor. They are so often a lot more knowledgable than the GP and as @grovesy said you are likely to get a much longer appointment. Eg At our Practice GP max 10 min, Diabetes nurse 30 min.

All the carbs that you eat will be converted to glucose once inside you. If you have high glucose you are not able to process this as your body cannot match the insulin it is making to cope with this. By reducing the amount of carbs you will have less glucose in your system so will need less insulin.

Whatever you choose to do it needs to be something that you can sustain. Swapping some of the high carbs in meals to lower options can help and also reducing portion sizes. You mention your concerns about following the path your Mum followed. You have the information and have already shown that you want to change things. Take things a step at a time, and use the information available to make the changes needed.

Keep in touch and ask any questions that arise. No one will mind.
 
grovesy said:
I have never seen a GP for my Diabetes in over 16 years, I see the Diabetes Nurse, she does the checks and prescribes medication. It is a much longer appointment.
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Oh dear that throws that theory out then! My appointment is a telephone appointment so not sure how that will work ‍♂️
 
I have had telephone appointments and they work well.
I would suggest gathering a list of questions beforehand, and if possible have someone else with you to make notes, as it is easy to miss things. I would also suggest asking for another appointment in a few weeks for all those things that you forgot to ask and to review progress and discuss what steps you have implemented.
 
Thank you. Do I need to buy a glucose monitor? Does everyone go on to metformin? I’m a little bit worried as I am a single mum to 3 and I have these periods when I cannot stay awake. I find them quite scary x
There will just be me on the call, maybe I can record it?
 
Me1971 said:
Thank you. Do I need to buy a glucose monitor? Does everyone go on to metformin? I’m a little bit worried as I am a single mum to 3 and I have these periods when I cannot stay awake. I find them quite scary x
There will just be me on the call, maybe I can record it?
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I would see what the nurse has to say. She may want to see you in person as Diabetic Check involves some things that can't be done over the phone such a foot check and examination, Blood Pressure, and weight.
 
Me1971 said:
Thank you. I was kind of thinking that if it was extremely serious I would have an appointment with the doctor rather than the diabetic nurse. I think I’m the back of my mind is my mum who had her leg amputated at 52 and is now bed bound with a catheter and a bed sore which will not heal (she has now had it 3 1/2 years x
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Hi, I had my diagnosis two years ago and tbh seeing the diabetes nurse rather than the GP was far more helpful. The GP doesn't really have the time for all my questions, probably because they have heard them from other patients! Whereas the nurse does have the time, understands concerns and in my experience are open to suggestions. At first
I thought the diabetes GP was the only.person to see, but have learnt that the Diabetes nurse is a much better option for me. At the back of my mind is if there are any problems, I will always be referred to the GP.
 
I am not even sure my Surgery has a designated GP for Diabetes it is not mentioned on the website, the previous one retired a few years ago. I never saw him for my Diabetes, as he got me offside when my son was a toddler and he was new to the surgery.
 
Hi and welcome from me too.

I am sorry to read that you have been diagnosed with diabetes and that your mother has suffered such horrible complication from it. The good news is that you are currently just over the HbA1c diabetes threshold which is 48, so making some changes now may well help to prevent you going on to suffer complications like your mother.

The thing to understand with diabetes is that it is not just about sugar but all carbohydrates. The digestive system breaks them all down into glucose which gets absorbed through the gut wall into the blood stream. As diabetics we have a problem with either not able to produce enough insulin (usually Type 1) or are insulin resistant (usually Type 2) and so that glucose gets stuck in the blood stream and is at risk of clogging up our small blood vessels. This can cause problems with vision and peripheral parts of the body like feet and hands. If you eat less carbs (don't get confused with calories/cals) you are not putting the glucose into the blood stream in the first place and therefore will reduce your levels.
Carbohydrates are both sugars and starches and even healthy foods contain carbs, so whilst the likes of fruit (in all it's forms fresh, dried or juiced) and porridge are considered healthy for most people, they are high in carbs and need to be rationed or avoided for us diabetics.
The first things to cut out of your diet are the obvious sweet stuff like cakes and biscuits and sugar in tea and coffee and sweets and chocolate or swap to high cocoa content (70% +) chocolate and limit yourself to just one or two squares. Full sugar drinks like cola and lemonade should also be cut out or switched for diet varieties.
Then you need to look at the starchy carbs like bread, pasta, rice, potatoes, couscous and breakfast cereals and start reducing portion size, so have half as many potatoes with your meals but add more leafy green veg to bulk your plate out.
If it helps to think of it like this, there is 5g carbs in a spoon of sugar. There are 15g carbs in a slice of bread.... even wholemeal bread, so that slice of bread is the equivalent of having 3 spoons of sugar. One potato the size of an egg is about 10g carbs and equivalent to 2 spoons of sugar. An apple contains the equivalent of about 3 spoons of sugar, a banana 4. Of course the bread also provides micronutrients like vitamin B and fibre and you get fibre and vitamin C from the fruit so they are much better for you than just eating sugar, but your body still converts them into glucose which causes us diabetics problems, so reducing the amount of them you eat and replacing them with other lower carb foods which will also provide you will healthy micronutrients is much better for us diabetics.

The way to start is to keep an honest food diary and write down everything you eat and drink now (before dietary changes) Identify the high carb foods and look at which ones you can avoid and which ones you could reduce the portion size of. If you want to post a typical day's menu, we could help you identify the problem areas and suggest alternatives. The surprising thing is that eating low carb can actually be pleasant and the less carbs you eat, the less you crave them, so once you get them reduced, it becomes easier to eat less and therefore lose weight and we all know how difficult losing weight can be.

Anyway, I hope the above makes sense and gives you some hope. We are here to support you and there are many inspirational stories from members who have shed weight and got their diabetes under control or into remission.

As regards Metformin/medication, with your HbA1c being relatively borderline you could ask for a 3 month period without medication to try to improve things through diet and exercise.... a brisk daily walk is as good as anything, so don't feel you have to do anything energetic. That said, Metformin has been known to work as an appetite suppressant so it may be helpful to you in the initial stages of getting your diet reined in. It does sometimes come with gastric upset, which may recede after a couple of weeks and if not, there is a slow release version which may be better for you if you can't cope with the side effects. Talking to your nurse about these options will help you to decide the best course of action for you.
 
Me1971 said:
I’m 49 yr old female bmi 40+. My mother is an insulin dependant diabetic. I had gestational diabetes in my last 3 pregnancies (as did my mother) and after feeling ‘off’ for the last year I requested bloods (previous practice used to do it annually.).
So today I was on the phone to the doctor as I have another UTI and asked if the bloods were back.
fasting bloods 9.7
Hc1a or something is 51
I was wondering if anyone had similar levels and did they go straight on to Metformin or do you have an attempt to control it with diet? What is the criteria for the VLCD option?
So many questions xx
Click to expand...
Please excuse this dose of total optimism. You probably don't have to try, you can go back to normal readings by changing your diet. You might even be able to help your mother at the same time, and help your children avoid the problems which an inability to deal with carbohydrates brings. My ability to heal seems to be absolutely normal too - I got some nasty infected insect bites just under two weeks ago and they are now almost gone, with no redness left.
I had the most dreadful reaction to Metformin and a statin - and I never needed them in the first place. I reduced my carbohydrates down to 50gm a day, got a blood glucose meter, and was back to normal in 6 months without really trying.
I started with a Hba1c of 91, so way above your result.
Not everyone has a reaction to the tablets, but quite honestly, it was so embarrassing it brings tears to my eyes even now -and the statin affected my memory so a lot of it is quite hazy, but thank the good lord for that.
These days I eat the equivalent of 10 gm of cabs in the morning - I make cheese scrambled eggs and put a thinly sliced tomato on top, or sausages and mushrooms, or a salad with meat or fish. After a mug of real coffee with cream I am set for the day. In the evening I have more carbs, but I am not hungry all day so don't feel the need to snack. I think this is a good thing, and my meter agrees with me. You might very well find that you can eat for more carbs than I can cope with, just changing some of the high carb foods to lower ones could be all that is required.
 
Thank you everyone for your advice. I have used Metformin when I had gestational diabetes and didn’t have any issues with it. In my last pregnancy I used insulin too but it was different as I knew that it had an end point. What a fantastic group of people and amazing advice. I understand better now about the levels and that 51 is not great but not really bad.
 
I recently had reading of 49, I didn’t get a diagnosis straight away but was told I needed second blood test to confirm. After changing my diet the second reading was 44, it took me 4 weeks to do this. I will always have that risk but using the advice on here I am starting to feel a little more in control but still all new to me, I am still asking lots of questions and learning more every day
 
Welcome to the forum @Me1971

Glad you have found forum members’ responses helpful. Keep asking away with any questions as they come up. We have lots of folks here using all sorts of strategies to manage their blood glucose and at all stages along their diabetes ‘journey’.

Sorry to hear about the difficulties your Mum has experienced. Diabetes can be cruel and unforgiving, but it is also something that can be managed well with a few adaptations and changes to routine along with appropriate medications if needed. And managing your diabetes and keeping blood glucose near the normal range will hugely reduce your risks of developing any diabetes-related complications.

Hope the appointment goes well with your diabetes nurse. Let us know how it goes and if anything mentioned confuses you 🙂
 
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