Type 2 Consultant (n/a now…but some further questions, skip to #23 onwards

[Deli06]

That is a fantastic reduction in HbA1c so many congratulations on achieving that. When you have worked hard at making changes as you have, it is important to acknowledge just how far you have come and what you have achieved. Yes we could probably all do a bit better and push ourselves harder and restrict our diet a bit more, but it is important to balance our effort with also enjoying life and diabetes is all about finding that balance. If you can maintain your HbA1c in the mid to upper 40s then that significantly reduces the risks of diabetic complications, if you feel you want to push it a bit lower and try for remission then fair enough but it isn't essential. You could do some testing to find particular foods that spike your levels more than others and fine tune your diet a bit more to substitute those foods for lower carb ones, if you haven't already been doing that and you could try to fit in a bit more exercise but to be honest it doesn't have to be anything overly exertive. A good brisk walk is as good as anything. Maybe pick up the pace of your dog walks if your dog is up to that and add in some hills to get you breathing more deeply and heart rate increased. Small sustainable changes are the best.

I can’t really convey how grateful I am for all your sound advice. I’ve made a decision consequently about alcohol, and going to try being a monk Ie abstain entirely from. I managed too last weekend whilst in one whilst all around enjoyed. My George Best days are over anyway, time to be Gary Lineker. Aiming for remission has to be the goal, and losing weight whilst still drinking even on occassion is unhelpful.

I’ve head my head buried in the sand for a good while after diagnosis. Don’t mean doing daft things, just not educating myself. Primarily because I’m scared what I may read. But I’m now feeling more confident and curious and this forum has already taught me lots - not least to put my big boy pants on and ask for advice.

A lot to learn but I’ve made a start. Thank you and many others for terrific support this far. I’m indeed very grateful.

 

[Maz2]

I thought there were Diabetes Specialists in most hospitals in urban areas on the NHS but, of course, there is the waiting list to consider. I would be very careful about private clinics and would want to know they are regulated and liable if anything goes wrong. I am always wary of "private" as money seems to be the main consideration but that is just my opinion and I am not suggesting that they are not good.

We are lucky at our GP surgery as we have a GP who specialises in diabetes. Again thought it is getting to see them.

 

[Deli06]

Hello,
1. For blood testing, why must you always prick your finger? Why can’t use lancet on eg forearm or some less sensitive part of body?

2. I telephoned DUK some time ago but no one really knew. Nor did GP/Dnurse. My question concerned Metformin, and when to take. Obviously it says take with food. My question: is this because it lessens the side effects eg stomach upsets, irritation. Or because you NEED to take at same time as food to lessen glucose rise? Because if I forget, and have to take 4 tablets daily, does taking 2 tablets a couple hours later than I ate matter much (ie as long as have 2 per day, twice a day but not ridiculously far apart ie all in one go)? Example: I don’t eat breakfast. I do take 2 tablets in morning first thing though. Probably 4hrs later or lunchtime that I then eat something for first time. Equally I then eat dinner at 7pm, usually with my Metformin. But if I say forget and at 9pm remember, I will take them then. Etc.

DUK (back then) thought the “always take with food” manufacturer leaflet is because it lessens chance of side effects. Not because it prevents spikes ie if you forget, as long as you’ve had 4 a day (2 in the morning and 2 before bedtime = 4 total) then you’re ok.

I googled and googled about this but couldn’t find anything, hence asked GP and DUK. But since discovering this forum, I thought I’d a double check.

In summary, MUST I ALWAYS have with/immediately before meal to lessen spikes? Sorry if this sounds naive to ask but only now am I starting to better understand T2. Have largely trusted and just followed GP orders ie “take these twice a day…see in 12months for another check up. Here’s a leaflet. Bye” Which is pretty much all the training I was given. I was even told I don’t need to test myself when I asked for a prescription for test strips (because not cheap!) so for months I didn’t. Only in the last week have I started to test myself and turned my fingers into a pin cusion because of andvice on here annd the need to understand myself how I react. And self funded the test strips regardless.

 

[Drummer]

@Deli06 Metformin is not something which deals with glucose from a meal - taking it with food is, I suspect, trying to reduce the effects it can have on those susceptible to them. I had explosive faecal incontinence and binned all the tablets after a month of total misery. Turned out I never needed them in the first place.
I bought the things required for testing my blood as it was only a temporary measure to find out what I ought to eat to keep my blood glucose in the normal range. Once sorted it was just a matter of eating low carb and waiting to see the results from HbA1c testing.

 

[Bruce Stephens]

Why can’t use lancet on eg forearm or some less sensitive part of body?

You can. It's known as alternate site testing. There are some (fairly minor, I think) issues just because meters are calibrated and tested for blood from fingers.

Alternate site testing for blood sugar levels

Can you test your blood sugar anywhere on your body besides your fingertips? Learn how and when it’s okay to use alternate site testing for blood sugar levels.

www.accu-chek.com

 

[Deli06]

I

You can. It's known as alternate site testing. There are some (fairly minor, I think) issues just because meters are calibrated and tested for blood from fingers.

Alternate site testing for blood sugar levels

Can you test your blood sugar anywhere on your body besides your fingertips? Learn how and when it’s okay to use alternate site testing for blood sugar levels.

www.accu-chek.com

thank you. I’ve had such trouble finding an answer for this it’s not true! Sorry, just sort of bloke I am. Wanting to know why, rather than just do it! Appreciated.

 

[Deli06]

@Deli06 Metformin is not something which deals with glucose from a meal - taking it with food is, I suspect, trying to reduce the effects it can have on those susceptible to them. I had explosive faecal incontinence and binned all the tablets after a month of total misery. Turned out I never needed them in the first place.
I bought the things required for testing my blood as it was only a temporary measure to find out what I ought to eat to keep my blood glucose in the normal range. Once sorted it was just a matter of eating low carb and waiting to see the results from HbA1c testing.

Thank you.

 

[Deli06]

@Deli06 Metformin is not something which deals with glucose from a meal - taking it with food is, I suspect, trying to reduce the effects it can have on those susceptible to them. I had explosive faecal incontinence and binned all the tablets after a month of total misery. Turned out I never needed them in the first place.
I bought the things required for testing my blood as it was only a temporary measure to find out what I ought to eat to keep my blood glucose in the normal range. Once sorted it was just a matter of eating low carb and waiting to see the results from HbA1c testing.

Extra thanks because I believed it did (counter affects of meal). Now I better understand it’s to stop my liver overproducing glucose throughout the day, every day, and help bring down to normal levels. Sure there’ll be people cringing how obvious this is and wondering why I didn’t know already. Entirely my dumb ignorance. Made the wrong assumption and (out of anxiety) wasn’t curious/brave enough to enquiry until found this forum. Well done Team Forum again!! 🙂

 

[Burylancs]

Hello, I wondered if anyone knows a T2 medically qualified expert you can perhaps book an hour or so with to go through all sorts of questions about T2? And if so recommend / provide contact details for eg a website or whatever please? I’m newly diagnosed and want to sit down with someone if such services exist (not a volunteer, I need them to be able to say with confidence yes or no to questions as such with authority and have found the former best endeavours not quite enough sometimes) Any known recommendations be appreciated. Thank you.

‘Type 2 Diabetes : The First Year by Gretchen Becker’ is often recommended as a starting point but it’s beginning to show its age a bit.

 

[Bruce Stephens]

I

thank you. I’ve had such trouble finding an answer for this it’s not true! Sorry, just sort of bloke I am. Wanting to know why, rather than just do it! Appreciated.

I think it's uncommon so often not mentioned. Fingers are just convenient (and the meters are designed for that) and the lancet devices are really good nowadays so using the edge of finger tips is fine for most people.

 

[Proud to be erratic]

I think it's uncommon so often not mentioned. Fingers are just convenient (and the meters are designed for that) and the lancet devices are really good nowadays so using the edge of finger tips is fine for most people.

Probably also just licenced for use on fingers and not necessarily licenced for use elsewhere. But if, @Deli06, you want to experiment and find what works for you I would suggest press on; its your D and your body. The meters display an answer to one decimal place - but that accuracy is simply not sustainable or justifiable by this relatively low cost device scrutinising such a complex and variable liquid which is constantly changing in response to many metabolic factors.

BG from spot checks with test meters is a terrific guide and speedy measure for "home or everyday use" - but can't have the precisenessof a laboratory test from a vial of blood!

 

[Deli06]

Probably also just licenced for use on fingers and not necessarily licenced for use elsewhere. But if, @Deli06, you want to experiment and find what works for you I would suggest press on; its your D and your body. The meters display an answer to one decimal place - but that accuracy is simply not sustainable or justifiable by this relatively low cost device scrutinising such a complex and variable liquid which is constantly changing in response to many metabolic factors.

BG from spot checks with test meters is a terrific guide and speedy measure for "home or everyday use" - but can't have the precisenessof a laboratory test from a vial of blood!

Thanks Proud, good explanation.