won't be doing porridge again.

[DeusXM]

It doesn't matter what type you have - the blood sugar goal we all have in common is the same ie normal blood sugar.

Once your blood sugar gets above about 7.5, it starts causing damage. So the fasting reading shouldn't ever be used as a benchmark for control because that gives you just one data point - your BG could be sky high throughout the day and having a 'good' fasting reading for an hour in the morning doesn't have the undo the damage from an entire day of hyperglycaemia.

Indeed, there is a strong school of thought that T2s should aim for tighter control than T1s because typically they are at less risk of hypoglycaemia and have often had undiagnosed diabetes for some time before treatment starts - meaning they could already have sustained quite a lot of damage and are already close to the threshold for complications to set in.

Incidentally, an A1c of 51 is actually higher than the new NHS threshold, which now holdsthat T2s should aim for a maximum of 48 and ideally, aim for the normal range ie. no more than 42.

I don't mean to dishearten you but your GP is behind the times and in all honesty, most medical professionals are seriously behind the curve when it comes to this stuff.

 

[AndBreathe]

Yep, as I've said elsewhere, my diabetic nurse told me that testing before and after meals would be advantageous but that the surgery couldn't prescribe a meter as the local authority had deemed the strips too expensive for T2s. Maybe they've made themselves more knowledgable as I know one of the receptionists and she's a T1?

The way my DN showed me the healthy eating plate was hilarious, she pulled it out, gave me a quick glimpse, told me what it was and then immediately put it away. I was like she had to show me it due to regulations, but really didn't want me to take any notice of it. She then gave me a bunch of DUK booklets that directed me here.

I'm sure they know that the official NHS guidelines are out of date, but they don't want to get in trouble so they go through the motions and surreptitiously point their patients towards more up-to-date information off the record. I'll be having a chat about this in more detail next time I see her in a few months time to see if my suspicions are correct.

NICE Guidelines are just that guidelines, not rules. That said, many practises seem to comply with them as if they are the latter. Certainly the December 2015 guidelines appear to allow greater flexibility, with more discussion on personalised care. We'll see.

On another forum where I am active, we have a GP from the North West, who is active in researching the metabolic syndrome and T2. He has run trials for reduced carb dietary treatment of T2s in his practise, with his findings published in both the BMJ and diabetes publications and has made waves by becoming the only GP practise in their area to have maintained a diabetes drugs budget at the same level for the last three years. He has also done some excellent work on NAFLD and to a lesser extent, to date, on lipids. We need more like him.

 

[Carolg]

Hi all.i'm interested in all these coments.this is my positive redponse. I was told about this site by locum GP on diagnosis in november and prescribed metformin straight away. Then changed to slow releade 1Gm twice a day in december. my GP at the start then gave me copy of eating well with type 2 from the web site followed by dietitian appointment who checked what i understood, recomended the carbs n cal book as i was stressing about amounts etc. She gave me lots of info which i undertood at the time, but is a bit of mush now..I have now bought a meter to check BG and supprised at the spikes but trying to tie in highs with food.its a long time to wait for formal testing and i have no yardstick to know how quickly my levels should come down.i think i am too hard on myself and expect too much improvement too soon. Sorry about the large post but any help is gratefully accepred.thanks catol

 

[Amigo]

Hi all.i'm interested in all these coments.this is my positive redponse. I was told about this site by locum GP on diagnosis in november and prescribed metformin straight away. Then changed to slow releade 1Gm twice a day in december. my GP at the start then gave me copy of eating well with type 2 from the web site followed by dietitian appointment who checked what i understood, recomended the carbs n cal book as i was stressing about amounts etc. She gave me lots of info which i undertood at the time, but is a bit of mush now..I have now bought a meter to check BG and supprised at the spikes but trying to tie in highs with food.its a long time to wait for formal testing and i have no yardstick to know how quickly my levels should come down.i think i am too hard on myself and expect too much improvement too soon. Sorry about the large post but any help is gratefully accepred.thanks catol

Sounds like you're doing the right thing Carol and by checking which foods uniquely spike or stabilise you, you'll work this out yourself. It can take time but I'm glad you've discovered the reality of what happens on a daily basis rather than relying on 3 or 6 monthly testing. I saw a dietician too but I felt that the advice she gave me was more suited to a general healthy eating regime rather than diabetic needs. I certainly couldn't cope with the amount of fruit suggested.
As long as you're starting to come down and are keeping a record of which foods and meals spike you, I'm sure you'll get there. If you continue to struggle, you may need to speak to your GP about meds.

Maybe one of the courses would help you...DAPHNE I think they're called. Others will know. Good luck!

 

[Carolg]

Thanks amigo for your kind support and advice. I am going to a 6 week course in feb through nhs which will make sence(hopefully) of my guddle.i am on metformin but suppose with honesty i don't like the out of control at the moment. I expected instant results which is a wee bit naive

 

[AndBreathe]

DAFNE is aimed at insulin dependent individuals, as far as I know. (Dose Adjustment For Normal Eating) For T2s, I believe it's DESMOND (no idea who he is...... 😉 ), or a few others.

 

[grovesy]

The courses can have different names in different parts of the country.

 

[Amigo]

Thanks folks, I'm getting my 'Arthurs & Marthas' mixed up! 😛

Glad you're going on a course Carol...hope it all starts to make sense soon.

 

[Carolg]

Xpert education programme for people with type 2 diabetes is the course here in fife (SCotland)

 

[Mark Parrott]

I'm amazed that I have had no complications at all, especially as I was diabetic for at least 6 months before being finally diagnosed. Had no symptoms at all.

 

[everydayupsanddowns]

Fortunately diabetes can be a fairly slow moving foe for many. Still every reason to work towards the very best non-diabetic numbers you can though (both in terms of hypers *and* hypos!)

 

[Mark Parrott]

Spot on. I will be back to normal BS levels without meds if it kills me.

 

[Amberzak]

I'm amazing to not having complications. Especially as pre insulin pump my control was horrendous. My hba1c was always double digits (old style) so above 86. I'm getting there now though, with the pump.

My friend lost his toe though due to complications

 

[Stitch147]

I'm amazed that I have had no complications at all, especially as I was diabetic for at least 6 months before being finally diagnosed. Had no symptoms at all.

I had no diabetic symptoms and (touch wood) no complications. When I was diagnosed my finger prick bg level was 26. Don't know how long I was diabetic before finding out!

 

[Amberzak]

I did have one little blip where they found some damage in my eye but it was all fine next check and no sign of the damage. They did say that often happens.

 

[Gary Vincent]

Gary - I clearly don't know your back story and how you came to be diagnosed with diabetes, or indeed how, as a T2, you manage to be seeing a Consultant in the subject, but I'll respond anyway.

I was diagnosed, as a result of a routine blood panel, later in 2013, with an HbA1c of 73 (stats are in my signature). At that time, I was given the usual NHS guidance of the Eat Well, Low Fat Plate and no requirement for testing. To me, neither made too much sense. I was diagnosed with an issue metabolising sugars, told to go away and make dietary changes (to a diet I was already eating), without any tools to measure my progress, aside from a promise of a repeat blood test in a few months hence.

For me, at the point of diagnosis, my personal target was to get a close to non-diabetic levels as possible. Why would I want to target to "a bit better" when I could target to put myself into a much better place? At my next HbA1c, I had lowered my score to 37, and have been marginally lower ever since. I have never taken any medication. The two big guns in my change have been everything I eat and drink and testing. Without testing, I would not have known where my intolerances lay.

My normal (non-medicated) fasting range is 3.5 - 4.5. Pre-prandial scores are similar and I like to keep my post-prandial scores under 7 - at any time - with a return to within 1 of the starting point at 2 hours. I prefer, where I can, to run with a non-diabetic level blood profile as I feel that it minimises the chances of the unwanted complications we're all trying to side-step.

I totally accept that I appear to have been fortunate to have been diagnosed whilst my body still functioned well enough to recover. I acknowledge not everyone gets that lucky. I also acknowledge that not everyone is as aggressive in their striving for better health, but to me it is the most precious thing we have and I don't want to knowingly play any part in ruining it. Life's for living and I have too many adventures to cram in yet, to contemplate a depleted lifestyle.

Good luck with it all.

I'm under a liver consultant because apart from T2 Diabetes, I have Haemochromotosis, this is a recessive gene condition inherited from my parents, it is an inability to regulate the levels of iron in the blood, as you progress into your 50's the accumulated iron collects around your heart, liver and pancreas.
When diagnosed in 2006 I had a ferritin level of 700, the normal range is 30-330mmol/ltr so just a bit more than double.
My T2 diabetes is as a direct result of the Haemochromotosis, 100% of people go on to develop Diabetes, because the accumulated iron damaging the pancreas and its ability to produce insulin.
Now after talking to both my Liver Consultant and GP , the real important issue is HB1ac, as it provides a 3 month history of the average sugar level over three months, the spikes are irrelevant, it's the median gluconated haemoglobin level which is vital.
They have said that there will be sugar spikes whenever you eat food, the amplitude of those spikes may sometimes be high, but if you also experience lower sugar levels, the median level (HB1ac) is the best guide.
By the way, when I have any levels below 4mmol/ltr I get sweaty, shaky.
Currently they are 6.6mmol/ltr and I haven't felt this good in years.

 

[pat.y]

I'm not saying type 2's should or should not test as they are currently instructed not too. HOwever after 12 years of no meter, medication being increased and increased and finally having a meter I have found out that most of the foods I was told to eat for breakfast can spike my blood sugar by 10. Since having the meter I have regulated my body much more by finding out what my body tolerates and what it does not. I fully support type 2 testing.

 

[Mark Parrott]

My DN encouraged me to get a meter. They could only give me one if I was on meds, which is fair enough.

 

[pat.y]

My GP won't give a meter until you are on or expecting to go on insulin. My blood glucose was 26 when I was diagnosed and the lady problem I went with (caused by the diabetes and now non existent) had been bothering me for 2 years so I have no idea how long I had been diabetic but luckily no complications.

 

[Amigo]

I'm not on meds but I was given a meter and supplied with testing strips. This has proven an interesting discussion (coming as it has out of a discussion on porridge!).

I'm particularly interested in your health history Gary because it demonstrates that a 'one size fits all' doesn't work for diabetics. We are all unique, respond differently and manage in line with pre-existing conditions which may impact. I'm sorry to hear of your haemochromotosis. It's a condition I've heard about and realise it must be challenging to manage. In your case the Hba1c may be more vital as an indicator than regular home testing.

But if I can just be a little indulgent and explain why I don't think that's quite the position for me and why I'm heavily weighted in favour of home testing for myself. I have a form of leukaemia, which is cancer of the B cell lymphocytes and immune system. As such the make up of my blood isn't remotely 'normal' and the red blood cells and haemoglobin in my system are much reduced and live a much shorter time than this test requires to be totally accurate. Which is why the Hba1c test is not always accurate for people with anaemia.
The theory behind the A1c test is that our red blood cells live an average of three months, so we measure the amount of sugar stuck to these cells (which is what the hemoglobin A1c test does). However the leukaemic cells in my blood are unfortunately taking out the red blood cells, outlive them and as a result I do wonder how totally accurate the Hba1c test can be. Home testing however is accurate because it's an 'as its happening measurement' with no reliance on averages. And I firmly believe that it's the spikes that do the damage. Even if I had total confidence that the Hb test was totally accurate in my case, I'm not sure I could trust it to measure and 'report back' on bad periods of hyperglacemia that I'd missed. I don't have hypos.

But this demonstrates that we are all very different and need to manage our diabetes care to fit us and not the average population.