Borderline Type 2

Diabetes
1

I have been having symptoms of type 2 diabetes and had the Hba1c test which came back at 48 mmol which my GP has said is borderline type 2 diabetis. He wants the repeat the test in 3 months (due next month). I have bought a blood glucose monitoring device, my readings have varied from 7.6 up to 11.6. This morning I checked when I woke up and it was 8.8, 2 hours after breakfast it was 10.4.  From what I have read these are slightly on the high side, I would be grateful for any feedback/advice.

Thanks

2

Reading should be between 4 and 7 but this does depend when you test. If it is within 2 hours of eating it may be a bit higher. Also itt ends to be higher if you are not well.

Hope this helps

Sarah

3

Are you doing anything besides the measurements?

Here's what you should do right now - treat it seriously!  But it turns out that's not so hard!

1.  Start eating on a diabetes diet.  This means (a) learning to count carbs, (b) limiting each meal to a range of about 50-75 (or lower), (c) reducing white bread, white rice, and sugar as close to zero as possible, (d) reducing snacks, even high-protein snacks like nuts or cheese, and finally (e) eat three meals, don't skip!

2.  Make certain you get an hour or more of good, low-level exercise per day.  This is a no-fooling requirement.  It lowers your BG readings TODAY!  Walking is fine, but they say you should also do some "weight-training", basically anything with your upper body, a brief bit of non-aerobic effort.  The thing is, you do NOT want to exercise too hard, that sets up all kinds of different insulin and sugar regimes in your body.

That's it!  Will stabilize and lower your numbers, may lead to a little weight loss too, and you may just plain feel better in short order.

4

You need to move towards a low GI, added sugar free diet whilst increasing physical exercise.  This is a bit daunting at first and it's best to get specialist advice (eg from a dietician or diabetic nurse) to teach you about foods and type of exercise to suit you.  Your doctor may suggest medication (Metformin) to help reduce your blood sugar.  At this stage it is quite possible to reverse these early symptoms (see Michael Mosley's book "The 8 Week Blood Sugar Diet"wink.  Nip it in the bud!  Good luck!

5

Dear tammy0608,

I'd advise you to start looking for a new doctor, ma'am.

Your HbA1c level of 48 mmol/mol (millimoles per mole) indicates that you are already diabetic ... NOT "borderline type 2".  As soon as your HbA1c level reaches 48 mmol/mol that is confirmation that you are diabetic, that's irrespective of whether your doctor wishes to carry out a second HbA1c test.  If you'd like confirmation of this, take a look at the following webpage on the Diabetes.co.uk website: https://www.diabetes.co.uk/what-is-hba1c.html (This is NOT the Diabetes UK website, by the way.)

Diabetes UK indicate that your HbA1c level should be below 48 mmol/mol.  See their webpage: https://www.diabetes.org.uk/professionals/position-statements-reports/diagnosis-ongoing-management-monitoring/new_diagnostic_criteria_for_diabetes

A fasting blood sugar (glucose) level on someone that is not diabetic should be below 5.5 mmol/l (millimoles per litre) and two hours after eating should be below 7.8 mmol/l.

As others have already stated, you should already be adhering to a low carbohydrate diet.  (The glycemic index (GI) diet which is being referred to indicates the speed with which glucose becomes available to your body from the breakdown of carbohydrates.  It's your overall consumption of carbohydrates that needs to be addressed, NOT just where they stand on the GI chart.)

The number of carbohydrates you should be taking in depends on a number of factors, such as how active you are; the type of work that you do; your overall weight, and whether you need to lose weight, etc.  There is NO SET NUMBER of carbs that you should be eating at each meal.

What MIGHT help is eating smaller, but more frequent, meals throughout the day. i.e. instead of eating three main meals, eat 5 or 6 times a day, but limit the amount of carbs that you eat at each meal.

Do you, or are you able to, exercise?  I ask this as exercise makes your body's cells better able to utilise the insulin that your pancreas is already producing. i.e. this means that your body's cells are able to 'burn up' the excess sugar that's floating around your bloodstream.

Hopefully, ma'am, and it doesn't seem that your GP is very pro-active in tending to your requirements, if your second HbA1c level is still as high, and I don't see any reason that it should lower ... unless you are dealing with an underlying infection of some sort ... you'll be prescribed medition(s) IF you haven't already been, and you'll see some improvement.

I wish you well, ma'am.

Lots of Love and Light.

 Mick

x x x x

 x x x

P.S. Please don't be offended, or alarmed, at the 'x's'.  It's merely a logo, of sorts, that I've used for some 40-odd years now.

6

Thank you

7

Thank you. Exercising is going to be a problem as I have a muscle condition also 😞. I think I certainly need more help and advice from my GP. 

8

I think I need help and guidance in regards to my diet. I will contact the GP. Thank you

9

That is what I had thought also. There is so much to take on board and it’s quite overwhelming. Unfortunately excercising is proving a problem as I also suffer with a muscle condition. I think my GP should be taking a more active role and supporting me more. I will make contact and request an appointment to discuss the above.

Thank you for your reply xx

10

Dear tammy0608,

Thank you, ma'am, for your reply.

You are correct in believing that there's so much to take on board, and it can be overwhelming for some people.  When I attend my own diabetes centre, attached o my local hospital, I am often asked to speak with diabetic patients ... some that are newly diagnosed and some that have been diabetic for some considerable amount of time.  This is because I have a way of explaining things in a more simplistic way that is often easier for some people to 'take on board'.

It might help you, tammy0608, to have a notepad and pen with you so that you can write down things as they're being told to you.  You WILL find it useful to write down things that you wish to ask your doctor as most people will forget all that they wanted to ask ... until they walk out of their doctor's surgery.

Sadly, ma'am, your doctor is not the only doctor that doesn't play a more active role when tending to diabetic patients.  I have a friend, who visits me fairly frequently, who saw me checking my blood glucose level prior to me having lunch.  He stated that it had been years since he had his blood checked, and asked me if I'd mind checking his.  Of course, I obliged and asked him to go wash his hands (this is because remnants of foods/drinks/certain moisturisers/creams/emollients can all affect the results obtained).  As soon as I saw his blood glucose reading I asked him if he was taking any medication(s) (certain medications can also affect the results obtained).  He stated that he wasn't, to which I replied that he is a diabetic, and that he should go and see his doctor as, by law, ONLY a practising medical doctor can diagnose diabetes.

A few weeks later he came to see me again and told me that he'd been to see his doctor and the doctor had informed him that he wasn't diabetic.  I asked if I could again check his blood glucose level, to which he agreed.  Again, his blood glucose level indicated that he IS diabetic.  I asked my friend if he could see another doctor at the surgery that he attends as I was 100% convinced that he is diabetic.

A second doctor at the surgery took a sample of blood so that a HbA1c level could be checked, and also so that he could carry out an 'on the spot' blood glucose test.  This second doctor also stated that he was not diabetic, but that he was "borderline" diabetic.  I asked my friend to speak with the diabetes centre that I attend and ask for an appointment there.  He did get an appointment, and sure enough it turns out that he IS diabetic.  A letter was sent to his GP's practice indicating to them that he had requested to be tested and the fact is that he IS diabetic, and should start treatment.

His doctor started him on Metformin (Glucophage).  After several months had elapsed, my friend again requested me to check his blood glucose level as he felt no different ... apart from the gastrointestinal upsets that are well known when taking this medication.  His blood glucose level was even higher than it had been when I tested it on previous occasions.  I questioned my friend about his diet and the amount of exercise he was doing.  Sadly, both his diet and his exercise regimen were worse than lacking.  (I KNOW, for instance that he still takes sugar in his coffee, and he's told me that he still eats cakes and other high carb foods.)  I suggested that he request his doctor arranges for him to speak with a dietitian, but his doctor 'poo pooed' the idea and suggested that he was "doing OK".

Even more time elapsed, and I was not happy with the support that he WASN'T getting.  Whilst he was talking to me, he appeared, to me, to suffering a stroke.  I told him what I believed was happening to him, but he said that he just felt tired.  He went home, but was later that night admitted to hospital having suffered a stroke.  (I've witnessed dozens and dozens of people having strokes having been a social worker for people suffering with different types of dementia ... Multi-Infarct dementia (now called vascular dementia) is a type of dementia where sufferers suffer repeated strokes ... so I know what they look like.)

Still his doctor WASN'T giving him the support that he SHOULD have been getting so I advised my friend to change doctors.  He has done this, moving to a different surgery.  His present doctor has started him on two other types of diabetes medication AND increased his Metformin doses.

Until yesterday it had been several week since I saw my friend.  It now appears that he needs to have an operation to remove a cataract from one of his eyes (cataracts are much more likely to develop in people who suffer with diabetes), and his doctor is also suggesting that my friend MAY need to go onto insulin injections soon as his HbA1c levels have been steadily climbing over the months.  (Sadly, type 2 diabetes IS a progressive illness, which means that medication(s) that work at one point in time are unlikely to continue to work as effectively as time passes.  This occurs due to the body's cells becoming more insulin resistant and/or loss of functioning beta cells (Islets of Langerhans), the insulin-producing cells in the pancreas.)  It also doesn't help if medication(s) aren't offered early enough, are not sufficient for that individual's needs, OR are not taken by the patient.

I'm sorry to hear of your "muscle condition", tammy.  Is there any chance that you could try swimming?  Swimming is LESS LIKELY to cause major problems than many other types of exercise.  I don't know what your muscle condition is, but swimming MAY help you in that area.  Check with your doctor to see what s/he says.

Hopefully, your doctor will be more forthcoming when you do get to see him/her.

Be well, ma'am.

Lots of Love and Light.

 Mick

x x x x

 x x x