Diagnosed Type 2 Diabetes (mild)

margaretclare

PeacefulWaters wrote: »

My apologies. I was being glib. And I am at risk.

I've been told that I am too, although no family history. It's one of those things with advancing age. All body systems get 'tired' and don't work so well. It may be chance whether it's your pancreas that gets tired of chucking out insulin, or it may be something else. It doesn't help, the way we eat nowadays, the food we eat etc.

I've recently been diagnosed with diverticular disease and also, heart valves are getting tired. Same thing. Results of living so long.

uk1

"Sorry madam, you really must eat more cakes "


http://www.thesundaytimes.co.uk/sto/newsreview/features/article1542377.ece?shareToken=99ee0e707fefdafc8d834ee50ea7813b

pension-newbie

thanks again - especially for advice and links

I had not imagined it would be beneficial to actively monitor sugar levels, rather I thought I would stick to my part of the bargain by exercising and eating less, and then get given the medical results at 6 monthly check ups. I have a meeting with the nurse soon so I will ask about that.

On the pension front it looks like impaired annuity may be available, but only if I still need the medicine. The Dr indicated he would not take me off the moment my results went under the limits, however we didn't really explore what if I significantly reduced weight and so forth. I am not looking to be on medicine for life, that was just the feeling I got.

jamesd

PeacefulWaters wrote: »

So if I overeat and get diagnosed as diabetic I can free up c£8 in prescription costs a year to invest in my pension!

Just for anyone who believed that, while losing weight is a treatment, it's not a direct cause and in some individuals is not a cause at all. Quite often the weight gain is a symptom of diabetes or metabolic syndrome that can lead to diabetes.

pension-newbie wrote: »

The Doctor is happy that weight loss and exercise should help get my levels back to normal ... although he would expect to sustain the prescribed medicine for a long time, possibly indefinitely

No surprise there. It's entirely possible that losing weight can push your A1c down below the diagnostic threshold for diabetes for a long time, even decades.

Metformin as well as increasing sensitivity to insulin is also associated with causing weight loss, as are a number of other medications for diabetes, like one that causes glucose to be secreted into the urine instead of absorbed by the body.

The concept of diagnostic threshold is important because the chance of complications increases with A1c and time. Diagnosis at a low threshold then dropping below the diagnostic threshold is good news because it'll effectively prevent the complications. The thresholds used for diagnosing diabetes or pre-diabetes have been getting lower over the years, partly as its become recognised that many of the treatments are safe and effective for use for many decades on very large parts of the population.

So not a big deal for you for now aside from the lifestyle and medication issues. Twenty years or thirty years from now it may affect you more, gradually.

The free prescriptions are just because you'll probably need a lot of them for the various medications.

Mojisola

pension-newbie wrote: »

I had not imagined it would be beneficial to actively monitor sugar levels, rather I thought I would stick to my part of the bargain by exercising and eating less, and then get given the medical results at 6 monthly check ups. I have a meeting with the nurse soon so I will ask about that.

The NHS doesn't think people who are not on medication should monitor their blood sugars themselves. Unless your nurse is an independent thinker, be prepared to hear things "Patients get obsessed and it's not good for them" and "Follow the dietary advice and you'll be okay".

If you spend some time on the diabetes forums, you'll see that some people can eat some foods without problems while others see spikes in their blood sugars.

I wanted to know what worked for me - and the NHS advised diet certainly didn't - and I'm pleased that I've been able to maintain healthy blood test results for years.

jamesd

pension-newbie wrote: »

I had not imagined it would be beneficial to actively monitor sugar levels, rather I thought I would stick to my part of the bargain by exercising and eating less, and then get given the medical results at 6 monthly check ups. I have a meeting with the nurse soon so I will ask about that.

For type 2 diabetes there is a ration of strips used for taking each reading. That doesn't allow routine daily or many times a day testing but does provide enough for occasional testing. You may instead find it useful to test more to understand how things work. If you do, you could consider the SD Codefree meter which is both cheap and has cheap strips.

It's also worth noting that while not formally correct it is normal practice for diabetics to reuse the lancets used to make a hole in the skin for blood samples many times. Always use a different lancet for a different person, though.

What you might find is that you have readings of say 6 mmol/dl the morning but 10 for a few hours after eating. Then the Metformin might reduce those to 5.2 and 7. While a young person might have the same value constantly, whether after eating or not.

There's also a drug called Prandin (generic name is Repaglinide) that acts quickly to increase insulin output when taken ten to thirty minutes before meals. This can be used either with Metformin to get levels down after meals or as a substitute when Metformin doesn't do enough or has sufficiently unpleasant side effects.

You might also find that splitting the Metformin dose into two tablets a day instead of one with twice the does helps, by producing more even level in the blood. You can balance that with the relative convenience for you of one or two tablets. There's an extended release version, Metformin XR, that may be preferable and that can also be taken twice a day at half the dose to keep things level.

Personally I'd ask about using both Metformin XR with two tablets a day and Repaglinide and adjust myself to achieve the best combination of low average and low after-meal levels.

Repaglinide is a good deal more expensive than Metformin, though neither is actually expensive.

pension-newbie wrote: »

The Dr indicated he would not take me off the moment my results went under the limits

That's sensible, since it is a continuum of risk, not a fixed value, while the diagnostic threshold is a fixed value.

margaretclare

uk1 wrote: »

"Sorry madam, you really must eat more cakes "


http://www.thesundaytimes.co.uk/sto/newsreview/features/article1542377.ece?shareToken=99ee0e707fefdafc8d834ee50ea7813b

The article is extremely interesting.

It's now known that the Ancel Keys research was flawed, but it gave rise to another 30 years of 'health advice' and resulted in bad eating habits, which really went against all our thousands of years of evolution.

I did have a myocardial infarction (heart attack) in 1989 and therefore, I should take statins. I won't take them. One of their side-effects is hair loss, but not only that, having survived 26 years now with no further effects of the infarction, I see no need to. I should have had angina for years - no, I haven't. Avoiding smoking, even passive smoking, has, to me, been a better preventative than anything I could have taken on prescription.

kidmugsy

margaretclare wrote: »

I did have a myocardial infarction (heart attack) in 1989 and therefore, I should take statins. I won't take them.

Quite right. Last I read, there was no evidence that they extend women's lives, but quite a lot of evidence that they cause adverse side-effects, some of them serious.