# New T2 Diagnosis - Conflicting Info



## NickC (Dec 20, 2016)

Hi all,

I'm T1 for 10 years, so this question is not related to me, but a colleague.  I'm an admin on the Freestyle Libre Users group on FB, in case anyone knows me  

A colleague has come up to me and told me that he's been informed that he's got D (16mmol/l spot test). He was prescribed Gliclazide by the doctor. He then went to see nurse and told not to take them (she couldn't work out why he was prescribed). He's going for a blood test tomorrow (A1C, I think). Nurse said that he's unlikely to be seen again before Christmas. His levels were 18.6 and 20.2 when I took them for him this morning. He's also got blurred vision. His symptoms came on rapidly (polyurea over weekend and some weight loss in the last month), but I would have thought he is probably prime T2 (slight worry about speed of onset).

I'm telling him that he needs to get himself into the doctor and on medication pre-Christmas...do you think this is the right advice and does he need to be forceful? What should he be saying?

Thanks for your help and have a great Christmas.

Nick


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## john pardo (Dec 20, 2016)

Hi and welcome


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## NickC (Dec 20, 2016)

john pardo said:


> Hi and welcome


Thanks John


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## Martin Canty (Dec 20, 2016)

Hi Nick, welcome to the group

Assuming that the 16 was a FBG reading then most likely he is D, the usual drug prescribed is Metformin before anything else (but we have has a few cases where Gliclazide was prescribed first). The weight loss is a little worrying (peeing a lot with those BG readings is expected), has he done a ketone test, normally this should be zero or trace.
If in doubt always go & see the Dr.


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## grovesy (Dec 20, 2016)

Welcome.


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## NickC (Dec 20, 2016)

Hi Martin...no tests apart from the blood glucose (not FBG) at the walk-in surgery.  I've since had an update that it was the doctor at the walk-in clinic that prescribed gliclizide and the GP this am that said not to take it.  The one this morning didn't check BG.  I did it for my colleague and it came up as 18+ this am and then 20+ after lunch.


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## Robin (Dec 20, 2016)

I would agree with you, if his levels are this high before he starts on the Christmas binge most of us have, they could quickly get to dangerous levels, so pushing for a proper diagnosis and treatment before Christmas would be sensible. There's always the risk that he's actually type 1, if it's come on this quickly.


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## Martin Canty (Dec 20, 2016)

Definitely IMHO this requires intervention, 20 is way too high even after eating, he should drink plenty of water to try & dilute the blood..... Perhaps A&E.... He shouldn't be driving at those levels


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## margaret jamieson (Dec 20, 2016)

Hello there hope my situation helps....
I had a diabetes test at the pharmacy and the reading was high (17). Was advised to go to GP same day. This reading was on an empty stomach. The GP tested and it an hour later and it had gone down to 14.8. He immediately prescribed 2 x 500mg metformin to be taken today and to see the nurse Friday for help with diagnosis. He has sent off a blood test (A1C) today but said he is 99.9pc sure I am diabetic and said that the metformin would help me to feel not so tired or thirsty. He did say that if I lose some more weight and exercise regularly that he could reduce or stop meds. So, I think the 18 and 20 readings are definitely worrying and should be treated I would think. Good luck with helping your friend.


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## NickC (Dec 20, 2016)

Thanks all...I've told him he must go to the docs in the morning...I'm surprised that they didn't see it as needing more urgent attention..his vision is blurred too. :-(


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## Grogg1 (Dec 20, 2016)

I was diagnosed with Hba1c of 117 so my average blood glucose over previous 3 months was 17+.  Three days later at my first D clinic I had a finger prick test and was almost 15.  I had been prescribed metformin 1 a day for a week upon diagnosis and up to 2 a day after a week.

I'm four weeks on now from diagnosis and using a low carb diet, medication and enthusiastic monitoring my levels started to drop.  Now waking on fives and never above 8 after eating.  It took me just over a week to be in single figures.

My eyesight was affected though I didn't realise it.  I've gone from being slightly short sighted to having perfect distance vision but now need reading glasses.  Optician has checked my eyes and thinks this is my correct prescription but wants to wait another month in case there are more changes.

I was told with such high levels I had been D for a long time but no one can say how long.  I had radiotherapy a year prior to being diagnosed with diabetes and one of the side effect of this was increased thirst so took me a while to get it checked out.


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## NickC (Dec 21, 2016)

Sometimes I despair!  

Colleague went to doctor this morning after his blood test, because I told him that he must.  He was told to continue not taking the Gliclizide and that they wouldn't do or prescribe anything until the blood test result comes back and that would be a week.  I tested him again this morning - 18.1.  He's been given no dietary advice.  I just hope he's not T1!!


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## Stitch147 (Dec 21, 2016)

Hi Nick and welcome to the forum. Sorry to hear about you colleague. If I was him id stay at the dr's until I got seen!!!


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## NickC (Dec 21, 2016)

Indeed...but he has seen one today...who said do nothing until the blood test result is back next week!  I've told him about how to 'taste' ketones and if that happens to get himself to A&E...not much else I can do, I guess.


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## Stitch147 (Dec 21, 2016)

Might also be worth getting some ketone test strips from the chemist, just in case.


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## NickC (Dec 21, 2016)

True...but he doesn't even have a meter!


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## Stitch147 (Dec 21, 2016)

You dont need a meter, get pee sticks to test for ketones


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## NickC (Dec 21, 2016)

Oh, I see...didn't realise...I'll get him to do that.


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## Stitch147 (Dec 21, 2016)

I get mine in boots, just ask for them at the pharmacy counter. Very easy to use.


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## trophywench (Dec 21, 2016)

Yup - Ketostix, Nick.  About a fiver a tub.

Stick changes colour after dipping (or being passed through the stream) which you match against the colour chart to see where you are.  All instructions on the tub or in the leaflet in the box.


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## NickC (Dec 21, 2016)

Just done his BG and he's now 26.8....more than a little concerned...told him to wash his hands just to double-check....22 on re-check...within normal variance so high!

Question is, at what point do I tell him to go to A&E?  Is this unnecessarily worrying?  He, of course, is unaware that this is quite a severe situation (or is it?), so I don't want to make more of it than is needed.

Thanks all


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## Martin Canty (Dec 21, 2016)

If he peed on a stick it would tell him whether he is on his way to DKA or not, having said that though, 22 is still brutally high..... He should be drinking a lot of water at this stage..... IMHO A&E


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## NickC (Dec 21, 2016)

Martin Canty said:


> If he peed on a stick it would tell him whether he is on his way to DKA or not, having said that though, 22 is still brutally high..... He should be drinking a lot of water at this stage..... IMHO A&E


Interestingly...he tells me that over the weekend he was really thirsty, but isn't now...update...4:45pm - 19.3 (347).


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## HOBIE (Dec 21, 2016)

NickC said:


> Hi all,
> 
> I'm T1 for 10 years, so this question is not related to me, but a colleague.  I'm an admin on the Freestyle Libre Users group on FB, in case anyone knows me
> 
> ...


I would get to see someone, The sooner you find out the less damage to oneself, Good luck


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## Katieb (Dec 22, 2016)

I have little personal experience as not Type 1, but my dad was and at those levels I/he would have worried. I would go to A&E because if he becomes unwell over Christmas it may be difficult to get to see someone quickly. You are a good friend. I wish there were more people like you around!


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## NickC (Dec 22, 2016)

The story continues - thanks all for support - I'm determined not to let my colleague go into Christmas untreated:

My colleague saw another doc (the third he's seen), who did take his levels this time - 17.6 (317).  Colleague said, aren't you going to treat it?  Doctor said, he could give him tablets, but wasn't prepared to as he didn't know whether it was diabetes (I thought a random BG over 11.1 was equivalent to a diagnosis?).  He has convinced them to speed his blood results through and has another doctor appointment tomorrow.  Colleague asked what else it could be apart from diabetes and the doctor wouldn't say.  He's not on any other medication, legal or otherwise


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## grovesy (Dec 22, 2016)

NickC said:


> The story continues - thanks all for support - I'm determined not to let my colleague go into Christmas untreated:
> 
> My colleague saw another doc (the third he's seen), who did take his levels this time - 17.6 (317).  Colleague said, aren't you going to treat it?  Doctor said, he could give him tablets, but wasn't prepared to as he didn't know whether it was diabetes (I thought a random BG over 11.1 was equivalent to a diagnosis?).  He has convinced them to speed his blood results through and has another doctor appointment tomorrow.  Colleague asked what else it could be apart from diabetes and the doctor wouldn't say.  He's not on any other medication, legal or otherwise


I too thought at that level it was defination, and a HBAC1 does not take for ever to come through.


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## trophywench (Dec 22, 2016)

GP ones normally within 48 hours.


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## mikeyB (Dec 22, 2016)

If a random BG was 17, and the doctor wasn't sure it was diabetes, then he must be a bloody idiot. Nothing else could be the cause with that history. He sounds very much like a T1 to me. Age and weight?

But if he shows any ketones, it's off to A&E, where you might come across doctors and nurses who know what they are doing. The shoddy treatment so far is dangerous.


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## NickC (Dec 22, 2016)

He's around 6'6" and 50 years old and probably overweight, but not 'fat'...so not typical T1 territory...but in my mind, I can't rule it out.  He's lost weight recently and not been on a diet.  I've told him to get some Ketostix...but as the doctor has not made him worried...he doesn't think it necessary.  He's had random BG on my meter between 17 and 26 (I retested the 26 and it came back 22 after he washed his hands again).


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## Stitch147 (Dec 22, 2016)

Those are very high numbers. I know I would be worried if I went that high again. Lets hope he gets somewhere with the Dr and quickly!


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## NickC (Dec 22, 2016)

Do GPs in this country routinely do c-peptide?  I know I didn't have that test, but that was back in 2007 (when they posted my 37mmol/l lab result from the GP to the hospital and I wasn't called in for 48 hours!!).


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## grovesy (Dec 22, 2016)

NickC said:


> Do GPs in this country routinely do c-peptide?  I know I didn't have that test, but that was back in 2007 (when they posted my 37mmol/l lab result from the GP to the hospital and I wasn't called in for 48 hours!!).


Not even when people's diagnosis is not clear cut and cost is often brought up, and it can take weeks to get a result.


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## NickC (Dec 22, 2016)

Evidently....the doctor this morning couldn't work the lancing device, so took the lancet out and used the lancet without the device...ouch - makes me wince just thinking about it!

Good news is that lab results are back...but receptionist wouldn't give him the results over the phone.  Appointment tomorrow am...have given him a list of questions to ask


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## Dannyboy (Dec 22, 2016)

Hi I have been diagnosed T2 recently,my reading at the docs was 20+,he imedeatly gave me 60mg of Gliclazide & a free test meter,which I thought was very good.I am 6ft 6" and was peeing like mad,so im not sure why these docs are being so cautious,it sounds pretty obvious.
I hope they sort your friend out at next visit
regards dan.


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## Robin (Dec 22, 2016)

Just for instance, I was 51 when I was diagnosed. GP assumed I was Type 2 because of my age. After several months of levels unresponsive to Metformin and Gliclazide, I finally got a hospital appointment, was given a GAD antibody test which was positive, but they didn't wait for the result of that to assume I was Type 1 because of the way I was presenting, and started insulin straight way. I had an HbA1c of 16 ( in old money, don't know what that equates to in the new system) at diagnosis, and my finger prick tests when I started doing them were often in the 20s. I didn't know just how bad that was! The comment by the hospital DSN was 'I'm surprised you were still walking round, with those levels!'


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## Grogg1 (Dec 22, 2016)

Well given the results would not be given over the phone it's obvious the hospital tests have confirmed the diagnosis.  Hopefully he will get the right treatment now


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## robert@fm (Dec 22, 2016)

Thank goodness lancing devices are no longer like this one:






(The same image search turned up a lancing device which looks a bit like a flying saucer; rather attractive, except that the green bits are in a yellow-green I find a bit yucky...)


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## Ljc (Dec 23, 2016)

robert@fm said:


> Thank goodness lancing devices are no longer like this one:
> 
> 
> 
> ...



Boy this brings back memories. . At my old work we were switched to that device from something very similar to this little beauty.
Imagine holding out your hand to have this thing jabbed into it


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## Ljc (Dec 23, 2016)

Hi Nick C . It a good job you are there for him. It is such a worry when you know things are not right.  I'm often shocked at how little some professionals know about diabetes .


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## NickC (Dec 23, 2016)

Probably the final chapter of this story:

He went to docs and took my list of questions, which he gave to the Doctor!  *HbA1C came back as 96mmol/mol (10.9%).*  So they finally told him he had diabetes and that was very high for his age.  To my questions about how they knew it was T2 and not T1, they said that the blood tests showed that (not sure what test shows this...but fingers crossed they're right!).  They've prescribed Metformin (at last) and taken him of Gliclizide, and conceded this should have been done earlier in the week.  He's starting on one dose a day and going up to three (not sure on strength).  Doctor said he didn't need a BG meter as T2's didn't generally need them (!).  I've told him to get one but he'll have to self-fund - worth it in my opinion.  She said he needed to moderate his diet, but understandably gave little info as to what that meant.  I've given him the link to the Carbs and Cals book and app.

Thanks for your continued support on this one - I really appreciate it.


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## Ljc (Dec 23, 2016)

Hi Nick. The cheapest meter to self fund is the SD Codefree on Amazon, the test strips are around £8 for 50 rather than the £15 to £25 brands on the high street . Back in a mo with a link
Here it is
https://www.amazon.co.uk/gp/product...p=1634&creative=19450&creativeASIN=B0068JAJFS


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## Stitch147 (Dec 23, 2016)

Glad your friend finally got the help he needed. My HbA1c was 127 when I was diagnosed in August 2015 at the age of 39. Fingers crossed the metformin does the trick for him. Tell him where to find us if he needs any extra help and advice.


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## Ljc (Dec 23, 2016)

Hi again , I'm not 100% sure but I believe many GPs just make an assumption of T2 based on age, weight etc . Rather than actually doing the necessary tests for T1 .  We've a few on here who fitted some of the profile, who after long attempts of trying to bang a square peg into a round hole by there diabetic team got the correct diagnosis, their was much wringing of hands , shaking of heads , shouting by us and of course advise , I can tell you.


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## Grogg1 (Dec 23, 2016)

NickC said:


> Probably the final chapter of this story:
> 
> He went to docs and took my list of questions, which he gave to the Doctor!  *HbA1C came back as 96mmol/mol (10.9%).*  So they finally told him he had diabetes and that was very high for his age.  To my questions about how they knew it was T2 and not T1, they said that the blood tests showed that (not sure what test shows this...but fingers crossed they're right!).  They've prescribed Metformin (at last) and taken him of Gliclizide, and conceded this should have been done earlier in the week.  He's starting on one dose a day and going up to three (not sure on strength).  Doctor said he didn't need a BG meter as T2's didn't generally need them (!).  I've told him to get one but he'll have to self-fund - worth it in my opinion.  She said he needed to moderate his diet, but understandably gave little info as to what that meant.  I've given him the link to the Carbs and Cals book and app.
> 
> Thanks for your continued support on this one - I really appreciate it.



I was diagnosed end of Nov 16 with hba1c of 117 (12.9%).  I am on metformin 500mg twice a day.  I was given a meter.  I downloaded the carbs and cal app and went low carb immediately.  I dropped steadily over the last 4 weeks and now waking at 4.5!!  I am always under 7 two hours after food.  I test because it keeps me motivated.  Looking at my BS spreadsheet first tested myself on 21st Nov 15.4.  I fasted from 2pm went to bed on 9.9.  I did low carb and some fasts i.e. not eat after a late lunch till morning and by 25th Nov I was in single figures throughout the day.  By 1st December between 6-8 throughout day and then finally 5th December I started getting into the 5s.   This how quick a low carb diet and intermittent fasting can get your levels down. I also increased my walking as I have desk job so randomly go up 3 flights of stairs to loo!

When I had my diagnosis I was devastated as it was so high and there were so many negative posts about dangers of it being so high, needing loads of meds etc.  yet I have done it with low levels of meds and diet.  I was already on a weight loss mission having lost 2 stone over 2 years.  I've lost another 1/2 stone since diagnosis.  So if your friend is stressed tell him within a month he can be on target ranges but agree with others that he needs a meter.


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## Martin Canty (Dec 23, 2016)

Good job, Nick..... Sorry about your friends DX though.... Would he be willing to join this forum?


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