# What is a Diabetic Review



## Katiekay (Nov 9, 2021)

Hello,
I am wondering if anyone can help me, I don't know where to turn. My Husband was diagnosed with type 2 around three years ago.
I have to be honest in saying I don’t think he has taken this seriously. He now takes medication , 5 tablets a day. When he was diagnosed his sugars  were of the scale. Apart from taking the tablets he has not changed his life style and I think At the moment it could be worse. He is eating like crazy and I think lost weight.

In the last three years he has never gone back to see a doctor only repeat prescriptions for his medication and excuses for not attending. We have now moved house and I was able to change doctors and make appointments for us both. My husband was given a Diabetic review appointment which he is happy to go to. Since knowing he has the appointment in two days he has cut out all sugar and eating sensibly I am guessing he is doing this so he gets a good reading when he goes.

My concern is it won’t be a true reading and therefor we won’t know if his current medication is correct.
I feel so terrible with this post but I am so concerned.
what does a diabetic review involve and will it really help if they are not seeing the true person or diet. 

Many thanks for reading this ,

kay


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## adrian1der (Nov 9, 2021)

Hi @Katiekay The blood test he will have done is called an HbA1c and it measures the amount of glucose bound to his red blood cells. Since red cells live, an average, around 3 months the test measures his average blood glucose over that period. A few days of cutting out sugar will not help.

He should have blood drawn for an HbA1c, cholesterol and kidney function. In addition they will measure his height and weight and will check the pulses in his ankle and feet and sensation in his feet.


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## Bruce Stephens (Nov 9, 2021)

adrian1der said:


> He should have blood drawn for an HbA1c, cholesterol and kidney function. In addition they will measure his height and weight and will check the pulses in his ankle and feet and sensation in his feet.


Quite likely talk about any symptoms, too. Maybe test a urine sample too (for kidney function) but that's usually a morning sample so they'd have asked about that.


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## Katiekay (Nov 9, 2021)

Hello Adrian,
Thank you so much for your reply. I am so happy that the test will see more than the next few days. 
I don’t want to catch him out,I just want him to stay well and see what is really going on With
out being boss. 
wow, I have just read your post, amazing Job on your weight loss.
many thanks,

Kay


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## Katiekay (Nov 9, 2021)

He has been asked to bring a morning urine sample.
Thanks Bruce for reminding me.


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## Burylancs (Nov 9, 2021)

Katiekay said:


> Hello Adrian,
> Thank you so much for your reply. I am so happy that the test will see more than the next few days.
> I don’t want to catch him out,I just want him to stay well and see what is really going on With
> out being boss.
> ...


An HbA1c is heavily weighted towards the last 10 days when most of the blood in circulation was made.


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## Katiekay (Nov 9, 2021)

Thank you Burylancs. i am sure we will catch a few of the Ten Days that would be my husbands normal diet,sugar level etc. He woke up yesterday stating he was cutting out sugar, I know this is just being done for the appointment. I know it can’t be easy but I think we just need to know what we are dealing with and what we can do. If he is taking the right medication etc. 
The appointment is on Thursday morning.

Many thanks for all the posts.
kay


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## Docb (Nov 9, 2021)

There is also an outside chance that the nurse might waken him up to treating things a bit more seriously.  Will depend very much on his/her level of "people" skills which if you look at members experiences can be a bit variable!


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## Katiekay (Nov 9, 2021)

Docb said:


> There is also an outside chance that the nurse might waken him up to treating things a bit more seriously.  Will depend very much on his/her level of "people" skills which if you look at members experiences can be a bit variableI


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## Katiekay (Nov 9, 2021)

I am crossing my fingers for exactly that. 
its  like my husband  almost thinks the medication works so that’s it. 

He is very much over weight and I hope this is mentioned at the review. He is obsessed with sugar being the only problem. He has never actually had an appointment due to his Diabetes so this one may help.
even though it has been 3 years I know my husband will know very little about type 2, what it can do and the damage it can cause.I am afraid me telling him is not helping or head in sand.

Many Thanks


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## Katiekay (Nov 9, 2021)

Crossing my fingers for a “Bingo moment” where he just gets it. 
I would like him around and healthy for a long time.


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## Docb (Nov 9, 2021)

If the DSN is worth her salt then being over weight will feature in their conversation. 

The DSN at our surgery once told me that her biggest problem was to get patients to recognise that it was the patient who had to take control, all she could do was advise and encourage.

Keep your fingers crossed!


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## Katiekay (Nov 9, 2021)

Docb said:


> If the DSN is worth her salt then being over weight will feature in their conversation.
> 
> The DSN at our surgery once told me that her biggest problem was to get patients to recognise that it was the patient who had to take control, all she could do was advise and encourage.
> 
> Keep your fingers crossed!


Many Thanks, lets hope it all goes well


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## ianf0ster (Nov 9, 2021)

@Katiekay Even if your husband has cut down on sugar, does he even know that refined carbohydrates start breaking down into glucose (the type of sugar carried in the blood) within moments of meeting  saliva in the mouth - so any bread, pasta, flour or even potato could scupper his plan even if he'd started weeks ago!


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## Felinia (Nov 9, 2021)

The other thing that is likely to happen is that he will be referred for an eye test to look for retinopathy. I have just had my regular review which included blood tests for the HbA1c, kidney and urine functions, plus an actual urine sample.  My weight, blood pressure and pulse were recorded, and my feet given the tickle test. I was asked questions about my lifestyle including level of exercise.  The test results were posted to my secure online portal and I will be discussing them with the DN tomorrow.  At my first review, I was referred to a diabetic nurse for advice on diet, and also for the Type 2 training course.  Things have changed with COVID but I think courses are still run online.  Can your husband be persuaded to work through the Learning Zone (orange tab on top)?


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## Sharron1 (Nov 9, 2021)

Felinia said:


> The other thing that is likely to happen is that he will be referred for an eye test to look for retinopathy. I have just had my regular review which included blood tests for the HbA1c, kidney and urine functions, plus an actual urine sample.  My weight, blood pressure and pulse were recorded, and my feet given the tickle test. I was asked questions about my lifestyle including level of exercise.  The test results were posted to my secure online portal and I will be discussing them with the DN tomorrow.  At my first review, I was referred to a diabetic nurse for advice on diet, and also for the Type 2 training course.  Things have changed with COVID but I think courses are still run online.  Can your husband be persuaded to work through the Learning Zone (orange tab on top)?


Oh I didn't  realise that they can check kidney function from the Hba1c.  I   thought that it  could only be done from a separate urine sample. Have I understood it correctly?


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## Pumper_Sue (Nov 9, 2021)

Sharron1 said:


> Oh I didn't  realise that they can check kidney function from the Hba1c.  I   thought that it  could only be done from a separate urine sample. Have I understood it correctly?


The kidney function is done via a blood test


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## Sharron1 (Nov 9, 2021)

Pumper_Sue said:


> The kidney function is done via a blood test


So much to learn. I did wonder why i had my  blood tests but stuff re kidney function appeared. Good. I hate peeing in that little bottle.  It's a nightmare for me. More miss than hit


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## Bruce Stephens (Nov 9, 2021)

Sharron1 said:


> So much to learn. I did wonder why i had my  blood tests but stuff re kidney function appeared. Good. I hate peeing in that little bottle.  It's a nightmare for me. More miss than hit


I suspect the tests are testing different things, and the urine test will stay.


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## Sharron1 (Nov 9, 2021)

Bruce Stephens said:


> I suspect the tests are testing different things, and the urine test will stay.


Hey ho. Practice  makes perfect...


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## Katiekay (Nov 9, 2021)

ianf0ster said:


> @Katiekay Even if your husband has cut down on sugar, does he even know that refined carbohydrates start breaking down into glucose (the type of sugar carried in the blood) within moments of meeting  saliva in the mouth - so any bread, pasta, flour or even potato could scupper his plan even if he'd started weeks ago!


No, he has no idea. I have spoken with him about it but he seems to think it’s just a sugar thing. I just hope the nurse will speak with him about every thing. He definitely has a plan as no sugar has touched his lips today , I think that’s a first in 3 years.


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## Katiekay (Nov 9, 2021)

He has been asked to bring in a urine sample and has been told he will have his bloods taken. I am not sure what else they will do or ask. 
I think hearing it from someone in the know and medical may change the way he is living. 
he was diagnosed 3 years ago and he has never been back to see a doctor Regards the diabetes.


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## Katiekay (Nov 9, 2021)

How long on average do you wait for the blood results to come back ?.
I am guessing the urine test is instant?


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## Felinia (Nov 9, 2021)

Sharron1 said:


> Oh I didn't  realise that they can check kidney function from the Hba1c.  I   thought that it  could only be done from a separate urine sample. Have I understood it correctly?


No it wasn’t from the HbA1c - they took 3 vials to run 3 different tests and they had a separate urine sample.


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## Bruce Stephens (Nov 9, 2021)

Katiekay said:


> How long on average do you wait for the blood results to come back ?.
> I am guessing the urine test is instant?


Blood tests will take a few days (so a week, probably), and probably the urine will be the same. (Though some may be faster.) If he's going to the hospital clinic they may do all the tests there, in which case the results might be done in a few hours. (I know when I used to go, I had the blood taken early in the morning and by the time of my appointment later that day they'd been done.)

Regardless, don't be surprised if none are ready that day, but expect them within a couple of weeks.


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## Burylancs (Nov 9, 2021)

Katiekay said:


> How long on average do you wait for the blood results to come back ?.
> I am guessing the urine test is instant?


Annual tests ...


			https://www.diabetes.org.uk/resources-s3/2018-07/15-Healtcare-essentials.pdf


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## Katiekay (Nov 9, 2021)

Can anyone let me know what your blood should read two hours after food( on medication)we have just taken them with a new machine In mmol 

many thanks


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## Katiekay (Nov 9, 2021)

Burylancs said:


> Annual tests ...
> 
> 
> https://www.diabetes.org.uk/resources-s3/2018-07/15-Healtcare-essentials.pdf


Thank you so much


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## Burylancs (Nov 9, 2021)

Katiekay said:


> Can anyone let me know what your blood should read two hours after food( on medication)we have just taken them with a new machine In mmol
> 
> many thanks


Under 8.5


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## Katiekay (Nov 9, 2021)

Burylancs said:


> Under 8.5


Oh ok, my husbands reading this evening was 11.8 so I guess too high


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## Bruce Stephens (Nov 9, 2021)

Katiekay said:


> Oh ok, my husbands reading this evening was 11.8 so I guess too high


Yes, but not crazily high.


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## ianf0ster (Nov 9, 2021)

Sharron1 said:


> Good. I hate peeing in that little bottle.  It's a nightmare for me. More miss than hit


Pee into a cup and then pour amount required into the little sample bottle - that's what I do.


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## Katiekay (Nov 9, 2021)

Bruce Stephens said:


> Yes, but not crazily high.


Oh that’s good news, 
Thanks


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## Burylancs (Nov 10, 2021)

Katiekay said:


> Oh ok, my husbands reading this evening was 11.8 so I guess too high


Any random reading at 11.1 or over used to be one of diagnostic criterion for Type 2 Diabetes.


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## Leadinglights (Nov 10, 2021)

Katiekay said:


> Oh that’s good news,
> Thanks


As you husband already has a diabetes diagnosis a level of 11.1mmol/l is not good to be seeing on a regular basis. I assume that was a 2 hour after meal reading rather than something random. But it does suggest that he is having meals that are far too carb heavy.
If his levels are high anyway then testing what food he can tolerate by testing before he eats and after 2 hours, aiming for no more than 2-3mmol/l increase and aiming for no more than 8.5mmol/l would be a good strategy.
Hopefully he will get some blood tests and good advice from his appointment.
If you do most of the cooking then gradually reducing carbs in the meals would be a good move, my other half really got on board with our new way of eating low carb and feels much better for his weight loss as well.


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## adrian1der (Nov 10, 2021)

On the after meals thoughts....Test before you eat and then two hours after eating. Ideally you are looking for a rise of no more than 2. Any higher than that and you need to think about the amount of carbs in the meal. This will enable you to identify what his body can, and can't tolerate. Over time the before meal number should drop if you can get the rise sorted out.


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## NotPink (Nov 10, 2021)

Choose a larger sterile pot to pee in and transfer to the little bottle using a funnel...wash out after use and store for future checks ...unless some one knows different.


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## everydayupsanddowns (Nov 11, 2021)

Hope the appointment goes well today @Katiekay 

Hopefully this will be a bit of a fresh start for your husband, and he will begin looking after his diabetes and his health in a more active way. Often you don’t realise how weary, worn down and lethargic you have been feeling. Erratic and elevated blood glucose levels can be exhausting and are linked with low mood, but this may have come on quite gradually. Making a few positive changes might give him more energy, a clearer mind, and a brighter outlook.

It will be a bit tricky for the Dr or nurse to give much more than general advice until the blood results come back - but hopefully it will be a positive appointment, and the start of something new


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## Katiekay (Nov 11, 2021)

everydayupsanddowns said:


> Hope the appointment goes well today @Katiekay
> 
> Hopefully this will be a bit of a fresh start for your husband, and he will begin looking after his diabetes and his health in a more active way. Often you don’t realise how weary, worn down and lethargic you have been feeling. Erratic and elevated blood glucose levels can be exhausting and are linked with low mood, but this may have come on quite gradually. Making a few positive changes might give him more energy, a clearer mind, and a brighter outlook.
> 
> It will be a bit tricky for the Dr or nurse to give much more than general advice until the blood results come back - but hopefully it will be a positive appointment, and the start of something new


Thank you so much for your reply,
The appointment is tomorrow, my mistake.
When he was diagnosed 3 years ago his bloods where so high the doctor tracked him down and asked him to come in straight away. He was given medication and sent away and asked to make a catch up appointment which he never made. Because the sugar levels dropped my husband thought he was fine and the medication had done it’s job. When ever we do a prick test at home he averages around 12 mmol.
I believe ,because this is far,far lower than his original reading ( which was off the scale)3 years ago he always sees it as a positive. 

I need to also find out more about diabetes so I can help my husband

you are absolutely correct, he lacks energy,Erratic and low mood, 

Thank you again for your message.


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## ianf0ster (Nov 12, 2021)

@Katiekay  An average of 12 isn't good by any means. An average of 8 is about acceptable for somebody in the early stages of controlling their T2 using a way of eating, but most of us who are serious about it do much better than that after a few weeks.


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## Katiekay (Nov 12, 2021)

Thank you for all your comments and advice. 
My husband went to his review today. Weight, health questions, urine test, blood test and foot touch test.
Apparently, every thing is good as far as the nurse can see. I am not sure how true this is but he was told his number are 11mol was ok as he drives a lot and it would not be good for it to go too low whilst he was driving. I am not sure how true this is.

we will wait for the blood test results to come back.
I am not sure what I thought would happen but again I believe My husband has gone in and said he smokes less than he does, walks further than he actually does, feels well when I know he doesn’t .

we won’t know if the medications he is on will need changing until his bloods come back.

I am and have been trying to help for 3 years ,not sure what else I can do.

k


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## Leadinglights (Nov 12, 2021)

Katiekay said:


> Thank you for all your comments and advice.
> My husband went to his review today. Weight, health questions, urine test, blood test and foot touch test.
> Apparently, every thing is good as far as the nurse can see. I am not sure how true this is but he was told his number are 11mol was ok as he drives a lot and it would not be good for it to go too low whilst he was driving. I am not sure how true this is.
> 
> ...


It sounds as if the visit was not particularly helpful at helping your husband to take things more seriously. I assume the blood glucose level of 11 that he was told was a spot test which is a high level to be seeing and I suspect it will be reflected in quite a high HbA1C. 
Hopefully the HbA1C test which I assume they will have done as well will give a better indication of his diabetic status and spur him into making some dietary changes.
I could understand the nurse saying she did not want his levels any lower because of driving if they were below 5.
Please check back in when the results come back so people can support you in trying to cope.


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## Katiekay (Nov 13, 2021)

Leadinglights said:


> It sounds as if the visit was not particularly helpful at helping your husband to take things more seriously. I assume the blood glucose level of 11 that he was told was a spot test which is a high level to be seeing and I suspect it will be reflected in quite a high HbA1C.
> Hopefully the HbA1C test which I assume they will have done as well will give a better indication of his diabetic status and spur him into making some dietary changes.
> I could understand the nurse saying she did not want his levels any lower because of driving if they were below 5.
> Please check back in when the results come back so people can support you in trying to cope.


Thanks for your reply, I would imagine the comment about the driving was actually someth8ng my husband said and not the nurse in a round about way. The level of between 11 and 15 is what we have been testing at home over the last two weeks. My husband has never read lower than 11 over that period. 
The results of the HbA1C test will be back next week. i am not sure what this blood test actually tests but I am sure we will find out, I am sure my husband mentioned Liver to me earlier.
I am sure we will know more when the results come back and it will stop the denial.

Thank you again,


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## trophywench (Nov 14, 2021)

Not unusual to get a whole raft of blood tests at the same time as the HbA1c - whilst they're taking blood for that, they may as well check Liver function, kidney function (eGFR and U&E tests) , possibly Thyroid function and Cholesterol at the same time.


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## Katiekay (Nov 15, 2021)

Thank you


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