I was just diagnosed with Type 2. I had an OGTT test last week and I was 207 after 2 hours. However my fasting glucose was 113. My A1C was 7.6. My understanding is that the results must be confirmed on a different day. Also, I understand that A1C is not supposed to be used to diagnose diabetes.
I have been checking my sugar all weekend and it has been around 100 to 109 and it was even 83 last night at bedtime.
I am on several meds that I think might also raise blood sugar, Metoprolol, Crestor, Niaspan,
Is it possible that I do not have Type 2 but rather impaired fasting and impaired glucose, ie prediabetes instead?
Based on what you write and what your A1C is you are a diabetic now and should be treated as such. Normal fasting should be between 70-100. Your A1C reading is more telling though as you now have a average blood sugar of 167 over the last 2-3 months which is about double the normal of around 83. I would not wait too long and get back to your doctor to do further testing. With these elevated BG sugars this needs attention.
You should at least target an A1C of 6.0 which you should easily be able to get to with proper diet, exercise, and medications if needed as a Type 2.
Actually, you are wrong. A1C is now the golden standard test used for diagnosing Diabetes, and more and more doctors are moving away from fasting blood glucose numbers, and glucose tolerance tests. Like Pauly explained, an A1C is an average of what your blood glucose has been for the last 2-3 months… and if it has been that high, on average, and higher than 6.5%, than you are a Diabetic… They just simply caught it early. Being able to get to good numbers with better diet, exercise, or medication, does not mean you are not Diabetic – it just simply means what what you may be eating sometimes, is working. Try eating meals with more non-starchy vegetables, and lean meats, dairy, or eggs. Limit your starchy veggies, pastas, rices, and whole wheat or multi grain breads to very small, or controlled portions… Test 1-2 hours after eating… and write down what you ate. Compare what you ate on good days, to what you ate on days when you may score higher. This is how you will learn what foods will work best for you, and control your numbers. Like Pauly said, make sure to follow up with your physician, and perhaps even get a referral for a diabetes educator. (Oh, and you only need one post, really… As they all show up on the main page… No need for three. )
You diagnosis sounds correct to me. You have diabetes. The difference between “pre-diabetes” and “type 2 diabetes” is not really important because both mean that you need to measure and manage your blood sugar. I know that many doctors don’t use the term “pre-diabetes” at all (some people say it would be like being “kind of” pregnant).
The fact that your blood sugar reading are good means that you are managing well. Having good blood sugars does not mean that your diabetes went away, it means that you are managing well (and that’s something to always be happy about!).
When are you mesauring your blood sugars? Most of us are advised to measure fasting blood sugar and 1.5-2 hours after eating. You may not need to measure after every meal. My Dad is a type 2 and he measures his fasting blood sugar everyday and after one meal (and he rotates which meal – one day he measures after breakfast, another day after lunch, …). This gives him and his doctor information about how his blood sugars are throughout the day on average.
We all know that a diagnosis of diabetes is hard. Please feel free to ask anything here and know that you are NOT alone!!! This is a caring community of people who are living well with diabetes! You can fit right in!
We all struggle to understand what is wrong with us, and often diabetes can be a very complicated condition. So let me give you the “party” line:
According to the new guidelines from the ADA, a HbA1c of 7.6 and having and 207 2 hours after any meals both indicate diabetes.
According to the guidelines from the AACE (the society of endochronologist, specialists in diabetes), going > 200 mg/dl 2 hrs after indicates diabetes.
So, unfortunately, according to both those criteria, you have diabetes, not prediabetes, but overt diabetes. I know that is not what you wanted to hear. Now that does not mean that you can’t make some lifestyle changes or reduce a complicating medication and get your blood sugar back to a “normal” ranges. But I have to be honest with you, it is unlikely that this is something you can just fix and go back to life before this happened. You very likely will have to accept that you have become intolerant of carbs.
When I was first diagnosed, I also thought that maybe things were mild and perhaps my condition was due to some medication or other thing and I could just fix it. But over time, I had to grudgingly come to accept that my blood sugar was not behaving normally and it was not just something that I could fix by dropping the medication that caused it. Eventually, I was able to use diet and exercise to obtain reasonable control for some time. And over time, I also came to realize that while I was diabetic, I still had a life, I could still be ‘healthy’ and I could still enjoy every quality of life that I had before.
That being said, I would tell you that I observed marked increases in my blood sugar with Niaspan and there is research behind that. Don’t take my harsh suggestion that you are a diabetic as sentence that you won’t be able to manage your condition, instead, I would tell you that there is every promise that with changes to your lifestyle (diet and exercise) you may well be able to control your condition without requiring any medication or insulin Only time will tell, and I would encourage you to hang around here, find out what others have found successful and see what you can do to manage your condition.
Thanks, BSC for the straight talk. Having said that, is it possible that the Niaspan has raised my BS into Diabetic range and that possibly it would lower to pre diabetes if I was off the Niaspan?
I have sold life, disability and health insurance for many years and there is a big difference in whether you can even get the insurance with the diabetes diagnosis which I am sure you are aware of. That is one reason I am fighting this diagnosis so much.
Having said that, how severe do my levels indicate. The Endo’ nurse said it was mild type 2 diabetes and that it was a 3 or 4 on a scale of 1 to 10? is that accurate?
thanks for your input. It has been a very traumatic few days since I was diagnosed.
I know that this is a difficult time. Clearly having a diagnosis of diabetes will mean that you are put into a high risk life insurance class, but this is only part of how your life is going to change. I would tell you that I obtained a reasonable life insurance policy after being diagnosed by demonstrating good control and a track record of good interactions with my doctor.
Realize that you are getting the news that you have a chronic condition and coming to terms with this and what it means to your life is going to take some time. You may have feelings that you don’t really have diabetes, that it is unfair and unjust, anger and depression. But right now, you are probably just somewhat in a state of shock. This is ok. I am telling you it is going to be ok. And part of what will make it ok for you is that you can come back here and interact with other people who have gone through very similar things.
thanks, BSC. I appreciate your kind words.
OK, here is a practical question. My Dr’s nurse told me she only changes her lancettes once a week. The pharmacist told me to change the lancette after each prick. What is the right answer. How often do you change the lancettes and how often do you check your BS. they have me checking before every meal, 2 hours after each meal and then at bedtime, 7 times a day. Also, how do you alternate fingers to prick?
Also, today I ate around 2:30pm. My BS was 94 before the meal, 2 hours later it was 109 and then tonight at 8:15pm before dinner it was 80. Are these good / bad normal??
Thanks again for all your help.
Ok, so here is the “party” line on lancets. Change them every use. Now, that being said, I bet if I asked aound these parts, I could find you some diabetics that only change their lancets when the little needle is worn right down into the plastic. I change mine every week or so. Do a search here, and you will probably find a thread on how long people go before changing their lancets and you will no doubt be amused at some of the answers. I prick my fingers on the sides, never on the pads. I do the left side and right side of every finger, but not the thumb and I rotate on a regular basis. Sometimes, I’ll work in my second joint as well. Rotating lance sites as well as injection sites help aid healing and avoids scar tissue over time.
My suggestion is that in addition to this web site you visit www.bloodsugar101.com, the host of that site Jenny has great advice and it will answer many of your questions about when to test and what is normal. I like to suggest that type 2s test first thing in the morning as a worst case measure of your fasting blood sugar and then test before your biggest meal of the day (typically dinner) and 2hrs after you first start eating. The numbers you quote are great numbers. I keep detailed logs of my numbers and have recorded my all blood sugar numbers going back to 2006. Good targets for control is to achieve a fasting blood sugar < 110 mg/dl and a 2 hour number < 140 mg/dl. As a type 2, you will find the greatest value of blood tests is learning what you can eat and how much. Jenny at bloodsugar101 will explain much.
thanks again BSC. You have been great today. I just got diagnosed on Friday. You’re right, shock is what is going on right now.
Thanks again.
I guess I better change my name on here and take off the “not sure”
Most of us go months before changing lancets. Bet your pharmacist isn’t a diabetic. Those are the right times to test & also first thing in the morning.
Some people don’t use their thumbs to test, but I do. Start with one finger & just go around to keep alternating & use both hands.
Don’t bother using alcohols wipes because they’re useless & will just dry your skin. Wash hands & dry well.
Wipe away the first drop of blood & use the next blood for testing.
You have already come to the conclusion it’s diabetes and sound like you are starting to accept - that will help you so much. Even if it’s the medication affecting you, your system is not handling carbohydrates properly. Once off that medication you may see an improvement - that is a plus.
Are you eating the same as you did before the testing? I suspect you have already made some changes and that is why you are not seeing such a swing in my glucose now. I remember when I first figured out I had glucose problems - I didn’t eat for days since I noticed everything I ate was causing high numbers. I thought I was fine since if I didn’t eat I was at 90. That only meant that part of the system was still working - which was great but didn’t mean I was saved from diabetes. Learn as much as you can - bloodsugar101 is a great site.
Test often at first. You want to know how your body reacts to certain foods.
Test right before a meal then 1 hour & 2 hour. Personally. I will check the 1/2 hour and check until my glucose goes back to normal. Not all foods will be the same - some will make your glucose peak quickly and others will be much more slowly. If I eat a piece of candy I am sure my glucose will be back to normal at the 2 hour mark. This would mean - ‘hey, it’s ok, I handled it’ WRONG. Check the 1/2 hour or even the 15 minutes after and you will see a HUGE spike followed by an over reaction by my system with insulin driving down that glucose number back to normal by 2 hours. Something else might make me too high at the 2 hour mark but be a slow rise to get there. In BOTH cases my system couldn’t handle it. That’s why it’s so very important to test often at first so you can get an idea of what works.
PLEASE REMEMBER DIABETES IS NOT A DEATH SENTENCE…IT IS A LIFESTYLE…
Please following the superior advice that has been given to you by several of our members. You do not want to spend the first several months in a diabetic denial status because you will be causing your body much grief even if you feel “fine.” Please seek the services of a Diabetic clinic in your city. Try to develop a support team for yourself which would include an Endocrinologist (ENDO), Diabetic Educator, a Dietician and some friends/family for support. Most people are not very knowledgable about diabetes and will say things that are not true or just plain ignorant. Do yourself a favor and educate yourself on diabetes and all your meds. Read about your meds and side effects. there will be times when you will get depressed about having this condition. This is natural. You can post your feelings on this site. There will always be somebody here to lend support. Learn about your body and the foods it can tolerate. You have to manually do the body functions that your pancreas can not perform well any more.
No question is a dumb question on this website. We are all in a state of continuous learning here.
Thank you for your comments. I am curious, why do you wipe away the first drop of blood, I have not heard this before. I am currently barely getting enough blood to get a good reading sometimes.
Thanks
Nobody told me that either until a nurse in a lab saw me testing. The first drop of blood contains tissue from the puncture & you want a more “pure” sample.
When you can’t enough blood (happens to everyone), wash your hands in really warm water, dry & then shake your hands (down at your side) to get the blood flowing. Sometimes I have to prick a couple of fingers to get blood. There are settings on the lancing device for different depths.
Like Pauly said, make sure to follow up with your physician, and perhaps even get a referral for a diabetes educator. (Oh, and you only need one post, really… As they all show up on the main page… No need for three.