[LarryR]

Hi,

I was just diagnosed a little over a week ago and am still in shock. I knew that I was somewhat at risk but no one in my family has had diabetes that I know of.

I went to my doctor because I had a cold that was hanging on with a cough that wouldn't quit. My Dr. sampled my urine and found that my BG was over 170. The blood test (finger stick) showed my BG to be 189. He then took a blood sample and the results showed that my BG was 199 and my A1C was 6.8%. I'm probably 40 to 50 pounds overweight so my Dr. gave me literature for a 1,500 calorie per day diet with sugar/carb restrictions. He did not prescribe any medication or testing supplies. He said we would repeat the blood test in about 4-5 weeks to see what my A1C is then. So, here I am trying to figure out just how bad things are. My Dr. mentioned that the A1C should be under 7% and that mine would most likely be much higher,

As far as my medical history goes, I have several chronic conditions. I had a heart attack 11 years ago when I was 42 and had a stent put in my RCA. I have regular blood tests that usually show my cholesterol is good but my triglycerides are usually on the high side. I had a angiogram several times since the heart attack that show my heart disease has not advanced over the last 10 years, I'm on Advicor and Tricor for cholesterol and several different blood pressure medications. My major problem over the last 10 years has been a chronic lumbar backache. I had surgery in 2006 and again just last July. They were both lumbar lamenectomies.

I have several questions regarding my type 2 diabetes; is it unusual that my A1C is only 6.8%? From what I've read I expected it to be much higher. Does this indicate anything? Also, is it unusual that my Dr. didn't prescribe anything outside of diet restrictions? Of course I have many other questions but right now I'm just trying to figure out what to do next. I'm still in a semi state of shock. Diabetes is the last thing that I thought would hit me.

I have a copy of "The First Year Type 2 Diabetes: An Essential Guide for the Newly Diagnosed" on the way but would like any suggestions for good web sites or other information that might guide me through what I should expect next.

It's always good to know that there are people out there in the same position as I am. Misery truly does like company.

Larry

[xMenace]

Welcome Larry,

Try out David Mendosa: A Writer About Diabetes


... and watch my first video below.

[fgummett]

Hi Larry and Welcome to DF! Visit often, ask questions and tell us more about yourself.

I do - as everyone her on DF does - understand your shock... but don't despair.. Diabetes can be controlled so long as you are willing to be proactive

I'm sorry to say that an A1c of 6.8% is not normal... normal for someone without Diabetes is around 5%. It just struck me that while our Doctors set much tighter standards for Blood Pressure and Lipids (cholesterol) when someone has Diabetes, at the same time they seem willing to accept much higher than normal BG levels

If I were you I would ask my doctor to treat the Diabetes more aggressively and not to adopt a "let's just wait and see how bad it gets" attitude which is all too common.

In the meantime get a meter and test your BG levels throughout the day (fasting, before and 2 hours after each meal or snack, before bed) keep a diary of your BG levels, what when and how much you ate, any physical activity, and how you felt. This is useful feedback for the Doctor but it is vital for you to start learning about your Diabetes and how different foods affect your BG levels.

Cut out - or at least down on - starchy or sweet foods such as bread, potatoes, pasta, rice, cereals, fruit juice

Learn to read nutrition labels.

Arm yourself with knowledge!

Here's another good website to learn about Diabetes: What is a Normal Blood Sugar?

[jakin]

a1c of 6.8 is not that bad. I suspect that if you lose the extra pounds with a proper diet and exercise, you will be just fine without meds. Try to avoid anything white such as white bread, white potatoes, white rice, etc. Good luck!

[fgummett]

Originally Posted by jakin

a1c of 6.8 is not that bad.

A1c of 6.8% is equivalent to an average (mean) blood glucose of 164.78 mg/dl (9.17 mmol/l)... considering that (as I understand) even the ADA recommends aiming for 140 mg/dl 2 hours after eating...

[LarryR]

Thanks so much for replying. A few questions; do I need a prescription to buy a meter, and, is there a general consensus on what the best meter is? As long as I need to carry it with me to work and such, I need something small. Is accuracy a big factor or are they all fairly accurate? I don't even know if my insurance will cover the machine and strips. Do I always need to get blood from a finger? I've seen meters that say they are "multi site," are they as accurate and what is the "alternate" site? I feel totally lost here! Any advice would really help. It's a good feeling knowing that there are people out there willing to share their advice.

Thanks again - Larry

[tealas]

Ask your doctor for a meter, or at least for a prescription for the strips. Tell him you would like to evaluate your post-meal readings so you can better adjust your diet. The strips are the expensive part, you can usually get the meter for free. I guess it will depend on your insurance coverage what the copay will be on the strips. Some insurance companies (like BCBSNC) will cover strips 100% if you purchase through their mail order providers.

I think for your purposes you could use one of the multi site meters (such as Freestyle Flash). That is the one I use. If you need very accurate readings (as for hypoglycemic reactions) then you need finger sticks. If you use your forearms (pretty painless) I find the readings are very similar to finger stick, and less painful.

[Handybear]

Here is a good place to start for those just diagnosed.

Diabetes 101 - What is Diabetes - Diabetes Overview

[fgummett]

Hey Larry, I assume you are in the USA? Your Doctor may have a "free sample" meter he can give you... here in Canada I have never bought a meter as they constantly have special offers where they include a "free" meter with the purchase of 100 test strips... the test strips can be around $1 each. For your insurance to cover the meter and strips you probably do need a prescription.
I'm really disappointed in your Doctor not getting you started on testing immediately... it is the only way to gain true control of your Diabetes. With a pre-existing heart condition I would want to maintain the very best BG control I could manage.
I've not had much success with alternate site testing...but that is just me. Finger testing is not so bad as you might think... use the sides of the finger tips rather than the pads which have much more nerve endings. Either your Doctor, a Nurse at his practise, or your Pharmacist should be able to teach you how to use the meter.
As for accuracy they are not 100% - some say they can be off as much as 20% - but there are many of us here - Type 1 and Type 2 - who are very successfully managing tight BG control with them. It does get easier

[KritterMom]

Hi there, and welcome! As you can tell already, you've come to the right place! There are so many awesome people here, and there is so much great advice to be soaked in. Glad you found us!

[Kanga]

Welcome to DF you have found the right place for both support and information.

[Caravaggio]

It is best to read as much as you could about diabetes, then discuss with your doctor what he thinks as well as what YOU think is the best plan for you at the moment.

I don't think it is unusual that your doctor did not prescribe meds or ask you to self-test, as there are T-2 diabetics who do not take meds and/or do not self-test, but deal with their diabetes only with diet and exercise. But, you must know the purpose of his prescription as you may not agree with his reasons.

In my case, when I first diagnosed last year, my doctor prescribed dietary changes (no flour, no added sugar), exercise and meds, in that order, with emphasis on diet and exercise. He did not immediately instruct me to test my blood sugar at home. We monitored my A1c closely, plus did blood tests at his clinic. Now, I self-monitor my blood sugar.

As my long-time GP, my doctor knows me well. I would have rebelled big time IF, on top of dealing with the diagnosis and all its emotional/psychological strains, the constant medication (I generally hate having to take any med), the regular testing at his clinic, I were to prick my fingers several times a day to check my BG, too. So, his plan was to deal with diabetes as aggressively as my patient profile will allow. My A1c, which was around 7.2% when I was diagnosed in September 2007, was 5.6% in September 2008 (and was no higher than 6% in between).

He would not have prescribed meds if he thought I could handle it with diet and exercise alone. Now that I've enormously improved my eating habits and having accepted my diabetes, I was ready to self-monitor my BG to better understand my BG's relationship with certain foods and with meds.

I would ask your doctor what his plan is and why he thinks you don't need meds or self-testing at this time. Then, if you are not happy with his philosophy, either let him know so you can work on something better or find a new doctor.

[genie86333]

Hi, Larry.

Welcome to the forum. Luckily, your initial numbers aren't that bad - they are above normal, but to put it in perspective, your 1st A1C was lower than mine was after 3 months of low-carbing it with 2 medications.

That's probably why your doc has a wait & see attitude. It is very possible your diabetes, for now, can be treated with diet/excercise. However, he should have recommended testing. The best thing you can do is learn how different foods affect you.

If you have insurance, let the doc know that you want to be proactive & see what your blood sugar levels are doing & ask him for a Rx for a meter. If you don't have insurance, go compare strip prices at your local pharmacy - you can get many meters for free/low cost because the strips are the expensive thing, but while some meters are $1 each, some are as low as 50 cents each, so look around for a low-cost meter that also has low cost strips. If you can find them (try Safeway or K-Mart if you have one nearby) I've found the cheapest is usually the TrueTrack Smart System. ($10 - $15 for the meter & $26 for 50 strips.)

[kgm0612]

Welcome to the forum, Larry. Glad to have you with us!

Karen