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Friday, September 18, 2015

I Think I May Have Diabetes...

"I think I may have diabetes....and I don't want to die..."

The wording varies but I see this question with increasing frequency on all the forums I read. I have written replies to these posts so often I felt it was time to archive a standard response.

The web is a wonderful source of information but too often people who really should be asking questions like this of their doctor are asking strangers on the net. 

My usual answer is very brief and says exactly that: see your doctor. I highlighted that because it needs to be emphasised.

Unfortunately that isn't always immediately possible for everyone. There can be many reasons for that.  The most common excuses are lack of money, lack of availability of medical support or simply fear of hearing bad news. 

For those with an urgent need and obvious hypo or hyper symptoms or who have tested repeatedly high on a glucometer the suggestion changes from "see your doctor soon" to "get to an ER (emergency room) fast". 

For others unable to see their doctor soon I urge them to at least make the appointment. Do what is necessary to find the money or time or courage but not seeing the doctor can turn out to be much more expensive in the long term. 

Another variant has appeared recently. Some doctors appear hesitant to diagnose if A1c is OK but fasting or casual blood glucose are just over diagnostic thresholds even when the patient has some symptoms. Too many doctors appear to have forgotten that A1c was only recently approved as a diagnostic tool because the patient can be diabetic if other indicators are high despite a normal A1c. I see an increasing number of posts from people in those circumstances who were told they are “borderline” - whatever that means - or “you are not diabetic yet, just eat healthy and exercise and you'll be fine” without a meter or other advice being prescribed.

At this point I will remind readers: I am a diabetic, not a doctor, and only a doctor can diagnose diabetes.

What follows are suggestions for people whose situation is not urgent, who have a long wait to see their doctor or who have seen their doctor but are still unsure. 

Part 1. Discovery

Obtain a home blood glucose test meter and an adequate supply of test strips. How you do that will vary depending on your local health support system. In the US cheap meters and strips are available from several sources; Walmart's Relion Prime was one of the first cheap meters but you may find others if you search. Note that the cost of test strips will be more important than the cost of the meter in the long term. In Australia you will have to pay full price until you are officially diagnosed, but check with the chemist because there are often discount specials.

When you get your meter read this (click on it): Painless Pricks.
Test four times a day for two or three days: immediately on waking (fasting) and one hour after your last bite of breakfast, lunch and dinner. The results you are hoping for are as follows:
  • Fasting: 4 to 5.5 mmol/l (Australia, Canada, UK or other millimole countries) or 70 to 99 mg/dl (USA and other milligrams countries).
  • Post-meal: 4 to 8mmol/l or 70 to 140mg/dl.
If all your tests are inside those ranges, relax. Diabetes is most unlikely to be your problem. Don't throw your meter away because it may be wise to occasionally test in future years to see if anything has changed. In that case be aware that test strips have an expiry date.

If any of your results are outside those ranges immediately wash your hands and re-test. If, after re-testing, it is still out of range just record it the first time. If a second test at another time is out of range make an appointment with the doctor for qualified diagnostic testing. 

Part 2. Action.

If your tests were outside the ranges read this while you wait for your appointment with the doctor: Getting Started
For those unable to obtain a meter, this may help while waiting to see the doctor: What to Eat at First

Cheers, Alan, T2, Australia.

Everything in Moderation - Except Laughter 
There is nothing I could eat I like more than my eyes


Nicole.lascurain@healthline.com said...

Hi Alan,

First off, I came across your site and wanted to say thanks for providing a great diabetes resource to the community.

This hilarious list, 29 Things Only a Person with Diabetes Would Understand, has really resonated with our followers because it provides emotional support and understanding in a comical way, and I thought you might enjoy it as well: http://www.healthline.com/health/diabetes/would-understand

Naturally, I’d be delighted if you share this list on http://loraldiabetes.blogspot.com/ , and/or on social , especially because they could really relate. Either way, keep up the great work Alan!

All the best,

Nicole Lascurain • Assistant Marketing Manager
p: 415-281-3130 | e: nicole.lascurain@healthline.com

Healthline • The Power of Intelligent Health
660 Third Street, San Francisco, CA 94107
www.healthline.com | @Healthline | @HealthlineCorp

Healthline.com is a trusted health information resource for over 30 million people. All content undergoes a rigorous editorial process. Learn more about Healthline at: http://www.healthline.com/health/about-healthline

Nicole.lascurain@healthline.com said...
This comment has been removed by a blog administrator.
tomi said...

thank you so much for the article, I am very happy to get this kind of information.

JupiterEyed said...

I used Walmart's ReliOn Prime for a brief period in 2015 and found that not only did it give me inaccurately high readings, its repeatability was awful. I remember reading somewhere with a Consumer Report attached that Walmart had changed either their testing unit or the strips in recent years, and since then the accuracy and dependability have plummeted. And I wondered why 1. The supplies were so cheap compared to others, and 2. Walmart removed every other testing strip brand but theirs off their floor shelves to behind the counter. Maybe as I'm in the USA it could be different, but I just wanted to throw that out there. This is not a meter I would buy again even if I was strapped for cash.