Diabetes diagnosis

[Soulcurry]

I had bloods done recently as I’ve been experiencing possible perimenopause symptoms of brain fog, anxiety and depression. All levels were normal but my hba1c came up as 53 mmol and vitamin B12 low at 177 ng/l.
I have no specific diabetes symptoms but have family history and was also gestational diabetic. I’m waiting for an appointment with my GP but want to know if I should expect a T2 diagnosis based on this or will I have to go through more tests for a formal diagnosis?

I would say that they'd diagnose you as diabetic with that. It depends on your surgery but my diagnosis came with a HbA1C of 63 - they gave me 3 months to try dietary changes/lose weight and in fact I stayed unmedicated for about 5 years but then my pancreas stopped playing ball and I went onto meds. I knew I'd be diabetic as my Dad was, and my gran.

I'm now on 10mg daily of dapagliflozin and my last HbA1C was 46 which they were happy with. I still follow a lower carb diet which helps and have lost nearly 5 stone in about 6 years.

They will normally take another HBA1C before diagnosing to allow you time to make lifestyle changes.

They need to repeat the HbA1c if you aren’t having any symptoms before making a diagnosis.

Just an update, GP diagnosed me with diabetes as I have family history and also had GD with my pregnancy. There was no advice given and spoke about Metformin. I’ve asked to give me 3 months to review my diet as I’m anxious about going on medication without trying dietary changes.

Both of these sites are very helpful OP in terms of diet advice.
https://lowcarbfreshwell.com/also has a phone app and it's free to use
https://www.lowcarbprogram.com/ it's a paid site but you can also buy the books - I got the starter program to get me going and it's incredibly good for carb swaps.https://shop.lowcarbprogram.com/collections/books
And this book is a must for any diabetic. https://www.amazon.co.uk/Carbs-Cals-Carb-Calorie-Counter/dp/1908261153 i've got a battered and well used copy in my handbag, it's so handy.

Please do try dietary changes, type 2 runs in my family and one sister did manage to stave it off till she hit about 60, the rest all had it by early fifties. My Mother was very careful and managed to never develop diabetes but it was a big effort on her part, she lived till 94. I have a blood test every year and I’m 60 this year last reading was very good. Beware alcohol and too many carbs and fruit.

Just wanted to say hi and that I’m in a similar position as of yesterday too. Had some routine bloods and my HBA1c came back at 48. Repeat blood test tomorrow.
I’m over-weight and have also discovered I have high blood pressure too.
Was all rather overwhelming.

Ask about the NHS pathway to remission programme. I did it 2yrs ago, am in remission and off all medication.

As someone mentioned above the freshwell website has lots of great info and advice.

Metformin gets a bit of a bad rap as it can sometimes cause gastric issues when first started (there are slow release versions if this occurs), but it’s actually a bit of a wonder drug. It has lots of other benefits besides glucose control. It’s gives cardiac and kidney protection to people with diabetes, seems to protect against certain types of cancer, and is currently being looked at as a drug that is somehow potentially “anti aging”. For something that’s one of the cheapest diabetes drugs around it’s pretty incredible really.

They are all sites that make money selking low carb diets.
Diabtetes.org is a legitimate advocate for diabetes.

My husband was diagnosed during Covid with a Hba1c of 60. He got it down to a normal (<42) reading within 12 weeks and has kept it there ever since with weight loss and a low carb diet. The Giancarlo Caldesi cookbooks are very useful and have information from Dr Unwin who spearheaded the campaign to get the NHS to at least offer support to get people into remission rather than just medicate them with no support.

The freshwell site is run by a gp surgery in Essex. It has a ton of free resources.

It is selling an app

Freshwell has some great resources. As PPs have said if you're not symptomatic they should repeat your bloods and if the second HbA1c is above 48 then you will receive a diagnosis of type 2 Diabetes. Lots of evidence says that aggressive management at the point of diagnosis leads to much better long term outcomes.
Path to remission I have seen some incredible results on, its a year long programme in total, starting with 12 weeks of total diet replacement with soups and shakes, around 800 calories a day. If you are offered medication Metformin is the first line, good point to note is that the NICE guidance has recently been updated to encourage modified release metformin as first line treatment rather than standard. Often people have fewer GI side effects with modified release. The new guidance also suggests adding in a second medication called an SGLT2i (such as dapagliflozin) fairly quickly once youre up to the maximum dose of Metformin. These have great heart and kidney protecting benefits so not a bad drug to be on.
With an HbA1c of 53 you're only just over the threshold, and some concerted effort on diet and lifestyle may well be enough to get you back down to below 48.
Its a lot to take in and think about, Diabetes UK have some really good resources too.

The app is free.

either way there is no research that low carb is any more effective than any other diet, it is just a quick fix at best.

https://www.diabetes.org.uk/for-professionals/supporting-your-patients/clinical-recommendations-for-professionals/low-carb-diets-for-people-with-diabetes

"But, there is no consistent evidence that a low carb diet is any more effective than other approaches in the long term. So it shouldn’t be seen as the diet for everyone"

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In disagreement here about charging in to low carb. I've been seen by a dietician who reminded me that the body is a system. Just treating the diabetes can lead to things like bowel cancer..

I'm in hospital and despite eating thinks like beetroot salad. A small cake etc they're really happy with my readings.
Exercise is the best thing to do.

Moderation is key. For instance if want chocolate get a mini bar.