I was diagnosed type 2 in April and put onto Metformin and told to have blood test done 12 weeks later, this was lost and had to have it redone 26th July. Rang up for results to be told normal? I am confused as what is normal? does it mean in remission? i have not been told to monitor levels at all.
What do others do on a daily basis to monitor blood sugar levels.
I'm sorry to hear you had some trouble with your results being lost, I'm sure that was very frustrating.
"Normal" levels
Unfortunately what you have been told is a little ambiguous, so you may be best contacting your practice to try and book a follow up appointment with a member of your healthcare team to discuss your results, or at least for them to provide you with the specific result.
In general, I would assume "normal" means that your HbA1c, a marker of blood glucose control, is within what is considered a normal range (between 20 and 41 mmol/mol). However, they could also mean it is below the cut-point used to classify diabetes (48 mmol/mol), or even that it is "normal" for what they expect from someone with type 2 diabetes (in which case it could still be above 48 mmol/mol). I am sorry I cannot be more helpful.
Remission
Type 2 diabetes is only usually considered to be in remission if HbA1c is in a normal range AND no medication is being taken to help lower blood glucose levels. So in this case, if your HbA1c is in a normal range, you would only be classed as being in true remission if you were able to maintain this without the need for Metformin. If remission is something you want to achieve you can discuss this with your healthcare team. One option could then be to have a trial period where you stop taking your Metformin, to see if any lifestyle changes you have made are sufficient to keep your blood glucose levels below the range used to define diabetes. You should however continue to take your medication as prescribed until this has been discussed and agreed with your care team.
If you have an X-PERT Diabetes Handbook, there is a page on diabetes remission (page 7 in version 14, or page 8 in version 15).
Monitoring blood glucose
With regards to tracking your own blood glucose levels, people with type 2 diabetes are only routinely given equipment for this if they are taking medication which increases their risk of hypoglycaemia (i.e., "hypos", or low blood glucose). Metformin does not carry this risk. In some cases practices are able to loan patients blood glucose testing equipment short-term to help them experiment with how different foods and/or activities affect their blood glucose levels. Monitors can also be purchased, but this can become expensive when the cost of testing strips is factored in. Continuous glucose monitors are now also available, but these are again not routinely provided to people with type 2 diabetes through the NHS and can be expensive to purchase and use.
There is a page on self-monitoring blood glucose levels in the X-PERT Diabetes Handbook (page 17 in version 14, or page 19 in version 15).
Where blood glucose testing equipment is not available other factors can be useful to help you make informed choices. These don't always provide as specific feedback, or provide information as quickly, but can be helpful nevertheless. This might include factors such as body weight, waist size, energy levels, hunger, and mood.
I hope that answers your questions, but please let me know if you want/need any more information.
Best wishes,
Sean (Science and Research Lead at X-PERT Health).
