Could this be diabetes?

[Frank303]

I had to go into emergency last weekend as I phoned up NHS24 for advice on a painful groin as i was sent home from work two days in a row and doubled up in pain. Non-hemlysed trace of blood in urine a week before at onset. The nurse answering the call asked if i had diabetes and had I been tested. The first question the Dr asked was had I diabetes so I'm guessing they might be trying to tell me something. The ER doc said it was a urinary tract infection.  Rxed Trimethoprim and said to see my own GP.

Also the GU/STD Doctor said it's nothing to do with HIV/STIs and didn't disagree I should get checked for Diabetes. ( I haven't had sex since Dec[ poor me] and been checked HIV 22wks, HCV 28wks, TP 14wks, HBV 14 wks, basically everything else out their respective window periods after) ,

Symptoms
Pain behind my knees since January
Itching all over body in February and various outbreaks since.
Muscle crawling in left leg in Feb for a week then persistent pins and needles on both feet and hands.
Burning sensation in my eyes particularly the left since April. Opthalmologist saw nothing out of sorts and said I;d 6/6 vision.
Burning at the back of my head at top of neck, centre.
I've had quite a lot of fatigue at work the last 6 mths or so
It just dawned on me last week that since eyes, circulation and urinary tract are involved I might be pre/diabetic diabetic.

I've been trying to watch my sugar intake.
The last few weeks I've been using artificial sweeteners in my beverages and I have noticed a marked reduction in eye pain. I've also only been on short working time the last few weeks too a day or two here or there so more relaxed.

Risk factors:
smoker, heavy social drinker, bit of extra weight round waist, varicose veins, active job, sedentary leisure time.
No diabetes in the family , though father had a kidney removed 30 yrs ago due to a stone.

Any thoughts?

How do I get tested? Appointment 29th, need to know what to do to prepare [e.g urine sample, 24hr collection,stool sample] if my Doc thinks I may need to be evaluated for DM so I don't have to make too may appointments.

[WaveRider]

They're asking if your a diabetic to insure there are no contradictions on medications if they were to prescribe any for your groin issue. Its should be seen as the same as "are you allergic to any medication?".
Go here for an explanation of the different diabetes tests. http://tinyurl.com/2wv9lj
Your doctor and/or his office staff should explain what you should do to prepare for testing.

[Frank303]

The nurse on the telephone is obvously not subscribing so I would disagree with you that she was looking for contraindications.
At the 24hr GP it was at the start of the discussion i.e. his diagnostic questioning..
In discussion with the GUM clinic Doctor prescribing wasn't an issue.  

Thanks for the link.

[Frank303]

Prescribing I meant, not subscribing.

[CoWriter]

According to the American Diabetes Association, a diagnosis of diabetes is made by having a fasting blood sugar >126 on two separate occassions.  

[Frank303]

D'Oh, maybe more appointments then. So I should maybe fast for my appt tomorrow 5pm?

Thanks

[Frank303]

My Dr said I don't have diabetes. He ran a multistix test all bands OK.
He's not following up with blood work for DM,
He is though gointg to run kidney, liver and endocrine tests as I have had cloudy urine,  prostatis/UTI and a lot of symptoms the last 6m.

[CoWriter]

Remind your doctor that the ONLY way to see if you have diabetes is by doing a FASTING BLOOD SUGAR.

A urine dipstick checks to see whether there's sugar, protein, and ketones in your urine.  

You don't usually spill sugar and ketones in your urine unless your blood sugar is very high.  In other words, you can be a diabetic without having any of those things in your urine.  

In all honesty, I have to wonder how current a doctor's knowledge of diabetes is when he tries to rule out diabetes with a urine dipstick.  

If you're having all those urinary type problems, perhaps it would be a good idea to see a urologist.

Good luck to you.

[Rachel_R]

Keep in mind fasting glucose test measures your glucose only at the time of your test. It is not the only way to see if you have diabetes. Here's why; excess glucose attaches to the walls of new red blood cells. Red blood cells live on average of 3 months before they die off and get turned in bile by your liver. This is where an HgbA1c (A1c) test comes in. It is the test the majority of doctors use to determine whether one is diabetic or not. A good reference source is here http://tinyurl.com/6cv36x

[Frank303]

I suspected he wanted me out his office.

I'm not even sure eye problems + neuropathy in the periphery + UTIs + recurrent fungal rashes + pain in the back of knees are even suggestive of DM, though Diabetics I know have these problems.

I'm getting a bit frustrated being sent back and fore between GenitoUrinary Medicine clinic and my own GP. I think they think I'm pulling these symptoms (and signs if some of the Docs would bother looking) out of a book. At least they got the blood on record -

I think there's a pharmacist in town that does DM testing

[CoWriter]

Below is a quote from the American Diabetes Association on the tests used to diagnose diabetes.  As you can see, they don't mention using the HgA1c test to diagnose diabetes.   You know why?  Because that test measures the AVERAGE blood sugar over the last three months....so if some days your blood sugar is very high.....and other days your blood sugar is very low....it will average to a good result.  

Also, if the person is ANEMIC, that means they have less hemoglobin....and that can cause the results of the Hemoglobin A1C to be low.

A HgA1c is used to monitor if your diabetes is under good control, but NOT to diagnose diabetes.



"In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes."

http://www.diabetes.org/about-diabetes.jsp

[Frank303]

Thanks.
My ferritin levels were fine in my CBC a few months ago, though I've had anaemia in the past
If the Dr wants to run a FPG test the blood could be stored overnight could it? The Phlebotomist is only in mornings so they can get blood away to the labs by courier at lunchtime. Getting up early to fast isn't my thing.

[CoWriter]

You have to be fasting from midnight until the blood test is done.  

The sample can be spun and then refrigerated.

[Frank303]

Thanks.