Bit despondent at diagnosis type 2

[Drakey]

Hi everyone, after peeing a lot more, losing a stone without trying and sometimes blurry vision I asked my GP for a blood test. Shocked my HB1c or whatever its called was 108! I am 67 year old who has had Rheumatoid Arthritis for over 20 years which is well controlled with a JAK inhibitor. Can't eat dairy cos it causes arthritis flares. So shocked to now have another chronic disease which I feel is my own fault through scoffing loads of carbs and a pringle addiction! Since diagnosis last Weds started eating 50-60g of carbs per day, a sort of low carb mediterranean way of eating with no bread, pasta grains etc. Just started 500 mg of metformin which increases to1000 after first week. Please, is this the right way to go as diabetic nurse gave me different advice, eatwell plate with bread etc. Feel bit scared and overwhelmed. I'm about a stone overweight all on my tum. Thanks everso for any advice.

 

[Windy]

Hi @Drakey welcome to the forum. Sorry to hear about your diagnosis and the shock it's caused you.
You're doing the right thing by cutting down on carbs, but could you phase it in for the first few weeks? I went from eating kitkats and crisps pre diagnosis onto a 800 calorie, low carb diet, and the transition was a bit harsh. You can get blurred vision as your blood sugar levels drop too quickly, so a slower start may be beneficial.
I'm trying to follow the low carb mediterranean diet too, and pretty much stopped bread etc. Some people continue eating it and other carbs (as per the eatwell plate), but I've got no self control with carbs, so it's cold carbs turkey for me! I'm with you on the Pringles btw. I'm like a badly behaved labrador when I used to buy them.
I was 5 stone overweight, so don't feel bad about your one stone!
The metformin may make your tummy bad (I mean, like rushing to the toilet frequently and having tummy pains bad). If this happens, you can ask your GP for slow release metformin, which isn't meant to be as explosive. I didn't have any problems with it myself, it seems to be a bit random who suffers with it and who doesn't.
But you're doing the right thing looking at your diet and reducing carbs.
Ask any questions you have, I'm sure the more knowledgable members of the forum will have the answers!
Best wishes, Sarah

 

[Drakey]

Hi @Drakey welcome to the forum. Sorry to hear about your diagnosis and the shock it's caused you.
You're doing the right thing by cutting down on carbs, but could you phase it in for the first few weeks? I went from eating kitkats and crisps pre diagnosis onto a 800 calorie, low carb diet, and the transition was a bit harsh. You can get blurred vision as your blood sugar levels drop too quickly, so a slower start may be beneficial.
I'm trying to follow the low carb mediterranean diet too, and pretty much stopped bread etc. Some people continue eating it and other carbs (as per the eatwell plate), but I've got no self control with carbs, so it's cold carbs turkey for me! I'm with you on the Pringles btw. I'm like a badly behaved labrador when I used to buy them.
I was 5 stone overweight, so don't feel bad about your one stone!
The metformin may make your tummy bad (I mean, like rushing to the toilet frequently and having tummy pains bad). If this happens, you can ask your GP for slow release metformin, which isn't meant to be as explosive. I didn't have any problems with it myself, it seems to be a bit random who suffers with it and who doesn't.
But you're doing the right thing looking at your diet and reducing carbs.
Ask any questions you have, I'm sure the more knowledgable members of the forum will have the answers!
Best wishes, Sarah

 

[Drakey]

Hi Sarah and thanks so much for your reply. Your tip on phasing low carb in is good as I do have blurry vision sometimes. Fright has made me go for it over last few days so eating 50 g of carbs daily so to phase it in just wondering how many to go up to? Made low carb lamb curry tonight with roasted cauliflower to replace rice it was yummy. Thanks again.

 

[Windy]

I'm not sure to be honest, less than 130g of carbs is considered low carb. There's some information on here about low carb diets, including some meal plans, but nothing about phasing it in. Hopefully someone else will be able to advise on that.
Curry and roasted cauliflower sounds delicious! Roasted brocolli is nice too, and kale crisps, though I tend to either undercook or burn mine, but that's more to do with my level of cooking skill.
I know it's all a bit daunting, but you should be able to get your HbA1c level down by diet and drugs. Mine was 80 at diagnosis in October, and I'm hoping it's reduced when I have my three month check up in February. I bought a blood sugar monitor (a gluco navii) as recommended by some of the forum members so I can track what my meals are doing to my sugar levels before and two hours after meals.
You can do this. Don't get overwhelmed by it, we've all got your back if you want support or have questions (though I definitely don't know all the answers)
Sarah

 

[Drakey]

Thanks Sarah, you sound like fun and your support and advice is much appreciated. Hope your BS continues to come down and your next blood test shows positive results. Thanks for helping me.

 

[Inka]

The blurry vision is caused by high sugar. The reason for not cutting carbs drastically too quickly is that occasionally a big drop in your blood sugar can cause eye damage (not blurriness). Better to cut your carbs gradually.

 

[Drakey]

The blurry vision is caused by high sugar. The reason for not cutting carbs drastically too quickly is that occasionally a big drop in your blood sugar can cause eye damage (not blurriness). Better to cut your carbs gradually.

Thanks Inka, I'm worried about my eyes so will up carbs and then reduce more gradually.

 

[rebrascora]

Hi and welcome.

There are a few things in your post which make me wonder if your Type 2 diagnosis is correct.
Did your symptoms of weeing and thirst come on quite suddenly?
Just to clarify, an HbA1c of 48 or more gets you a diabetes diagnosis. The Type of diabetes is often a bit of guess work taking into account a few clinical signs. Thinks like being overweight and a mature adult and having a bad diet and perhaps being inactive push the "likely" diagnosis more towards Type 2 whereas, being slim and young, particularly a child or young adult make it almost certainly Type 1 but many Type 1 diabetics develop the condition later in life. Unfortunately a lot of GPs don't have an indepth knowledge of diabetes and can be under the misapprehension that Type 1 diabetes ONLY exhibits in children and young adults, so if you are a mature adult, particularly if you are carrying a little bit of surplus weight and perhaps confess to a penchant for Pringles 🙄 they might easily assume you are Type 2.... It happened to me although I didn't confess to my Pringles habit, it was my sugar addiction which I mentioned. Just out of curiosity.... which flavour Pringles? My weakness was Sour Cream and Chive.

The two, maybe three things that make me think it is possible you could actually be Type 1 are the sudden unexplained weight loss and the fact that you have Rheumatism which I believe is an autoimmune condition as is Type 1 diabetes and autoimmune ailments are known to be "gregarious".... ie they like to meet up and have a party in the same body. The third thing is that your HbA1c is very high which can still happen with Type 2 but is more common with Type 1 at diagnosis as the insulin producing beta cells i the pancreas get killed off and reach a tipping point where they can no longer keep a lid on your BG levels anymore and levels shoot up. Most Type 2s who are newly diagnosed are able to produce large amounts of insulin but their body is resistant to it, so it is often a more gradual rise in BG and HbA1c.

 

[Inka]

Thanks Inka, I'm worried about my eyes so will up carbs and then reduce more gradually.

Work out roughly how many carbs a day you were having before diagnosis, then cut it by a third or a quarter initially, depending on your pre-diagnosis total.

 

[Inka]

It’s the monosodium glutamate in Pringles @rebrascora and @Drakey I don’t normally buy them but made the mistake of getting some for the children. As might be expected, most made their way into my mouth. I know all crisps have carbs and the salt is moreish too, but the MSG is the nuisance IMO.

I agree with @rebrascora that Type 1 should be ruled out.

 

[Windy]

@rebrascora If it's type 1, what would @Drakey need to do/say for the GP to have another look at it? I wonder what you had to do to get your diagnosis sorted?
PS Salt and vinegar are the premier Pringles flavour 😉

 

[Drakey]

Hi and welcome.

There are a few things in your post which make me wonder if your Type 2 diagnosis is correct.
Did your symptoms of weeing and thirst come on quite suddenly?
Just to clarify, an HbA1c of 48 or more gets you a diabetes diagnosis. The Type of diabetes is often a bit of guess work taking into account a few clinical signs. Thinks like being overweight and a mature adult and having a bad diet and perhaps being inactive push the "likely" diagnosis more towards Type 2 whereas, being slim and young, particularly a child or young adult make it almost certainly Type 1 but many Type 1 diabetics develop the condition later in life. Unfortunately a lot of GPs don't have an indepth knowledge of diabetes and can be under the misapprehension that Type 1 diabetes ONLY exhibits in children and young adults, so if you are a mature adult, particularly if you are carrying a little bit of surplus weight and perhaps confess to a penchant for Pringles 🙄 they might easily assume you are Type 2.... It happened to me although I didn't confess to my Pringles habit, it was my sugar addiction which I mentioned. Just out of curiosity.... which flavour Pringles? My weakness was Sour Cream and Chive.

The two, maybe three things that make me think it is possible you could actually be Type 1 are the sudden unexplained weight loss and the fact that you have Rheumatism which I believe is an autoimmune condition as is Type 1 diabetes and autoimmune ailments are known to be "gregarious".... ie they like to meet up and have a party in the same body. The third thing is that your HbA1c is very high which can still happen with Type 2 but is more common with Type 1 at diagnosis as the insulin producing beta cells i the pancreas get killed off and reach a tipping point where they can no longer keep a lid on your BG levels anymore and levels shoot up. Most Type 2s who are newly diagnosed are able to produce large amounts of insulin but their body is resistant to it, so it is often a more gradual rise in BG and HbA1c.

 

[Drakey]

Hi and thanks for your warm welcome and very comprehensive reply. Yes I too have heard if you have one auto immune disease you may well get another. I haven't seen a doctor, referred straight away to diabetic nurse who said I had type 2. I'll ask for a second opinion although not easy to access any doctors at my surgery. I'm speaking to my specialist rheumy nurse on the 20th for catch up so will get her take on what I should do. I just loved Texas BBQ Pringles but haven't eaten them since Oct when I realised I had a serious habit! My diabetes symptoms did come on suddenly and I lost a stone over last 3 months without trying, unheard of so I knew something was up. Thanks a lot for your input.

 

[Drakey]

It’s the monosodium glutamate in Pringles @rebrascora and @Drakey I don’t normally buy them but made the mistake of getting some for the children. As might be expected, most made their way into my mouth. I know all crisps have carbs and the salt is moreish too, but the MSG is the nuisance IMO.

I agree with @rebrascora that Type 1 should be ruled out.

Thanks Inca. I've had to step away from the Pringles not easy cos I live opposite a shop. Texas BBQ used to call to me!

 

[rebrascora]

@rebrascora If it's type 1, what would @Drakey need to do/say for the GP to have another look at it? I wonder what you had to do to get your diagnosis sorted?
PS Salt and vinegar are the premier Pringles flavour 😉

I went progressively lower carb over a period of 5 weeks (totally determined to push it into remission, until there really wasn't much else I could cut out. I was on max dose of Metformin and a high dose of Gliclazide and my BG readings just dropped under 10 for the first time. I was in regular contact with my nurse at the practice and she was in contact with the consultant and they were having case conferences about my progress or lack of it during that time, as there was a question mark in their mind I think that I might not be a straightforward Type 2. I had a second HbA1c test after 5 weeks which actually showed an increase instead of a decrease and I was started on insulin the week after and referred to the consultant's clinic. He then sanctioned the tests (C-peptide and GAD antibody) which are used to indicate Type 1 diabetes. These tests are not routine tests that a GP could necessarily request as there are logistical considerations re special handling and transport of one of the samples so best taken at a major hospital which have the necessary facilities and are familiar with the process. Also the results can be difficult to interpret, so ideally you would want a consultant with some experience to be making an assessment of the results. Therefore it might be worth asking the GP or nurse at the surgery why they think you are Type 2 and if it is possible you might be a slow onset Type 1 like LADA (Latent Autoimmune Diabetes in Adults) as this would explain your sudden and unexplained weight loss of a stone prior to diagnosis and your very high HbA1c. They will likely ask you to continue with the Type 2 medication and gentle dietary changes and keep a food diary alongside Blood Glucose readings so that they can see what is going on. I was supplied with a BG meter as I was prescribed Gliclazide which can cause hypos, but they are not prohibitively expensive to self fund if they won't give you one... (Approx £15 for a basic meter kit .... Gluco Navii or Spirit Healthcare Tee2 and approx. £8-10 for additional pots of 50test strips). This will help to educate you on which foods cause you the most BG upheaval as well as providing info to your Health Care Professionals. Hopefully a second HbA1c will be done sooner rather than later to assess progress and shine more light on the situation but unfortunately some people take years to get the correct diagnosis, I was lucks and it just took a few months, but i had open minded staff supporting me. It can be a lottery as to how it goes.

I think it is worth planting that seed of a possibility with them but playing along with their treatment plan and seeing how that goes, but keep it in mind that you might have to push more firmly for more testing at some point in the future and asking for a referral to a specialist diabetes clinic/consultant would be the best way to get the testing done and the results interpreted.

 

[rebrascora]

PS. Can't believe you guys are so misguided! 😳 How can the Cream cheese and chive not be your favourite flavour! (shrugs and walks away shaking head emoji 😎 )

 

[Drakey]

I went progressively lower carb over a period of 5 weeks (totally determined to push it into remission, until there really wasn't much else I could cut out. I was on max dose of Metformin and a high dose of Gliclazide and my BG readings just dropped under 10 for the first time. I was in regular contact with my nurse at the practice and she was in contact with the consultant and they were having case conferences about my progress or lack of it during that time, as there was a question mark in their mind I think that I might not be a straightforward Type 2. I had a second HbA1c test after 5 weeks which actually showed an increase instead of a decrease and I was started on insulin the week after and referred to the consultant's clinic. He then sanctioned the tests (C-peptide and GAD antibody) which are used to indicate Type 1 diabetes. These tests are not routine tests that a GP could necessarily request as there are logistical considerations re special handling and transport of one of the samples so best taken at a major hospital which have the necessary facilities and are familiar with the process. Also the results can be difficult to interpret, so ideally you would want a consultant with some experience to be making an assessment of the results. Therefore it might be worth asking the GP or nurse at the surgery why they think you are Type 2 and if it is possible you might be a slow onset Type 1 like LADA (Latent Autoimmune Diabetes in Adults) as this would explain your sudden and unexplained weight loss of a stone prior to diagnosis and your very high HbA1c. They will likely ask you to continue with the Type 2 medication and gentle dietary changes and keep a food diary alongside Blood Glucose readings so that they can see what is going on. I was supplied with a BG meter as I was prescribed Gliclazide which can cause hypos, but they are not prohibitively expensive to self fund if they won't give you one... (Approx £15 for a basic meter kit .... Gluco Navii or Spirit Healthcare Tee2 and approx. £8-10 for additional pots of 50test strips). This will help to educate you on which foods cause you the most BG upheaval as well as providing info to your Health Care Professionals. Hopefully a second HbA1c will be done sooner rather than later to assess progress and shine more light on the situation but unfortunately some people take years to get the correct diagnosis, I was lucks and it just took a few months, but i had open minded staff supporting me. It can be a lottery as to how it goes.

I think it is worth planting that seed of a possibility with them but playing along with their treatment plan and seeing how that goes, but keep it in mind that you might have to push more firmly for more testing at some point in the future and asking for a referral to a specialist diabetes clinic/consultant would be the best way to get the testing done and the results interpreted.

Thanks yes will definitely plant the seed I may be type 1 with the diabetic nurse by asking a few questions but think you're right initially will have to go with their diagnosis. I really appreciate yours and everyone's help.

 

[Inka]

To be fair @rebrascora i like them all Oh, except the barbecue one. I bought an Extreme one that I didn’t like much, but ended up stuffing them in my face anyway 🙄 MSG, I tell you. Addictive.

As (another) aside, I just googled the JAK mentioned and saw they’d experimented with using it as a kind of treatment for diabetes. Well, for diabetic mice, at least.

 

[rebrascora]

I wondered what the JAK was and could it possibly be triggering high BG levels.