Guess I’m t2

[Ceeque]

DSN rang and said most of my antibody tests came back neg she’s still waiting on zinc - she wants to get me in to begin Ozempic and start reducing my insulin, starting with Novorapid.

Is this normal? I’ve had one ‘controlled’ day and I’ve been counting carbs beyond belief. Cut out every thing she’s told me and my HBA1c is still 86.7 (as opposed to 57 on 10 May.)

Meh, not sure how to feel really!

 

[Drummer]

The advice some people get about what not to eat can raise eyebrows for type 2s - if an ordinary plain uncomplicated type 2 cuts back on carbs of all types and colours then the glucose in the blood should reduce too.
As you have been prescribed insulin and then told to reduce it, it is a more complex juggling act and should be done with caution - but it looks as though the intention is for you to stop using insulin completely.
I need only to eat low carb which is fairly simple as I simply exclude high carb foods and go with what I know I can cope with - it is very simple to do and sustainable year on year.
Yesterdays dinner was roast chicken, Yorkshire pudding, swede and mixed veges then coffee with cream. It is almost noon and I don't feel hungry so I will probably only have one meal today. Not needing medication means that I am free to eat, or not just as the whim takes me.

 

[Ceeque]

The advice some people get about what not to eat can raise eyebrows for type 2s - if an ordinary plain uncomplicated type 2 cuts back on carbs of all types and colours then the glucose in the blood should reduce too.
As you have been prescribed insulin and then told to reduce it, it is a more complex juggling act and should be done with caution - but it looks as though the intention is for you to stop using insulin completely.
I need only to eat low carb which is fairly simple as I simply exclude high carb foods and go with what I know I can cope with - it is very simple to do and sustainable year on year.
Yesterdays dinner was roast chicken, Yorkshire pudding, swede and mixed veges then coffee with cream. It is almost noon and I don't feel hungry so I will probably only have one meal today. Not needing medication means that I am free to eat, or not just as the whim takes me.

Thanks for your reply,

I was following a near-keto diet before I was diagnosed with diabetes and had managed to lose 10kg. The extra things I’ve been told to cut out are zero sugar drinks with flavourings and the one zero sugar drink of monster I have a day.

My point is, I was already doing all of the low carb things, and still my blood sugars ended up in their 20s then I was told I have to eat carbs until I find out whether I’m type one or type two.

Now she’s ‘pretty confident’ I’m T2 so I’m going backwards again. Which is fine, just, I was already extremely carb conscious, and still my blood sugars struggled to remain under control until novo rapid was introduced.

 

[Drummer]

Ah - you seem to be something more interesting then.
I started off with a Hba1c of 91 and was down to 47 at the first retest then at the top end of normal eating 50 gm of carbs a day, but I didn't have anyone giving me advice, and I threw away the tablets (I was so very ill). For me it was very simple.
There are more choices than 1 or 2 on top of personal idiosyncrasies - I used my blood glucose tester to check before and after eating and realised that I am far more intolerant of carbs in the morning than the evening, so I usually eat no more than 10 gm at breakfast and then the rest in the evening.
I have read that some people do react somewhat to sugar free drinks - but it seems rather like clutching at straws.

Ozempic is semaglutide - and there can be problems with that - and unwanted consequences, so I hope that you can find a way to manage blood glucose.

 

[Ceeque]

Ah - you seem to be something more interesting then.
I started off with a Hba1c of 91 and was down to 47 at the first retest then at the top end of normal eating 50 gm of carbs a day, but I didn't have anyone giving me advice, and I threw away the tablets (I was so very ill). For me it was very simple.
There are more choices than 1 or 2 on top of personal idiosyncrasies - I used my blood glucose tester to check before and after eating and realised that I am far more intolerant of carbs in the morning than the evening, so I usually eat no more than 10 gm at breakfast and then the rest in the evening.
I have read that some people do react somewhat to sugar free drinks - but it seems rather like clutching at straws.

Ozempic is semaglutide - and there can be problems with that - and unwanted consequences, so I hope that you can find a way to manage blood glucose.

Thank you,

I was just so certain I had been doing all I could in the months prior to diagnosis, that for my blood sugars to be raised, and again further raised what else can I do? I’ve jumped through all the hoops and my next attempt Is to cut all food completely and do a meal replacement diet, because I’m just so done. I feel like I have the body of an eighty year old.

I’m going to try and kerb it the best way I can, but I really feel like my already (successful weight loss and diet attempts) have just counted towards nothing. Extremely disheartening.

 

[Drummer]

Thank you,

I was just so certain I had been doing all I could in the months prior to diagnosis, that for my blood sugars to be raised, and again further raised what else can I do? I’ve jumped through all the hoops and my next attempt Is to cut all food completely and do a meal replacement diet, because I’m just so done. I feel like I have the body of an eighty year old.

I’m going to try and kerb it the best way I can, but I really feel like my already (successful weight loss and diet attempts) have just counted towards nothing. Extremely disheartening.

Weightloss is often quoted as a way to get out of type 2 - but it is often a symptom rather than a cause.
It often takes the attention away from doing anything but blaming the problem on the weight rather than setting the wheels turning to find out the real problem.
I was very muscular when I worked as a roadie and was told that my weight was a problem even though I had a 24 inch waist - then I was told to eat low fat and high carb, felt really unwell - which was blamed on my weight and even greater efforts were required on my part, to get my weight down - up to the point I collapsed from lack of nourishment.

 

[Bruce Stephens]

I’m going to try and kerb it the best way I can, but I really feel like my already (successful weight loss and diet attempts) have just counted towards nothing. Extremely disheartening.

Some people who are Type 2 are nevertheless dependent on insulin. Some people who don't produce insulin (or don't produce nearly enough) don't have the antibodies that you've been tested for (I think normally that's because of pancreatitis (so there are obvious signs) but I'd be surprised if there weren't other causes).

 

[Ceeque]

Weightloss is often quoted as a way to get out of type 2 - but it is often a symptom rather than a cause.
It often takes the attention away from doing anything but blaming the problem on the weight rather than setting the wheels turning to find out the real problem.
I was very muscular when I worked as a roadie and was told that my weight was a problem even though I had a 24 inch waist - then I was told to eat low fat and high carb, felt really unwell - which was blamed on my weight and even greater efforts were required on my part, to get my weight down - up to the point I collapsed from lack of nourishment.

Well exactly,

I was worried about the whole T2 thing because the whole stigma attached and how differently some people with T2 get treated than people with T1.
And it would have been much easier on my emotional well-being if they’d have said it’s type one rather than type two but such is life! lol.

 

[Ceeque]

Some people who are Type 2 are nevertheless dependent on insulin. Some people who don't produce insulin (or don't produce nearly enough) don't have the antibodies that you've been tested for (I think normally that's because of pancreatitis (so there are obvious signs) but I'd be surprised if there weren't other causes).

Thank you, think I’m just feeling rotten about it to be honest, I did read that you don’t always have to have the antibodies to be T1 I guess the proof will be in the pudding re: seeing how it goes with the reduction of insulin. I just am worried that they’re gonna climb rapidly like they already were doing now that she’s reducing the insulin.

 

[Benny G]

Hello @Ceeque if your glucose levels go back up on your new regime, push your medical team for a C-peptide test, this will show the amount of insulin your pancreas is making. If the C-peptide result is too low they will put you straight back on insulin.
Antibodies, pancreatitis, insulin resistance, hormone imbalance; there are several possibilities for why your glucose levels are going high, so it is a case of trying different options and ticking off boxes until you find what works.

 

[Ceeque]

Hello @Ceeque if your glucose levels go back up on your new regime, push your medical team for a C-peptide test, this will show the amount of insulin your pancreas is making. If the C-peptide result is too low they will put you straight back on insulin.
Antibodies, pancreatitis, insulin resistance, hormone imbalance; there are several possibilities for why your glucose levels are going high, so it is a case of trying different options and ticking off boxes until you find what works.

I only really noticed difference in my blood sugars when Novorapid was introduced lantus and metformin weren’t doing the job and then when I began Novorapid, I had one day (wednesday) that was a full green day, other than that I’m usually above 10mmol

 

[everydayupsanddowns]

Sorry to hear the results you’ve had back haven’t brought the clarity you were hoping for @Ceeque

Antibody tests are rarely conclusive in and of themselves, diagnosis is still best done on clinical indicators.

As @Benny G says, getting a cPeptide result might throw some light on things.

Sorry you are having to jump through all these hoops. Were they aware that you were eating a very low carb diet as part of your blood glucose management strategies?

 

[Rae]

I only really noticed difference in my blood sugars when Novorapid was introduced lantus and metformin weren’t doing the job and then when I began Novorapid, I had one day (wednesday) that was a full green day, other than that I’m usually above 10mmol

It seems really peculiar to take someone off insulin who seems to need it. This is one of my big worries too, that now the antibody test is negative they will stop doing what is indicated and start doing what is believed to be 'normal' for t2.

The mod comment that antibody tests are not conclusive is really interesting, as my consultant was very clear that no antibodies = t2, despite the DKA and lack of response to medication other than insulin.

My fingers crossed for you, and if something doesn't feel right - don't give up. You deserve the right treatment for YOU.

 

[Ceeque]

Sorry to hear the results you’ve had back haven’t brought the clarity you were hoping for @Ceeque

Antibody tests are rarely conclusive in and of themselves, diagnosis is still best done on clinical indicators.

As @Benny G says, getting a cPeptide result might throw some light on things.

Sorry you are having to jump through all these hoops. Were they aware that you were eating a very low carb diet as part of your blood glucose management strategies?

Yup,

I told them, I’m eating around 150-180g carbs max over 3 meals a day. I avoid the big carby things like bread potatoes and rice and cereals.

She just doesn’t seem to be interested. One of the days my blood sugars spiked to 17.5 and she asked ‘what had you eaten different?’ Nothing.. and her response was ‘well something must have happened’

This is how we aren’t going to actively manage to achieve anything if we get all blamey. ESP when I’m telling her nothing new had happened!

 

[Ceeque]

It seems really peculiar to take someone off insulin who seems to need it. This is one of my big worries too, that now the antibody test is negative they will stop doing what is indicated and start doing what is believed to be 'normal' for t2.

The mod comment that antibody tests are not conclusive is really interesting, as my consultant was very clear that no antibodies = t2, despite the DKA and lack of response to medication other than insulin.

My fingers crossed for you, and if something doesn't feel right - don't give up. You deserve the right treatment for YOU.

Yeah, I find it interesting but if I argued the toss with her I know she wouldn’t be best pleased with me. I can’t see how we will move forward without me getting to the point of way too scared to eat/drink anything especially considering I’ve been low carb before I was diagnosed. I have really good insight but sometimes I just can’t manage to keep it low even with the most strict diet.

 

[Ceeque]

It seems really peculiar to take someone off insulin who seems to need it. This is one of my big worries too, that now the antibody test is negative they will stop doing what is indicated and start doing what is believed to be 'normal' for t2.

The mod comment that antibody tests are not conclusive is really interesting, as my consultant was very clear that no antibodies = t2, despite the DKA and lack of response to medication other than insulin.

My fingers crossed for you, and if something doesn't feel right - don't give up. You deserve the right treatment for YOU.

Are you also in the same boat? Be great to stay in touch so we can moan about our bodies! Haha

 

[Rae]

Are you also in the same boat? Be great to stay in touch so we can moan about our bodies! Haha

Seems that way!

I can definitely offer an ear (or eye?) to moan and vent to!

 

[Drummer]

Your nurse sounds very unhelpful - and seems to lack any understanding of the reason for testing - it is because some days we will react one way, and on another, eating the same things, totally different.
It is why no one just injects the same amount of insulins and eats the same amount of carbs to achieve perfect control - it just doesn't work like that.
I should point out that you are eating about 4 times more carbs in a day than I do to keep to normal levels - there are a fair number of type 2s eating around 50 gm of carbs or less in order to achieve remission without medication.
It is why I just ate chicken and strawberries for dinner, with a mug of coffee with cream.
This might seem to be bad news - but I find it really easy, far easier than trying to eat more carbs and keep track of them.

 

[Ceeque]

Thank you, took the plunge to follow an exante diet, (shakes and VLCD) they were planning to put me one if I were t2 so I thought I’d be proactive. Still not seeing fab numbers though and less than 60g carbs a day now.

 

[Ceeque]

Seems that way!

I can definitely offer an ear (or eye?) to moan and vent to!

That sounds good to me!