Hi all I am new to this I have just been told that my bloods were at 19 and that I need to go on insulin by the Diabetic nurse to which I refused as I

[Deleted member 27171]

Hi @DIAMONDH

Welcome to the forum.

Anyone with diabetes could get a reading of 19, it is not the number which determines whether you have Type 1 or Type 2 diabetes.

Did you have the diagnosis of diabetes prior to getting Covid or did it only come after? It is unusual (but not unheard of) for someone with newly diagnosed Type 2 to go straight onto insulin, so if you had Type 2 already and your levels have increased since being unwell then it is understandable that insulin was suggested. Were you treated with steroids for Covid? That can make levels higher in someone who has diabetes and even bring about a temporary diabetes in those who don't have it, in which case the insulin treatment could be a temporary thing - did they mention that as a possibility?

If you have Type 1 diabetes and the medical team know it is Type 1 then they would not have agreed to you treating with anything other than insulin as that is the only way to treat Type 1. If they are unsure of what type you have then they may be more willing to try alternatives.

Why is it that you were so concerned about taking insulin to lower your bgl in particular?

 

[Becka]

someone just did

Then why are you still asking?

There are actually more than two types of diabetes, and the difference between all of them is the cause of high glucose levels, which matters because that determine how to treat it. That is why you cannot diagnose from the effect alone.

You could get a glucose test result of 19 mmol/L with any of them.

That said, the only treatment for type 1 is insulin, so if your nurse was willing to put you on a different medication if presumably means they think you are still producing insulin. And you seem to be responding to the medication.

However that still does not mean you are type 2, as it could be that your ability to produce insulin is dying out. So whilst you can get some short term benefit from medication, you will eventually need to take insulin.

You need to be asking your questions of the nurse, they are the only one who can answer as they will have your medical history. And they will not have simply checked your glucose levels then diagnosed anything from that alone. With a reading that high they would have certainly followed it up with an HbA1c level if one was not performed at the same time.

 

[leonS]

It would help a great deal if you were to include the units or what the test actually was or even better both. We assume the 19 is the result of a finger prick test and the result is in mmol/L.

If so this is high. But all that anyone can say for sure is that you are probably diabetic. If you are, and if you are fat and forty (or older as you are) then the changes are in favour of type 2.

NOTHING is CERTAIN and you must be guided by DRs

 

[ColinUK]

yes but if i have a score of 19 someone on here will know if that's type 1 or 2 surely

It’s impossible for anyone here to determine whether you’re T1, T2 or anything else without more details and we will never have the details. I’m sorry it’s not what you want but it is for your healthcare professional to determine which type you have anus that’s as a result of looking at your overall medical history, family history and blood test results.
It is quite possible for us to know that the readings you’ve shared are very high and to be concerned however.

 

[DIAMONDH]

How long after eating are you testing to determine this?

A finger prick test of 19 tells you nothing other than that your Blood Glucose level is too high and an HbA1c test needs to be done. An HbA1c result of 48 or more gets you a general diabetes diagnosis. If you are an overweight mature adult then it is assumed you are Type 2 but there is no specific test for Type 2. If there are other factors like sudden onset symptoms and/or not responding to oral Type 2 meds and a change of diet or if you have close relatives who are Type 1 then additional testing can be done to confirm or rule out Type 1, but that testing is more expensive and not routinely done unless there are factors which suggest you might be Type 1. Sadly many people are misdiagnosed as Type 2 when they are actually Type 1, mostly because doctors have been lead to believe that Type 1 only occurs in children and young people.
Just to be clear, needing to use insulin is not in itself an indication of Type 1 as many Type 2 diabetics also use insulin but for different reasons. Type 1 diabetics are unable to produce enough insulin to survive because their immune system has attacked the cells in the pancreas which make insulin. Type 2 diabetics are usually able to produce plenty of insulin but their bodies have become resistant to it, so they need to inject extra to get it to work properly.

I believe that the people who have been very ill with Covid-19 sustain damage to their organs due to the immune response to the virus, so I wonder if it can actually trigger Type 1 diabetes in someone with no genetic history of it.

Is there any particular reason why you refused to use insulin? I know I was resistant at first because I really wanted to control my diabetes through diet but unfortunately that was not possible much as I tried. Personally I think I would rather use insulin than Ozempic from some of the threads here on the forum about it, particularly if you don't need to lose a significant amount of weight, but I have no personal experience of it and as with anything you are always more likely to remember negative reviews. What is it about insulin use which concerns you?

Hi Barbara It was not a finger prick it was a fasting blood test I had . I did not want insulin as I think my levels are high as I have not been mobile for about three months due to covid so think that is why they are high also insulin gives you thrush if you drive you need to take your bloods every two hours also it makes you put weight on .

 

[DIAMONDH]

Then why are you still asking?

There are actually more than two types of diabetes, and the difference between all of them is the cause of high glucose levels, which matters because that determine how to treat it. That is why you cannot diagnose from the effect alone.

You could get a glucose test result of 19 mmol/L with any of them.

That said, the only treatment for type 1 is insulin, so if your nurse was willing to put you on a different medication if presumably means they think you are still producing insulin. And you seem to be responding to the medication.

However that still does not mean you are type 2, as it could be that your ability to produce insulin is dying out. So whilst you can get some short term benefit from medication, you will eventually need to take insulin.

You need to be asking your questions of the nurse, they are the only one who can answer as they will have your medical history. And they will not have simply checked your glucose levels then diagnosed anything from that alone. With a reading that high they would have certainly followed it up with an HbA1c level if one was not performed at the same time.

I am not still asking those responses were from my origional question . I have been doing the finger prick without medication and my numbers are coming down with watching my diet and no carbs so think i was right to reject the insulin she suggested .

 

[DIAMONDH]

Hi @DIAMONDH

Welcome to the forum.

Anyone with diabetes could get a reading of 19, it is not the number which determines whether you have Type 1 or Type 2 diabetes.

Did you have the diagnosis of diabetes prior to getting Covid or did it only come after? It is unusual (but not unheard of) for someone with newly diagnosed Type 2 to go straight onto insulin, so if you had Type 2 already and your levels have increased since being unwell then it is understandable that insulin was suggested. Were you treated with steroids for Covid? That can make levels higher in someone who has diabetes and even bring about a temporary diabetes in those who don't have it, in which case the insulin treatment could be a temporary thing - did they mention that as a possibility?

If you have Type 1 diabetes and the medical team know it is Type 1 then they would not have agreed to you treating with anything other than insulin as that is the only way to treat Type 1. If they are unsure of what type you have then they may be more willing to try alternatives.

Why is it that you were so concerned about taking insulin to lower your bgl in particular?

I had type 2 about a year ago was just over borderline went on trulicity for 3 months my diabetes went so came off it I was diagnosed recently with no vitamin D in my body when i was in hospital for covid my doctor seems to think my bloods were at 19 because of the stress of the illness the nurse said that was not true she took a finger prick there and ten and it was 16.7 that was last tuesday I have not started the meds she prescribed yet I have been watching what I eat and no carbs and my average bloods are 12.1 so I don't think I need insulin .

 

[Inka]

Thanks for explaining more @DIAMONDH I think there have been reports about Covid causing high blood sugar so perhaps that’s not helping.

You’re within your rights to refuse insulin, but just one thing - it doesn’t give you thrush. High blood sugar can cause thrush not insulin.

If you were diagnosed Type 2 a while ago, it’s possible your recent illness has messed up your blood sugars. As I’m sure you know, 12 is still too high. I guess you’re going to monitor things over the next few days and see how it goes?

Do you have a follow-up appointment?

 

[Ralph-YK]

There's no need to repeat responses in separate posts. We can all see every post, so see it repeated. A thread is eaiser to follow if you post them just the once.

I had type 2 about a year ago

Then you are type 2.

went on trulicity for 3 months my diabetes went

I take it you mean your BG went down. You're still counted as diabetic. And probably big reason why you're so high now, regardless of C19.

average bloods are 12.1 so I don't think I need insulin .

That's still too high. And being an average means your going higher than that. It's not just the average, it's the highs that matter too. I'm personally not comfortable saying a T2 *must* take insulin. I'd advice you to really consider it though.

I'm getting the impression you want someone to tell you you're not diabetic. Nor need treatment. I'd go the other way and say you are diabetic and that *is* why your levels are High. And suspected insulin would be of help (at least in the short term).
Now, as The Patient, you get to refuse treatment. Whether or not you have the condition. You can accept you're T2, and say no to insulin.

 

[Becka]

I have been doing the finger prick without medication and my numbers are coming down with watching my diet and no carbs so think i was right to reject the insulin she suggested .

If it continues to fall then you may be correct that you can manage without insulin. But if you are only able to achieve fasting readings of 12 – 14 mmol/L (backed up by a HbA1c reading) then insulin is the required treatment for a type 2 diabetes.

The general target for those with type 2 diabetes without significant comorbidities who are taking medications like Trulicity or Ozempic is an HbA1c level of 7% / 53 mmol/mol. The fasting levels your are citing are equivalent to 9 – 10.5% / 75 – 91 mmol/mol. Notwithstanding that actual targets are individual to patients, and that glucose readings cannot be used in place of an HbA1c, that is a clear difference.

So no, nothing you have said so far suggests you were right to reject insulin. Your levels are still far too high, so at this stage it cannot be determined either way. And if you are not taking the prescribed medication you really should be. The normal fasting glucose range is 4 – 7 mmol/L and the readings you are seemingly happy with are double to triple where they should be.

But no one can force you to take insulin or any medication. Nor can you be forced to take any action with your diabetes. But you will have to accept the damage it can do to your body and the effect it will have on your life if you reject such advice.

 

[DIAMONDH]

If it continues to fall then you may be correct that you can manage without insulin. But if you are only able to achieve fasting readings of 12 – 14 mmol/L (backed up by a HbA1c reading) then insulin is the required treatment for a type 2 diabetes.

The general target for those with type 2 diabetes without significant comorbidities who are taking medications like Trulicity or Ozempic is an HbA1c level of 7% / 53 mmol/mol. The fasting levels your are citing are equivalent to 9 – 10.5% / 75 – 91 mmol/mol. Notwithstanding that actual targets are individual to patients, and that glucose readings cannot be used in place of an HbA1c, that is a clear difference.

So no, nothing you have said so far suggests you were right to reject insulin. Your levels are still far too high, so at this stage it cannot be determined either way. And if you are not taking the prescribed medication you really should be. The normal fasting glucose range is 4 – 7 mmol/L and the readings you are seemingly happy with are double to triple where they should be.

But no one can force you to take insulin or any medication. Nor can you be forced to take any action with your diabetes. But you will have to accept the damage it can do to your body and the effect it will have on your life if you reject such advice.

Hi I was only told this on tuesday so what I am saying is I have changed my diet and already my bloods are coming down and I only started Ozempic yesterday so early days to say I need insulin I think ?

 

[DIAMONDH]

There's no need to repeat responses in separate posts. We can all see every post, so see it repeated. A thread is eaiser to follow if you post them just the once.

Then you are type 2.

I take it you mean your BG went down. You're still counted as diabetic. And probably big reason why you're so high now, regardless of C19.

That's still too high. And being an average means your going higher than that. It's not just the average, it's the highs that matter too. I'm personally not comfortable saying a T2 *must* take insulin. I'd advice you to really consider it though.

I'm getting the impression you want someone to tell you you're not diabetic. Nor need treatment. I'd go the other way and say you are diabetic and that *is* why your levels are High. And suspected insulin would be of help (at least in the short term).
Now, as The Patient, you get to refuse treatment. Whether or not you have the condition. You can accept you're T2, and say no to insulin.

No I know I am now diabetic what I was saying as I prob don't need insulin and Ozempic will do the trick I was only given it yesterday so early days

 

[DIAMONDH]

Thanks for explaining more @DIAMONDH I think there have been reports about Covid causing high blood sugar so perhaps that’s not helping.

You’re within your rights to refuse insulin, but just one thing - it doesn’t give you thrush. High blood sugar can cause thrush not insulin.

If you were diagnosed Type 2 a while ago, it’s possible your recent illness has messed up your blood sugars. As I’m sure you know, 12 is still too high. I guess you’re going to monitor things over the next few days and see how it goes?

Do you have a follow-up appointment?

Hi the diabetic nurse and everything I have read about insulin says it does give you thrush also the diabetic nurse told me it does . I have been given Ozempic only took my first dose yesterday i am on a no carb diet now so I will see how it goes I have a check up in three months to see how I am doing .

 

[Bruce Stephens]

Hi the diabetic nurse and everything I have read about insulin says it does give you thrush also the diabetic nurse told me it does .

That seems like nonsense. There are medications (usually for type 2) that could increase your chances of thrush.

And not controlling glucose levels will do the same (which is entirely possible with insulin), but surely not insulin itself. That doesn't make any sense. (It might be that the kinds of people who need to take insulin are also more likely to have less controlled glucose levels, and that might explain the opinion.)

 

[DIAMONDH]

That seems like nonsense. There are medications (usually for type 2) that could increase your chances of thrush.

And not controlling glucose levels will do the same (which is entirely possible with insulin), but surely not insulin itself. That doesn't make any sense. (It might be that the kinds of people who need to take insulin are also more likely to have less controlled glucose levels, and that might explain the opinion.)

She told me that and she is a qualified diabetic nurse also that insulin puts weight on and that if you drive you eed to check your bloods every two hours hence why I declined .

 

[DaveB]

Hi. Insulin does not give you thrush - in fact it helps to avoid thrush as it avoids sugar in the urine. Your nurse was talking nonsense on that. Insulin does not cause weight gain. It enables the body to metabolise carbs properly and if you eat too many you will gain weight just as a non-diabetic would without insulin.

 

[Bruce Stephens]

if you drive you eed to check your bloods every two hours hence why I declined .

Yes, taking insulin does have those kinds of costs. (Other medications also do: anything where you might have hypoglycaemia requires informing the DVLA and may involve that kind of testing.)

And if non-insulin medications turn out to be sufficient then it's sensible to avoid insulin (and your healthcare team will be fine with that: insulin can be dangerous and is relatively expensive so they'll be much happier with things that are easier to manage).

I just don't buy that insulin increases the risks of thrush or weight gain. (Causes weight gain in children with the traditional presentation of Type 1 diabetes, but that's because they've lost weight because of a lack of insulin. It usually (and did, in my case) just results in a normal weight afterwards.)

 

[DIAMONDH]

Hi. Insulin does not give you thrush - in fact it helps to avoid thrush as it avoids sugar in the urine. Your nurse was talking nonsense on that. Insulin does not cause weight gain. It enables the body to metabolise carbs properly and if you eat too many you will gain weight just as a non-diabetic would without insulin.

sorry but just googled it she is correct

15,600,000 ResultsDateLanguageRegion

1. PEOPLE ALSO ASK
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   Insulin and weight gain often go hand in hand, but weight control is possible. If you need insulin therapy, here's how to minimize — or avoid — weight gain. By Mayo Clinic Staff. Weight gain is a common side effect for people who take insulin — a hormone that regulates the absorption of sugar (glucose) by cells.
   Insulin and weight gain: Keep the pounds off - Mayo Clinic
   www.mayoclinic.org/diseases-conditions/diabetes/in-dept…
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[rebrascora]

I totally agree with @DaveB's comments above. You either misunderstood the nurse or she is mistaken. There are many of us here on the forum who use insulin and have no problems with thrush. The only time I had it was before I started on insulin because my BG levels were too high allowing the thrush to bloom.
Eating too many carbs causes weight gain. People who are put on insulin and gain weight do so because they are eating too much, just like anyone else but the insulin is not to blame, it is their diet, which should have been modified first.

I really like the fact that you are following a low carb diet as that will definitely help but can I point out that a "no carb diet" which is what you mentioned, is pretty much impossible.... even cabbage and lettuce contain carbs but just in small quantities.
Can you give us an idea of what you are eating on an average day for breakfast lunch and dinner as many people do not fully understand the concept of low carb and I wonder (since you mention following a "no carb diet" if you have fully grasped what carbs are.... for instance fruit in all it's forms ie fresh, frozen, dried and juiced is all quite high carb. Beans and lentils are quite high carb. Porridge which is often recommended by nurses is high carb. These are all healthy foods for not diabetic people but can be a problem for us diabetics and need to be rationed, as well as the obvious bread, pasta, rice, couscous, potatoes, cakes, biscuits, sweets and chocolate.

 

[DIAMONDH]

I totally agree with @DaveB's comments above. You either misunderstood the nurse or she is mistaken. There are many of us here on the forum who use insulin and have no problems with thrush. The only time I had it was before I started on insulin because my BG levels were too high allowing the thrush to bloom.
Eating too many carbs causes weight gain. People who are put on insulin and gain weight do so because they are eating too much, just like anyone else but the insulin is not to blame, it is their diet, which should have been modified first.

I really like the fact that you are following a low carb diet as that will definitely help but can I point out that a "no carb diet" which is what you mentioned, is pretty much impossible.... even cabbage and lettuce contain carbs but just in small quantities.
Can you give us an idea of what you are eating on an average day for breakfast lunch and dinner as many people do not fully understand the concept of low carb and I wonder (since you mention following a "no carb diet" if you have fully grasped what carbs are.... for instance fruit in all it's forms ie fresh, frozen, dried and juiced is all quite high carb. Beans and lentils are quite high carb. Porridge which is often recommended by nurses is high carb. These are all healthy foods for not diabetic people but can be a problem for us diabetics and need to be rationed, as well as the obvious bread, pasta, rice, couscous, potatoes, cakes, biscuits, sweets and chocolate.

Hi I just don't eat any of the above i am eating chicken eggs salmon bananas prawns salad but craving potatoes