Chemist feels my blood sugar may be to low !

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It’s not just insulin resistance. That’s the prediabetic stage. Once you are type 2 the pancreas has started to lose its ability to produce insulin, either by beta cell apoptosis (cell death) or a process of ‘dedifferentiation’ which means they revert to a state where they do not produce insulin. Some people can reverse dedifferentiation by losing weight, but if they have died this is not reversible.

The work at Newcastle showed that after a while done T2s could revert back to a normal diet.
 
harbottle said:
It’s not just insulin resistance. That’s the prediabetic stage. Once you are type 2 the pancreas has started to lose its ability to produce insulin, either by beta cell apoptosis (cell death) or a process of ‘dedifferentiation’ which means they revert to a state where they do not produce insulin. Some people can reverse dedifferentiation by losing weight, but if they have died this is not reversible.

The work at Newcastle showed that after a while done T2s could revert back to a normal diet.
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According to the information I learnt, which includes the information on the main website, for some Type 2 diabetics the pancreas starts to have problems producing enough insulin. For most type 2 diabetics the problem isn't how much insulin is being produced, it is the failure of the liver to respond to it properly
 
T2 is a combination of insulin resistance plus beta cell dysfunction. In partially the ‘first phase’ insulin response to food that tells the liver to stop producing glucose is either missing or too weak to work, so the liver keeps producing glucose and this leads to elevated levels. Some studies show that this might be the initial sign of T2 as it starts to happen during the prediabetic phase.
 
harbottle said:
It’s not just insulin resistance. That’s the prediabetic stage. Once you are type 2 the pancreas has started to lose its ability to produce insulin, either by beta cell apoptosis (cell death) or a process of ‘dedifferentiation’ which means they revert to a state where they do not produce insulin. Some people can reverse dedifferentiation by losing weight, but if they have died this is not reversible.

The work at Newcastle showed that after a while done T2s could revert back to a normal diet.
Click to expand...
Hi

Can I ask whether you can avoid insulin once you are T2 rather than prediabetic, just from reading that it sounds like type 2s beta cells are dying off once over the diabetic level. For an example, my HBA1C in July was 80 and through diet it is now 50, but still diabetic, so my cells I presume even while I am losing weight and cutting carbs are still dying as I am still diabetic and not prediabetic? Just trying to work out and prepare myself mentally. So my question is, is it only people that make life changes when prediabetic that can keep their beta cells alive whereas once diabetic, whatever you do you will eventually not make insulin in the end? Sory if I have missunderstood. I am hoping to continue to reduce my level but wonder if its too late for me.
 
Jenny65 said:
Hi

Can I ask whether you can avoid insulin once you are T2 rather than prediabetic, just from reading that it sounds like type 2s beta cells are dying off once over the diabetic level. For an example, my HBA1C in July was 80 and through diet it is now 50, but still diabetic, so my cells I presume even while I am losing weight and cutting carbs are still dying as I am still diabetic and not prediabetic? Just trying to work out and prepare myself mentally. So my question is, is it only people that make life changes when prediabetic that can keep their beta cells alive whereas once diabetic, whatever you do you will eventually not make insulin in the end? Sory if I have missunderstood. I am hoping to continue to reduce my level but wonder if its too late for me.
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Keep going, you're doing great! It's clearly working, as well.

It's better to catch it during the pre-diabetic stage, I believe, as this is more state of high insulin and the beta cells are still working (Or overworking). Once into the diabetic state the insulin volume drops as the pancreas stops producing enough to overcome the insulin resistance.

I don't think all T2s end up on insulin, but we may have to when all the medications and diet/exercise changes stop working. I've seen a figure that shows a small percentage of beta calls stop working each year as the disease progresses... BUT, I'm not sure if that is being rethought these days with the work that shows how some can get it under control with weight loss. From the Newcastle research they don't know why some people could restore their beta cells and others couldn't, but it did seem linked to duration since diagnosis. It does also seem to be linked to this idea that they may 'dedifferentiate' and just stop working, rather than dying. [From what I've read, pancreatic cells start off the same and then go through a process called 'differentiation' where they change roles - some produce insulin, some glucogen. The idea is that in T2D they go back to the pre-beta-cell state, but losing visceral fat around the organs prods them back into life.]

From talking to a GP friend of mine, I wonder if most T2s don't really change their lifestyle and, of course, it progresses... It did with my Dad who never lost weight, but that was 20 years ago. (And I know someone who just takes pills and carries on with the same diet.)
 
I'll be 4 years since diagnosis in the coming January - I have lost a little weight and could stand to lose a bit more (and I think I am but very very slowly) but haven't used diabetes meds for most of that time and fingers crossed things seem to be improving little by little each year. I got back to pre-diabetes numbers within three months and back to 'normal/pre-diabetes' not long after that and kept them there ever since with my last hba1c being 'normal.' I keep carbs as low as I can manage and aim for 20g per day.
 
Firstly Metformin does not cause hypoglycaemia so that won't be the cause of feeling funny. . Secondly I have been "impaired insulin resistant" for 20 years. By cutting carbs out - am pretty well keto except I eat a little fruit twice a day I have remained just under the cut off point for actual Type 2. My problem is high fasting numbers maybe due to high cortisol levels at night which I have tried everything out there to lower!! However taking 1 x500 metformin will bring my lunch time reading down to normalish <6 (today 5.4) in 4-5 hours after breakfast when I will then allow myself to eat my salad lunch!!
 
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Ricky43 said:
Firstly Metformin does not cause hypoglycaemia so that won't be the cause of feeling funny. . Secondly I have been "impaired insulin resistant" for 20 years. By cutting carbs out - am pretty well keto except I eat a little fruit twice a day I have remained just under the cut off point for actual Type 2. My problem is high fasting numbers maybe due to high cortisol levels at night which I have tried everything out there to lower!! However taking 1 x500 metformin will bring my lunch time reading down to normalish <6 (today 5.4) in 4-5 hours after breakfast when I will then allow myself to eat my salad lunch!!
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Hope this isn't being annoying but I used to get high cortisol levels at night because I had undiagnosed sleep apnoea and the incidents of no oxygen were unsurprisingly causing my body to repeatedly go into fight or flight 40+ times an hour.

If you haven't already explored that possibility it may be worth looking into. I had a CPAP machine and for 6 years things improved a lot but not completely because the Philips machine I had was not the best one for me - I have a Resmed now and that has made a huge positive difference.
 
Hi , I had a telephone consultation with a Doctor from our surgery. She was extremely good and I was not rushed at all.

I explained to her what happened with my dizzy spell. I told her that I took a small brown sugar cube and really helped the problem.

Conclusion : She felt that I might have reacted to the Metformin but we agreed that I would take the agreed amount for a few days to see if my body reacts to the increased dose.

What I have noticed ( told the doctor ) that the tingle / light pins and needles have gone in both feet.I pass the tickling stick with ease and tell the nurse exactly where she is touching my feet.

Let's see what the next few days brings ?
 
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