Diabetes Review Confusion

[Sheppeyescapee]

I had my first diabetes review with my GPs practice as it's been just over a year since I was diagnosed. Due to the diabetes clinic not putting a "type" on my letter just a vague diagnosis of "Diabetes likely combination of insulin insufficiency secondary to pancreatitis and insulin resistance secondary to family history and raised BMI" my gp practice keeps getting themselves confused on how to treat me. The diabetes clinic seem very reluctant to name it type 3c or any type so depending on which medic I see I get treated differently. I've been on Humulin I since I was in hospital last year and metformin for a few months. The gp's nurse was under the impression that I was type 2, so when we went over my test results she was talking about taking me off the insulin. My HbA1c was 96 when I was diagnosed last year, my one taken last week was 36. I've lost a couple stone in weight since diagnosis so that has probably helped, I'm still in the overweight category with a BMI of 28. The nurse was worried that I may have been having more hypos and just not noticing the symptoms, and possibly having some overnight in my sleep as my levels before bed tend to be around 5ish and waking up around 4.5-5.5. She's going to speak to my GP and advise what to do next but she wants me to halve my insulin in the meantime. I had the impression that because she thought it was type 2 that they weren't getting the insulin insufficiency part I'm just confused.

 

[Cherrelle DUK]

Hi Sheppeyescapee, I'm not surprised you're confused, I am too!

It can be tricky to get an exact diagnosis and many are misdiagnosed in regards to their type but I would hope that they make clarity a priority to at least rule out type 2.

Your number has come down nicely (congratulations!!) and therefore it seems an important point to get to the bottom of this.

I'd be inclined to request a review with the GP directly who can make a referral to an endocrinologist if they're still unsure, especially if you may be experiencing hypos without realising it.

 

[Sheppeyescapee]

Thank you Cherrelle, I hadn't had a hypo for a while or at least not knowingly and then last night had a bad one. Typical the same evening after I talk to them Went down to 2.5 at about 3am. I'm going try calling the diabetes nurse at the hospital to ask advice.

 

[helli]

@Sheppeyescapee is Humulin the only insulin you are on? Is it a mixed insulin? If so, rather than having fixed doses of Humulin, I wonder if your clinic would consider prescribing basal-bolus regime. This is two different types of insulin - a long acting one you take once or twice a day and a fast acting one you take with food. The huge advantage of this is flexibility. A mixed insulin requires you to eat a certain amount of carbs at a certain time of day, do the same amount of exercise, have the same amount of stress, ... Basal -bolus allows you to eat at different times and different amounts, ...

 

[Sheppeyescapee]

Yes, Humulin I is the only insulin I'm on.