-
Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
-
Learn more about joining the Diabetes UK Support Forum team here: https://forum.diabetes.org.uk/boards/threads/volunteering-opportunities-why-dont-you-join-us.112862/
Hello , confused newbie here :)
- Thread starter Oshi
- Start date
- Status
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Hi Tom and welcome.
Fire away with any questions you have.... that is what the forum is here for. It will however help if you can supply us with as much information as possible about your situation and your relationship to diabetes....
Things like:-
1. Do you have a diagnosis and if so when was that and how did it come about? Were you symptomatic or found via a routine blood test?
2. Do you know which Type of diabetes the medical profession believe/suspect you have?
3. Have you been prescribed any medication?
4. Your latest HbA1c blood test result.... This is the blood test used to diagnose and monitor diabetes and will usually be over 47 if you have a formal diagnosis.
5. Do you have much/any weight to lose or have you lost weight recently?
Fire away with any questions you have.... that is what the forum is here for. It will however help if you can supply us with as much information as possible about your situation and your relationship to diabetes....
Things like:-
1. Do you have a diagnosis and if so when was that and how did it come about? Were you symptomatic or found via a routine blood test?
2. Do you know which Type of diabetes the medical profession believe/suspect you have?
3. Have you been prescribed any medication?
4. Your latest HbA1c blood test result.... This is the blood test used to diagnose and monitor diabetes and will usually be over 47 if you have a formal diagnosis.
5. Do you have much/any weight to lose or have you lost weight recently?
hi , i dont want really to generate a wall of text, so ill try to cut long story short.Two years of unplesant symptoms ,like instan falling a sleep after any meals , excessive tiredness, high blood pressure , and rapid weight gain - caused me and my consultants ( yeah, i have other underlying health conditions)to investigate the subject without success, till past June. I was on holiday in PL , after conversation with my siblings ( both of them suffers from type2 diabetes) they advised to do a glucose tolerance test, the result was : before 75g of glucose intake ,fasting 7.4mmol - one hour ater 75g of glucose 16.1 mmol and another hour later it came down to 11.6 mmol.
Numbers were no sky high but the lab referred me to see specialist who said i have early stage of type 2. which didn't surprised me a lot, as most of my family members has it. So I've been prescribed with forxiga, equipped with glucometer and told to see my doctors here on my return . I tried to tell ,that my hba1c is kinda normal , but the specialist I've seen said that other medication i take may affect this type of test.
i launched on taking this medicine, and couple days later started to felling better but again didn't see much of improvement on tests done with glucometer: fasting sometimes was hitting 9mmol and an hour after meal 10.5 . finally decided to see my GP good few weeks after my return and that was the point where my confusion comes from . My GP said i am fine hba1c is ok so theres no diabetes and blood pressure 140/100 is kinda ok , my results from glucometer or the GTT made abroad were completely ignored. Now i do not really know what to do, either trust doctor from PL and travel often to get medicine or just to cut it off and trust GP I've seen bck at home. Worth of mentioning is a fact that 12 months ago i went on low carb diet which helped me with weight problem but still i was affright to eat at work etc. as it was literally knocking me off.( less of this since i am on forxiga)
My apologies, just created a wall of text unitencionally.,
Numbers were no sky high but the lab referred me to see specialist who said i have early stage of type 2. which didn't surprised me a lot, as most of my family members has it. So I've been prescribed with forxiga, equipped with glucometer and told to see my doctors here on my return . I tried to tell ,that my hba1c is kinda normal , but the specialist I've seen said that other medication i take may affect this type of test.
i launched on taking this medicine, and couple days later started to felling better but again didn't see much of improvement on tests done with glucometer: fasting sometimes was hitting 9mmol and an hour after meal 10.5 . finally decided to see my GP good few weeks after my return and that was the point where my confusion comes from . My GP said i am fine hba1c is ok so theres no diabetes and blood pressure 140/100 is kinda ok , my results from glucometer or the GTT made abroad were completely ignored. Now i do not really know what to do, either trust doctor from PL and travel often to get medicine or just to cut it off and trust GP I've seen bck at home. Worth of mentioning is a fact that 12 months ago i went on low carb diet which helped me with weight problem but still i was affright to eat at work etc. as it was literally knocking me off.( less of this since i am on forxiga)
My apologies, just created a wall of text unitencionally.,
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Thanks for the extra info. No need to apologize here for giving lots of details. The more the better so we get a better understanding of your situation, because diabetes can be highly individual and so many factors can influence it.
When did you see your GP and did they do an HbA1c test at that time and what was the actual result. Don't let them fob you off with OK or normal or whatever. Actual numbers are what counts.
Your fasting levels are obviously higher than you would like. Can I ask when you take them? ie. As soon as you wake up and before you get out of bed or after you are up and washed and dressed and about to have breakfast? That 15- 30mins can make a significant difference to the result you get despite not eating or drinking anything in that time, because your liver pumps out glucose to give you energy for the day ahead (Dawn Phenomenon/Foot on the Floor Syndrome). If you are carrying a lot of visceral fat in and around your liver and pancreas, then this inhibits those organs from communicating effectively with each other and so the pancreas doesn't get the message to increase insulin to match the liver output.
Sometimes eating something low carb as soon as you wake up can switch off this glucose dump by the liver, so a few nuts on waking works for some people. If you are carrying weight around that abdomen and rib cage area, then losing that weight will be important to help restore good balance of your BG levels. Clearly you are still producing plenty of insulin if you have been piling on weight, so it seems to me like it is the weight/fat which is causing the problem.
The Forxiga is Dapagliflozin which works by encouraging your kidneys to remove more glucose through your urine. You need to drink plenty of low carb fluids to help it do this. To me this is treating the high BG levels but not the cause and I wonder if the Newcastle/Fast 800 diet might be successful in your situation. It involves a short term 8-12 week very low calorie (800calories per day) usually meal replacement shakes based diet, to burn off that visceral fat with the hope of restoring better function of those organs and pushing the diabetes into remission. Professor Roy Taylor and colleagues pioneered this approach at Newcastle University and it is well documented and now recognized by the NHS with referrals through the NHS in some cases, so some people can actually get the shakes prescribed. I do not believe that it would be a good idea to follow this route whilst taking Forxiga though and might be dangerous, so you would need to make a decision about whether you want to manage your diabetes with medication or actually try to push it into remission. Following a low carb diet whilst taking Dapagliflozin/Forxiga can lead to a type of Diabetic KetoAcidosis (DKA) which can cause organ failure coma and even death in very extreme circumstances, so you really want to have medical supervision when taking such medication in my opinion. You would also need to maintain the weight loss to maintain remission, if you are part of the 50% who are lucky enough to achieve remission.
Personally I would be wary of taking medication long term which is not supported by your GP. There can be some quite serious side effects of Dapagliflozin which could make you very ill and without it being in your UK medical notes, that illness might not easily be diagnosed. I think it can also put a strain on the kidneys and regular tests might be important to keep an eye on kidney function.
Treating diabetes with Forxiga to me is like a sink that is overflowing and you just put an overflow in that is a bit lower, so that it overflows before the risk of flooding. It isn't really tackling the problem which is that there is too much water running into the sink. If you reduce the flow from the tap, that will ultimately be more effective.
Those are just my thoughts and I am sure other people will have other views.
When did you see your GP and did they do an HbA1c test at that time and what was the actual result. Don't let them fob you off with OK or normal or whatever. Actual numbers are what counts.
Your fasting levels are obviously higher than you would like. Can I ask when you take them? ie. As soon as you wake up and before you get out of bed or after you are up and washed and dressed and about to have breakfast? That 15- 30mins can make a significant difference to the result you get despite not eating or drinking anything in that time, because your liver pumps out glucose to give you energy for the day ahead (Dawn Phenomenon/Foot on the Floor Syndrome). If you are carrying a lot of visceral fat in and around your liver and pancreas, then this inhibits those organs from communicating effectively with each other and so the pancreas doesn't get the message to increase insulin to match the liver output.
Sometimes eating something low carb as soon as you wake up can switch off this glucose dump by the liver, so a few nuts on waking works for some people. If you are carrying weight around that abdomen and rib cage area, then losing that weight will be important to help restore good balance of your BG levels. Clearly you are still producing plenty of insulin if you have been piling on weight, so it seems to me like it is the weight/fat which is causing the problem.
The Forxiga is Dapagliflozin which works by encouraging your kidneys to remove more glucose through your urine. You need to drink plenty of low carb fluids to help it do this. To me this is treating the high BG levels but not the cause and I wonder if the Newcastle/Fast 800 diet might be successful in your situation. It involves a short term 8-12 week very low calorie (800calories per day) usually meal replacement shakes based diet, to burn off that visceral fat with the hope of restoring better function of those organs and pushing the diabetes into remission. Professor Roy Taylor and colleagues pioneered this approach at Newcastle University and it is well documented and now recognized by the NHS with referrals through the NHS in some cases, so some people can actually get the shakes prescribed. I do not believe that it would be a good idea to follow this route whilst taking Forxiga though and might be dangerous, so you would need to make a decision about whether you want to manage your diabetes with medication or actually try to push it into remission. Following a low carb diet whilst taking Dapagliflozin/Forxiga can lead to a type of Diabetic KetoAcidosis (DKA) which can cause organ failure coma and even death in very extreme circumstances, so you really want to have medical supervision when taking such medication in my opinion. You would also need to maintain the weight loss to maintain remission, if you are part of the 50% who are lucky enough to achieve remission.
Personally I would be wary of taking medication long term which is not supported by your GP. There can be some quite serious side effects of Dapagliflozin which could make you very ill and without it being in your UK medical notes, that illness might not easily be diagnosed. I think it can also put a strain on the kidneys and regular tests might be important to keep an eye on kidney function.
Treating diabetes with Forxiga to me is like a sink that is overflowing and you just put an overflow in that is a bit lower, so that it overflows before the risk of flooding. It isn't really tackling the problem which is that there is too much water running into the sink. If you reduce the flow from the tap, that will ultimately be more effective.
Those are just my thoughts and I am sure other people will have other views.
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Welcome to the forum @Oshi
Hope you find it helpful and reassuring to compare experiences with others.
@rebrascora has given you some helpful pointers above, and your situation does seem to be slightly unusual and complex. But it is important to keep the lines of communication open with your Dr, and to make sure they know what meds and dietary approaches you are taking, so that incorrect assumptions aren’t being made.
Let us know how things go, and keep asking questions 🙂
Hope you find it helpful and reassuring to compare experiences with others.
@rebrascora has given you some helpful pointers above, and your situation does seem to be slightly unusual and complex. But it is important to keep the lines of communication open with your Dr, and to make sure they know what meds and dietary approaches you are taking, so that incorrect assumptions aren’t being made.
Let us know how things go, and keep asking questions 🙂
I want to thank all of you for your reply. @rebrascora you made a good point , one of my conditions is actually liver issue, also my liver is fatty indeed and i know this well as i have fibroscan every 6 months- from very beginning i was not convinced to take forxiga, it was a second choice of the Dr. I've seen abroad due to the liver condition .As he said other may put too much work for liver.
So could it be the reason why my hba1c test is "kind of ok" but in the mean time my glucose levels are rised??? - also u have asked when i or how i do fasting test, usually it is 15-25 after i woke up, morning shower etc. but before any food or drink.
Kind regars.
So could it be the reason why my hba1c test is "kind of ok" but in the mean time my glucose levels are rised??? - also u have asked when i or how i do fasting test, usually it is 15-25 after i woke up, morning shower etc. but before any food or drink.
Kind regars.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
If you have fatty liver then that is likely the cause of your high fasting readings and in my opinion it would be worth doing some reading into the Newcastle diet and professor Roy Taylor and colleagues' work which was on reducing this through a short term, very low calorie diet and in 50% of cases this reversed the diabetes. It may well resolve other health issues too but should be done in consultation with your GP or consultant, particularly if you are on other medication.
The longer I am diabetic and the more I experiment with diet (and exercise), the more I realize that it is the key to many conditions, not just diabetes. Changing my diet has resolved bowel/digestive issues, stopped my 20+yr acute and chronic migraine problem literally overnight and improved joint pain and my skin and asthma is also improved.
Not saying losing weight or changing your diet is easy, but it has absolutely been worth the effort for me and I think it is within many of us to cure ourselves. For me my diabetes diagnosis was the impetus I needed and even though I am Type 1 and therefore unable to reverse it and I need insulin and could simply eat whatever I want and inject insulin to cover it, the health benefits of my new way of life show that this is the right path for me and many of the ailments I was suffering were in fact within my own hands to resolve through lifestyle changes, rather than medication. I am not the only one to experience this by any means.
The longer I am diabetic and the more I experiment with diet (and exercise), the more I realize that it is the key to many conditions, not just diabetes. Changing my diet has resolved bowel/digestive issues, stopped my 20+yr acute and chronic migraine problem literally overnight and improved joint pain and my skin and asthma is also improved.
Not saying losing weight or changing your diet is easy, but it has absolutely been worth the effort for me and I think it is within many of us to cure ourselves. For me my diabetes diagnosis was the impetus I needed and even though I am Type 1 and therefore unable to reverse it and I need insulin and could simply eat whatever I want and inject insulin to cover it, the health benefits of my new way of life show that this is the right path for me and many of the ailments I was suffering were in fact within my own hands to resolve through lifestyle changes, rather than medication. I am not the only one to experience this by any means.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
The 15-20 relates to minutes after getting up before doing the fasting test, not the actual results which I think were 7-9
harbottle
Well-Known Member
- Relationship to Diabetes
- Type 2
Ah, I see.
How long do they persist at this level?
If it goes down quickly it may not cause the hba1c to be high.
If it stays at this level until the afternoon I'd expect your hba1c to be at least in the pre-diabetic range, possibly diabetic.
How long do they persist at this level?
If it goes down quickly it may not cause the hba1c to be high.
If it stays at this level until the afternoon I'd expect your hba1c to be at least in the pre-diabetic range, possibly diabetic.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
If your HbA1c is genuinely in the normal range. then I wonder if you are going low at other times. HbA1c is a measure of the glucose molecules stuck to your red blood cells, which have a lifespan of about 3 months. If your levels are constantly high then more glucose will be stuck to your Haemaglobin and your HbA1c will indicate diabetes. If however they fluctuate high and low, this can mean that a normal HbA1c can be achieved even with elevated levels. In the early stages of Type 2 I think this is more likely and may well be down to poor communication between the pancreas and liver due to fatty deposits. Do you ever feel wobbly and sweaty with your heart pounding? That might indicate that you are dropping low and it would be useful to test your levels at those times. Typically it would happen after a high carb meal, because levels rise rapidly but pancreas is initially slow to respond and releases insulin, but then when levels get really high it wakes up and dumps a load of insulin into your blood stream to tackle the high which then sends your levels plummeting back down usually an hour or two after eating. It is normal for levels to go up and down but this becomes an extreme where it goes much higher than normal and then crashes back down.
Doing some strategic testing immediately before and then 1 and 2 hours after a meal might shine a better light on what is happening together with keeping a food and drink diary and noting things like how you feel or what your levels are when you feel unwell or sleepy.
Doing some strategic testing immediately before and then 1 and 2 hours after a meal might shine a better light on what is happening together with keeping a food and drink diary and noting things like how you feel or what your levels are when you feel unwell or sleepy.
Actually, I have never checked it , soon after ill test , i eat breakfast walk my dogs an shoot of to work. thats usually 5:40 AM - but i did two test on separate occasions (weekend time) when i woke up arround 8:00 , ( test was made 8:37 fasting one) came back as quite high so I've repeated and i came even higher - see attachment.
Attachments
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
!40mg/dl isn't particularly high at 7.8mmols/l. I am talking about spiking up to mid teens (270mg/dl) or above and then crashing back down.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
So is it just your fasting readings which are elevated likely down to fatty liver and perhaps if you are following a low carb way of eating, that is most likely to be helping to manage your levels throughout the day and perhaps that is why you are not getting a diabetes diagnosis via HbA1c. It would be really interesting to know what your actual result was and I am guessing probably in the pre diabetic range with those fasting numbers.
It would also be interesting to do some testing as soon as you wake up and before you get out of bed as well as your usual timing of 15-25 mins later. My BG levels could easily rise 2-3 mmols in that time due to Foot on the Floor syndrome, so it may be that your overnight levels are pretty good but you are just getting a normal surge of glucose from the liver in the morning which your pancreas isn't being triggered to deal with, until you have something to eat.
It wasn't initially clear that you were still following a low carb way of eating.
Roughly how many grams of carbs do you aim for or do you not count them?
What sort of things do you typically eat for breakfast, lunch and evening meal and what sort of readings do you get 2 hours afterwards.
It would also be interesting to do some testing as soon as you wake up and before you get out of bed as well as your usual timing of 15-25 mins later. My BG levels could easily rise 2-3 mmols in that time due to Foot on the Floor syndrome, so it may be that your overnight levels are pretty good but you are just getting a normal surge of glucose from the liver in the morning which your pancreas isn't being triggered to deal with, until you have something to eat.
It wasn't initially clear that you were still following a low carb way of eating.
Roughly how many grams of carbs do you aim for or do you not count them?
What sort of things do you typically eat for breakfast, lunch and evening meal and what sort of readings do you get 2 hours afterwards.
- Status