Hello Everyone

[elliem]

I've been type 2 for a few years now but it has recently got out of hand as my pancreas seems to be giving up! I'm not overweight but find that recipes presume I am. I'd love some advice from anyone who knows how to keep weight stable. (I dont want to gain weight either!!) Many thanks.

 

[ianf0ster]

Hi @elliem and welcome to the forum.
What is your HbA1C ? Do you have a Blood Glucose meter?
My BMI was only just 25 when diagnosed with T2D - just 2lbs officially overweight though a Low Fat wat of eating had seen me gain 2lbs per year for nearly 20yrs from what I consider my normal weight (way back 40yrs ago).
I used a Low Carb way of eating without calorie restrictions to put my T2D into remission. I did lose the extra weight (back down as low as a BMI of 22), but put 5lbs back on deliberately by adding a bit more protein and fat e.g. hard cheese.

 

[rebrascora]

Hi and welcome

I would say that since you are not overweight and your diabetes has suddenly got "out of hand" then there is a strong possibility that you are not actually Type 2 but a slow onset Type 1 usually referred to as LADA (Latent Autoimmune Diabetes in Adults). Unfortunately many GPs are under the misunderstanding that Type 1 only exhibits in children and young adults and assume that if you are a mature adult, then you must have Type 2. The standard test for diabetes is a blood test called an HbA1c and a reading of 48 or more gets you a diabetes diagnosis, but the Type is usually down to clinical assessment. Whilst there are genuine slimmer Type 2s, the fact that your diabetes has suddenly deteriorated suggests that you are more likely LADA unless your diet has notably changed recently for the worse. There are tests they can do to assess how much insulin your pancreas is producing (C-peptide test) and a GAD antibody test which, because LADA and Type 1 are autoimmune conditions, looks for the antibodies associated with your immune system having targeted the insulin producing beta cells in your pancreas. It is usually best that a diabetes specialist consultant authorizes these tests and assesses the results as they can be tricky to interpret sometimes, so you might be best pushing for a referral to a specialist diabetes clinic. Unfortunately, if you are LADA, then you will need to start on insulin at some point in the near future, but the insulin will enable your body to utilize the food you eat and help to stabilize your weight.

Of course, it may be that you are actually one of the slimmer Type 2 diabetics but certainly worth asking the question about LADA and testing.

 

[oneuser]

Merhaba ve hoş geldiniz

Fazla kilolu olmadığınız ve diyabetinizin aniden "kontrolden çıktığı" için, aslında Tip 2 değil, genellikle LADA (Yetişkinlerde Gizli Otoimmün Diyabet) olarak adlandırılan yavaş başlangıçlı Tip 1 olma olasılığınız olduğunu söyleyebilirim. ). Ne yazık ki birçok pratisyen hekim, Tip 1'in sadece çocuklarda ve genç yetişkinlerde görüldüğünü yanlış anlıyor ve olgun bir yetişkinseniz, o zaman Tip 2'ye sahip olmanız gerektiğini varsayar. 48 veya daha fazlası size diyabet teşhisi koyar, ancak Tip genellikle klinik değerlendirmeye bağlıdır. Gerçek daha ince Tip 2'ler olsa da, diyabetinizin aniden kötüleşmesi gerçeği, diyetiniz son zamanlarda daha da kötüye gitmedikçe, LADA olma ihtimalinizin daha yüksek olduğunu gösteriyor. Pankreasınızın ne kadar insülin ürettiğini değerlendirmek için yapabilecekleri testler (C-peptid testi) ve LADA ve Tip 1 otoimmün durumlar olduğu için, insülini hedef alan bağışıklık sisteminizle ilişkili antikorları arayan bir GAD antikor testi vardır. pankreasınızda beta hücreleri üretmek. Genellikle en iyisi bir diyabet uzmanı danışmanının bu testleri onaylaması ve sonuçları değerlendirmesidir, çünkü bazen yorumlamak zor olabilir, bu nedenle uzman bir diyabet kliniğine sevk için en iyi siz olabilirsiniz. Ne yazık ki, LADA iseniz, yakın gelecekte bir noktada insüline başlamanız gerekecek, ancak insülin vücudunuzun yediğiniz gıdaları kullanmasını sağlayacak ve kilonuzu dengelemeye yardımcı olacaktır. LADA ve Tip 1 otoimmün durumlar olduğundan, pankreasınızdaki insülin üreten beta hücrelerini hedef alan bağışıklık sisteminizle ilişkili antikorları arar. Genellikle en iyisi bir diyabet uzmanı danışmanının bu testleri onaylaması ve sonuçları değerlendirmesidir, çünkü bazen yorumlamak zor olabilir, bu nedenle uzman bir diyabet kliniğine sevk için en iyi siz olabilirsiniz. Ne yazık ki, LADA iseniz, yakın gelecekte bir noktada insüline başlamanız gerekecek, ancak insülin vücudunuzun yediğiniz gıdaları kullanmasını sağlayacak ve kilonuzu dengelemeye yardımcı olacaktır. LADA ve Tip 1 otoimmün durumlar olduğundan, pankreasınızdaki insülin üreten beta hücrelerini hedef alan bağışıklık sisteminizle ilişkili antikorları arar. Genellikle en iyisi bir diyabet uzmanı danışmanının bu testleri onaylaması ve sonuçları değerlendirmesidir, çünkü bazen yorumlamak zor olabilir, bu nedenle uzman bir diyabet kliniğine sevk için en iyi siz olabilirsiniz. Ne yazık ki, LADA iseniz, yakın gelecekte bir noktada insüline başlamanız gerekecek, ancak insülin vücudunuzun yediğiniz gıdaları kullanmasını sağlayacak ve kilonuzu dengelemeye yardımcı olacaktır. Genellikle en iyisi bir diyabet uzmanı danışmanının bu testleri onaylaması ve sonuçları değerlendirmesidir, çünkü bazen yorumlamak zor olabilir, bu nedenle uzman bir diyabet kliniğine sevk için en iyi siz olabilirsiniz. Ne yazık ki, LADA iseniz, yakın gelecekte bir noktada insüline başlamanız gerekecek, ancak insülin vücudunuzun yediğiniz gıdaları kullanmasını sağlayacak ve kilonuzu dengelemeye yardımcı olacaktır. Genellikle en iyisi bir diyabet uzmanı danışmanının bu testleri onaylaması ve sonuçları değerlendirmesidir, çünkü bazen yorumlamak zor olabilir, bu nedenle uzman bir diyabet kliniğine sevk için en iyi siz olabilirsiniz. Ne yazık ki, LADA iseniz, yakın gelecekte bir noktada insüline başlamanız gerekecek, ancak insülin vücudunuzun yediğiniz gıdaları kullanmasını sağlayacak ve kilonuzu dengelemeye yardımcı olacaktır.

Tabii ki, aslında daha zayıf Tip 2 diyabetlilerden biri olabilirsiniz, ancak LADA ve testler hakkında soru sormaya kesinlikle değer.

Bilgi için teşekkürler.

 

[cameron]

Welcome to the forum @elliem. 🙂

What medication are you taking for diabetes? Have you seen your diabetes team recently for your annual checks?

If you need some recipes ideas, you can use the recipe finder on the Diabetes UK website to find all sorts of healthy recipes. Please feel free to ask any questions on the forum if you'd like any help with anything.

 

[everydayupsanddowns]

Welcome the forum @elliem

Let us know the results of any discussions with your Dr about the possibility of LADA.

Has your weight been fairly stable since your diagnosis? What has given you the impression that your diabetes is getting out of hand?

Has your Dr or nurse been expressing concerns?

 

[elliem]

Hi @elliem and welcome to the forum.
What is your HbA1C ? Do you have a Blood Glucose meter?
My BMI was only just 25 when diagnosed with T2D - just 2lbs officially overweight though a Low Fat wat of eating had seen me gain 2lbs per year for nearly 20yrs from what I consider my normal weight (way back 40yrs ago).
I used a Low Carb way of eating without calorie restrictions to put my T2D into remission. I did lose the extra weight (back down as low as a BMI of 22), but put 5lbs back on deliberately by adding a bit more protein and fat e.g. hard cheese.

Hi Ian (presume that's your name!) Thanks for replying. My HbA1C was last measured at 100mmol/mol. I do have a blood glucose monitor which reads anything from 17mmol/L to 32mmol/L before meals My BMI is 23, so I'm not skinny but neither wish to lose nor gain weight. Currently eating low carb and/or slow release carb diet. Think I'm going to just keep weighing myself and upping or decreasing protein and fats to keep it in order. Many thanks

 

[elliem]

Welcome the forum @elliem

Let us know the results of any discussions with your Dr about the possibility of LADA.

Has your weight been fairly stable since your diagnosis? What has given you the impression that your diabetes is getting out of hand?

Has your Dr or nurse been expressing concerns?

 

[elliem]

Hi there. I have had a Type 1 test but it came back as definitely Type 2. Is that the same thing? My diabetes was pretty much under control with Metformin for quite a few years but I had cancer last year and underwent chemotherapy (yuk!!) up until a year ago and some injections up until September this year. My diabetes took a back burner during chemo especially as the only stuff I could eat was very cold jelly and ice cream or anything cold, sweet and smooth. I did go from 68 kilos to 56 kilos so ate anything I could! I currently weigh around 60 kilos and wish to remain at that weight which gives me a BMI of around 23. My nurse was going to put me on insulin but decided to give me gliclazide as a trial for a month or so. Been on it for over a week and have not recorded any change in blood sugars so far. Do you know if chemo can affect the pancreas?

 

[elliem]

Hi and welcome

I would say that since you are not overweight and your diabetes has suddenly got "out of hand" then there is a strong possibility that you are not actually Type 2 but a slow onset Type 1 usually referred to as LADA (Latent Autoimmune Diabetes in Adults). Unfortunately many GPs are under the misunderstanding that Type 1 only exhibits in children and young adults and assume that if you are a mature adult, then you must have Type 2. The standard test for diabetes is a blood test called an HbA1c and a reading of 48 or more gets you a diabetes diagnosis, but the Type is usually down to clinical assessment. Whilst there are genuine slimmer Type 2s, the fact that your diabetes has suddenly deteriorated suggests that you are more likely LADA unless your diet has notably changed recently for the worse. There are tests they can do to assess how much insulin your pancreas is producing (C-peptide test) and a GAD antibody test which, because LADA and Type 1 are autoimmune conditions, looks for the antibodies associated with your immune system having targeted the insulin producing beta cells in your pancreas. It is usually best that a diabetes specialist consultant authorizes these tests and assesses the results as they can be tricky to interpret sometimes, so you might be best pushing for a referral to a specialist diabetes clinic. Unfortunately, if you are LADA, then you will need to start on insulin at some point in the near future, but the insulin will enable your body to utilize the food you eat and help to stabilize your weight.

Of course, it may be that you are actually one of the slimmer Type 2 diabetics but certainly worth asking the question about LADA and testing.

Thanks for the reply Barbara

I have had the test but the result came back as definitely Type 2 (No antibodies). My recent NbA1C result was 100. I had cancer last year and wonder if the chemotherapy affected my pancreas. The diabetic team have put me on gliclazide for a trial run. I've been on it for just over a week with no change to my blood monitor results so far (generally between 17mmol/L to 32mmol/L before food). Maybe too early to tell. I think I've flummoxed the diabetes team but they have been absolutely amazing, phoning me nearly every day to check on progress. I suspect they will be giving me insulin sooner rather than later.

Thank you again.

 

[elliem]

Welcome to the forum @elliem. 🙂

What medication are you taking for diabetes? Have you seen your diabetes team recently for your annual checks?

If you need some recipes ideas, you can use the recipe finder on the Diabetes UK website to find all sorts of healthy recipes. Please feel free to ask any questions on the forum if you'd like any help with anything.

Hi Cameron

Thanks for your reply

ATM I am taking 2X Metformin twice a day and gliclizide (not sure of the dose) twice a day. Yes, I have been under quite a bit of scrutiny from my diabetes team!!

I will definitely take a look at the recipes.

Many thanks

 

[Leadinglights]

Thanks for the reply Barbara

I have had the test but the result came back as definitely Type 2 (No antibodies). My recent NbA1C result was 100. I had cancer last year and wonder if the chemotherapy affected my pancreas. The diabetic team have put me on gliclazide for a trial run. I've been on it for just over a week with no change to my blood monitor results so far (generally between 17mmol/L to 32mmol/L before food). Maybe too early to tell. I think I've flummoxed the diabetes team but they have been absolutely amazing, phoning me nearly every day to check on progress. I suspect they will be giving me insulin sooner rather than later.

Thank you again.

Those levels before food do seem very high, I would check with your diabetic team they are happy with those levels, remembering that after food they are going to be higher.

 

[elliem]

They aren't happy which is why they phone me most days! I'm on a trial run of gliclazide but that won't work if my pancreas has been damaged by the chemotherapy. However, that hasn't been proven. I suspect I'll be on insulin in a few weeks. Thanks for the reply.

 

[everydayupsanddowns]

Hi there. I have had a Type 1 test but it came back as definitely Type 2. Is that the same thing?

They aren't happy which is why they phone me most days! I'm on a trial run of gliclazide but that won't work if my pancreas has been damaged by the chemotherapy. However, that hasn't been proven. I suspect I'll be on insulin in a few weeks. Thanks for the reply.

Ah interesting that you have tested negative for antibodies.

It might be interesting to know what your cPeptide level was. This measures how much home grown insulin you are producing. Glic works by stimulating the pancreas to release more insulin - but if your cPep is low it might suggest that your insulin production is impaired (so there isn’t much to stimulate)?

In which case a switch to insulin would be the right thing. And that doesn’t mean you’ve ‘failed’ or that things have ‘got worse’. It’s just a different medication based on what your body needs. 🙂

Good to hear your Drs are on top of things, and keeping a close eye on you.

 

[rebrascora]

Good that your diabetes team are keeping in close contact and that they have done appropriate tests for type 1. I just wonder why they are leaving it so long to start you on insulin because those levels are dangerously high at the top end and if that is before food, you will be off the scale after eating.
I hope you are started on insulin sooner rather than later and I wonder if a scan of your pancreas might be appropriate. It sounds like you are more likely going to be a Type 3c rather than Type 2 if they have ruled out Type1 although the GAD antibody test isn't always definitive. I know none of us want to be injecting insulin every day but it is better than having those high levels and lets not kid ourselves they can become fatal. it is clear from those readings that you are not producing enough of your own and I really don't understand why they are delaying. Do you have any means of testing for ketones? If you are Type 2 then I appreciate that you are unlikely to produce ketones but I would imagine that if your pancreas is not producing insulin or very little then there is a possibility. I believe most Type 2's don't get ketones because they produce plenty of insulin but the body is resistant to it. The fact that you are taking Metformin and Gliclazide and seeing those numbers tells you that you are not producing anywhere near enough insulin.

Anyway, I would encourage you to push for insulin sooner rather than later and ask for a basal/bolus system as this will give you more flexibility in your diet. And if you start to feel unwell with abdominal pain or respiratory difficulty or your breath starts to smell of pear drops, get yourself to A&E pronto. If you don't have any, Ketostix can be purchased over the counter at most pharmacies for about £5 and you should be checking your urine for ketones when your Blood Glucose levels are mid teens and above.... which sounds like all the time right now!!

Please take care. Starting on insulin should not be feared. It is what you need and will make you feel much better once those levels start to come down. We are here to support you but please ask why they haven't started you on insulin yet and push for it. Those levels are not acceptable on a daily basis.

 

[elliem]

Ah interesting that you have tested negative for antibodies.

It might be interesting to know what your cPeptide level was. This measures how much home grown insulin you are producing. Glic works by stimulating the pancreas to release more insulin - but if your cPep is low it might suggest that your insulin production is impaired (so there isn’t much to stimulate)?

In which case a switch to insulin would be the right thing. And that doesn’t mean you’ve ‘failed’ or that things have ‘got worse’. It’s just a different medication based on what your body needs. 🙂

Good to hear your Drs are on top of things, and keeping a close eye on you.

Thank you for replying. My cPeptide CR RATIO is 3696.9 pmol/mmol which is apparently normal. So the gliclazide might work, given a bit of time.

 

[elliem]

Good that your diabetes team are keeping in close contact and that they have done appropriate tests for type 1. I just wonder why they are leaving it so long to start you on insulin because those levels are dangerously high at the top end and if that is before food, you will be off the scale after eating.
I hope you are started on insulin sooner rather than later and I wonder if a scan of your pancreas might be appropriate. It sounds like you are more likely going to be a Type 3c rather than Type 2 if they have ruled out Type1 although the GAD antibody test isn't always definitive. I know none of us want to be injecting insulin every day but it is better than having those high levels and lets not kid ourselves they can become fatal. it is clear from those readings that you are not producing enough of your own and I really don't understand why they are delaying. Do you have any means of testing for ketones? If you are Type 2 then I appreciate that you are unlikely to produce ketones but I would imagine that if your pancreas is not producing insulin or very little then there is a possibility. I believe most Type 2's don't get ketones because they produce plenty of insulin but the body is resistant to it. The fact that you are taking Metformin and Gliclazide and seeing those numbers tells you that you are not producing anywhere near enough insulin.

Anyway, I would encourage you to push for insulin sooner rather than later and ask for a basal/bolus system as this will give you more flexibility in your diet. And if you start to feel unwell with abdominal pain or respiratory difficulty or your breath starts to smell of pear drops, get yourself to A&E pronto. If you don't have any, Ketostix can be purchased over the counter at most pharmacies for about £5 and you should be checking your urine for ketones when your Blood Glucose levels are mid teens and above.... which sounds like all the time right now!!

Please take care. Starting on insulin should not be feared. It is what you need and will make you feel much better once those levels start to come down. We are here to support you but please ask why they haven't started you on insulin yet and push for it. Those levels are not acceptable on a daily basis.

Thanks Barbara.

I don't think they are delaying as it's very early days (just over two weeks) since we discovered the sugar hike. They are just looking at the options. I don't follow the usual Type 2 profile as I'm not overweight and quite fit for my age (64)
I have been testing for ketones for a couple of weeks and every test has shown negative or trace, so no worries there. I feel absolutely fine, swimming, digging the garden, walking/jogging with our dog etc and wouldn't know that my blood sugars are high except for the tests!! I'll follow the advice of my diabetic team and keep taking the gliclazide, monitoring my blood sugar and I'm also keeping a food diary and test chart. My diabetes nurse is due to phone me tomorrow and she has said that it is very likely I will have to go on insulin. I'm not remotely worried about it as I'm very organised about it all and the injections won't bother me (Having had to inject my own stomach during cancer treatment with quite a long needle!!) Just hope they can get me sorted before we go to Scotland for a few weeks....... 🙂

Thanks for the support.