Hello, I am new to the forum

[rpg-girl86]

Hi all. New here. Diagnosed type 2 6 years ago when I found out I was pregnant (not gestational) did amazingly on insulin (day and night) went from 85 HBA1C to 33 when I had my daughter. Came off insulin onto Metformin and then later, glimeparide. Latest HBA1C was 87. For those of you late diagnosed type 1's, how did your doctors tell the difference?

 

[Leadinglights]

Hi all. New here. Diagnosed type 2 6 years ago when I found out I was pregnant (not gestational) did amazingly on insulin (day and night) went from 85 HBA1C to 33 when I had my daughter. Came off insulin onto Metformin and then later, glimeparide. Latest HBA1C was 87. For those of you late diagnosed type 1's, how did your doctors tell the difference?

Often diagnosis is based on a combination of clinical symptoms, age, effectiveness of dietary changes or oral medication, however this does lead to misdiagnosis for some people. The tests that need to be done to confirm Type 1 are c-peptide and GAD antibodies but GPs are often reluctant to do them as they are expensive and the sample has to be collected and processed under special conditions.
For example a friend in her late 70ies had been losing weight, had very high blood glucose despite changing her diet and taking metformin, gliclazide was added but there was no improvement and only then after 2 years did she have the tests and Type 1 was confirmed.
For many the correct diagnosis can take many years as sometime test results are not clear cut.

 

[rpg-girl86]

Thanks for your reply I was diagnosed at age 30, have family with autoimmune disease (no type 1's) my HBA1C came down a little bit and had a couple of hypos when first started taking glimeparide which I think stimulates your pancreas, but no longer has much effect. Metformin has never done much, now on 1g and 1mg glimeparide. I'm now 36 and it's just getting higher and I don't have an excessive amount of carbs per day. I'm 16st and struggle to lose any weight since being on Metformin, I just fluctuate by a few lbs no matter what I eat or do. Just not sure what to do about it anymore.

 

[Leadinglights]

Thanks for your reply I was diagnosed at age 30, have family with autoimmune disease (no type 1's) my HBA1C came down a little bit and had a couple of hypos when first started taking glimeparide which I think stimulates your pancreas, but no longer has much effect. Metformin has never done much, now on 1g and 1mg glimeparide. I'm now 36 and it's just getting higher and I don't have an excessive amount of carbs per day. I'm 16st and struggle to lose any weight since being on Metformin, I just fluctuate by a few lbs no matter what I eat or do. Just not sure what to do about it anymore.

You may benefit from testing your meals to see how well you tolerate the amount of carbohydrates you are having. Often people say they are not having many carbs per day but that could still be more than your body can cope with despite the medication. Testing before you eat and after 2 hours will give you a good indication if you tolerate the meal if the increase is more than 2-3mmol/l.
One pointer of Type 1 is losing weight rapidly which is not something you are experiencing however the autoimmune aspect would fit.
By collecting some data on your meals with how many carbs and your reading would provide evidence for a review of your medication regime.
There are some Type2s who need insulin as other meds are not working but there may be other oral medication options before that option.
Have a look at this link to see if that dietary approach may help. https://lowcarbfreshwell.com/

 

[rpg-girl86]

Thank you. I did used to have a monitor and bloods were always highest in the morning when I did my fasting reading (never below 6 even with the lower HBA1C). I haven't done it after a meal in a long time as GP won't give me a monitor anymore so will have purchase one I think and start logging carbs consumed and testing before and after. Thank you for your advice!

 

[Leadinglights]

Thank you. I did used to have a monitor and bloods were always highest in the morning when I did my fasting reading (never below 6 even with the lower HBA1C). I haven't done it after a meal in a long time as GP won't give me a monitor anymore so will have purchase one I think and start logging carbs consumed and testing before and after. Thank you for your advice!

As the medication you are on, the glimepiride has the potential to cause low blood glucose your GP should prescribe a monitor and test strips, maybe not enough to do before and after meal testing but it would help.
Many don't see fasting levels lower than 6 so that is within expected range of 4-7 fasting and before meals and 2 hours post meal aiming at no more than 8-8.5mmol/mol.

 

[rpg-girl86]

Sorry I hit 6 instead of 9. Had to keep a diary when I was pregnant with all my readings while I was on insulin. The glimeparide doesn't seem to work now it's been 18month since I started. I have a review due soon so hopefully they might suggest something new. When I was insulin I could hit the post meal targets but not on any sort of oal medication no matter what I eat. But, like I said, I've not tested in a while so will order a glucose monitor and see what happens

 

[Leadinglights]

Sorry I hit 6 instead of 9. Had to keep a diary when I was pregnant with all my readings while I was on insulin. The glimeparide doesn't seem to work now it's been 18month since I started. I have a review due soon so hopefully they might suggest something new. When I was insulin I could hit the post meal targets but not on any sort of oal medication no matter what I eat. But, like I said, I've not tested in a while so will order a glucose monitor and see what happens

It is very easy for carb intake to drift upwards and the medication can only do so much.
Keeping a food diary with an estimate of your carbs in each meal and any extras for drinks and snacks could reveal that has happened.
Gliclazide is suggested as a more effective oral mediation for some people.
If your fasting level is 6mmol/l then that would suggest that if your HbA1C is high that it is your post meal levels are drifting too high.

 

[everydayupsanddowns]

Welcome to the forum @rpg-girl86

Sorry to hear how difficult your diabetes is being.

Antibody checks aren’t always completely clear cut, and there is a greater risk of false negatives the longer it has been since diagnosis.

However we have lots of members who have been able to get clarification of their diabetes type by getting either or both of antibody and cPeptide checks.

I wonder if cPeptide might be more helpful for you at this point, as it gives an indication of how much insulin your body is able to naturally produce - and from what you’ve said a low production (despite the glimipiride) may convince a reticent GP that your diabetes type may need reviewing?