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Bazarama

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Hi, newly diagnosed (type still tbc - waiting on results back from the hospital) 3 weeks ago. I’m a recently turned 50 year old!!!

Had been feeling fatigued, ‘woozy’ and generally off for a few weeks after Covid. Thought it was the knock on effects of that. Had an telephone appt with my GP surgery arranged for 2 weeks time but felt I couldn’t wait any longer (a colleague strongly persuaded me to call and push for a quicker appt) and got a same day nurse appt. Within an hour I was in hospital EMU getting lots of tests.

A few hours later I was advised I had diabetes, my Hba1c was 119. They suggested I was probably type 2. The hospital wanted to keep me in but after being on a couple of drips, given insulin, and looking like a pin cushion the doctors agreed I could go home.

I was advised that if I’d waited for medical assistance much longer I would have been in a much worse place.

Currently taking metformin 2x500mg a day and insulin x2 daily. BG is steadying at 7mmol on average this last week.

Still getting my head round all this new stuff which can be quite overwhelming, but getting there.

The last couple of conversations I’ve had with the diabetes clinic is that it’s leaning more to type 1, however until the results come back I’ll continue doing what I’m doing and getting more of an understanding of what this is all about with the help of this forum.
 
Welcome to the forum and well done on getting your BG down to where it is at the moment. Hopefully, when all your results come back, you'll get a definite diagnosis of type so you can move on with the right management plan. In the meantime welcome aboard.
 
Hi and welcome. Covid can prompt T1 in some people, and if small doses of insulin have got you down to 7mmol then it would seem more likely but your tests will confirm.

What insulins and doses are you on? Are the diabetes clinic going to change the insulins?
 
Yes, welcome to the forum @Bazarama.

If you could clarify exactly which insulin you've been prescribed (there are many types with some quite different performance characteristics) that might provide some extra insight into what the current "holding" strategy is for you while you wait for your test results.

Were you given any guidance on diet during this period? Until you know where your diagnosis is heading I would caution against any sort of knee-jerk reaction and not to set about changing your world. Particularly since you are already taking extraneous insulin and other radical changes could make you very vulnerable to hypoglycaemic episodes. I presume these were explained to you along with how to treat hypos. [Please note I am not in any way medically qualified!]

While "diabetes" is the common denominator and thus generically in the diagnosis of both T2 and T1 - the treatment paths are generally very different. So it is possible that significant changes now could also obscure results from any future tests and confuse matters down the line. The good thing is that you seem to have taken your BG back into normal, reasonable territory. Presumably very much thanks to the extra insulin. [Again, this is my layman's perspective.]
 
Thanks for the welcome

I’m on humulin 70/30 taking 12 units before breakfast and dinner.

The clinic wanted to change me to a basal bolus routine after a week, I was nervous about this as I thought it was too early and suggested I wait another few weeks which they agreed to.

I’ve a dietician appointment in a couple of weeks and hopefully by then will know which type.
 
I should also say that I have experienced a number of ‘hypos’ since (around 5 or 6). I find them very noticeable and quite quick to come on. I think I cut too many carbs from my diet!
 
Bazarama said:
Thanks for the welcome

I’m on humulin 70/30 taking 12 units before breakfast and dinner.

The clinic wanted to change me to a basal bolus routine after a week, I was nervous about this as I thought it was too early and suggested I wait another few weeks which they agreed to.

I’ve a dietician appointment in a couple of weeks and hopefully by then will know which type.
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Humbling 70/30 is a mixed insulin, part basal, part bolus. The basal is intended to deal with internal glucose releases that your body makes hour by hour, day by day. For the most part you can't prevent these glucose releases. The bolus is for the carbs that are in your food and because the mixed insulin is in fixed proportions you have to eat the right amount of carbs for the insulin you have been given. This is putting the cart before the horse. If you were housebound or bedbound then this sort of insulin regime has a place.

But I can see that a basal/ bolus regime would give you better flexibility, albeit that it means more work (learning) at this stage. But the learning is probably inevitable and unlikely to be wasted.
Bazarama said:
I should also say that I have experienced a number of ‘hypos’ since (around 5 or 6). I find them very noticeable and quite quick to come on. I think I cut too many carbs from my diet!
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Yes, too many carbs cut as you say. However your comment tells me you have a pretty good idea of what is going on with your metabolism.

Have you been advised to reduce your insulin slightly? Hypos are a consequence of too much insulin around! The Humulin can result in your pancreas getting some respite and then producing more of your own insulin - hence a surplus in your BG and a tendency for hypos. Better, in principle, to reduce the insulin rather than having to keep feeding it.
 
Thanks, that’s really helpful information.

No advice on changing the insulin as yet we agreed to review in a couple of weeks time.

Part of me hopes for T2, but T1 might be easier to manage - who knows! I’m sure this steep learning curve will continue for quite a while!
 
Bazarama said:
Part of me hopes for T2, but T1 might be easier to manage
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I think it depends. Many with T2 just need manageable changes to what they eat and can otherwise more or less ignore it, but some need very much the same level of insulin management as T1 but aren't offered the same options as people with T1. So it just depends. (Some with T2 are started with some insulin just to get levels down initially.)
 
Bazarama said:
The clinic wanted to change me to a basal bolus routine after a week, I was nervous about this as I thought it was too early and suggested I wait another few weeks which they agreed to.
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Id say yes to this ASAP, basal bolus will make things far easier for you, it’s very difficult to get good blood sugars and good flexibility in life with mixed insulin. There are some exceptions such as if you have a carer come to do your injections or if you live a very regimented life eg resident in a care home.
 
Bazarama said:
No advice on changing the insulin as yet we agreed to review in a couple of weeks time.
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You don’t have to wait a couple of weeks. When you feel ready for it you can just ring and ask to arrange to start it, then they can arrange an appointment and sort the prescriptions out etc.
 
Welcome Bazarama, best wishes with your test results.
 
Welcome to the forum. I'm newly diagnosed Type 2 so don't have much in the way of useful knowledge to add but I've found this forum so useful, I like welcoming other people who've found it too!
 
BobbleHat said:
Welcome to the forum. I'm newly diagnosed Type 2 so don't have much in the way of useful knowledge to add but I've found this forum so useful, I like welcoming other people who've found it too!
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Thank you BobbleHat
 
Hi @Bazarama and welcome to the forum!

Gosh, that must have been quite a shock, I hope you get your results soon! The only thing I would add is that if you'll be looking for more info once you get your full diagnosis, you might find our Learning Zone useful. There's also a thread with some reading that other users have found useful, and if you'll have any questions at all - do share!
 
So no real update - spoken to my clinic yesterday, no results back yet so no type identified yet. Have a dietitian appt next Mon and nurse appt a week Fri. I’ve reduced my insulin by 2 units to 10 as I was getting a few hypos. Strangely, yesterday read 13.5 before lunch and today with the exact same breakfast (less a Warburton wholemeal thin - nothing on it) today I was at 2.8. Surely one of those wouldn’t make such a difference??!
 
Welcome to the forum @Bazarama

Did the nurse explain to you that on the mixed insulin you need to eat at fixed times and the dose is set to deal with the same amount of carbs at each meal. When you switch to basal/bolus regime you are likely to find life a lot easier, as you can then eat or not eat when you want to and can eat meals of whatever size you want. It requires you to work out how many carbs are in each meal and then do an appropriate dose for meals of that size. This may sound complex but it is amazing how much information about the foods you usually eat that you can hold in your head.

Let us know how you get on with your appointments and come back with any questions that arise.
 
Dietician appointment done, he was great, worked with my diabetes nurse and we agreed at the appointment that I would get the Libre fitted and onto basal bolus.

I’m less than 24 hours in and I can already see a flattening of my blood sugar within range.

Next appt with the nurse is tomorrow and already have questions!!! All good though. Still no type yet and upped Metformin too.

Shout out to the team at St John’s in Livingston, they have been great. My mind is so full of ‘what ifs’etc and I’m sure I’ll get there (with a lot of hiccups on the way). Next appt is eye screening then consultant. It’s all pretty full on!

After today I probably need to realise not to be too reactionary to peaks and troughs with my BG unless they are going crazy! That’s where the insulin kicks in.
 
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