Hi,

[brendawright]

Hi, I was diagnosed T2 about 18 months ago 48mm and have been trying to keep my levels down with diet. My weight is 10s 1 and I eat healthily, exercise and no diabetics in the family
My latest test showed 56mm and I've just been put on Metformin, 500mg morning and evening.
All a bit depressing

 

[rebrascora]

Hi and welcome.

Sorry to hear that you haven't had any reward from your dietary changes and are feeling a bit disillusioned.
You mention eating healthily but what is healthy for a non-diabetic person may not be quite so suitable for a diabetic. Y The NHS dietary guidance can sometimes not be too helpful in this respect.
Can you give us an indication of the sort of things you were typically eating and drinking for breakfast lunch and evening meal, so we can see if you have perhaps fallen into the common mistake of assuming diabetes is all about added sugar rather than all carbohydrates. We could then possibly suggest some alternatives which might give you better results.

Also you mention your weight as 10st 1 but without knowing your height and build, it is difficult to assess whether this indicates you are overweight by a little or quite a bit or not at all.

Have you also been able to increase your activity levels? It doesn't have to be anything too exertive. A brisk daily walk is ideal if you are able or swimming or cycling or certainly something more exertive if you fancy it.

Anyway, I hope that we can help you to turn things around for you if you can provide us with a little more info about your current diet and lifestyle, so we can make appropriate suggestions.

 

[brendawright]

Hi Barbara, thanks so much for responding .
My usual meals are something like
Breakfast, either eggs or a spoon of muesli, no added sugar, nuts, seeds, full fat Greek yoghurt and a handful of berries plus splash of no added sugar almond milk.
I always start the day with a mug of hot water and lemon.
Cup of tea, no milk.
Coffee,, black
Lunch, varies, sometimes home made veg soup or couple of eggs, or mackerel or sardines on a slice of wholemeal toast or home made soda bread,(no sugar)

Maybe an apple in the afternoon or a small orange. Summertime I love cherries !!
More tea and a couple of glasses of water
Dinner, can be a lot of things...fish, chicken sometimes pork or beef, pasta once a week .. i make rhe sauce rather than a jar, , curry, low carb recipe and spoon of rice.
Try to have as much veg as possible
Summertime lots of salad and fresh salmon, olive oil and balsamic.
I might have a small bit of cheese with a cracker or some stewed apple ir rhubarb from the garden made with little bit of stevie.
I don't snack much but like one of those little lotus coffee biscuits
After dinner, coffee and a square of 85 or 90% dark chocolate and another glass of water
I'll also have green tea and camomile through the day.
I'm medium build and 5ft4.
I've lost half a stone so I wasn't massively overweight to start and trying to lose another half.
Drinking has been cut back and I only have a glass ir two of wine at weekends as a rule.

 

[brendawright]

Sorry, that posted before I finished....exercise.... I walk fairly briskly for about 45 minutes most days.
Thanks so much.

 

[everydayupsanddowns]

You seem to have cut your carb intake down to pretty low levels from the menu you’ve posted. But your HbA1c is still rising.

And it sounds like you weren’t particularly overweight at diagnosis.

Did your diagnosis come on fairly rapidly? And did you unintentionally lose any weight before you were diagnosed? Do you have close family members with T2?

I’m just wondering if there might be a chance you could have a slow-onset autoimmune diabetes such as LADA, or even straight T1 which can come on more slowly in adulthood?

 

[brendawright]

Hi, no it came as quite a shock when I had a private health screening a couple of years ago, they told me I was pre diabetic but the levels keep rising everytime I get checked
The doctor said I'm not your typical diabetic and probably just unlucky.. no diabetes in the family history so far as I know.
I don't know about the LADA..never heard of it. Would this show in my usual blood tests?

I have to say I'm finding the dietary advice on different sites very confusing and contradictory. The one I was looking at today on a link from here said no bread, pasta, cereals, rice, potatoes alcohol etc and others say most sensible things in moderation !

 

[rebrascora]

I agree that you appear to have stripped your carb intake down to a reasonably low level and to not see improvement in HbA1c from that makes me also wonder if you may not be a straightforward Type 2 and should perhaps push for some other testing (C-peptide and GAD antibody tests) to shed a bit more light on the situation.
LADA or Latent Autoimmune Diabetes in Adults is a slow onset form of Type 1 diabetes, where the body's immune system slowly kills off your insulin producing beta cells. It often initially presents like Type 2 where BG levels and as a result HbA1c is inflated, but can sometimes respond to dietary changes or increased activity and/or oral meds initially but over months or years, sometimes in response to a trigger like a virus or even a vaccination, the immune system gets it's knickers in a twist and accidentally kills off a few more beta cells. Eventually you get to a point where the remaining beta cells can no longer produce enough insulin to keep a lid on levels and they can escalate quite suddenly once this "tipping point" is reached and insulin therapy becomes a necessity. Some people can go many years with a Type 2 diagnosis, doing their very best with lifestyle changes and oral meds until insulin is the only option. Sadly some of those people never get the appropriate testing to confirm that they are LADA and not Type 2 and whilst it is unfair, there is very much a 2 tier system with regard to treatment of diabetes based on your diagnosis with Type 1 diabetics getting much more support (and sympathy in many cases) both in terms of technology and education and access to specialists, whereas Type 2s are usually managed at GP practices my nurses with a very limited understanding of diabetes and unfortunately sometimes a quite negative approach. LADA is a form of Type 1 diabetes, but it just has a slower onset which can make it look like Type 2 initially and once you get the "Type 2 label" it can be a hard battle to get that reviewed and the testing mentioned above done. The situation is compounded at the moment by the specialist diabetes clinics being over stretched as a result of Covid which may well be one of the triggering factors in the body killing off it's own insulin production, as well as diabetics being at higher risk of complications due to the action of Covid.

Apologies if that is all a lot to try and take in but if you have a good relationship with your doctor you might be able to get them to refer you to a clinic where those tests really need to be authorized and the results interpreted because GPs really don't have enough knowledge of diabetes to make an educated decision on these more complex cases and some GPs may not even have heard of LADA. There are some GPs who still believe that you can't be Type 1 diabetic if you develop diabetes later in life (and therefore must be Type 2) because Type 1 is a childhood illness..... which is totally incorrect and there are plenty of us here on the forum to prove them wrong.

Not saying you are definitely LADA or Type 1 but it is something to keep in mind and perhaps start introducing into the conversation with your GP.

Really just want to reassure you that you are clearly doing your best judging by your menu and exercise levels to improve things and when your levels have gone up instead of down, it is very easy to beat yourself up and feel like you are failing (been there and got the T-shirt 🙄 ) when, in reality, there may be nothing you can do to prevent it from progressing to you needing insulin at some point down the line, if your immune system is killing off your own insulin production. It is just bad luck in a lot of respects as your GP said but getting the right diagnosis is still important, so do be prepared to push for that if you think you may be LADA..... Having other autoimmune conditions can be another indicator or other family members with autoimmune conditions.

 

[brendawright]

Hi, no it came as quite a shock when I had a private health screening a couple of years ago, they told me I was pre diabetic but the levels keep rising everytime I get checked
The doctor said I'm not your typical diabetic and probably just unlucky.. no diabetes in the family history so far as I know.
I don't know about the LADA..never heard of it. Would this show in my usual blood tests?

I have to say I'm finding the dietary advice on different sites very confusing and contradictory. The one I was looking at today on a link from here said no bread, pasta, cereals, rice, potatoes alcohol etc and others say most sensible things in moderation

I agree that you appear to have stripped your carb intake down to a reasonably low level and to not see improvement in HbA1c from that makes me also wonder if you may not be a straightforward Type 2 and should perhaps push for some other testing (C-peptide and GAD antibody tests) to shed a bit more light on the situation.
LADA or Latent Autoimmune Diabetes in Adults is a slow onset form of Type 1 diabetes, where the body's immune system slowly kills off your insulin producing beta cells. It often initially presents like Type 2 where BG levels and as a result HbA1c is inflated, but can sometimes respond to dietary changes or increased activity and/or oral meds initially but over months or years, sometimes in response to a trigger like a virus or even a vaccination, the immune system gets it's knickers in a twist and accidentally kills off a few more beta cells. Eventually you get to a point where the remaining beta cells can no longer produce enough insulin to keep a lid on levels and they can escalate quite suddenly once this "tipping point" is reached and insulin therapy becomes a necessity. Some people can go many years with a Type 2 diagnosis, doing their very best with lifestyle changes and oral meds until insulin is the only option. Sadly some of those people never get the appropriate testing to confirm that they are LADA and not Type 2 and whilst it is unfair, there is very much a 2 tier system with regard to treatment of diabetes based on your diagnosis with Type 1 diabetics getting much more support (and sympathy in many cases) both in terms of technology and education and access to specialists, whereas Type 2s are usually managed at GP practices my nurses with a very limited understanding of diabetes and unfortunately sometimes a quite negative approach. LADA is a form of Type 1 diabetes, but it just has a slower onset which can make it look like Type 2 initially and once you get the "Type 2 label" it can be a hard battle to get that reviewed and the testing mentioned above done. The situation is compounded at the moment by the specialist diabetes clinics being over stretched as a result of Covid which may well be one of the triggering factors in the body killing off it's own insulin production, as well as diabetics being at higher risk of complications due to the action of Covid.

Apologies if that is all a lot to try and take in but if you have a good relationship with your doctor you might be able to get them to refer you to a clinic where those tests really need to be authorized and the results interpreted because GPs really don't have enough knowledge of diabetes to make an educated decision on these more complex cases and some GPs may not even have heard of LADA. There are some GPs who still believe that you can't be Type 1 diabetic if you develop diabetes later in life (and therefore must be Type 2) because Type 1 is a childhood illness..... which is totally incorrect and there are plenty of us here on the forum to prove them wrong.

Not saying you are definitely LADA or Type 1 but it is something to keep in mind and perhaps start introducing into the conversation with your GP.

Really just want to reassure you that you are clearly doing your best judging by your menu and exercise levels to improve things and when your levels have gone up instead of down, it is very easy to beat yourself up and feel like you are failing (been there and got the T-shirt 🙄 ) when, in reality, there may be nothing you can do to prevent it from progressing to you needing insulin at some point down the line, if your immune system is killing off your own insulin production. It is just bad luck in a lot of respects as your GP said but getting the right diagnosis is still important, so do be prepared to push for that if you think you may be LADA..... Having other autoimmune conditions can be another indicator or other family members with autoimmune conditions.

Wow, thank you for such a detailed response and it is, definitely, a lot to take In
I'll talk to my surgery on my next check.

Wishing you well.