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Amberwood99

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Type 2
Hi. I’ve been living with type 2 since diagnosed in 2008 and controlled my glucose levels fairly adequately via diet and Metformin. Over the past year levels have been gradually increasing and I’m afraid that I’m rapidly heading towards type 1.
Have joined this forum to get any advice - particularly whether the new scanning system would be useful to me instead of finger pricking.
 
You cannot become Type 1 unless misdiagnosed in the first place as they are different conditions. What can happen is your tolerance to carbohydrates can change which means you may need to review your diet or have additional oral medication or if that doesn't work then some people who are Type 2 will need insulin.
The first thing to look at would be your intake of carbohydrates as over time that can creep up. This link might help with some ideas for modifying your diet if your carb intake is a bit too high. https://lowcarbfreshwell.co.uk/
Many find no more than 130g total carbs per day is where they need to be at to keep blood glucose levels where they need to be, but some people need to be lower than that.
Are you testing before and 2 hours after meals to see if you are tolerating them.
Keeping a food diary of everything you eat and drink, estimating the total carbs may help you see where you are at with your intake.
 
Hi @Amberwood99 and welcome to these forums. You’ll get loads of info and support on here from some very friendly and knowledgeable people.

As @Leadinglights has said, you cannot become type 1, but may have been misdiagnosed back in 2008 (which happened to me). In rough terms, T1 means that your pancreas no longer produces any insulin (by an auto immune attack killing the beta cells that produce insulin in the pancreas) whereas T2 is a combination of the pancreas not producing enough insulin and your cells becoming “Insulin Resistant”. Your T2 could become worse over the years and eventually need additional insulin injected to supplement what your pancreas is producing.

I know there are lots of T2 people who successfully improve their insulin sensitivity by way of what they eat and losing any excess weight, so diet is still a strategy along with Metformin which helps your body make better use of the insulin you have. There are also other drugs that can stimulate the pancreas into creating more insulin.

Given your diagnosis is so long ago it would not be possible now to get a definitive diagnosis of T1 as this relies on testing for antibodies (Gad) that have destroyed the insulin producing beta cells or a c-peptide test to ascertain whether your pancreas is making any insulin at all (but presumably you still are producing insulin otherwise you would very quickly be in trouble with very high BGs)

My situation was that Metformin and diet did nothing to help me at all and so I was started on insulin really quickly, even though still diagnosed as T2. Fast forward to this year (20 years from starting on insulin) and my current consultant has changed my diagnosis to T1 (which I must have been all along) given how I respond to insulin and how much insulin I need. Whatever the original cause I now know that I do not produce any insulin myself and that the amount of insulin I need reflects no increased insulin resistance. There are others on this forum who were also misdiagnosed as T2, so it is possible.

Maybe your insulin production is slowing and / or your insulin resistance increasing? I did have a GP tell me that D is a progressive disease so this maybe what is happening?

As to your question about scanning, definitely very useful regardless of what type you are. Sadly only T1s can currently get the Libre system prescribed on the NHS so you would be faced with having to self fund and at around £50 per sensor every 14 days this is a very expensive option. I have seen some people on here self fund for short periods and use the information to gauge how they respond to carbs, which foods cause high BG readings, which are better to maintain a more consistent BG throughout the day, etc. I would definitely advocate for the Libre system, for a lot of us it has been a real game changer. For those of us using insulin this also removes the multiple finger prick testing, which only gives you a snapshot when you do it (like driving on a mountain road at night with your eyes closed and only opening your eyes every few miles!).

Sorry for the long answer, but I hope it helps you in some way! Please keep asking questions as I’m sure you will find something that helps you to keep your BG levels down and get a more normal HbA1c!
 
Hi Amberwood99, welcome to the forum.

As kindly advised above, you can't become type 1 but the way in which type 2 diabetes needs to be managed can change for a variety of reasons such as a change in lifestyle, stress levels and getting covid to name a few.

It sounds like it might be worth booking an appointment with your GP and have your HbA1c tested along with a review of how things are going and what may need to be done to improve things.
 
Thank you for all your replies. I now understand the difference between the types. Over the past few years my annual HbA1c test has averaged around 40mmol but in the latest test it has risen to 89mmol. Doctor says its a general progression of the disease but seems a bit extreme considering there has been no radical change to my lifestyle/diet since the last test. She want to add more medication but I have asked her to defer for 4 months.
Now looking at my food intake once again and have reverted to a vegetarian diet as this has worked for me in the past although I hate it and I wasn't able to keep it up permanently. However, after a month it doesn't seem to have had much of an effect on my glucose levels this time. I am now finger pricking 2 hours after each meal to see how different foods are affecting levels. this morning I tested at 8.5 before a bowl of porridge - 2 hours later it was 12.7. Can someone tell me what I should be looking for from this? Is this a good or bad difference?
 
Ideally you are looking for a before number of between 4-7. Guidelines for after are either up to 8.5, or a 2-3mmol rise from before.

You had a rise of 4.2 there which suggests that your body can't adequately cope with that much carbohydrate - or at least not that much without fat and protein to slow absorption as for some of us that makes a significant difference to how much carbohydrate we can cope with for a meal. You might find your body can cope better with having eggs instead of porridge for breakfast, or having a smaller portion of porridge alongside an egg, some nut butter, or similar.

It's often recommended for type 2 diabetics on metformin or diet only (no medications that can cause hypos) to try to limit total carbohydrate for the day to 130g.
 
I have had to reevaluate what works for me a number of times over the years, and adjust what I eat,
 
Porridge may have a reputation for being "healthy" and low GI but it isn't for everyone and it is still a high carbohydrate food.
If you don't like/want to be vegetarian, then to be honest, don't be. A meat and dairy based diet is easier to reduce carbs than vegetarian/vegan because meat and fish has zero carbs whereas the vegetarian protein sources like beans and lentils also have carbs.

It sounds like you may need to reassess your understanding of food in terms of your diabetes. Many of us have eggs for breakfast or full fat Greek yoghurt with a few berries and mixed seeds. These are good low carb options.
Many people are more insulin resistant in the morning and therefore eating a carb rich food for breakfast can be more challenging for their diabetes than at other times of day.
In your situation, I would swap your breakfast for a lower carb option as a first step and see how you get on with your testing. High fasting readings in the morning are usually the last to come down and it may take weeks/months of low carb eatng to bring them down into range, but you are looking for a meal increase (ie the rise in BG due to the food you ate) to be consistently less than 3 mmols for those fasting levels to start reducing. If you can keep the meal rise to under 2mmols they should come down a little quicker, but mostly between 2-3mmol rise from a meal should give you effective results.
 
rebrascora said:
Porridge may have a reputation for being "healthy" and low GI but it isn't for everyone and it is still a high carbohydrate food.
If you don't like/want to be vegetarian, then to be honest, don't be. A meat and dairy based diet is easier to reduce carbs than vegetarian/vegan because meat and fish has zero carbs whereas the vegetarian protein sources like beans and lentils also have carbs.

It sounds like you may need to reassess your understanding of food in terms of your diabetes. Many of us have eggs for breakfast or full fat Greek yoghurt with a few berries and mixed seeds. These are good low carb options.
Many people are more insulin resistant in the morning and therefore eating a carb rich food for breakfast can be more challenging for their diabetes than at other times of day.
In your situation, I would swap your breakfast for a lower carb option as a first step and see how you get on with your testing. High fasting readings in the morning are usually the last to come down and it may take weeks/months of low carb eatng to bring them down into range, but you are looking for a meal increase (ie the rise in BG due to the food you ate) to be consistently less than 3 mmols for those fasting levels to start reducing. If you can keep the meal rise to under 2mmols they should come down a little quicker, but mostly between 2-3mmol rise from a meal should give you effective results.
Click to expand...
Wow. you have just given me more information in that reply than my doctor has given me in years. Thank you.
 
Would you like to tell us the sort of things you have for other meals to see if we can spot other carb rich foods..... many of which are healthy for non diabetic people but not great for a diabetic trying to manage their condition with diet and/or medication. Things like fruit for instance.... Bananas and grapes and mangos etc are higher carb. Berries like rasps and blackberries and strawberries and black/redcurrants etc are lower carb. Apples are somewhere in between. Having a small portion of these fruits once or twice a day (I sometimes have half an apple at lunch and the remainder with cheese in the evening, so that I am spreading out the carbs and eating it with cheese slows down the release of glucose from it... and the cheese helps to keep me feeling full... Fat is important with a low carb diet because it provides slow release energy and takes longer to digest so that you don't get a spike of glucose in your blood stream and then a drop like you do from carbs which is why you feel hungry mid morning and mid afternoon and want more food. I can eat 2 meals a day, with more fat in my diet and not feel hungry in between and have plenty of energy..... and my cholesterol levels are coming down instead of going up as you might expect. Eating like this has helped me enormously with the disordered eating I was struggling with before and made my Blood Glucose levels much more stable than eating grain based foods, like bread and pasta and rice and breakfast cereals including porridge.... which hits my blood stream in 20mins even made with cream. I used to love my morning porridge but now I love my morning yoghurt. I try not the think about the things I can no longer eat and instead find new things that I really enjoy.
This has to be a way of eating for life, so I need to enjoy it and 3.5 years into it, I just don't crave those carb rich foods anymore and I enjoy what I eat and it is clearly healthy for me because I am fitter and stronger and slimmer and feel younger than I have for years. My joints don't give me grief like they used to and my digestive system (particularly my bowels) are the happiest they have been for most of my life and at 58yrs old, I think that is a fair indication that my current diet agrees with me even if the NHS might have a fit about the amount of cheese I eat! 😱🙄
 
rebrascora said:
Would you like to tell us the sort of things you have for other meals to see if we can spot other carb rich foods..... many of which are healthy for non diabetic people but not great for a diabetic trying to manage their condition with diet and/or medication. Things like fruit for instance.... Bananas and grapes and mangos etc are higher carb. Berries like rasps and blackberries and strawberries and black/redcurrants etc are lower carb. Apples are somewhere in between. Having a small portion of these fruits once or twice a day (I sometimes have half an apple at lunch and the remainder with cheese in the evening, so that I am spreading out the carbs and eating it with cheese slows down the release of glucose from it... and the cheese helps to keep me feeling full... Fat is important with a low carb diet because it provides slow release energy and takes longer to digest so that you don't get a spike of glucose in your blood stream and then a drop like you do from carbs which is why you feel hungry mid morning and mid afternoon and want more food. I can eat 2 meals a day, with more fat in my diet and not feel hungry in between and have plenty of energy..... and my cholesterol levels are coming down instead of going up as you might expect. Eating like this has helped me enormously with the disordered eating I was struggling with before and made my Blood Glucose levels much more stable than eating grain based foods, like bread and pasta and rice and breakfast cereals including porridge.... which hits my blood stream in 20mins even made with cream. I used to love my morning porridge but now I love my morning yoghurt. I try not the think about the things I can no longer eat and instead find new things that I really enjoy.
This has to be a way of eating for life, so I need to enjoy it and 3.5 years into it, I just don't crave those carb rich foods anymore and I enjoy what I eat and it is clearly healthy for me because I am fitter and stronger and slimmer and feel younger than I have for years. My joints don't give me grief like they used to and my digestive system (particularly my bowels) are the happiest they have been for most of my life and at 58yrs old, I think that is a fair indication that my current diet agrees with me even if the NHS might have a fit about the amount of cheese I eat! 😱🙄
Click to expand...
Thank you Barbara, some very relevant things for me to think about. Looking back at my usual diet, I can see that carbs could be my downfall so I am giving up the vegetarian diet for a low carb one. I was encouraged today by a pre - lunch 7.8, had eggs (scrambled), took the dog for a walk and then tested (2 hours after eating) at 7.6!
thank you to everyone for their input, you're good guys!
 
You seem to be on the right track now. I am very low carb (20g or fewer per day) and I find that very easy to stick to - I check the nutritional info on food and try where possible to buy ingredients and foods that are between 0 - 5.5g carbs per 100g and that usually keeps me on track.

This is a post I shared on another thread that may be of interest to you.
Since I made that post I discovered that Sainsbury sell a pea milk alternative that tastes wonderful and is zero carb it is called Wunda Unsweetened. My non diabetic husband prefers it to dairy milk and it is amazing in coffee as it can be frothed beautifully.

 
If you want ideas for low carb meals we are happy to make suggestions. I know how mind boggling it was for me at first to imagine meals without bread (which is of course a carrier for so many foods) potatoes, pasta and rice once I had cut out the obvious cakes and biscuits and sweets of course. You may be able to manage small portions of those foods rather than remove them from your diet altogether or find lower carb alternatives like LivLife bread and Edamame bean pasta but I just don't miss those bulk beige foods anymore and I just have the tasty stuff with more low carb veggies. So I am quite happy with my bolognaise sauce on a plate of chopped or spiralized courgettes or shredded cabbage or if you really wat the look of spaghetti, you can use konjac noodles (also available as rice) which is high in fibre but pretty well zero carb. It comes in pouches and needs to be drained and well rinsed before heating. You can make chips from celeriac instead of potatoes and have that with a nice steak (rib-eye being my favourite) with mushrooms and a big plate of salad and a large dollop of coleslaw (full fat variety... personally I prefer cheese coleslaw because there are few things which don't taste better with cheese) Another favourite of mine is ratatouille made with plenty of olive oil and served either with halloumi or high meat content sausages (cheap sausages contain more rusk/carbs) or chicken or gammon. Halloumi also goes really nice in a cauliflower curry. Cauliflower can be mashed with a dollop of cream cheese and a spoon of wholegrain mustard to make a mashed potato alternative and works with the sausages or gammon or can be used to top a cottage/shepherd's/fish pie. Lots and lots of tasty options.... so do ask if you need inspiration or Google low carb recipes.... there are plenty out there. Some will need special ingredients, but most are available in large supermarkets. We have one or two members here who bake their own very low carb bread and bake lovely cakes with low carb ingredients, so there really isn't anything much which is off the table and alternatives are just as delicious but you just need to give it a little more thought and it takes a bit of experimenting to find what works for you.
 
We also have a thread in the Food and Recipes section with meal ideas including photos of meals some of us have made. Some of the meals are higher carb ones posted by Type 1 diabetics who can eat more carbs so long as they give themselves enough insulin, but myself and a couple of the other main posters in the thread usually post low carb meals there.
 
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