Hello - I was diagnosed with diabetes (probably type 2) on 31 January after routine blood test. I have been trying to read up on it all and am concerned that my numbers seem to be way higher than anyone else I have seen posting on here (HBac1 124, BG 20). I was put on metformin and gradually working up to 4 tablets a day (going up to 3 today). I have relatively high cholesterol (5.5) but asked not to go on the statins yet until I work out if that comes down with the BG. I’m not overweight (58kg, BMI 21, waist 27inches) and have normal blood pressure and am relatively active (swimming and walking). My symptoms only added together in light of diagnosis (tingly feet, dry mouth, hair not growing properly, most of which I put down to menopause) but I did have borderline gestational diabetes right at end of my last pregnancy 18 years ago which they decided not to treat. No one told me that might be something to watch… My brother had pre diabetes a couple of years ago which he managed with diet but I was feeling fine. On diagnosis I immediately went on a low carb diet (basically no bread, pasta, potatoes, rice etc and no sugar) but I am a little concerned that it won’t take me long to become underweight so I don’t have too much wiggle room. My GP (on a phone consultation) told me I didn’t need to test BG before my next consultation on 24/2 but I have ignored this on advice of people on this forum and am currently round about 10 or 11 mol/l on fasting with top level after eating at about 13.4 (only on 2 tablets so far). But these are obviously too high. Someone told me that I ought to be using a continuous monitor but I suppose I should wait until I’m on the full 4 pills of metformin - but quite a lot of people seem to say that metformin doesn’t actually reduce BG that much… All very confusing. Sorry for essay but thought I’d better get as many of the facts as I could in there!
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New diagnosis
- Thread starter Fleetwood
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Felinia
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- Type 2
Hello and welcome. First diagnosis can be quite scary but managing it does become 2nd nature after a time. From what you say, you fall into the slim Type 2 category, which is more unusual. Your change of diet has seen a great improvement in your blood glucose, so it is working. Most of us would advise continuing to monitor so you can work out what does and doesn't cause spikes. As you have reduced your carbs, I suggest you increase your protein, as you don't want to lose weight. It sounds as though your brother would be a good support person, as he's learned to manage his Type 2.
Leadinglights
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- Type 2
As you don't want to lose weight then compensating for reducing carbohydrates which is needed with protein and healthy fats should help. Metformin will help by assisting the body to use the insulin it produces more effectively but dietary changes will be equally important and it looks as if you have made a good start with that. It is suggested that reducing your carbs gradually is kinder on the body and will help to avoid issues with your eyes and nerves. Low carb approach suggests no more than 130g per day total carbs but does not mean NO carbs so make the carbs you have worth it for flavour and enjoyment and are not empty carbs like sugar and sugary foods.
This link may help you with some ideas for modifying your diet. https://lowcarbfreshwell.co.uk/
It would not surprise me if you turned out to be Type 1 in which case treatment will be a different ball game.
Finger pricking to check out your tolerance to meals is a good idea, your levels are pretty high at the moment so look for an increase of no more than 2-3mmol/l from before to 2 hours after meals. As levels come down then no more than 8-8.5mmol/l post meal and 4-7mmol/l before meals would be the aim. But for now take is slowly.
It is a good idea to keep a food diary of everything you eat and drink with an estimate of the amount of carbs, alongside your readings as that will provide evidence of your progress when you see your nurse
This link may help you with some ideas for modifying your diet. https://lowcarbfreshwell.co.uk/
It would not surprise me if you turned out to be Type 1 in which case treatment will be a different ball game.
Finger pricking to check out your tolerance to meals is a good idea, your levels are pretty high at the moment so look for an increase of no more than 2-3mmol/l from before to 2 hours after meals. As levels come down then no more than 8-8.5mmol/l post meal and 4-7mmol/l before meals would be the aim. But for now take is slowly.
It is a good idea to keep a food diary of everything you eat and drink with an estimate of the amount of carbs, alongside your readings as that will provide evidence of your progress when you see your nurse
Thank you- I am definitely still learning the ropes But it’s really helpful to get your advice here.
Many thanks. I’m interested to hear that you think I might be Type 1: I wonder why? I imagine I had better try and get this tested when I see GP on 24th. Should I ask for particular tests? At the moment I feel that I am really eating the bare minimum of carbs (less than 50g per day) but only see the BG go down significantly when I do a lot of exercise like 3 hours walking. But I don’t have time to do this all the time so not sure how sustainable it is. Still, I only went on the 3rd metformin yesterday so still one to go…
Leadinglights
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- Relationship to Diabetes
- Type 2
Not overweight or losing weight without effort and high HbA1C which your is can be a pointer to Type 1 or LADA (a lte onset Type 1). If dietary changes and medication have little effect is is worth asking for the tests which can rule out Type 1, those being C-peptide and GAD antibodies. Again the fact you are having to go so much exercise may also be a pointer especially with a very low carb intake.
Worth bearing in mind and mentioning at your appointment.
Worth bearing in mind and mentioning at your appointment.
That’s really helpful, thank you. I will make sure I ask.
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Welcome to the forum @Fleetwood
A diagnosis with diabetes can certainly be a confusing and worrying time - with lots of snippets of information which may (or may not!) seem to fit your situation.
Often classifying someone’s type correctly becomes something of a gradual process based on how an individual responds to different options.
There are classic forms of the main 2 types of diabetes, but pretty much any type can be diagnosed at any age, and there are rarer types (like those which involve just one wonky gene like MODY) plus atypical presentations such as underweight T2 where visceral fat still builds up around the organs even though the person is normal weight or under weight.
Unintentional weight loss, a high starting HbA1c, a fairly rapid-moving diagnosis, and not much extra weight to begin with can all suggest T1 (or another autoimmune variant) rather than T2 - and you can get T1 at any age despite it’s reputation for being connected to childhood.
Sounds like you are off to a great start with the changes you’ve been making. Keep an open mind about types, and let us know how things go at your follow-up appointments 🙂
A diagnosis with diabetes can certainly be a confusing and worrying time - with lots of snippets of information which may (or may not!) seem to fit your situation.
Often classifying someone’s type correctly becomes something of a gradual process based on how an individual responds to different options.
There are classic forms of the main 2 types of diabetes, but pretty much any type can be diagnosed at any age, and there are rarer types (like those which involve just one wonky gene like MODY) plus atypical presentations such as underweight T2 where visceral fat still builds up around the organs even though the person is normal weight or under weight.
Unintentional weight loss, a high starting HbA1c, a fairly rapid-moving diagnosis, and not much extra weight to begin with can all suggest T1 (or another autoimmune variant) rather than T2 - and you can get T1 at any age despite it’s reputation for being connected to childhood.
Sounds like you are off to a great start with the changes you’ve been making. Keep an open mind about types, and let us know how things go at your follow-up appointments 🙂
Thank you - I really appreciate the information - I’ve been feeling a bit like ‘here’s this bombshell, now get on with it’ as far as my diagnosis is concerned so it’s very heartening to hear from others.
Hi,
I have just been diagnosed (20Feb) and feel that I am the same as you apart from they put me directly onto the Atorvastatin and currently only taking 1 metformin. I am also 2 days into the lowcarb diet. My fasting blood is was really high (14.8) this morning after being around 12 previous 2 days. It was showing 9 2 hours after my evening meal last night which makes me worried. Guess it is best to keep monitoring
How are you getting on now? Has your sugar levels settled down?
Leadinglights
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- Type 2
Just to say taking steps to reduce your carb intake is a good start but don't be too much of a rush as bringing down glucose levels slowly is kinder on the eyes and nerves. Look for trends rather than individual reading as many things will affect blood glucose levels. Metformin will take a while to kick into action and therefore looking at your carb intake reducing it gradually over a few weeks. Morning readings are usually the last to come down but by reducing the increase from your meals then it will eventually reduce.
You obviously have a monitor so make good use of the information it can give you. Testing before you eat and after 2 hours aiming for an increase of no more than 2-3mmol/l will indicate the meal is OK and as your levels come down then no more than 8-8.5mmol/l 2 hours post meal is the aim. with 4-7mmol/l before meals or fasting /morning readings.
Once you have found meals which are Ok then no real need to test those again.
Low carb is suggested as being no more than 130g per day total carbs not just sugar so make sure you are looking at the total carbs in the nutritional information on products. It is definitely not NO carbs.
This link may help with some ideas and do's and don'ts, https://lowcarbfreshwell.co.uk/
The atorvastatin is presumably because your cholesterol is higher than that recommended for folk with diabetes which they like to be below 4.
Hi
Thank you that is really good advice and good to hear that morning readings are the last to come down. I have set up a spreadsheet for my readings and carb intake. I am now taking readings as you suggested before meals and 2 hours after and they have dropped during today.
Thanks for the link to the website. It has very much clarified that it is carb & sugar intake and not a low fat one - I think nowadays they all get mixed into one category.
I will be patient and keep monitoring - it is early days and I know it will take time to settle - I am being impatient!
From my perspective (which is admittedly from someone who still doesn’t know much!) your figures are not that bad given you were only diagnosed 5 days ago… I think I view the whole thing as trying to turn round a supertanker, taking quite a while to change direction. You don’t say what your Hba1c was or your cholesterol levels so I don’t really know what you are working down from.
As for me, I am now on the full four Metformin tablets as of five days ago and have been on a very low carb diet since 31 January. My BG levels have definitely come down overall. When I first tested at the beginning of February (Contour tester and App) I had highs after a (low carb) meal of 15 which was dispiriting but the average has come down bit by bit over the month from 11.02 for the first 15 days to 8.08 for the last 10 days. But actually the recent individual readings are a bit more encouraging - for example yesterday today my fasting BG was 6.9 (today 7.4 - no idea why) but by 4pm my readings were 5.6 on both days despite lunch. I definitely see the effects of exercise (only walking so far but for a couple of hours). I saw the doctor on Friday who said she had put me on Metformin immediately given how high my Hba1c was (124) and BG (20). However, they are also going to send me for tests to make sure that these readings were caused by type 2 diabetes and not something else to do with my pancreas/liver - sensible but somewhat scary to be honest.
I hope you aren’t finding the low carb diet too difficult? I found Michael Mosely’s recent keto diet book good (excellent seed crispbreads!) and generally don’t find it too bad though I did feel very miserable when family all had Italian ice-creams recently and I realised there was absolutely nothing in the place that I could actually eat! All takes a bit of getting used to…
Leadinglights
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- Relationship to Diabetes
- Type 2
It does take a while for your body to adapt to a low carb regime and anyway it is kinder on your eyes and nerves to reduce blood glucose gradually. I reduced by carbs substantially and had problems with my eyes for several months though I only started at an Hba1C of 50mmol/mol. About a month in to my low carb regime my near vision was blurry and my eyes felt as if they were not working together. There is no real difference between 6.9 and 7.4 they are within the accuracy of a blood glucose monitor.
Hi
Thank you for replying.
I do like the analogy of the supertanker and I agree that it is going to be slow progress and I am being impatient!
My Hba1c was 116 and BG 12.8 with cholesterol of 6.1. I am still on 1 metformin and Top readings have been 14.8 but generally they have been averaging at about 12
I am finding low carb quite easy - I don't have a particularly sweet tooth and not big on carbs - it was a bit of a shock as I thought I ate a generally healthy diet and tried to walk 6,000 steps a day. Crisps and salty snacks are/were my downfall and a glass of wine at the weekend. I am slightly over weight (I blame the monopause) so the diet will help me loose the excess but my father had late onset diabetes as well so mine could also be genetic as well.
Congratulations for reducing your BG that is really good and good luck with the other tests.
Hilary
Thanks for the info I will keep an eye on the amount of carbs I am eating. I hope all is well now
Well, it turns out @Leadinglights was right and I just got the results of the Gads antibody test yesterday to say that I was definitely LADA late onset type 1 and put immediately onto insulin (the BG levels on metformin with diet changes had initially lowered but were starting to creep up again from 8/9 to 12/13 in the morning so something wasn’t working). I jabbed myself for the first time this morning with épi pens and to be fair it didn’t hurt but an awful lot to take in….
Leadinglights
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- Type 2
I'm glad you have now got a proper diagnosis. There are quite a few people here with a LADA diagnosis and I'm sure they will help with any questions and experiences.
It would be useful to avoid confusion if you change your profile to say LADA rather than Type 2.
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Thanks for the update @Fleetwood
Hopefully now you have started on insulin your levels will begin to come down gently.
A tiny point, but they are just insulin pens - epi pens are epinephrine (adrenaline) for anaphylactic shock and allergic reactions 🙂
And yes - the needles these days are tiny and you can barely feel them 🙂
Tdm
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I was thinking lada also. Glad you have got the right diagnosis. Have you got a cgm ( vontinous glucose monitor) like libre 2 or dexcom? If not, ask for one, they are a game changer! You get alarms if you go too low, and at list probably best set alarms around 4.5 or 5 so you have time before you go hypo)
Did they mention where you jab can make a difference? Bum is slowest, i tend to save for long acting insulin. I use thigh and legs which i find medium action. Tummy is quickest, i tend to keep that for when i need to bring high glucose down/ correction.
Are you carb counting yet? What insulins are you on? And do you have hypo treatment - i use glucose tablets, though i also find jelly belly jelly beans good and conveniently one carb each.
Welcomecto the lada club. It is a bit much at first but does get easier!
You may find walking with rapid insulin on board can bring your bs down quckly, so watch out for that. You will soon learn how to offset that with glucose (well, it took me a year but i was particularly plummety...plus libre tends to overreact, unlike dexcom)
Did they mention where you jab can make a difference? Bum is slowest, i tend to save for long acting insulin. I use thigh and legs which i find medium action. Tummy is quickest, i tend to keep that for when i need to bring high glucose down/ correction.
Are you carb counting yet? What insulins are you on? And do you have hypo treatment - i use glucose tablets, though i also find jelly belly jelly beans good and conveniently one carb each.
Welcomecto the lada club. It is a bit much at first but does get easier!
You may find walking with rapid insulin on board can bring your bs down quckly, so watch out for that. You will soon learn how to offset that with glucose (well, it took me a year but i was particularly plummety...plus libre tends to overreact, unlike dexcom)
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