New type 2

[Diabeticem2]

Hi, im em and ive just been diagnosed as a type 2 diabetic at 25. had a routine blood test and my hba1c number came back as 125 compared to 35 a year earlier which came as a huge shock. I was initially put on 2g metformin and 40mg gliclazide however ive been taking these for 6 weeks and have only seen a small improvement in my numbers - I used to be between 18 and 20 and now sit somewhere between 10 and 14. my medication was changed recently to 1.5g metformin and 160mg gliclazide and im still not seeing much change for example this morn I took 1g metformin and my 80mg of gliclas=zide and had chicken sausages and eggs and still ended up at 14 blood glucose reading. my DSN has said when I am consistently in single figures she will change me to just jardiance (Empagliflozin) but single figures feels a million miles off at the minute. I am awaiting an appointment with a dietician and then to see someone from weight management although my BMI is 27 so only just in the overweight category.

just looking for some advice really, has anyone finally managed to get into single figures and be moved to the new medication im just stumped as ive been eating really well and as low carb as I can with minimal improvement.

my biggest worry is im still very young and want to have another baby in the future which I know with levels like mine isnt doable right now so again anyone whos been in the same boat as me id love some reassurance, tips, advice etc.

Thankyou !!

 

[rebrascora]

Hi and welcome.

Sorry you qualify to be here but you are definitely in the right place to learn more about diabetes and how to manage it well.

Can I ask if anyone has mentioned/considered that you might be Type 1 and not Type 2? That is a massive jump in HbA1c and you are quite young and not particularly overweight and the fact that the Type 2 medications are not having a significant impact although by the look of it you are also reducing your carbs if that breakfast is anything to go by, then that is likely the only thing which is helping to reduce your levels a bit. I would be asking why they think you are Type 2 and can you have tests for Type 1..... those tests would be antibody tests and C-Peptide test to see how much insulin you are actually able to produce.

The HbA1c test just tells them that you are diabetic and some health care professionals just assume that you must be Type 2 if you are not a child, but many of us developed Type 1 much later in life. I was 55yrs old and similarly assumed to be Type 2 initially although thankfully I was able to get tested in the first few months and a Type 1 diagnosis confirmed. The longer it goes before you get the antibody test, there is a risk that the antibodies fade and you get a false negative, so pushing for those tests sooner rather than later might be quite important.

You say it was a routine blood test that highlighted it, but you had had an HbA1c a year before which was normal. Is there a reason why they have been monitoring your HbA1c annually? Did you perhaps have gestational diabetes when you were pregnant before? Just trying to understand your background that lead up to this massive jump in levels in a year.

 

[Diabeticem2]

Hi and welcome.

Sorry you qualify to be here but you are definitely in the right place to learn more about diabetes and how to manage it well.

Can I ask if anyone has mentioned/considered that you might be Type 1 and not Type 2? That is a massive jump in HbA1c and you are quite young and not particularly overweight and the fact that the Type 2 medications are not having a significant impact although by the look of it you are also reducing your carbs if that breakfast is anything to go by, then that is likely the only thing which is helping to reduce your levels a bit. I would be asking why they think you are Type 2 and can you have tests for Type 1..... those tests would be antibody tests and C-Peptide test to see how much insulin you are actually able to produce.

The HbA1c test just tells them that you are diabetic and some health care professionals just assume that you must be Type 2 if you are not a child, but many of us developed Type 1 much later in life. I was 55yrs old and similarly assumed to be Type 2 initially although thankfully I was able to get tested in the first few months and a Type 1 diagnosis confirmed. The longer it goes before you get the antibody test, there is a risk that the antibodies fade and you get a false negative, so pushing for those tests sooner rather than later might be quite important.

You say it was a routine blood test that highlighted it, but you had had an HbA1c a year before which was normal. Is there a reason why they have been monitoring your HbA1c annually? Did you perhaps have gestational diabetes when you were pregnant before? Just trying to understand your background that lead up to this massive jump in levels in a year.

hi, yeah there was thoughts that it could be type one as no one would believe it was T2 with my age and weight etc but antibodies came back negative, I actually somehow ended up having the antibodies tested twice within the space of 2 weeks and both were negative and my c-peptide was showing a normal range too so the specialist doctor has said type 2. im guessing they think upping the gliclazide by such a huge amount is going to maybe help something??

im not sure if its just my GP surgery but ive had a blood test every year since turning 18 and have always been in the normal hba1c range so not sure really. and no gestational when I was pregnant too I had multiple blood tests during pregnancy to check it and one fairly soon after birth which was normal too.

if im honest I really am in shock that my levels are so high too - all symptoms started to come to the forefront after I got covid in may time last year so theres potential thinking that I had it already and then my body hasn't coped with the covid properly and then symptoms have just come from no where - constant peeing and thirst, weight loss, tiredness and then when I had the blood test that showed the high levels I had ketones of 1.7 which went to 0 within a few days. other than that ive not presented unwell etc and had I not had that blood test when I did would've continued not knowing at all.

 

[rebrascora]

Ah, so you did have symptoms! When I read that it was picked up in a routine blood test, that made me think you didn't have symptoms, but that seemed odd when your lHbA1c was so high.

I believe that a negative antibody test doesn't always rule out Type 1. Do you know if they checked for a full range of antibodies or just GAD antibodies?
You obviously are still producing some insulin as otherwise your levels would not have come down at all. Did you do the C-peptide test carb loaded or fasting? Going low carb can muddy the water a bit with getting a clear diagnosis.

Covid is certainly believed to have triggered a significant number of new diabetes diagnosis and perhaps not enough is known yet for a clear understanding of the pathway or perhaps new antibodies have developed which are not covered in the tests.

@Lucyr was diagnosed a bit younger than you I think and her diagnosis has always been unclear although she was originally categorised as Type 2 but needed insulin fairy quickly after diagnosis. I think she is about 15 years down the line now and recently been reassessed, but still not conclusive, although they are now treating her as Type 1, in that she is now getting access to technology (Constant Glucose Monitor) that she previously had to self fund and access to an intensive education course on insulin dose adjustment which is generally only open to Type 1s or Type 3cs.

Unfortunately there is a bit of a 2 tier support/treatment system within the NHS where Type 1s are more able to access cutting edge technology whereas Type 2s sometimes have to fight their own corner to get the basics.

I hope I am wrong and you start responding to the oral meds soon but I would mentally prepare yourself that insulin may be the necessary treatment. Either way, we are here to support you so please ask if you need any information or advice ot just want to have a rant about the unfairness of it all as we do understand and providing a space to blow some steam occasionally is one of the forum's functions. The people here get it whereas, even really supportive family and friends cannot really grasp the mental toll that diabetes can have on us. That said, there are far worse health conditions and we can mostly live very healthy long lives provided we put a bit of effort into it. I am actually healthier now than I was before diagnosis because I can't just eat anything without giving it some consideration (and injecting insulin of course) and I need to keep fit and look after myself to make that easier.

 

[Diabeticem2]

Ah, so you did have symptoms! When I read that it was picked up in a routine blood test, that made me think you didn't have symptoms, but that seemed odd when your lHbA1c was so high.

I believe that a negative antibody test doesn't always rule out Type 1. Do you know if they checked for a full range of antibodies or just GAD antibodies?
You obviously are still producing some insulin as otherwise your levels would not have come down at all. Did you do the C-peptide test carb loaded or fasting? Going low carb can muddy the water a bit with getting a clear diagnosis.

Covid is certainly believed to have triggered a significant number of new diabetes diagnosis and perhaps not enough is known yet for a clear understanding of the pathway or perhaps new antibodies have developed which are not covered in the tests.

@Lucyr was diagnosed a bit younger than you I think and her diagnosis has always been unclear although she was originally categorised as Type 2 but needed insulin fairy quickly after diagnosis. I think she is about 15 years down the line now and recently been reassessed, but still not conclusive, although they are now treating her as Type 1, in that she is now getting access to technology (Constant Glucose Monitor) that she previously had to self fund and access to an intensive education course on insulin dose adjustment which is generally only open to Type 1s or Type 3cs.

Unfortunately there is a bit of a 2 tier support/treatment system within the NHS where Type 1s are more able to access cutting edge technology whereas Type 2s sometimes have to fight their own corner to get the basics.

I hope I am wrong and you start responding to the oral meds soon but I would mentally prepare yourself that insulin may be the necessary treatment. Either way, we are here to support you so please ask if you need any information or advice ot just want to have a rant about the unfairness of it all as we do understand and providing a space to blow some steam occasionally is one of the forum's functions. The people here get it whereas, even really supportive family and friends cannot really grasp the mental toll that diabetes can have on us. That said, there are far worse health conditions and we can mostly live very healthy long lives provided we put a bit of effort into it. I am actually healthier now than I was before diagnosis because I can't just eat anything without giving it some consideration (and injecting insulin of course) and I need to keep fit and look after myself to make that easier.

yeah I had symptoms but I didnt know they were symptoms of diabetes so kinda ignored them as I thought covid had just ruined me for some reason as they started bang on with me getting covid and then when they told me I had it I researched and it all kind of clicked! my hair falling out is the latest one which is the thing thats killing me the most as its just horrible.

they did 3 types of antibodies GAD, IA2 and something else. erm I cant remember if im honest wether I had fasted I think I unintentionally had but it was also 2 days after Christmas Day that they took the blood for it so I deffo wasn't as good as I have been since then but I deffo didnt Indulge like I would have.

im lucky that ive had a CGM since I first saw my dr but after my current one runs out they aren't going to give me it anymore due to the whole funding thing.

if im honest im concerned that the type 2 diagnosis is wrong but ive got a call with the diabetic nurse from my GP surgery tomorrow rather than the hospital one so im just gonna see what her opinion is on the face my levels are so high after being on the medication for 6 weeks already. I suppose the only way to tell is that ultimately if it is type 1 then I'll just end up getting sick and they'll have to reassess it if that does happen?? I had already sort of convinced myself that I was gonna maybe need inulin regardless because of the readings so we will see what happens.

 

[De Bois]

Hi, im em and ive just been diagnosed as a type 2 diabetic at 25. had a routine blood test and my hba1c number came back as 125 compared to 35 a year earlier which came as a huge shock. I was initially put on 2g metformin and 40mg gliclazide however ive been taking these for 6 weeks and have only seen a small improvement in my numbers - I used to be between 18 and 20 and now sit somewhere between 10 and 14. my medication was changed recently to 1.5g metformin and 160mg gliclazide and im still not seeing much change for example this morn I took 1g metformin and my 80mg of gliclas=zide and had chicken sausages and eggs and still ended up at 14 blood glucose reading. my DSN has said when I am consistently in single figures she will change me to just jardiance (Empagliflozin) but single figures feels a million miles off at the minute. I am awaiting an appointment with a dietician and then to see someone from weight management although my BMI is 27 so only just in the overweight category.

just looking for some advice really, has anyone finally managed to get into single figures and be moved to the new medication im just stumped as ive been eating really well and as low carb as I can with minimal improvement.

my biggest worry is im still very young and want to have another baby in the future which I know with levels like mine isnt doable right now so again anyone whos been in the same boat as me id love some reassurance, tips, advice etc.

Thankyou !!

Hi, I have recently changed meds from purely 2mg of metformin to also introduce 10g of Jardiance empagliflozin ( 1 tab per day) and that combined with a Keto diet has seen my normal range drop to between 5.1-7.5 down from previously 9-11. Appreciate its a very personal thing as we all react differently to meds n diet but you might be pleasantly surprised with empagliflozin impact? Are you also on a statin, as like you I was about 25 BMI but because of the BG levels then it seemed to be a default addition. Keep the faith.

 

[Diabeticem2]

Hi, I have recently changed meds from purely 2mg of metformin to also introduce 10g of Jardiance empagliflozin ( 1 tab per day) and that combined with a Keto diet has seen my normal range drop to between 5.1-7.5 down from previously 9-11. Appreciate its a very personal thing as we all react differently to meds n diet but you might be pleasantly surprised with empagliflozin impact? Are you also on a statin, as like you I was about 25 BMI but because of the BG levels then it seemed to be a default addition. Keep the faith.

im gonna call in a week or so and question why they're holding off the empagliflozin until im in single figures as its clear that the medication so far isnt making that happen! no ive never even heard of a statin not sure what that does or is for?

 

[Leadinglights]

Hi, I have recently changed meds from purely 2mg of metformin to also introduce 10g of Jardiance empagliflozin ( 1 tab per day) and that combined with a Keto diet has seen my normal range drop to between 5.1-7.5 down from previously 9-11. Appreciate its a very personal thing as we all react differently to meds n diet but you might be pleasantly surprised with empagliflozin impact? Are you also on a statin, as like you I was about 25 BMI but because of the BG levels then it seemed to be a default addition. Keep the faith.

If you are taking empagliflozin then you should be careful of adopting a keto diet as it puts you at risk of euglycemic DKA. Although it is a rare side effect it is listed as one of the possible ones./

 

[Lucyr]

im gonna call in a week or so and question why they're holding off the empagliflozin until im in single figures as its clear that the medication so far isnt making that happen! no ive never even heard of a statin not sure what that does or is for?

If you do ask for empagliflozin make sure to ask for ketone testing strips too as it has a risk of DKA and as you’ve previously had ketones you’d be at higher risk.

Do you have the actual number for your cpeptide test? “Normal” can mean a whole lot of things. Would also need to know if it was fasted or stimulated (high bg at the time), though it sounds like your bg probably would have been high.

Then normally they would test for multiple antibodies, as you might have some but not others. My cpeptide was right at the bottom end of the inconclusive range (so below normal but above the T1 definite range. I had one antibody but not a second type. This was all 16 years after diagnosis though.

Whatever happens, I’d think of yourself as not a standard type 2, even if classed as type 2, and not be afraid of insulin if it’s mentioned. I’d also suggest that you make sure anyone treating you knows that you want to get your levels down to have another baby… there’s generally more funding and support in pregnancy for things like starting insulin and then a CGM etc if things end up going down that path.

 

[everydayupsanddowns]

im gonna call in a week or so and question why they're holding off the empagliflozin until im in single figures as its clear that the medication so far isnt making that happen! no ive never even heard of a statin not sure what that does or is for?

Welcome to the forum @Diabeticem2

Hope you get some clarity over your diagnosis soon, and are able to get a treatment plan that works for you, as it seems that standard first-line and second-line oral meds haven’t been very effective.

A statin is a commonly prescribed medication to reduce cholesterol levels. Having diabetes makes us more susceptible to heart attack and stroke (sad but true) so the recommendations for people with diabetes are to aim for lower cholesterol levels than the general population, and statins are a well studied and very effective means of achieving that.