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Newbie Type 2 and worried!

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J

JustSue

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Type 2
Morning everyone. Just been diagnosed as Type 2 Diabetes which if I’m honest isn’t a massive surprise! I’ve been pre-diabetic for about 4 years following gestational diabetes while pregnant with my little boy. Reality has hit now! What worries me and I hope I can find some reassurance is that my liver function test came back with an elevated ALT reading of 354.0. Im guessing after a ridiculous amount of googling that this isn’t good. Has anyone had experience of an elevated ALT? Hope everyone is having a good day. X
 
Firstly don't panic. What other details can you tell us? Yes the ALT figure is high enough to be concerning and it'll be taken into consideration when determining treatment options for your diabetes. Have you been advised on making changes to diet etc or just been prescribed meds and given zero advice?

I'll also say that obviously I've no experience of gestational diabetes so don't know if there are specifics to T2 from GD but I'm sure that others on the forum will have that knowledge and will be along to say Hi soon 🙂
 
Hi from me as well @JustSue

For obvious reasons I also have no experience of gestational diabetes. However, I can add some general advice. This is an edited cut and paste from another thread.
The best approach is probably to loose some weight and to have a look at your diet. Carbohydrates are the problem for diabetics. This includes starchy things (rice, pasta, bread, potatoes) as well as obviously sweet, sugary things. The body rapidly breaks down carbs into glucose. Some gentle to moderate exercise will also help. A combination of reduced portions of carbs and some exercise should see the pounds drop off as well (if you need to loose them ) which will help further. It is a virtuous circle.

I was nearly 20 stone last year and weighed in at 13st 6lbs this morning and I feel fitter and healthier than I have done in years. @ColinUK has also lost a lot of weight so it can be done. Note that I am now off medication and my blood sugar levels are back to normal. It is hard work but you can turn this around
 
@adrian1der But although lost I have put a large percentage back on. I'm hoping that now I've got a handle on the really stressful things I was going through I'll get the weight off again. That aside I'm pleased with my BG levels most of the time as they're certainly in the green. Obviously the next HbA1C will be interesting. I expect it to have clicked up a little from last time and then to come down again on future readings.
 
Welcome @JustSue 🙂 I hope your Googling informed you rather than caused you stress. Did the GP suggest you might have fatty liver?Do you have a follow-up appointment?

Do you know what your HbA1C was (diabetes diagnosis test)?
 
Hi all, thank you so much for your replies. My head is spinning with it all! My HbA1C level is 103. My ALT for my liver is 304 and I hardly ever drink!! So it must be food related. I spoke to the Sister earlier and she mentioned kidney damage also. She said that due to my liver level being so high I can’t start on Metformin as it could cause issues. She said there is another mess which is injected but she said it’s not insulin. So it all looks worse than I feared. She said I need to speak to the Doctor which I am doing tomorrow morning as a telephone consultation. Seriously worried and anxious!!!
 
JustSue said:
Hi all, thank you so much for your replies. My head is spinning with it all! My HbA1C level is 103. My ALT for my liver is 304 and I hardly ever drink!! So it must be food related. I spoke to the Sister earlier and she mentioned kidney damage also. She said that due to my liver level being so high I can’t start on Metformin as it could cause issues. She said there is another mess which is injected but she said it’s not insulin. So it all looks worse than I feared. She said I need to speak to the Doctor which I am doing tomorrow morning as a telephone consultation. Seriously worried and anxious!!!
Click to expand...
You obviously have a number of things going on so it would be worthwhile having a list of questions you want to ask as it is easy for things you meant to ask to go out of your head. Also make notes of what is said if you can.
Try to get a face to face appointment with the specialist diabetic nurse at your surgery or ask for referral to your diabetic specialist clinic if there is not one, you should also expect to have foot and eye checks arranged so make sure you ask about those.
 
My Hba1c was 91 when I was diagnosed, and five years later I am feeling fine, even my thyroid has picked up.
I didn't have any problems with my liver, but my middle was so swollen and rock hard I could not bend down without pushing my ribs out of place - very painful.
The liver is the organ most able to recover itself so with a bit of luck all should right itself, though it might need a change in diet to achieve the best results.
I have had a few days where I could not get to the shops and although I did not starve I was on reduced rations, and my waist has reduced again. I was practically spherical at diagnosis, but I was already remaking all my winter clothes, or buying new. If things go on like they are I will be able to bring out clothes from the back of the wardrobes I have not worn since my hippy days.
 
In my opinion eating low carb but without initially reducing calories is a gentle way to improve overall health, mood, energy , weight as well as reduce Blood Glucose. This is best done by use of a Blood Glucose meter to test the impact of meals . A rise of more than 2.0 mmol from just before eating to 2hrs after first bite tends to indicate that your body didn't tolerate the carbs in the meal very well. And that you need to look to either reduce the portions of the most high carb food or to make simple lower carb substitutions such as Celeriac or Swede instead of potato and courgetti, egg noodles or bean based low carb pasta for normal noodles and pasta. These alternatives are available at major supermarkets.
 
Hope your telephone consultation goes well this morning @JustSue

And that the Dr can give you some reassurance and a practical plan for moving forwards.

Let us know how things go 🙂
 
And please don't be unduly frightened by a medication having to be injected, either. Hypodermic needles are no longer as fat as knitting needles and the majority are less than a centimetre in length. (Vaccines eg flu and Covid, are usually intra muscular jabs hence the needle needs to be longer - but those aren't usually issued for home use by amateurs like you and me) The vast majority are now single-use ones so one helluva lot sharper than years ago. eg insulin jabs - which us T1s rely on for life itself - it is 100% possible to not even feel the needle going in or the insulin going in or the needle coming out.

If you need that medication to sort out whatever's wrong with you - then you need it whether it's a tablet or liquid to drink or a jab - and nobody medically qualified would ever prescribe it if you didn't need it!
 
- and nobody medically qualified would ever prescribe it if you didn't need it!

I can't agree with this part. Unfortunately just about every week I hear of a newly diagnosed T2 - barely diabetic or even some pre-diabetic being put on high doses of metformin sometimes even an SGLT2.
Do they all need such medication/ Surely to start with (perhaps allow 3 months) they should be encouraged to lose weight or to low carb - so the absolute most medication (unless they can't handle the lifestyle changes) should be a low dose of Metformin.
See https://forum.diabetes.org.uk/boards/threads/confused-with-food.96096/#post-1108032 The OP only has an HbA1C of 48, is put on a path to 3 metformin a day even though they were already losing weight (14lbs). They are also now learning about low carb - so keen to fix it by lifestyle yet I would wager they were not offered any options and were told not to test their BG.
 
Hi again, thank you all for your replies. Been a worrying week that’s for sure! I spoke to the Dr and he referred me for a liver ultrasound which I had today. It has picked up gallstones and fatty liver. Surprised at the gallstones, had no idea! The fatty liver wasn’t really a shock though. Just need to wait for the Dr to ring me now. I’m guessing I’ll be going into the Doctor’s at some point this week to discuss meds for the T2. Hope everyone is ok this evening. Thank you all for your advice. X
 
Drummer said:
My Hba1c was 91 when I was diagnosed, and five years later I am feeling fine, even my thyroid has picked up.
I didn't have any problems with my liver, but my middle was so swollen and rock hard I could not bend down without pushing my ribs out of place - very painful.
The liver is the organ most able to recover itself so with a bit of luck all should right itself, though it might need a change in diet to achieve the best results.
I have had a few days where I could not get to the shops and although I did not starve I was on reduced rations, and my waist has reduced again. I was practically spherical at diagnosis, but I was already remaking all my winter clothes, or buying new. If things go on like they are I will be able to bring out clothes from the back of the wardrobes I have not worn since my hippy days.
Click to expand...
Must admit I’m looking forward to rooting out old clothes that I’ve not been able to get into for a few years!
 
JustSue said:
Must admit I’m looking forward to rooting out old clothes that I’ve not been able to get into for a few years!
Click to expand...
While the majority of those who low carb lose weight and reduce waist size (even without any conscious reduction in calories), there is a small minority (perhaps as much as 5% for whom this doesn't happen. The only certain thing is that for Type 2 diabetics (without further complication) lower carbohydrates does reduce Blood Glucose.
 
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