Newly diagnosed at 56

[Mick B1966]

Hello I'm Mick and just been diagnosed as type 2. Currently on Insulin and Metformin and seem to be doing OK so far. Bit worried about losing weight as there isn't much of me to start with.

 

[Leadinglights]

Welcome to the forum, would you like to say a bit more about your diagnosis as I wonder if you are actually Type 2 rather than Type 1 as you mention losing weight and that you have been started straightaway on insulin which together with metformin seems a bit unusual.
Do you know what your HbA1C is as that is important and will help people comment.
Have you been given and dietary advise and what insulin regime and insulins are you on.
I assume you have been given blood glucose testing equipment so you can check your levels.
It is important to keep that with you at all times as well as hypo treatment.

 

[Mick B1966]

Hello my HbA1C was 117 which was picked up on my annual blood tests for a meds review. Was called by my GP and asked to go to A+E as they wanted me to be checked for ketone (none present)
Was put on Novomix30 (12 units AM 8 units PM) and 1x500mg Metformin twice daily.
Was given loads of advice and leaflets at the hospital and had a follow up call from the Diabetes Specialist team who also send me info.
All have been very supportive.
I am counting my carbs to keep my bloods within target and that is going well and testing 4 times per day at the moment.
Take my monitor with me at all times and have a small carton of orange juice and some jelly babies should I feel a bit wobbly.
Early days but feeling OK so far

 

[Leadinglights]

Hello my HbA1C was 117 which was picked up on my annual blood tests for a meds review. Was called by my GP and asked to go to A+E as they wanted me to be checked for ketone (none present)
Was put on Novomix30 (12 units AM 8 units PM) and 1x500mg Metformin twice daily.
Was given loads of advice and leaflets at the hospital and had a follow up call from the Diabetes Specialist team who also send me info.
All have been very supportive.
I am counting my carbs to keep my bloods within target and that is going well and testing 4 times per day at the moment.
Take my monitor with me at all times and have a small carton of orange juice and some jelly babies should I feel a bit wobbly.
Early days but feeling OK so far

You seem to have been given some sensible advice, I expect the idea is to bring down your glucose levels slowly as a rapid drop can give you issues with your eyes and nerves, but hopefully you will already be seeing an improvement in your level.
Please do ask any questions and people will do their best to help.

 

[Mick B1966]

Can I ask what issues does a rapid drop risk?

 

[Leadinglights]

Can I ask what issues does a rapid drop risk?

If you have had high glucose levels for a while the environment in the eye becomes 'sugary' so the shape of the eye changes but that may have happened slowly so you didn't really notice but if blood glucose drops quickly the eye environment returns to the normal 'salty' so the shape changes again and the focus is all over the place.
You can also get pains in your feet and hands from sudden changes in the nerves.
Usually these are transient but something to be aware of.

 

[Mick B1966]

Ah thank you very much. My focus has changed and have booked an eye test to get that sorted. Had odd aches and pains in legs and feet which I didn't have before. Just had a foot check and fortunately all OK.

 

[harbottle]

Same happened to me - just before I was diagnoses, my near vision had improved (It had been going bad naturally due to aging!) and far vision had gone. I also had leg pains.

The lens changes shape when BG is high, so vision changes. My eyesight is poor (I wear glasses) so I just assumed it was time for a new pair of glasses!

After a few weeks of cutting carbs, it improved dramatically. I noticed it when I was walking up to our local high street and could see the city centre skyline very clearly. Unfortunately, the near sight reverted back to how it was before!

All the aches and pains went as well.

 

[rebrascora]

Your optician should not prescribe new lenses for you at this early stage of diabetes diagnosis because your eyes will continue to change and it would be a waste of money as the prescription would be wrong again in a very short space of time. Most of us got around it by buying a couple of cheap pairs of ready readers from the pound shop to tide us over this transitional period until your blood glucose levels are in range and more stable. A few months is generally about how long you need for your levels and therefore eyes to readjust.

As regards your diagnosis, I would second the concerns that you may be Type 1 and not Type 2. Diabetes is diagnosed by the HbA1c test and a reading of 48 or more gets you a diagnosis. Obviously 117 makes that a very obvious diagnosis.
After that, the type of diabetes is often based on clinical factors and some of these can be misleading. The red flag here is that you are slim and having unintentional weight loss, which is much more common with Type 1 than Type 2 where people are often overweight and struggling to lose it. Unfortunately many clinicians are under the false impression that Type 1 only exhibits in children and young adults, so if you are a mature adult they assume you must be Type 2.
There is no specific test for Type 2 diabetes but there are tests they can do to check if you might be Type 1 and I would suggest you push for these tests..... They are the GAD antibody test and a C-peptide test. Type 1 diabetes is an autoimmune condition where the body's immune system mistakenly kills of your insulin producing beta cells often in response to a trigger which can be viral.... and if you have had Covid, this could be the trigger. The C-peptide test tells them how much insulin your body is currently producing. Many Type 2 diabetics produce extra insulin to overcome the insulin resistance their body has developed, so their C-peptide will be at the higher end of the normal range or above. With Type 1 you are likely to be at the lower end of the range or below, but it depends how many beta cells have been killed off and how well the remaining ones are managing to make up for the shortfall but increasing production.
You may wonder if it makes much difference between being diagnosed Type 1 or Type 2 and unfortunately it does. Type 1 diabetics get access to better technology support and education than Type 2s. It isn't right but sadly the NHS seems to offer a 2 tier system for diabetes management.

The early introduction of insulin is important as it will help out those remaining beta cells if you are Type 1, but the current insulin regime you have been given (mixed insulin) is quite restrictive and requires you to eat regular meals at set times to try to balance your levels and this doesn't always fit in with modern day life. Hopefully this is just a stop gap approach and you will be moved onto a basal/bolus regime in due course.

It sounds like you have come to terms with the practicalities of injecting and testing very well so far but do be kind to yourself and know that it is perfectly normal to become overwhelmed at times, particularly as the long term nature of the condition starts to sink in. We are here to support you in any way we can, so please shout up if you are struggling with anything or don't understand something. There is a massive amount to get your head around particularly in the early days so do give yourself a big pat on the back for everything you have achieved so far and try not to worry if your BG levels don't always do what you expect. Perfection is impossible with diabetes management and you have to find a balance between living life and doing what you want to do but taking a bit of time out to plan for it and take your diabetes into consideration and most importantly, to keep yourself safe.

 

[Mick B1966]

Thank you so much for the information and the support, it is greatly appreciated and I take on board everything you have said. In my chat with the diabetes specialist team Lawrence did say I might be type 1 lada and is going to arrange a blood test for me so I guess that will answer that question.
I will hold off on the eye test for now and see how it all progresses.
Once again thanks so very much

 

[Inka]

Hello I'm Mick and just been diagnosed as type 2. Currently on Insulin and Metformin and seem to be doing OK so far. Bit worried about losing weight as there isn't much of me to start with.

Welcome @Mick B1966 🙂 It definitely sounds sensible to rule out Type 1. Contrary to popular belief, Type 1 can occur at any age and is not just a childhood condition.

The Novomix you’re on demands a bit of a schedule eg lunch at the same time each day. There are other insulin regimes if you find that inflexible. If you find you’re having to limit your carbs to stay in range, then do speak to your team. It might be that your insulin needs adjusting. As you say, you need to be able to eat enough to nourish yourself and keep at a healthy weight.

Well done on keeping hypo treatments with you. That’s very important. You mention you test 4 times a day. Do you drive? If so, you have to test before your drive and also inform the DVLA if you haven’t already.

 

[Mick B1966]

Hi Inka
Informed DVLA and licence returned to be replaced with a medical review licence. Finding the limiting of carbs going OK and introducing low carb high calorie alternatives to replace the extra carbs. Started calorie counting today and aiming for 2000 per day to see how that goes. I'm sure all of this experimenting will come in handy when I have my appointment in the team in January. Hopefully by then a clearer picture will have developed.
Thanks for the advice, greatly appreciated

 

[everydayupsanddowns]

Sounds like you are off to a solid start @Mick B1966

Hope your January appointment fills in some of the blanks, and you can get a confirmation of your diabetes type.

Keep firing away with any questions you have on the forum too - nothing will be considered too obvious or ’silly’

 

[Mick B1966]

Thank you Mike. I certainly will. Hope you all have a lovely weekend