Newly Diagnosed

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Kat94

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Diagnosed last month - my hba1c came back at 138. Prescribed Metformin and Gliclazide straight away. I have made numerous diet changes for the better since and waiting for my next hba1c test. I’m normal weight and only 29 years old - pretty scared!
 
Welcome @Kat94 🙂 Are they sure you’re not actually Type 1? You mention your normal weight and are quite young.

Did you have any symptoms pre-diagnosis? Did they check your urine for ketones? Have you lost any unexpected weight recently?
 
Inka said:
Welcome @Kat94 🙂 Are they sure you’re not actually Type 1? You mention your normal weight and are quite young.

Did you have any symptoms pre-diagnosis? Did they check your urine for ketones? Have you lost any unexpected weight recently?
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Plus that is a very high HbA1c. I would be asking why they think you are Type 2 and also ask for some Ketostix, so that you can check your urine for ketones when your Blood Glucose (BG) levels are mid teens or above. I assume they have given you a means of testing your BG levels. Ie a finger pricker and BG meter??

Oh and please excuse my rudeness in not welcoming you first and foremost.... I hope you find being a member of the forum as massively beneficial as I have over the past 4.5 years since diagnosis.
 
They checked my ketones and I check them myself for ketones in blood regularly and they have never been above 0.3. I had lost unexplained weight, frequent urination during the night and constantly hungry for a few months. I finally went to the docs after recurring Thrush for 2 months (sorry if too much info!!)

I have a finger pricker for glucose levels yes and awaiting an antibody to rule out type 1 and my glucose levels have definitely improved with the medication but I didn’t really get an explanation either way. I was just given a leaflet for both and left with them saying it’s likely type 2 :(
 
At least they’re doing a Type 1 antibodies test. Unfortunately those do take a while to come back. The unexplained weight loss and frequent urination, along with your age and normal weight, do suggest Type 1.

There are two concerns: obviously the first is that you’ve been misdiagnosed (sadly there are far too many adults just assumed to be Type 2 when they’re actually Type 1); the second is that Gliclazide isn’t a good drug if you’re Type 1 because it would squeeze the remaining life out of your beta cells. It would have been better to give you insulin.

More adults than children are diagnosed with Type 1. It comes on more slowly in adults.
 
Just to add, when I was first diagnosed with Type 1, I had ketones and then they reduced (without insulin). Fortunately, I was given the insulin I needed because I was in hospital and saw a consultant. Don’t be afraid to speak up if you feel things aren’t right or you feel ill.

Type 1s can eat a normal diet with insulin. My concern when suspected Type 1s change their diet pre-insulin is that the Type 1 is masked, leading to further delays in diagnosis.
 
Thank you for your replies and support. Will keep pushing for an accurate diagnosis. Concerned that I am taking gliclazide now you say that!
 
From that extra information I think it is far more likely that you are Type 1 than Type 2. I didn't develop ketones at all and never have. I was initially started on Metformin and then Gliclazide added and it did nothing but changing my diet did improve my results to a limited extent but it wasn't sustainable and after 5 weeks I was thankfully started on insulin.
I am relieved that they have sent off blood for antibody tests and they generally take about 6weeks to come back, so little point in chasing those before that. As long as you have a means of testing for ketones then you can be forewarned of them developing and get emergency help if they do.
As regards Gliclazide, it is a bit like flogging a dying horse. Your pancreas is going to run out of insulin production sooner or later but Glic can make that sooner, because it puts the remaining beta cells which produce insulin under pressure and they are then potentially more likely to break down quicker. Longer term, they are likely going to die anyway, so you are not losing something that you would otherwise hope to keep, but insulin can eke them out a bit longer because it takes the pressure off them. Sometimes the remaining beta cells can smooth off the corners of your insulin useage in the early days/months/years of the honeymoon period, but sometimes they can just make everything so much more erratic, so they can be a blessing or a curse and it is a bit of a lottery, but if you are Type 1 then ultimately they are doomed anyway, but the important thing is that you have a means of testing for ketones so that if you drop below a critical level of insulin production and ketones start to develop, you can get to hospital and get insulin in plenty of time.
 
Kat94 said:
Diagnosed last month - my hba1c came back at 138. Prescribed Metformin and Gliclazide straight away. I have made numerous diet changes for the better since and waiting for my next hba1c test. I’m normal weight and only 29 years old - pretty scared!
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Hello. No real advice as I’m pretty new here but just wanted to say hello. One thing I would say is that Drs and GP practices don’t seem very forthcoming with advice, so read as much as you can and make a list of questions for them, then push for answers. X
 
Kat94 said:
Thank you for your replies and support. Will keep pushing for an accurate diagnosis. Concerned that I am taking gliclazide now you say that!
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As @rebrascora explained, it’s like flogging an ill horse rather than giving it veterinary treatment. It’s makes things worse because the horse isn’t lazy, it’s actually ill and needs treatment. Early introduction of insulin, on the other hand, can help temporarily revive and preserve the remaining beta cells (insulin= veterinary treatment in the horse example).

How are you blood sugars and what kind of things are you eating each day?
 
Ultimately this horse is dying though and early treatment with insulin will just let it limp along for a few more months or years not really much use and in some cases getting in the way. I did not find the honeymoon period a good time as my levels seemed unpredictable compared to now.
 
Yes, agreed @rebrascora the beta cells/horse are dying. I just didn’t want to get into a tortuous horse analogy bearing in mind your horse expertise!
 
My blood sugars have generally been ok since the medications - 5/6 on a morning and before dinner and 7/8 two hours after. I’ve been trying to eat as advised - better carbs,protein and fruit and veg
 
Kat94 said:
My blood sugars have generally been ok since the medications - 5/6 on a morning and before dinner and 7/8 two hours after. I’ve been trying to eat as advised - better carbs,protein and fruit and veg
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That’s a promising sign @Kat94 - and hopefully will alleviate any symptoms you may have been getting from high glucose levels (thrush, thirst, tiredness) while you await your confirmation of diabetes type.

The ‘4 Ts’ of Type 1 are Tired, Thirsty, Toilet and Thinner - and you seem to have all of those. Plus are relatively young, and are not carrying lots of extra weight as would be typical in T2. Plus your diabetes arrived swiftly with a bang, rather than building up to 138mmol/mol over many years.

Diabetes can be a tricksy beast, and there are atypical presentations of all types, of course, but like others I am struggling to see why they opted for T2 as a first thought, given that the only indication for T2 seems to be ‘not a child’ - and as @Inka says 50% of people with T1 are diagnosed as adults!

The forum has had a pretty good nose for mis-classification in the past!

Welcome to the forum 🙂
 
Inka said:
Yes, agreed @rebrascora the beta cells/horse are dying. I just didn’t want to get into a tortuous horse analogy bearing in mind your horse expertise!
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Must confess, I was getting uncomfortable about the analogy, especially as I had to have the vet out late last night as an emergency call out for one of mine!
 
Hi @Kat94 and welcome to the forum. I also think it sounds as though you have type 1 so am glad they are doing an antibody test and that you are checking for ketones.

LADA (also known as type 1.5) is just another way of saying "type 1 which starts slowly" as opposed to "type 1 which starts suddenly" so the tests for LADA are the same as the tests for rapid-onset type 1.
 
Kat94 said:
I’ve got in my head I may have LADA now - does the antibody test cover this as well, does anybody know?
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LADA isn’t a term my consultant uses much really. It just means slow-onset Type 1. If you do turn out to be Type 1, my consultant wouldn’t label you LADA due to your age and obvious onset. The antibodies test can detect LADA as it’s just a term used for a particular form of Type 1. It’s also used by some GP surgeries who still label anyone over 21 with Type 1 as ‘LADA’ because they’re unaware of the number of people diagnosed with Type 1 in adulthood.
 
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