I apologise for including your full answer in my reply, still getting to grips with the forum.
No problem as far as I'm concerned. To do this, ie reply with text inserted as here I press reply, then go to the place where I want to comment and press enter. That opens a writing apace which allows me to comment in a pertinent place.
1. Both my DN and GP are aware of T3c.
My perception is they may be aware but do not understand!
The DN doesn’t have anything to do with T3c as they’re treated as T1 as you and others have said previously.
The DN, who may have the medical lead for diabetic patients in a GP's Surgery can be forgiven completely for that. He/she will meet a huge no of T2s most on oral meds and will be constrained by the NICE Guidance (including no testing and follow the NHS Healthy Diet recommendations - which is in itself a dreadful diet for anyone who needs to reduce all carbs).
From what I remember of the DN saying after speaking to the GP, Insulin is an option but would like to wait for next HBA1c results which won’t be until late Jan or early Feb. They are both aware of my previous medical history, hence my telephone consultation this Thursday.
The GP is not trained in helping T1s how to manage their D and has also got NICE Guidance to refer all T1s to Hospital Specialists. So they just need to be alert to when a patient is outside their experience and training.
In my (non-medical) opinion you could well be just that - outside your GP's experience. Every day the GP delays that referral is another day of you not being helped. The GP needs to face up to the obvious fact that your circumstances are at the very least unusual and do the right thing - raise an Urgent referral request
Meanwhile, if by the 7th your BG remains above 10, proved from your data compilation, your GP should (again in my non-medical opinion) be prescribing insulin - straightaway.
This does not need to be a permanent arrangement, but your GP owes it to you (the patient), particularly now you are so openly intent on getting your D under better management, to at least get your BG down. Current oral meds aren't doing that. More might be doable with your diet (I'll come back to that) and the GP's choice of insulin type might need altering either from a Consultants opinion or just as part of the trial and learning.
You might sub-conciously be hoping insulin can be avoided and sub-conciously not want to start on a regime of injecting. That would be normal and I certainly didn't want that either. But I can assure you that my injecting keeps me alive and as I learn the more subtle aspects the process gets easier with time. It looks more scary than it actually is.
2. DN suggested more exercise but I currently have little or no motivation to increase what I’m doing now. I walk between 3000 and 5000 steps a day. I’ve given thought to joining a gym, the motivation being I’m paying to attend, but that’s as far as it’s got.
Exercise is seen as the classic treatment response for T2 and exercise is good for anyone, regardless of being diabetic. But sometimes exercise is not enough; if you should possibly need insulin exercise alone will never be enough. 3-5k steps is a huge amount more than many people achieve.
3. Work are aware of my situation and have commented on mood swings etc. It apparently has been that bad that some staff have contacted the head office and I’m now being “investigated”.
This is an inportant point to make to your GP (and Consultant once you get there). You need help now, not next year. You want to get your mood swings under control and if they are D related (which is very possible) action is needed now
4. Diet. This a big one for me, unfortunately I’ve never been a fan of leafy veg or anything salad related. I’m not a lover of fish. Maybe I’m a true caveman. To say I don’t eat veg isn’t entirely correct as I do eat peas, carrots, various beans, sweetcorn and of course spuds and I’ll eat pasta.
I think Diet is a big one. You are expecting a lot from your pancreas by your irregular eating arrangements. Work wise I can see that a business might be helped by having a key member of staff available constantly through a long shift and I understand that some shifts have to be until midnight (or late). But all employees are entitled to some down time for proper meal breaks and just to get that short period of respite in a hectic environment. So whatever headway you can make with getting better breaks should be to both your metabolic benefit as well as your employers.
A lower carb diet includes more meat, not just fish. Ideally that meat should not be ultra-processed foodstuffs. But from baby steps of more meat (including sausages and burgers) can come better meat choices!
Veg and some fruits are all lower carb options. Use of a range of herbs and seasonings can make repetition of lots of peas, carrots, various beans and sweetcorn more tolerable as a long term solution. Hose herbs and seasonings might make other veg tolerable to add variety and economy. I can't help much with this, I'm an omnivore and I need less than 10 fingers to count foods I simply don't enjoy. But there is a wealth of knowledge within this forum that you could tap into.
The essential thing is to find a long term diet that is sustainable; short term fixes might work in the short term but you need a diet that will remain enjoyable fairly permanently; including options for eating out.
5. I have kept all the results from my blood tests on my phone and can put them onto a spreadsheet, however adding what I’ve eaten with portion size might be a bit more difficult.
Spreadsheet = great. Perhaps a modest remarks box (column) that just records what the food was and a column that records how big (by weight or by cupful or even by plate size and fullness) plus one more column that includes your best guess at the carb content. We can help you with how to guestimate carbs if that sounds daunting - many of us do this several times a day!
It's more of a table, than a mathematical spreadsheet, that will help you see your results in relation to your dietary actions and demonstrate to your GP that you have evidence for needing wider help; also to share with the forum when you want help and advice from members. The table could be the winning action in this struggle.
