Recently diagnosed- HELLO!

[AHSAMI]

Hi,

I was recently diagnosed with Type 2 in the first week of February.

a1c 157 (yikes) fasting 14.7. Was called in to my GP 2 days after the blood test and was sitting at 24.0 mmol on the day (ate a whole Tesco's pizza before meeting the doctor). He was unsure initially if I am T1 or T2 due to ketones in my urine which vanished after 1.5 weeks. The plan has been to avoid medication if possible and to manage this via diet mostly.

It has been 3 weeks and 2 days, I had so many strange symptoms and aches especially in the left flank and abdomen.. worst of all blurry vision which has been most distressing due to drastically lowering my blood sugar level in the first week.

I'm pleased to be able to say my vision has finally returned as of yesterday to what looks like "normal" or at least 90% there, after relying on cheap ready readers-for the last couple of weeks. My fasting numbers have consistently been 3.9-4.8 for the last 10 days and I am not getting readings above 4.8 before meals anymore.

This forum has been such a valuable resource for getting me through this initial period, the knowledge from the members especially on the blurry vision topics helped me understand what was going on and gave me patience / reassurance that things will settle eventually... Thank you for being patient with all the newbie questions on all of the various topics.


A

 

[Leadinglights]

Welcome to the forum. I am hugely surprised that you GP didn't send you straight to A & E with an HbA1C as high as that or at the very least prescribe some medication.
What measures have you taken to bring down your glucose level so quickly in the absence of any meds.
But well done anyway.

 

[DiabloT2]

@AHSAMI - Well done for getting your BG readings down so much to very good levels indeed and so quickly. I had an HBA1c at similar levels to yours at diagnosis and eventually got mine down, although not as much as you nor as quickly.

 

[AHSAMI]

Welcome to the forum. I am hugely surprised that you GP didn't send you straight to A & E with an HbA1C as high as that or at the very least prescribe some medication.
What measures have you taken to bring down your glucose level so quickly in the absence of any meds.
But well done anyway.

@Leadinglights Thank you.

Yes I was a little scared reading that some had been admitted to hospital for lower readings than mine.
I did have a few low dose insulin (Lantus) prescribed and ready to use as a just in case, but it was not administered.

My GP who is the lead of his practice saw me every day for about a week (after the surgery closed so after hours as the last patient of the day) so he could monitor me closely which I am really lucky to have had. I imagine this is the result of me having been there 3 times complaining about all of the symptoms of diabetes without it being identified (urinating every 2 hours throughout the nights, persistent thirst etc.)

I drank only water for the first 2 weeks, now I have started black coffee once in the mornings. I took a week off my job to learn about which types of food to consume always referencing the glycemic index for anything I was considering putting close to my mouth! I have also been scouring the internet and this forum, and learned that intermittent fasting has helped a lot so far, keeping it simple - I stop eating at 5-6pm and do not eat until 8-9am in the morning only drinking the odd bit of water or squash (sparingly).

Needless to say I have drastically reduced my carbohydrate intake, and as advised by my doctor to re-portion my plate of food so that I have more veggies and protein and generally lower the amount I eat. More specifically I am consuming Weetabix with almond milk (unsweetend) in the mornings with a few raspberries, strawberries and a tiny bit of manuka honey. A salad with either fish, chicken, or boiled eggs for lunch. Most of my dinners have been omlettes, steaks (lamb beef or chicken) and steamed veggies. If I need some cabs I will eat some Ryvita (cracker bread) with a small amount of soft cheese and some pine nuts.

I walk for about 30 mintues every afternoon between 3-4pm but I will be introducing more exercise in the coming weeks as I have lost a lot of weight before being diagnosed (unintentionally) and have not been feeling as "strong" as I was a few months ago.

That's all I have been doing for now, still a lot to learn.
A

 

[AHSAMI]

@AHSAMI - Well done for getting your BG readings down so much to very good levels indeed and so quickly. I had an HBA1c at similar levels to yours at diagnosis and eventually got mine down, although not as much as you nor as quickly.

@DiabloT2

Thank you! It is not easy but I want that HBA1c down going forward.

I have seen some say that bringing it down quickly is not the best way to go about it, and as a result I have had blurred vision for almost 3 weeks which seems to be clearing up now, not out of the woods yet though. I think my doctor just wanted me to get the numbers down asap due to how high they were initially.

 

[everydayupsanddowns]

Thanks for sharing your story @AHSAMI I’m sure it will be inspiring to others.

And I’m glad that you have de-lurked too. Good to hear some of the reading you did on the forum helped you along your way to this point too. 🙂

 

[rebrascora]

Hi and welcome from me too.

Sounds like you have made a massive effort to get your levels down so WELL DONE but I would just like to add a word of caution to keep in the back of your mind.....

udden onset of symptoms along with a VERY high HbA1c and unintentional weight loss are all red flags for Type 1 rather than Type 2. I appreciate that you have got your levels down into range by reducing your carb intake, but if you are Type 1 that may be a temporary reprieve, so do be alert to levels rising again, even with your restricted diet and exercise. It may be weeks, months or years and it may happen after an unrelated illness.
The fact that you have got your waking fasting BG down into the normal range so quickly also suggests you are Type 1 as it often takes months for normal Type 2s to bring their waking BG levels down to that level, especially from such a huge starting point. Not knocking the effort you have put in because it is obviously huge but I don't think you can clear the visceral fat from the liver and pancreas quite that quickly.

Basically Type 1 diabetes is an autoimmune condition where the immune system kills off some of your insulin producing beta cells. Often there is a trigger like a virus and it is believed that Covid has triggered it causing a significant increase in cases, but the predisposition is usually there before the trigger. In adults the attack on beta cells is sometimes quite slow and may occur in stages, which often makes it look more like Type 2 and can respond to Type 2 management in the early stages as yours has. The remaining beta cells continue to function and if you reduce your carb intake, they can manage for a while because you have reduced their workload, but will be under increased pressure because there are less of them and gradually you reach a tipping point when too many are taken out and the remainder can no longer cover even a very restricted diet and you need injected insulin. This tipping point is a dangerous time because levels can go very high as yours did at initial diagnosis and it can happen quite quickly and if you develop ketones due to a lack of insulin, you are at risk of Diabetic Ketoacidosis, which is potentially life threatening and needs urgent treatment.
For that reason, I would encourage you to arm yourself with a pot of Ketostix to check your urine for ketones when/if your BG levels return to mid teens. Being able to monitor your BG levels is important and if you see them starting to rise again then this is likely the situation and no matter how stringent your diet or how much exercise you do, you can't reverse Type 1 and it will eventually require injected insulin.

There are 2 tests for Type 1, a C-Peptide test which measures the amount of insulin you are able to produce usually after you have eaten a carb rich meal to stimulate insulin production and an antibody test to check for the antibodies which the immune system has developed to target the beta cells. GAD antibodies are the most common but there are others. These antibodies sometimes fade after an attack so in many respects it is best to have this test done early after diagnosis to help make a Type 1 diagnosis more clear as sometimes these tests can become less definitive with time and some people end up with no clear diagnosis after years of trying to manage their diabetes with oral meds and then insulin.

Just to be clear, Type 2 diabetes is metabolic usually caused by a build up a fat in the liver and pancreas and insulin resistance develops and in the early stages, the body is usually producing excess insulin to overcome insulin resistance and if it is caught early there is a good chance that it can be pushed into remission by burning that visceral fat off and kept there by lifestyle changes. It is very different to Type 1 although both cause high BG levels but with Type 2 it is usually a slow gradual process rather than the sudden symptoms and very high HbA1c you experienced. Most GPs have little understanding of Type 1 and assume you must be Type 2 because you are not a child and/or admit to a poor diet and/or are carrying a bit of extra weight. There are many of us here on the forum who were misdiagnosed as Type 2 and we have some who went years trying to get a correct diagnosis and at least one member who still hasn't got a clear diagnosis 15 years after initial diagnosis and has been on insulin most of that time. You might wonder what difference it makes, but sadly there is a 2 tier support system within the NHS. Type 1 diabetics get much better support and access to better technology. Type 2s even those on identical treatment systems with insulin are not routinely given educational courses and technology to support them. It is wrong but it is the case. It is also often apparent in the approach of health care workers and Type 1s quite often get a more sympathetic approach than Type 2s which can sometimes be made to feel like they aren't trying hard enough and are at fault. I think the tide is slowly changing but we get many people here on the forum who experience this.

Anyway, just really wanted to explain all that because there are lots of warning bells in your story which really suggest you are Type 1 and if so, sooner or later things could deteriorate fast when you are not on insulin, particularly if you become unwell, so it is worth mentioning it to your Dr now just to plant the seeds of doubt, so that they give it some thought and keep it in your own mind and ask for some Ketostix so that you can monitor ketones if levels suddenly rise into the mid teens again. It is always the way that these things happen at inconvenient times like weekends and bank holidays and whilst on holiday and perhaps indulging in a few extra carbs or having been exposed to a virus on the flight out on holiday, so do keep a close eye on things and be prepared.

 

[AHSAMI]

Hi and welcome from me too.

Sounds like you have made a massive effort to get your levels down so WELL DONE but I would just like to add a word of caution to keep in the back of your mind.....

udden onset of symptoms along with a VERY high HbA1c and unintentional weight loss are all red flags for Type 1 rather than Type 2. I appreciate that you have got your levels down into range by reducing your carb intake, but if you are Type 1 that may be a temporary reprieve, so do be alert to levels rising again, even with your restricted diet and exercise. It may be weeks, months or years and it may happen after an unrelated illness.
The fact that you have got your waking fasting BG down into the normal range so quickly also suggests you are Type 1 as it often takes months for normal Type 2s to bring their waking BG levels down to that level, especially from such a huge starting point. Not knocking the effort you have put in because it is obviously huge but I don't think you can clear the visceral fat from the liver and pancreas quite that quickly.

Basically Type 1 diabetes is an autoimmune condition where the immune system kills off some of your insulin producing beta cells. Often there is a trigger like a virus and it is believed that Covid has triggered it causing a significant increase in cases, but the predisposition is usually there before the trigger. In adults the attack on beta cells is sometimes quite slow and may occur in stages, which often makes it look more like Type 2 and can respond to Type 2 management in the early stages as yours has. The remaining beta cells continue to function and if you reduce your carb intake, they can manage for a while because you have reduced their workload, but will be under increased pressure because there are less of them and gradually you reach a tipping point when too many are taken out and the remainder can no longer cover even a very restricted diet and you need injected insulin. This tipping point is a dangerous time because levels can go very high as yours did at initial diagnosis and it can happen quite quickly and if you develop ketones due to a lack of insulin, you are at risk of Diabetic Ketoacidosis, which is potentially life threatening and needs urgent treatment.
For that reason, I would encourage you to arm yourself with a pot of Ketostix to check your urine for ketones when/if your BG levels return to mid teens. Being able to monitor your BG levels is important and if you see them starting to rise again then this is likely the situation and no matter how stringent your diet or how much exercise you do, you can't reverse Type 1 and it will eventually require injected insulin.

There are 2 tests for Type 1, a C-Peptide test which measures the amount of insulin you are able to produce usually after you have eaten a carb rich meal to stimulate insulin production and an antibody test to check for the antibodies which the immune system has developed to target the beta cells. GAD antibodies are the most common but there are others. These antibodies sometimes fade after an attack so in many respects it is best to have this test done early after diagnosis to help make a Type 1 diagnosis more clear as sometimes these tests can become less definitive with time and some people end up with no clear diagnosis after years of trying to manage their diabetes with oral meds and then insulin.

Just to be clear, Type 2 diabetes is metabolic usually caused by a build up a fat in the liver and pancreas and insulin resistance develops and in the early stages, the body is usually producing excess insulin to overcome insulin resistance and if it is caught early there is a good chance that it can be pushed into remission by burning that visceral fat off and kept there by lifestyle changes. It is very different to Type 1 although both cause high BG levels but with Type 2 it is usually a slow gradual process rather than the sudden symptoms and very high HbA1c you experienced. Most GPs have little understanding of Type 1 and assume you must be Type 2 because you are not a child and/or admit to a poor diet and/or are carrying a bit of extra weight. There are many of us here on the forum who were misdiagnosed as Type 2 and we have some who went years trying to get a correct diagnosis and at least one member who still hasn't got a clear diagnosis 15 years after initial diagnosis and has been on insulin most of that time. You might wonder what difference it makes, but sadly there is a 2 tier support system within the NHS. Type 1 diabetics get much better support and access to better technology. Type 2s even those on identical treatment systems with insulin are not routinely given educational courses and technology to support them. It is wrong but it is the case. It is also often apparent in the approach of health care workers and Type 1s quite often get a more sympathetic approach than Type 2s which can sometimes be made to feel like they aren't trying hard enough and are at fault. I think the tide is slowly changing but we get many people here on the forum who experience this.

Anyway, just really wanted to explain all that because there are lots of warning bells in your story which really suggest you are Type 1 and if so, sooner or later things could deteriorate fast when you are not on insulin, particularly if you become unwell, so it is worth mentioning it to your Dr now just to plant the seeds of doubt, so that they give it some thought and keep it in your own mind and ask for some Ketostix so that you can monitor ketones if levels suddenly rise into the mid teens again. It is always the way that these things happen at inconvenient times like weekends and bank holidays and whilst on holiday and perhaps indulging in a few extra carbs or having been exposed to a virus on the flight out on holiday, so do keep a close eye on things and be prepared.

@rebrascora

Thank you so much for your detailed comment I really appreciate this.

I have my follow up with the Dr. on Monday where he will be discussing my ultrasound scans and I think the C-peptide/Antibody results. He even mentioned just taking fasting readings from the beginning of this week (week 3) but I am still taking regular readings throughout the day for my own peace of mind and have signed up to a free trial for a CGM too.

Noted re. the ketostix, brilliant idea. I will remain cautious and keep in mind the possibility of a misdiagnosis.

Best,
A

 

[AHSAMI]

Small update.

Saw the doc on Monday morning. All additional blood tests are "clear" (peptide and antibody tests).
Ketones were checked by him again (via a small finger prick monitor) with a "Lo" result.

Like a proud parent.. I was encouraged to keep doing whatever I am doing as it seems to be working and I have gained some pancreatic function - whatever this means! The plan is to do another a1c in mid May, and to relax the diet ever so slightly in August by which time the way I consume food now will probably become "normal" and I won't crave junk.. maybe. The words "reversal" were used by the end of summer, although I understand this can simply be interpreted as good control.

I will remain vigilant with the testing as I feel the numbers are a source of motivation at the moment and it is a small price to pay for the strips. The highest numbers I am seeing on waking up in mornings is 5.1, which fluctuates between this and 4.6 consistently. Before meals I am somewhere between 4.1 - 4.7 (mostly sedentary but very hungry!). I am definitely Type 2 at this point in time after asking if the doc is sure I am not Type 1.

Thanks for reading about my situation, and for your input.

A

 

[Lucyr]

Saw the doc on Monday morning. All additional blood tests are "clear" (peptide and antibody tests).

Did you get the actual numbers, as ‘clear’ could mean anything.

 

[PerSpinasAdAstra]

Many congratulations on such a massive improvement so fast. It's awe-inspiring frankly.

Do please keep us all up to date in the months (and years) ahead. If there were a Remission Olympics I think you might be a strong contender for a Gold with pre-meal numbers like that. Strictly speaking 'remission' is getting to a point where a person no longer needs medication following changes in weight or diet or exercise, or a combination. With a HbA1c of 157 I think almost any doctor would have put you on meds immediately, so in my book at least you've qualified for the Games 😉

 

[AHSAMI]

Did you get the actual numbers, as ‘clear’ could mean anything.

I will get the report printed for more specifics. They gave the impression everything was fine with the results and I am content with the level of one-to-one service he's given me over the month, listening attentively and giving ample time to ask as many questions as possible, I feel like I can trust him as he has about 700 diabetic patients in his practice.

I imagine he's well informed - although his caveat has been that everyone handles this situation differently, and every body is unique. I have a course to go on with a specialist nurse in the coming weeks, and an eye screening too. Luckily my eyesight feels almost 100% normal again after 3 weeks.

Will keep this thread updated in the coming months.

A

 

[Lucyr]

They gave the impression everything was fine with the results and I am content with the level of one-to-one service he's given me over the month, listening attentively and giving ample time to ask as many questions as possible, I feel like I can trust him as he has about 700 diabetic patients in his practice.

“Everything is fine with the results” in the context of a cpeptide test could mean so much though.

You could be producing crazy high levels of insulin, showing you are definitely t2 with high insulin resistance. You could be producing low normal levels of insulin suggesting you’re not type 1 but you’re not a straightforward type 2 either. Discussing the actual numbers in appointments rather than accepting an “all ok” message gives you so much more knowledge and understanding of your diabetes.

 

[rebrascora]

You could be producing low normal levels of insulin suggesting you’re not type 1 but you’re not a straightforward type 2 either.

Or could be low normal C-Peptide and still be Type 1 as I was, but perhaps have a different antibody than GAD if GAD was negative. It also depends if the C-peptide was done fasting or carb loaded.

@AHSAMI I can understand you having confidence in this GP but just bear in mind that he may still be wrong, so keep an eye on your levels particularly if you pick up an illness because that can trigger things to deteriorate again and possibly quite rapidly.
Wishing you lots of luck for long lasting remission if you are Type 2. You are clearly putting a lot of work into it.

 

[JITR]

Hi and welcome from me too.

Sounds like you have made a massive effort to get your levels down so WELL DONE but I would just like to add a word of caution to keep in the back of your mind.....

udden onset of symptoms along with a VERY high HbA1c and unintentional weight loss are all red flags for Type 1 rather than Type 2. I appreciate that you have got your levels down into range by reducing your carb intake, but if you are Type 1 that may be a temporary reprieve, so do be alert to levels rising again, even with your restricted diet and exercise. It may be weeks, months or years and it may happen after an unrelated illness.
The fact that you have got your waking fasting BG down into the normal range so quickly also suggests you are Type 1 as it often takes months for normal Type 2s to bring their waking BG levels down to that level, especially from such a huge starting point. Not knocking the effort you have put in because it is obviously huge but I don't think you can clear the visceral fat from the liver and pancreas quite that quickly.

Basically Type 1 diabetes is an autoimmune condition where the immune system kills off some of your insulin producing beta cells. Often there is a trigger like a virus and it is believed that Covid has triggered it causing a significant increase in cases, but the predisposition is usually there before the trigger. In adults the attack on beta cells is sometimes quite slow and may occur in stages, which often makes it look more like Type 2 and can respond to Type 2 management in the early stages as yours has. The remaining beta cells continue to function and if you reduce your carb intake, they can manage for a while because you have reduced their workload, but will be under increased pressure because there are less of them and gradually you reach a tipping point when too many are taken out and the remainder can no longer cover even a very restricted diet and you need injected insulin. This tipping point is a dangerous time because levels can go very high as yours did at initial diagnosis and it can happen quite quickly and if you develop ketones due to a lack of insulin, you are at risk of Diabetic Ketoacidosis, which is potentially life threatening and needs urgent treatment.
For that reason, I would encourage you to arm yourself with a pot of Ketostix to check your urine for ketones when/if your BG levels return to mid teens. Being able to monitor your BG levels is important and if you see them starting to rise again then this is likely the situation and no matter how stringent your diet or how much exercise you do, you can't reverse Type 1 and it will eventually require injected insulin.

There are 2 tests for Type 1, a C-Peptide test which measures the amount of insulin you are able to produce usually after you have eaten a carb rich meal to stimulate insulin production and an antibody test to check for the antibodies which the immune system has developed to target the beta cells. GAD antibodies are the most common but there are others. These antibodies sometimes fade after an attack so in many respects it is best to have this test done early after diagnosis to help make a Type 1 diagnosis more clear as sometimes these tests can become less definitive with time and some people end up with no clear diagnosis after years of trying to manage their diabetes with oral meds and then insulin.

Just to be clear, Type 2 diabetes is metabolic usually caused by a build up a fat in the liver and pancreas and insulin resistance develops and in the early stages, the body is usually producing excess insulin to overcome insulin resistance and if it is caught early there is a good chance that it can be pushed into remission by burning that visceral fat off and kept there by lifestyle changes. It is very different to Type 1 although both cause high BG levels but with Type 2 it is usually a slow gradual process rather than the sudden symptoms and very high HbA1c you experienced. Most GPs have little understanding of Type 1 and assume you must be Type 2 because you are not a child and/or admit to a poor diet and/or are carrying a bit of extra weight. There are many of us here on the forum who were misdiagnosed as Type 2 and we have some who went years trying to get a correct diagnosis and at least one member who still hasn't got a clear diagnosis 15 years after initial diagnosis and has been on insulin most of that time. You might wonder what difference it makes, but sadly there is a 2 tier support system within the NHS. Type 1 diabetics get much better support and access to better technology. Type 2s even those on identical treatment systems with insulin are not routinely given educational courses and technology to support them. It is wrong but it is the case. It is also often apparent in the approach of health care workers and Type 1s quite often get a more sympathetic approach than Type 2s which can sometimes be made to feel like they aren't trying hard enough and are at fault. I think the tide is slowly changing but we get many people here on the forum who experience this.

Anyway, just really wanted to explain all that because there are lots of warning bells in your story which really suggest you are Type 1 and if so, sooner or later things could deteriorate fast when you are not on insulin, particularly if you become unwell, so it is worth mentioning it to your Dr now just to plant the seeds of doubt, so that they give it some thought and keep it in your own mind and ask for some Ketostix so that you can monitor ketones if levels suddenly rise into the mid teens again. It is always the way that these things happen at inconvenient times like weekends and bank holidays and whilst on holiday and perhaps indulging in a few extra carbs or having been exposed to a virus on the flight out on holiday, so do keep a close eye on things and be prepared.

Many T2Ds will be able to get their fbg down to a normal level in 7 days on a balanced 600-800 calorie per day diet. Professor Roy Taylor proved that in his Counterpoint study in c.2008. After an ultrasound scan on 23 December 2022 confirmed a fatty liver, the radiologist advised diet. My bfg came down from 17.1 (at diagnosis) to 5.8 between Christmas Eve and New Years Eve. My liver was back to normal according to a second scan 6 months later.

 

[childofthesea43]

Hi and welcome from me too.

Sounds like you have made a massive effort to get your levels down so WELL DONE but I would just like to add a word of caution to keep in the back of your mind.....

udden onset of symptoms along with a VERY high HbA1c and unintentional weight loss are all red flags for Type 1 rather than Type 2. I appreciate that you have got your levels down into range by reducing your carb intake, but if you are Type 1 that may be a temporary reprieve, so do be alert to levels rising again, even with your restricted diet and exercise. It may be weeks, months or years and it may happen after an unrelated illness.
The fact that you have got your waking fasting BG down into the normal range so quickly also suggests you are Type 1 as it often takes months for normal Type 2s to bring their waking BG levels down to that level, especially from such a huge starting point. Not knocking the effort you have put in because it is obviously huge but I don't think you can clear the visceral fat from the liver and pancreas quite that quickly.

Basically Type 1 diabetes is an autoimmune condition where the immune system kills off some of your insulin producing beta cells. Often there is a trigger like a virus and it is believed that Covid has triggered it causing a significant increase in cases, but the predisposition is usually there before the trigger. In adults the attack on beta cells is sometimes quite slow and may occur in stages, which often makes it look more like Type 2 and can respond to Type 2 management in the early stages as yours has. The remaining beta cells continue to function and if you reduce your carb intake, they can manage for a while because you have reduced their workload, but will be under increased pressure because there are less of them and gradually you reach a tipping point when too many are taken out and the remainder can no longer cover even a very restricted diet and you need injected insulin. This tipping point is a dangerous time because levels can go very high as yours did at initial diagnosis and it can happen quite quickly and if you develop ketones due to a lack of insulin, you are at risk of Diabetic Ketoacidosis, which is potentially life threatening and needs urgent treatment.
For that reason, I would encourage you to arm yourself with a pot of Ketostix to check your urine for ketones when/if your BG levels return to mid teens. Being able to monitor your BG levels is important and if you see them starting to rise again then this is likely the situation and no matter how stringent your diet or how much exercise you do, you can't reverse Type 1 and it will eventually require injected insulin.

There are 2 tests for Type 1, a C-Peptide test which measures the amount of insulin you are able to produce usually after you have eaten a carb rich meal to stimulate insulin production and an antibody test to check for the antibodies which the immune system has developed to target the beta cells. GAD antibodies are the most common but there are others. These antibodies sometimes fade after an attack so in many respects it is best to have this test done early after diagnosis to help make a Type 1 diagnosis more clear as sometimes these tests can become less definitive with time and some people end up with no clear diagnosis after years of trying to manage their diabetes with oral meds and then insulin.

Just to be clear, Type 2 diabetes is metabolic usually caused by a build up a fat in the liver and pancreas and insulin resistance develops and in the early stages, the body is usually producing excess insulin to overcome insulin resistance and if it is caught early there is a good chance that it can be pushed into remission by burning that visceral fat off and kept there by lifestyle changes. It is very different to Type 1 although both cause high BG levels but with Type 2 it is usually a slow gradual process rather than the sudden symptoms and very high HbA1c you experienced. Most GPs have little understanding of Type 1 and assume you must be Type 2 because you are not a child and/or admit to a poor diet and/or are carrying a bit of extra weight. There are many of us here on the forum who were misdiagnosed as Type 2 and we have some who went years trying to get a correct diagnosis and at least one member who still hasn't got a clear diagnosis 15 years after initial diagnosis and has been on insulin most of that time. You might wonder what difference it makes, but sadly there is a 2 tier support system within the NHS. Type 1 diabetics get much better support and access to better technology. Type 2s even those on identical treatment systems with insulin are not routinely given educational courses and technology to support them. It is wrong but it is the case. It is also often apparent in the approach of health care workers and Type 1s quite often get a more sympathetic approach than Type 2s which can sometimes be made to feel like they aren't trying hard enough and are at fault. I think the tide is slowly changing but we get many people here on the forum who experience this.

Anyway, just really wanted to explain all that because there are lots of warning bells in your story which really suggest you are Type 1 and if so, sooner or later things could deteriorate fast when you are not on insulin, particularly if you become unwell, so it is worth mentioning it to your Dr now just to plant the seeds of doubt, so that they give it some thought and keep it in your own mind and ask for some Ketostix so that you can monitor ketones if levels suddenly rise into the mid teens again. It is always the way that these things happen at inconvenient times like weekends and bank holidays and whilst on holiday and perhaps indulging in a few extra carbs or having been exposed to a virus on the flight out on holiday, so do keep a close eye on things and be prepared.

Brilliantly clear and cogent synopsis.