Type 2 Now Injecting! ... and now Type 1

[CivicFreak]

Hope your test results bring clarity @CivicFreak, and you can get a confirmed classification.

Glad to hear that your levels are slowly beginning to improve.

Hopefully you’ll be rockin and rollin with basal:bolus MDI in no time, giving you much more chance to aim for in-range BGs much more of the time 🙂

Thank you! my levels are definitely going in the right direction - averaging around 8 in the mornings before breakfast, but jumping up to around 15 afterwards, same goes for midday meals and evening meals. Average before going to bed is still around 16. Spoke to nurse yesterday and she has said they are going to look at putting me on Novorapid (when I was put on Tresiba last week I was also given Novorapid but told not to use it until instructed) to bring those spikes down, but they just want to see what my levels are hitting after a week of being on Tresiba first, so I have to call them back on Thursday with my results. I think in order to bring my background levels down to more acceptable readings the Tresiba will need to be increased a little - as it is I'm only taking 6 units a day currently.

Feels like I'm starting entirely from scratch! I had it under control with diet, exercise and a low does of metformin and that was doing the job nicely for 3 years. As you say though, I'll have a better idea of what I'm dealing with when my results come back. Type 1.5 is definitely a new one to me but after researching this it seems to make some sense.

Will feed back when I have more info.

 

[CivicFreak]

I now have an update.

My blood results have returned - high levels of antibodies were present, consistent with type 1, so that is the diagnosis I now have. Interesting times!

I have antibodies in my thyroid also, and although I've been losing weight - likely due to sustained high blood sugar - I do have symptoms of an underactive thyroid so my doctor has put me on a very low dose of levothyroxine to start with, and I have to have some follow up blood tests in a few weeks, to see if it is helping.

I've been talking to my diabetic nurse weekly and am having to record my blood readings. Since starting on the insulin my BG have come down a lot, and is much more stable now, however I'm still having spikes around midday and after evening meals, in spite of keeping carbs low, so Novorapid has now been added to the mix, which seems to help my fasting BG overnight. I've also been taken off Gliclazide as it was having no effect whatsoever. Next plan is that since the insulin has been so effective I would like to stop taking metformin, although my nurse seems to want to keep me on it if I can tolerate it. My argument is that I don't want to take any more drugs than I have to, and I think by now it's clear that the tablets are no longer effective, as my pancreas seems to be more or less shot.

Anyway, early days but since starting the insulin a few weeks back my BG levels are generally more stable. My DSN has referred me to a "new type 1" clinic so I can get educated, and I'm also being given a keto meter and being shown how to properly carb count so I can manage my Novorapid doses more accurately - right now I'm just estimating.

Adjusting well to my new routine, but there's a lot to take on board. Being diagnosed as type 1 at the age of 39, after having been diagnosed as a type 2 3 years earlier does seem a touch surreal.

 

[rebrascora]

Hi.
So pleased you have your diagnosis confirmed and the wheels are in motion to give you more training to manage your insulin doses effectively yourself.
I was lucky in that it was just 6 weeks from Type 2 diagnosis with oral meds and strict diet to insulin use and then another couple of months before I got confirmed Type 1, but at the age of 55 it does take a bit of coming to terms with. That said, we at least only have to cope with it for about half of our lives whereas those babies and children getting diagnosed have a full lifetime sentence with it. Imagine having to cope with adolescence and diabetes together!
Having said that, it was the kick up the pants I needed to improve my health, diet and lifestyle and I feel like I might make it to 150 at the moment since I am the fittest I have been in 30 years, so it is not all that bad.

Stick around on the forum. You will pick up lots of tips on how to maximize your insulin effectiveness, like perhaps extending the prebolus time, so that the insulin and glucose both hit the blood stream at the same time to reduce the spike you get after eating and learn about the latest tech available to help us Type1s.... Freestyle Libre for example, is a fantastic system which enables you to see what your levels are doing throughout the day and night without finger pricking and is a real eye opener when it comes to managing your diabetes.

 

[pm133]

I've been talking to my diabetic nurse weekly and am having to record my blood readings. Since starting on the insulin my BG have come down a lot, and is much more stable now, however I'm still having spikes around midday and after evening meals, in spite of keeping carbs low,

What kind of spikes are you talking about relative to your pre-meal levels?

 

[Ralph-YK]

I agree I'm not not quite sure why they decided so quickly to move me from just the metformin, to gliclazide and insulin in a little over a week but this is where I am.

Could be because of your high HbA1c, though that's guessing at their motivation.

I would certainly prefer not to be stuck on insulin in all honesty.

Some T2 find insulin helps get their diabetis under control. Some T2 then get to reduce or stop the insulin later.

I know I'm on low doses of metformin and glic but now neither are effective at all, so the next step was insulin. Now having further tests to determine whether I'm T1 or not, but I suspect not.

Being T1 would be a reason why metformin & gliclizide are not particularly effect, whatever does you are taking.
Any advice we might give will depend on whether you are T2 or T1/T1.5/LADA.
If they suspect you're T1/T1.5/LADA, that would be a reason for you to be taking insulin.

I assume the C-Peptide and antibody blood tests I'm having done may go some way to determining this.

Yes, this is to determin which type you are.

 

[Ralph-YK]

but I think the plan was for me to keep a diary of my BG levels over the days since taking my insulin and present them with it this coming week so they can get a picture of the spikes that are occurring. Interestingly the spikes are still very much present. At my breakfast my BG was 9.1 and I just tested before my midday meal now and it's up at 18.5. These spikes are frequent even though I don't have many carbs at all. I suspect that the nurses will tell me I will need to use novorapid to bring these spikes down quickly, and what units I need to take. I was told to call them tomorrow, so hopefully will find out a little more.

My understanding is that is the way things work. You mention getting the spikes regardless of whatever you eat, that'll possibly be another reason to start on insulin.

 

[Ralph-YK]

I've also been taken off Gliclazide as it was having no effect whatsoever.

Gliclazide prompts the body to produce *more* insulin. A type 1 (and 1.5/LADA/3c as I understand it) can't produce any, so glic can't help.

 

[everydayupsanddowns]

My blood results have returned - high levels of antibodies were present, consistent with type 1, so that is the diagnosis I now have. Interesting times!

Ah! glad you have a confirmed diagnosis now @CivicFreak

I’ve taken the liberty of updating your thread title to clarify your situation 🙂