weight loss

[sugarmelvis]

Hi i have experienced a stone of unexpected weight loss since april ,checked my bloods and they are over 15 some times 19.I am on 2mg of morphine and going docs monday.Just wondering if anyone recommends an additional drug they have used .I am in a safety critical role so cant take anything that gives low sugars .
regards
sm

 

[Lucyr]

Do you mean morphine or did you mean metformin? Lots of drug options don’t cause hypos eg sitagliptin or the flozins

 

[sugarmelvis]

sorry metformin

 

[rebrascora]

Hi and welcome.

Can you tell us a bit about your diabetes? Things like....
How long you have been diagnosed?
How that diagnosis came about? ie. Were you symptomatic or was it just found via a routine blood test or some other means?
What if any dietary and lifestyle changes you have made?
Have you ever had any issues with your gall bladder or pancreas?
Do you have any other autoimmune conditions?

The reason I ask these questions is that unexplained weight loss is more often associated with undiagnosed Type 1 or Type 3c rather than Type 2 and with your BG levels being high it suggests the weight loss is associated with your diabetes rather than some other cause, so suggests that you may not be a straightforward Type 2. There are many of us here who were misdiagnosed as Type 2 when we are actually Type 1 and some who were diagnosed as Type 2 when they were Type 3c. In reality, the Type of diabetes you are diagnosed with is usually a bit of guess work on the part of the doctor or nurse and can be based on poor understanding of the different types of diabetes. Often if you are a mature adult, you are just assumed to be Type 2, especially if you are carrying a bit of excess weight or have a poor diet. Many doctors wrongly believe that Type 1 only develops in children and young people and have not even heard of other types of diabetes like Type 3c.

It could however also be that you are genuinely Type 2 but if you have been diagnosed a long time and not made the necessary dietary/lifestyle changes, then you may have burnt out some of your insulin producing beta cells. Sometimes with weight loss and dietary changes it can be restored to some extent but I suspect that you may be beyond treatment with oral drugs. It may depend what you currently eat and how much dietary changes you can make. Oral medication alone is very unlikely to manage it.

I appreciate what you are saying about your job although I believe there are airline pilots and certainly bus and lorry drivers who use insulin to manage their diabetes. Hypos don't generally just happen at a moment's notice. You get warning signs and there is technology which warns us when our levels are heading low so that we can treat them promptly or mostly prevent them altogether. Most of my hypos, the people I am with don't even know I am having one unless they see me eat a jelly baby or two. It does take a lot of thought and effort to manage diabetes with insulin but it should not stop you doing most jobs. Ultimately, if your body is unable to produce enough insulin to enable you to gain energy from your food ie you are loosing weight, then you need injected insulin. Oral meds just tend to get rid of the excess glucose by flushing it out through your kidneys etc meaning you need to drink plenty and consequently wee a lot but that doesn't tackle the weight loss issue and the fatigue that will come with it if your body is unable to get energy from your food. Those are my thoughts so do be prepared to consider insulin although I doubt your GP will prescribe it in this first instance.

You might want to ask them to check you for ketones since you are losing weight which is a simple test that the GP or nurse can do there and then on either blood or urine. A C-peptide test might also be really useful. This shows how much insulin your body is able to produce. Ideally a blood C-peptide test is more reliable than a urine C-peptide test but it usually needs to be taken at a hospital as it has to be frozen immediately and sent off to the lab frozen which most GP practices can't facilitate. Antibody tests for Type 1 might also be useful. The latter are best authorized by a consultant, so maybe a specialist referral would be helpful, but the specialist clinics have a long waiting list and I suspect a GP will may not be keen to authorize this yet and you may have to push for it.
Ultimately your health is worth more than your job and you won't be able to do your job very well if you need the loo very frequently or your eyesight is affected because you have poorly managed diabetes, or you start to have issues with your feet etc, so try to keep an open mind about what treatment your body needs rather than what fits in with your job. I hope I am wrong and some dietary changes and oral medication will help but you cannot afford for you to continue with levels that high long term, so do monitor closely and push for insulin if oral meds and dietary changes don't work.

 

[DaveB]

I agree with @rebrascora. I had a similar problem just before diagnosis and have been on insulin now for many years. Try to get a C-Peptide test. If the NHS won't offer it you can have one done privately. You may also have antibodies but these are now always present; I didn't have any antibodies. Don't let your GP assume because any GAD test is negative that all is OK. There are several causes of beta cell damage including viruses.