Controlled Diabetes (2 years) but still losing weight

[Zohaib]

Hi,
My name is Zohaib. I am 24 years old.
I am suffering from Diabetes Type 1 since two years. I have lost almost 18 kg in these 2 years (from 72 kg to 54 kg now).
I am taking oral medicines Galvus met 50/1000 mg (1+0+1) and Diamicron 30 mg (1+0+1).
Despite taking special care in my diet (small meals six times a day), I am still losing my weight.

Kindly guide me. Anyone suffering from similar condition may contact me.

Regards
Zohaib

 

[azure]

Hi @Zohaib

Are you taking insulin too?

What blood sugar results are you getting when you test?

 

[Zohaib]

Hi @Zohaib

Are you taking insulin too?

What blood sugar results are you getting when you test?

No I am not taking insulin.

My blood sugar levels for past 2 weeks vary between 67-150 for fasting and 63-160 for random.

 

[ickihun]

Hi @Zohaib .
Who told you you are type1?

I believe type1s produce no insulin so must take insulin.

Could you be type2? Taking metformin and gliclazide only.
Some type2s need insulin too but.... no insulin for you?

 

[ickihun]

I am type1 diabetes as my gad antibodies result was 0.29 U/ml

I took insulin for first month after diagnosis but it resulted in hypoglycemia therefore doctor advised me to only take tablets.

I see. Thanks for clearing that up for me.
I'll tag @Kristin251 and @Brunneria for guidance. Hopefully they know your diabetes type better and what works well for it!
Hang in there!

 

[azure]

I am type1 diabetes as my gad antibodies result was 0.29 U/ml

I took insulin for first month after diagnosis but it resulted in hypoglycemia therefore doctor advised me to only take tablets.

@Zohaib Ok, then that sounds like you're having a honeymoon period. That is, when your own pancreas recovers a little after the help of insulin injections and is able to make small amounts of insulin of its own This recovery is only temporary and all Type 1s will need insulin sooner or later.

The fact you're losing weight is a little worrying. How often do you test your blood sugar during the day? Could you be going high and not realising? The highest of the numbers you've given are higher than I'd want to be.

Perhaps a tiny amount of insulin would help? Have you spoken to,your doctor about this?

Other Type 1s will be along to comment soon Tagging @DaftThoughts and @catapillar and @noblehead and @urbanracer

 

[catapillar]

If you're a honeymooning type 1 not on insulin you should be keeping a close eye on blood sugar to check there is no indication you would benefit from commencing insulin. Fasting and random testing doesn't give a full picture. You should be testing before and after meals - 2 hours after eating. You should be having quarterly hba1c tests.

If youre content your blood sugar is controlled and it's not high blood sugar causing weight loss have a discussion with your doctor to check for other issues that might be causing weight loss.

 

[Zohaib]

Can you please guide me on how to regain weight? Or is the weight loss permanent?

I test my blood sugar on regular intervals before and after meal. Plus i also test hba1c level. It was 8.6% in february and 8.5% in september last year.

I consulted my doctor on this and he prescribed these medicines which I am taking now.

 

[azure]

Can you please guide me on how to regain weight? Or is the weight loss permanent?

I test my blood sugar on regular intervals before and after meal. Plus i also test hba1c level. It was 8.6% in february and 8.5% in september last year.

I consulted my doctor on this and he prescribed these medicines which I am taking now.

@Zohaib You'll regain the weight when you keep your blood sugars within range. 8.6% and 8.5% HbA1C are higher than they should be. We're roughly aiming for 6.5% or lower. Your Hba1C gives an average blood sugar of 10.9mmol (196mgdl). That would explain your weight loss.

My opinion is that you should consider changing your tablets to small doses of insulin so you can control your blood sugar better and then you will be able to,regain the weight.

 

[Zohaib]

Here is the complete history of my hbA1c to give you a better idea.

9/6/15 - 5.7%
2/2/16 - 11.0%
3/6/16 - 7.4%
15/8/16 - 8.5%
24/2/17 - 8.6%

But now with increase in medicine dosage for last month my sugar levels have returned to normal as I mentioned earlier.

 

[azure]

Just my opinion, but you'd find control a lot easier with insulin. Insulin would also help your remaining insulin producing cells survive for longer. Tablets can wear them out and lead to less than good control.

Your weight loss and inability to regain the weight suggests your control isn't as good as it could be. I lost a lot of weight before I was diagnosed but regained it all quickly once my body had the insulin it needed. I only took tiny doses to start with, but that made all the difference - both to my weight and to my HbA1C.

To be blunt, I'm not sure why your doctor is trying to use tablets to control your Type 1 when it appears you need insulin. Even blood sugar levels slightly above normal can cause complications over time.

 

[Brunneria]

@Zohaib Hi and welcome! Looks like you are getting great advice from experienced T1s.

@ickihun I am afraid that tagging me into this thread won't do Zohaib any good at all, since I don't know anything about these meds, and cannot advise on weight loss in T1s.

 

[Sid Bonkers]

I would go back to see your doctor Zohaib, Galvus met is what we in the UK call Metformin and Diamicron is known here as Gliclazide and both these drugs are commonly given to T2 diabetics and not generally prescribed to T1 diabetics except Metformin when it is sometimes prescribed to help T1's who have developed insulin resistance but that is unlikely in a newly diagnosed T1 as far as I am aware.

It could be that you are still in the T1 honeymoon period although 2 years seems a long time and as Gliclazide works by forcing the pancreas to produce more insulin I would think it unlikely that it would be offered to a T1 in the honeymoon period as it would seriously decrease the life of your insulin producing beta cells.

So I would definitely advise a visit back to your doctor and explain what is happening and try to get some professional answers.

Good luck.

 

[connie104]

I was on Galvus for 6 years and always thought it was for type 2 treatment. It's generic name is vildagliptin

 

[Daibell]

Hi. I agree with many of the other posts. On the basis you are a T1 in the honeymoon period typically you would be on a low dose of insulin and not the Gliptin (Galvus) or sulfonylurea (Diamicorn). You would be expected to move thru the honeymoon period and gradually increase the insulin. I was Late onset T1 mis-diagnosed as a T2. I was on the same tablets as you and they did help reduce my weight loss and blood sugar for a while before insulin. I wish I had gone onto insulin earlier but it was refused thru GP ignorance. I think you need to suggest it again to your doc as the continued weight loss suggests your are burning fat as the body can't use carbs properly. Are you managing to control your blood sugar as I couldn't shortly before I went onto insulin?

 

[Zohaib]

Thank you for your replies. I would surely be visiting my doctor soon to discuss the issue with him.
But I have few other questions to ask about type 1.
Firstly, is it impossible to control blood sugar through diet control?
Secondly, when I do walk or running for say 2 km I start having low sugar mostly below 70. Why does this happen and how to avoid it?

 

[catapillar]

Firstly, is it impossible to control blood sugar through diet control?

Yes. In a type 1 diabetic it is impossible to control blood sugar through diet alone long term. Your immune system is killing off the beta cells in your pancreas that make insulin, not all of your beta cells are dead yet. You're in the honeymoon, you still have some endogenous insulin production. But nothing is going to stop your immune system killing off all the beta cells. Soon you won't have enough beta cells for insulin production to be sufficient to manage blood sugar on any diet. No matter what we eat our body works har to turn carbs and protein into glucose, this glucose is stored in our liver and trickled ou through the day to keep us with enough energy. If you don't have sufficient endogenous insulin production that just raises blood sugar to dangerously high levels. Your body can't use the glucose for energy withou insul and thinks you must be starving so starts remaking Dow fat and muscle and other tissue for energy. This tissue breakdown releases ketones and turns your blood to acid. These are complications that can rapidly become fatal.

Secondly, when I do walk or running for say 2 km I start having low sugar mostly below 70. Why does this happen and how to avoid it?

A low 70 isn't technically hypo is it? I think you have to be under 70 to be hypo. If your not on insulin your body should self correct a low blood sugar. When you are on insulin you adjust the dose for exercise. The oral medication you are taking forces insulin production and it's probably this causing the low during exercise. I don't have any experience of these meds and I don't think they have flexibility to be adjusted for exercise. Given your high hba1c and weight loss I wouldnt recommend reducing. You may just need a carby snack pre exercise to keep blood sugars up.

 

[azure]

Thank you for your replies. I would surely be visiting my doctor soon to discuss the issue with him.
But I have few other questions to ask about type 1.
Firstly, is it impossible to control blood sugar through diet control?
Secondly, when I do walk or running for say 2 km I start having low sugar mostly below 70. Why does this happen and how to avoid it?

Type 1 can't be controlled through diet. Sometimes during the honeymoon period, it can be for a little while but all people with Type 1 diabetes will need insulin. Before insulin was discovered, Type 1 was a terminal illness as no one can survive without insulin.

Your Diamicron might be contributing to your blood sugar drop (although 70 isn't too low). Both the drugs you're on are Type 2 drugs and Diamicron is contraindicated for Type 1.

Please do speak to your doctor as soon as you can. If they're not experienced in Type 1, find a new doctor. It really is important you get the correct treatment as soon as you can.

 

[Kristin251]

I am in agreement that you should move to small doses of insulin. I too was misdiagnosed and out on gliclazide and my bs was all over the place. It randomly squeezes your pancreas to spit out insulin. With an already failing pancreas this is not ideal. Eventually it will squeeze it to death. Small doses of insulin will preserve the beta cells you do have. Knowing what I know now I never would have taken gliclazide. There's no way to know when it's going to squeeze your pancreas. It just randomly happens. That makes it very hard to control your bs. I could go from 85 to 50 to 150 in an hours time without eating!! Those swings are very hard on your body. I have much better control with insulin. It just took time and resting to figure out the right doses.


When insulin was causing hypos were you perhaps taking too much for your meals ? I eat very small meals and only take 1/2-1 unit with them.

Can you ask for a c- peptide test? That will show how much insulin you produce on your own. I have no idea what your GAD measurement is and how to convert it to US. But I do know it should be close to zero.

 

[Kristin251]

Hi,
My name is Zohaib. I am 24 years old.
I am suffering from Diabetes Type 1 since two years. I have lost almost 18 kg in these 2 years (from 72 kg to 54 kg now).
I am taking oral medicines Galvus met 50/1000 mg (1+0+1) and Diamicron 30 mg (1+0+1).
Despite taking special care in my diet (small meals six times a day), I am still losing my weight.

Kindly guide me. Anyone suffering from similar condition may contact me.

Regards
Zohaib

I forgot to acknowledge the weight loss issue. I lost loads of weight that I didn't need or want too. I was also eating as much food as I could ( not carbs though as I couldn't handle them) and still lost weight. I was waking up early to get another whole meal in. It was explained to me that it didn't matter how much I ate, that without insulin the bs nutrients weren't getting into my cells and my body was feeding off itself, not my food. Immediately after starting insulin I gained my weight back and it stopped right where it left off.

As for your insulin causing hypos perhaps you were taking too much for your small meals. As I said, I take 1/2-1 per meal. However I also eat a high healthy fat diet, moderate protein and very low carb. When I did eat carbs I would drop then spike. @azure taught me the importance of timing my insulin to meet my food.