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High cholesterol and triglycerides

Discussion in 'Newly Diagnosed' started by Bertyboy, Dec 1, 2017.

  1. Bertyboy

    Bertyboy Type 1 · Well-Known Member

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    I got a diagnosis about three weeks ago, which was "diabetes, treated as type 1". The rationale for that was high ketone levels, plus they said I was a bit too young to have type 2. I thought type 2 would have been more likely given that I'm obese (90kg on 6'10") around my belly.
    Anyway, I just got a copy of a letter to my GP saying that the blood results showed very elevated "cholesterol levels" (nothing about type) and triglycerides and it was probably because I was poorly controlling my diabetes (although I didn't know at the time).
    Does this then open the possibility that it is actually type 2, and that if I continue with the low carb diet (and obviously low fat if cholesterol levels are too high), then I could potentially come off the insulin and reverse it?
     
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  2. Daibell

    Daibell Type 1.5 · Expert

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    Hi. Confusing isn't it. Yes, if you are T2 and not T1 then having the low-carb diet may enable you to come off the insulin once your body weight/BMI is in a good place. The meter should guide you plus and HBa1C next time you have one. Cholesterol has only a loose connection to the diabetes. Many find that their lipids ratios improve as the low-carb diet progresses but as it's the liver that determines your blood cholesterol it's not a simple relationship. It's best to focus on the lipids ratios rather than the total cholesterol figure. I agree that as you have excess weight T2 becomes quite likely but not always. Just see how the diet and blood sugar goes and perhaps the insulin need will reduce. Do use the meter to check you aren't going into the hypo area.
     
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  3. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    Type 2 is a metabolic disease. Other metabolic diseases are high cholesterol and triglycerides, high blood pressure, and insulin resistance. They go hand in hand.

    Whilst your doctor may believe you are too young for Type 2 (how old are you??) I wonder if he is up to date with this? More and more school children are now being diagnosed with Type 2. It isn't age restricted.

    Your first job should be to ask for a print out of the test results. They will show which tests you had, what the results were, and what the standard range is for each test. They are invaluable, and in my opinion necessary for you to see. Your doctor has told you your cholesterol levels were elevated. That means absolutely nothing, to anyone. You need to know what the levels were, exactly how elevated, and which parts of the cholesterol were elevated. (There are a few different part to it). You also need to know your glucose test results, HbA1c result (the diagnostic test), liver and kidney function tests and full blood count tests. You could also do with knowing what your ketone levels were.

    Did your doctor also do the c-peptide and GAD blood tests before he decided you may be Type 1? Deary me if he didn't. "Treated as Type 1" is an awful diagnosis. You can ask if these tests were done, or if they are going to be done, and the results of them.

    Type 1 and Type 2 are very different diseases with very different treatment.
     
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  4. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Pondering the difference between insulin dependant T2 and T1, especially during the honeymoon period for T1s.

    I think the underlying reason for T1 is an autoimmune disease where the beta cells in the pancreas are destroyed by your own immune system. However at the time of diagnosis there are still some functioning beta cells so the need for insulin is reduced.

    In the case of T2 it is usually that the beta cells have just worn out, or that insulin resistance is so high the insulin just doesn't work any more. Again the pancreas will still be producing some insulin, so the need for additional insulin is reduced.

    So if the above is reasonably true, then the treatment for newly diagnosed T1 and insulin dependant T2 is likely to be much the same. Straight onto insulin, but with baby steps to try and avoid hypos.

    It may be that if there is any doubt, treat as T1 is the safest protocol pending further tests and evaluation.

    I know at least one insulin dependant T2 who was rushed to hospital with diabetic keto acidosis which is dangerously high ketones. Assuming the T2 diagnosis is correct high ketones is a suggestion of T1 but not definitive.

    Edit: forgot to mention that it is worth reading more about cholesterol before diving into low fat or statins. One surprising thing is that most cholesterol is manufactured by the body, mainly from carbohydrates. So eating cholesterol doesn't directly raise your cholesterol levels. Post your breakdown of cholesterol readings and i will see if I can top it :)
     
  5. Bertyboy

    Bertyboy Type 1 · Well-Known Member

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    The diagnosis came initially from a private GP who referred me straight to the local rapid access diabetes clinic, whose DSN did another ketone test (blood instead of urine this time) and concurred with the GP. I'm 39, which I don't think is too young for type 2 (as some people would say too old for type 1, but I appreciate that understanding is changing).
    The DSN did tick the box for GAD and c-peptide, but given they didn't mention them in the letter, one would assume they are negative (I don't know why they don't just include the results with the letter).
    Also, she asks the GP (who I've never met as it takes 4-6 weeks to make any sort of appointment) to review my lipid profile once the BG profile has stabalised. Does that mean I have to make an appointment or do they call me in? It doesn't actually say. There seems to be an assumption that I know how the NHS works!
     
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  6. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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  7. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    The answer is to ring them and ask the question. You can't always trust them to follow up in a timely fashion.

    I would advise also asking for either online access to your test results, or a print out of the results so that you can see them and resolve any doubts about the results. You could also post them on here.

    With a chronic disease (this just means long term) you have to become your own expert and take responsibility for chasing the NHS if they drag their feet or don't give you the information that you need.

    Can you ask for an emergency appointment or cancellation? 4-6 weeks is far too long to wait. Alternatively is there a DSN at your surgery who could walk you through the results? Third option is to go back to the rapid access diabetes clinic and ask them there for your results and some advice.
    If your local surgery is generally crap at diabetes support you may be able to get your support directly from the clinic.
    I know that these is a split in most areas where some diabetics get their treatment through primary care but others get it through secondary care at hospital clinics.
     
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  8. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    I agree with @LittleGreyCat . You need more information on the lipid panel first of all. They're not gonna treat that until your diabetes gets under control better. From what I've seen on this forum, in the UK they take that pretty slow for the most part. Appointments with the diabetes nurse take a lot of time, seeing a specialist is a pretty slow moving target too. It seems the diabetes nurse is often the primary driver of the bus around there, so don't piss them off.
     
  9. Bertyboy

    Bertyboy Type 1 · Well-Known Member

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    I saw my DSN yesterday for some travel advice (trying to stave off my first hypo until I'm back in the UK) and I asked about the blood results. GAD and c-peptide not back yet, but total cholesterol was 6.8, but they hadn't broken it down into LDL/HDL. Anyone know why they don't produce a separate figure for this?
    I also have rubbish liver function, apparently. Again, not sure if this is likely to be tied in with the diabetes or my penchant for wine!
     
  10. Guzzler

    Guzzler Type 2 · Well-Known Member

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    Regarding age and T2 you may be interested in the article posted by the DCUKNewsbot over in the Diabetes News and Research Forum. More and more children are being diagnosed as T2. It staggers me sometimes that HCPs fail to keep up with current (and not so current) research.
     
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