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Am I now a type 3 Diabetic?

Wraakian

Wraakian

Well-Known Member
Messages
65
Location
UK
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Dislikes
Loud, bawdy people and over muscled macho men out to prove they're tougher than everyone else or with bad attitudes, mobile phones being used whilst driving, unfair VAT and tax.
In the past with the help of Diabetes.co.uk members I have been able to control my blood glucose levels via my oral meds and low carb diet but now my fasting bloods have recently been 12.4 and today I managed to get them down to 9.5.

At 70 years of age after 30 years as a type 2 diabetic I am no longer well controlled and a couple of months ago my GP sent me to the local hospital diabetic centre where the nurse changed me to injections of the non-insulin medication Victoza (Liraglutide) from the highest level of tablets metformin/gliclazide/sitagliptin. I still take the highest amounts of gliclazide and metformin but have dropped the sitagliptin in favour of the Victoza. I now believe that my levels cannot be controlled using non-insulin medications and that my pancreas no longer makes enough insulin to stabilise my blood glucose levels. The diabetic nurse said they could try me on a medication that stops the liver holding glucose and giving it out every morning but that it does cause water infections which I am prone to getting anyway so she thought it would be too risky for me. I need to convince them that I should go on to insulin but the nurse was totally against putting me on insulin at our last meeting? My daily blood glucose readings have been as high as 18mmol/l before going on Victoza but have still been as high as 13.9mmol/l using Victoza. My low carb diet was helping to keep my results more stable but the diabetic nurse told me I should add more carbs to my diet which I have done and these latest figures are the result of that change too. I would like to retain some carbs as I find the extremely low carb diet regime far too strict for my liking. I just want to be able to have the occasional cornflakes/shreddied wheat/special K rather than my usual Flax meal, walnut, raisin and chia seed mix? I would also enjoy some wholemeal bread and the occasional potatoes or fries - all of which throw my blood glucose levels sky high? I would now like to know, considering the changes in my sugar levels, if I am now a type 3 diabetic because my pancreas isn't making enough insulin even with the meds I'm on?
 
No - as I understand Type 3 diabetes is diabetes developed as a consequence of damage to the pancreas via pancreatitis / tumours etc. What you are describing sounds more like the insulin producing beta cells in the pancreas no longer being able to keep up with the demand for insulin - type 2s can require insulin when other interventions do not provide enough suppourt / respite for the struggling pancreas
 
Thanks Boo, It certainly looks like I'm in need of insulin now and will ask the diabetic nurse why she won't put me on it, it is possible she was waiting to see if the Victoza worked first which it obviously hasn't. I just wonder if I will be able to have carbs again once on insulin though or if I will still have to keep on a low carb diet?
 
Wraakian said:
usual Flax meal, walnut, raisin and chia seed mix
Click to expand...

Hi, happy new year to you.

Sorry, the above stood out for me with regards to your current BS control..

I don't feel your breakfast is doing your blood sugar levels any favours? The raisins alone are pretty sweet.
Do you test prior to brecky then 2 hours after to note the effects? (The raisin would have immediate effect with me.)
 
The medics will Certainly want to try all interventions short of insulin and with good reason.
Im not on insulin so this is from what Ive read not from experience and there are many people here who can give better / more detailed info
My limited understanding is that for insulin dependent diabetics, thre is a background level of insulin required to cover the bodys functions ( gluconeogenesis etc etc) and that above and beyond that level the ingestion of carbs requires a matched dose of insulin such that higher carb intake requires a higher insulin dose to cover it - in much the same way as higher carb ingestion requires the pancreas to produce more insulin in order to maintain stable blood sugars in a non insulin dependent diabetic
 
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@Wraakian how your diabetes is treated doesn't change what type of diabetes it is. If you're type 2 you continue being type 2 whether your diabetes is treated with diet alone or with insulin injections.

Type 3 diabetes is Alzheimer's.

Type 3c diabetes is diabetes caused by physical damage to the pancreas from pancreatitis or Whipple procedure.

Boo1979 said:
My limited understanding is that for insulin dependent diabetics, thre is a background level of insulin required to cover the bodys functions ( gluconeogenesis etc etc)
Click to expand...

Basal insulin doesn't cover gluconogenesis. Gluconogenis isn't a spontaneous bodily function. It happens when, in the absence of carbs, the body turns protein eaten into glucose. It is covered by bolus insulin because the job of bolus insulin is to cover meals.

Wraakian said:
I just wonder if I will be able to have carbs again once on insulin though or if I will still have to keep on a low carb diet?
Click to expand...

It depends what insulin regiem is being used.
 
@Wraakian - hi, I'm insulin deficient. I'm type 2 and was diagnosed in 1998. I've had the diagnostic tests done 3 times over the years. The last lot they did was beginning of 2010 where the c-peptide test result was in the red meaning I no longer produce the insulin I need. I'm on full time insulin therapy. I haven't changed diabetic type. My understanding is that insulin resistance can wear out your pancreas where it gets beta cell damage and stops producing the insulin you need. I still produce a little bit of insulin apparently but was told I need insulin therapy to treat my diabetes. I'm guessing you're in the same boat being that you've been type 2 for 30 years. Have your docs done the GAD and c-peptide test for you recently?
 
Wraakian said:
Thanks Boo, It certainly looks like I'm in need of insulin now and will ask the diabetic nurse why she won't put me on it, it is possible she was waiting to see if the Victoza worked first which it obviously hasn't. I just wonder if I will be able to have carbs again once on insulin though or if I will still have to keep on a low carb diet?
Click to expand...
First of all you need to understand your diabetes. So your type 2. Insulin resistant.
Secondly understanding how bad your insulin resistance is. So your not coping with basic carbs like cereal and bread. Your meter has informed you of what carbs take your BG levels too high.

Your meter will keep you right.

Believe me injecting more insulin can put badly controlled type2 into control to stop complications or those complications getting worse but not replace tablets to reduce the insulin resistance.

I'm assuming you cannot exercise? Like me. Walking in pain is my current limit.

Diet and the right exercise is the biggest help to any type2 sufferer.
Injected insulin is the last resort.

So many meds for type2s can help type2s but I understand where your insulin resistance has progressed to most tablets not working with a high carb diet.
I now do low carb and reduce my insulin injected needs and in doing so reduces my insulin resistance but I'm not yet at a position to be able to stop my insulin therapy. After bariatric surgery I may be able too. At least my fast acting insulin.
I have a plan to try and improve my insulin resistance with mostly on target bgs due to medication.

Many would advise a low carb diet as it gives some many type2s much better BG results and a far improved hba1c.

Even some insulin takers like me need to not eat cereal and wholemeal bread to keep good BG levels and a good hba1c.

Those carbs are the cause of your higher bgs not lack of insulin.
 
No I don't use a pump if that question was directed to me I list my self as type 2 in remission but technically I am type 3E as my diabetes was caused by a medication I take I am not Type 3c.

Edit to add.

"
Diabetes has long been divided into type 1 and type 2. But a third type has entered the mix — and we aren’t diagnosing it correctly.

Type 1 diabetes occurs when the pancreas doesn’t produce insulin and is usually diagnosed at a young age. Type 2 diabetes shows up later in life when the pancreas can’t make enough insulin to keep up with the body. This new third type, Type 3c, starts with a damaged pancreas."

http://www.diabetesincontrol.com/awareness-of-type-3c-diabetes-and-why-it-is-misdiagnosed/
 
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Jaylee said:
Hi, happy new year to you.

Sorry, the above stood out for me with regards to your current BS control..

I don't feel your breakfast is doing your blood sugar levels any favours? The raisins alone are pretty sweet.
Do you test prior to brecky then 2 hours after to note the effects? (The raisin would have immediate effect with me.)
Click to expand...

Hi Jaylee and a happy New Year to you too!
Thanks for you reply. Yes, I do take my levels b4 and after breakfast and they do not rise much as I only have a few raisins ... Maybe 6 - 9 max just to flavour the flax meal. It's the carbs that I can't tolerate so many if not all proprietary breakfast cereals including steel cut porridge oats are a no go for me as is bread ... except for hi-lo multi grain bread which I do get fed up of having instead of my wife's preferences Warburton's wholemeal which again puts my blook glucose sky high. I will try out no raisins to see if having them in the morning effects my bloods later in the day (over the usual 2 hours). Thanks again Jaylee ... Every input helps! Kind regards ... Jim
 
ickihun said:
First of all you need to understand your diabetes. So your type 2. Insulin resistant.
Secondly understanding how bad your insulin resistance is. So your not coping with basic carbs like cereal and bread. Your meter has informed you of what carbs take your BG levels too high.

Your meter will keep you right.

Believe me injecting more insulin can put badly controlled type2 into control to stop complications or those complications getting worse but not replace tablets to reduce the insulin resistance.

I'm assuming you cannot exercise? Like me. Walking in pain is my current limit.

Diet and the right exercise is the biggest help to any type2 sufferer.
Injected insulin is the last resort.

So many meds for type2s can help type2s but I understand where your insulin resistance has progressed to most tablets not working with a high carb diet.
I now do low carb and reduce my insulin injected needs and in doing so reduces my insulin resistance but I'm not yet at a position to be able to stop my insulin therapy. After bariatric surgery I may be able too. At least my fast acting insulin.
I have a plan to try and improve my insulin resistance with mostly on target bgs due to medication.

Many would advise a low carb diet as it gives some many type2s much better BG results and a far improved hba1c.

Even some insulin takers like me need to not eat cereal and wholemeal bread to keep good BG levels and a good hba1c.

Those carbs are the cause of your higher bgs not lack of insulin.
Click to expand...

Thanks ichihun, that is helpful info, having recently had a hip replacement I too have been unable to do my usual exercise programme which as you say doesn't help. If I can stay low carb without big rises in my blood glucose control that would be okay and I wouldn't need insulin but I have been a low carber for 2 years now and a bit fed up with it plus my blood levels seemed to rise even on a strict low carb diet so I may be at the stage of having to switch to insulin as a last resort though looking at what you've just told me it would still mean staying on low carbs forever. :( Thanks again ... Jim
 
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