More medication

[Jillyfl]

i was diagnosed in September 2018 with an hba1c of 66. I am 5foot 2inches and my weight was 54 kilos. I am now 47 kilos and painfully thin. I feel really well though and have been following the keto diet rigorously.

I am struggling to get my blood sugar levels down to 5,s and 6,s ( although they are sometimes). I am mostly at 6,s and 7,s with odd 8’s. I have a friend also diabetic and he eats normally, even eats cake and chocolate and his numbers are 7,s. He is on more medication than me. I am on 500mg of metformin twice a day. It doesn’t seem fair that I am very restricted in what I eat. I work with 2 people who are diabetic and they eat sandwiches and crisps for lunch ! Should I ask for more medication? How can I get my numbers down to “normal levels” when I really can’t change my diet any more. I also skip breakfast often because my morning sugars are too high for my liking. Or do I stick with it and see how I feel in 6 months and see where I am numbers wise?
I have just had a blood test to measure where I’m at as regards hba1c now 3 months after diagnosis. I don’t have my results yet.

 

[JoKalsbeek]

i was diagnosed in September 2018 with an hba1c of 66. I am 5foot 2inches and my weight was 54 kilos. I am now 47 kilos and painfully thin. I feel really well though and have been following the keto diet rigorously.

I am struggling to get my blood sugar levels down to 5,s and 6,s ( although they are sometimes). I am mostly at 6,s and 7,s with odd 8’s. I have a friend also diabetic and he eats normally, even eats cake and chocolate and his numbers are 7,s. He is on more medication than me. I am on 500mg of metformin twice a day. It doesn’t seem fair that I am very restricted in what I eat. I work with 2 people who are diabetic and they eat sandwiches and crisps for lunch ! Should I ask for more medication? How can I get my numbers down to “normal levels” when I really can’t change my diet any more. I also skip breakfast often because my morning sugars are too high for my liking. Or do I stick with it and see how I feel in 6 months and see where I am numbers wise?
I have just had a blood test to measure where I’m at as regards hba1c now 3 months after diagnosis. I don’t have my results yet.

Usually, the downside to more medication rather than a diet change, is that is doesn't stop there. The condition is a progressive one if diet isn't a factor in the treatment, and the need for meds will increase, with quite possibly insulin at the end of it. So it kindof depends... Diet and (more than you have now) meds combined could be perfect for you, or just meds, or just diet... Wholly depends on what suits you best, mentally, and physically. Your bloodsugarlevels seem alright, so.... Just see what works for you, what is sustainable in the long run.

 

[Member496333]

In my opinion no. The goal is to purge decades of glucose from your body, not use drugs to allow you to put more in. Depending on the severity of your insulin resistance it can take a long time for your body to repair itself and return insulin sensitivity. Liver, pancreas and dawn phenomenon particularly. Stick with it long enough and, you never know, one day you might have blood glucose to shame your friend without the use of any drugs at all. See how he likes them apples?

Your choice of course, but using more and more medication to move glucose out of your blood and into tissues and organs is unlikely to reduce your chances of complications later in life.

 

[Antje77]

Have they looked into other types of diabetes? Of course, there are thin T2's, but when a newly diagnosed diabetic is stick thin other types become more likely.

 

[Member496333]

Thin type 2 diabetics, myself being one, are actually at a distinct disadvantage. Not having enough fat cells in which de novo lipogenesis can stash away the unused glucose means our insulin sensitivity is always on a knife edge. We don’t have much of a buffer. We can’t get fat so we just get hyperglycaemia quicker than those who can. All the more reason to get that glucose out of the body, not put more in. In your face glucose!

And remember, it’s not just what’s in your blood, it’s what’s everywhere else where you can’t measure! Eyes, tissues, organs...the bits that fail even in diabetics with seemingly good glucose control.

 

[Jillyfl]

Thank you everyone!! I kind of expected these responses yet I don’t feel dissapointed . Maybe I am trying to run before I can walk. I do feel at a bit of a disadvantage to start with like Jim says. Just have to accept it. I don’t really want to “put more sugar in”, not really, but I feel like I need help. You guys are great and just what I need. I am going to stay keto because anything else now just feels wrong. I will keep at it and hopefully another 6 months down the line I will be announcing that I am in remission ha ha

You have helped me enormously by your words all of you!!

 

[Member496333]

Time is your friend. Give your body the right tools to do its job and it will reward you

 

[Deleted Account]

Like @Antje77 says, you could have a different type of diabetes.
What was the reason for being diagnosed as type 2?
There is a common misconception that type 1 is a “childhood disease”. However, more than half of people with type 1 are diagnosed over the age of 20. So age should not be a reason for type 2 diagnosis.
Furthermore, there is a belief you can only have type 1 if it is in you family. Again, this is not true.

I am not saying you definitely have type 1 (I am not a doctor) but, if you do not see improvements with your BG, it could be worth asking to get your type 2 diagnosis confirmed I don’t know how long to suggest but the 6 months of Keto you suggest may be too long if you have been misdiagnosed.

Keep an eye on your BG, fingers crossed for the 6 month remission but if you see your BG continue to climb, revisit your doctor.

 

[Bluetit1802]

If you are still losing weight on keto, perhaps increase your fats to add extra calories?

Ignore your diabetic friends - they have no idea what damage they are causing their bodies in the long term.

 

[Daibell]

Hi. Being painfully thin on a keto diet and still struggling with BS indicates you may be T1 (LADA) and not T2. I would ask the GP for the two tests for T1 i.e. GAD and C-peptide. There are more meds for early stage LADA such as Gliclazide but if you are LADA then you will go thru a honeymoon period and then insulin and starting insulin early is good. Discuss with the GP but don't just assume you are T2. GPs frequently miss Late onset T1s (LADA) and diagnose T2 by default.

 

[Robbity]

I was going to suggest exactly what @Bluetit1802 has - more fats (and "good" oils) may be what you need to keep your weight up. But do consider as well what has been suggested regarding your type of diabetes as people do occasionally get wrongly diagnosed.

A ketogenic doesn't necessarily have to be restrictive in any way - either in food quantity or type - if you make the right food choices.

And please be aware - your morning levels will generally be the last ones to come down, so take care of the ones you can control with your diet, and leave mornings to your liver to handle!

Robbity

 

[Alexandra100]

Thin type 2 diabetics, myself being one, are actually at a distinct disadvantage.

Hi @Jim Lahey I didn't realise that you are another skinny diabetic. Maybe we should have our own Forum! I read in Jenny Ruhl that it is very hard to control bgs in thin diabetics, as we produce very little insulin, and my goodness she was right. Unfortunately she didn't expand on this statement with any suggestions for management, I suppose because she has herself always had to struggle with the problem of unwanted weight gain. I would actually like to experiment with the lowest possible dose of basal insulin, but I'm not getting my hopes up that I'll get my GP to prescribe me that any time soon. What is your daily carb allowance? I am eating under 10g carbs daily, often under 7.

 

[Bluetit1802]

I read in Jenny Ruhl that it is very hard to control bgs in thin diabetics, as we produce very little insulin, and my goodness she was right.

Does JR have any research to back this up? I notice you use the word "we" in your post .... but you are not diabetic, or have you recently had a diagnosis?

 

[carty]

Can I join the skinny type 2club I reduced my Hba to 43 but it has crept up to 50 for no apparent reason except perhaps less exercise ,it is very frustrating to eat low carb but lots of calories at not gain weight
Carol

 

[Alexandra100]

Does JR have any research to back this up? I notice you use the word "we" in your post .... but you are not diabetic, or have you recently had a diagnosis?

I might best be characterised as Glucose Intolerant. My last two A1cs were both 38, (down from my original A1c of 41 but up from the 37 I achieved by lowering carbs) which is nowadays considered pre-diabetic in the US, though the WHO has not caught up yet. However I am eating under 7 and always under 10g carbs daily to achieve this level of control. Were I to eat even Dr B's 30g carbs a day, goodness knows what my A1c would be. In addition, my fasting and meal-time bgs are a lot higher than they were even in November 2017, so I fear my next A1c will be higher again. Fortunately my GP takes my bgs seriously enough to have prescribed me the maximum dose of Glucophage.

IMO the question of where to draw the line in assessing people as normal, pre or full diabetic is a distraction. I follow Dr B in thinking that what matters is whether one has a harmful level of bg. and what needs to be done to bring one's bg down to normal levels.

 

[Alexandra100]

Does JR have any research to back this up? I notice you use the word "we" in your post .... but you are not diabetic, or have you recently had a diagnosis?

If you have read any of JR's books or visited her website https://www.bloodsugar101.com you will know that she cites reams of research to back up everything she says. Unfortunately her website doesn't seem to have a search facility. I know I read it in her book "Your Diabetes Questions Answered". If it would be any use to you I could probably find you a page reference.

 

[Alexandra100]

Can I join the skinny type 2club I reduced my Hba to 43 but it has crept up to 50 for no apparent reason except perhaps less exercise ,it is very frustrating to eat low carb but lots of calories at not gain weight
Carol

Yes, frustrating is a good word for the skinny diabetic experience. However, I must admit that nowadays I find some consolation in my newish willowy silhouette! Having spent most of my life wishing I could lose a few pounds, recklessly eating fried chicken skin and full fat cheese, not to mention double cream is quite an enjoyable novelty. I just wish I didn't feel so tired a lot of the time.

 

[Alexandra100]

Could I ask any skinny diabetics reading this, do your bgs worsen towards evening? Mine do. So I avoid eating many carbs at breakfast because we are supposed to be more resistant to carbs then, eat a few at lunch, and then almost none for dinner. This can pose scheduling problems, especially as I am concerned not to miss meals.

 

[Jillyfl]

Hi. Being painfully thin on a keto diet and still struggling with BS indicates you may be T1 (LADA) and not T2. I would ask the GP for the two tests for T1 i.e. GAD and C-peptide. There are more meds for early stage LADA such as Gliclazide but if you are LADA then you will go thru a honeymoon period and then insulin and starting insulin early is good. Discuss with the GP but don't just assume you are T2. GPs frequently miss Late onset T1s (LADA) and diagnose T2 by default.

Thank you, I’ll book an appointment when I get my results

 

[Jillyfl]

Could I ask any skinny diabetics reading this, do your bgs worsen towards evening? Mine do. So I avoid eating many carbs at breakfast because we are supposed to be more resistant to carbs then, eat a few at lunch, and then almost none for dinner. This can pose scheduling problems, especially as I am concerned not to miss meals.

No mine dont worsen in the evening. Mornings mostly. But sometimes are higher all day. I know portion sizes matter, but they really do with me. I am trying to eat a little more because I’m 59 years old and skin on bone, but I think need to stay FULLY within the portion sizes at the moment