Finally got my GAD results

[MisplacedIdentity]

I'm not sure if I feel at the moment!

Last november I started feeling unwell and ended up in hospital for 5 days newly diagnosed as type 1.
My HbAc1 results on leaving were 12.7

After a couple of months I was informed that I was most likely type 2, day time insulin was stopped and replaced with metformin.
Background insulin was reduced to 6 units with the plan to reduce and remove. I dropped it down to 2 with guidance then it got put back up to 8 due to high readings.

I then had another blood test and 7 weeks later my results came back.
HbAc1 is now 6.3
GAD is 77
This now means I'm type 1 and will eventually be insulin dependant but for now I need to keep doing what I'm doing but reduce carbs even more and drink more water.

I'm glad that I now know my official condition but still confused as to why I can't go back on the daily insulin. I have an appointment with the consultant in July which will be my 6 month review.

I know noone will have the answer on here, just wanted to type this somewhere without my family feeling sorry for me as that is rather unhelpful!

 

[Juicyj]

Hello @MisplacedIdentity its good you've had your diagnosis, so although type 1 it's a sigh of relief to know where you stand. Ultimately insulin dosing is dependent on your daily readings, so if you're managing fine without hypos or hypers on your current basal dose then no need to add quick acting into the mix otherwise you will be feeding the insulin to avoid going low, at this stage it's a good idea to simply keep a diary of your readings so as and when your pancreas decides to really call it a day, that you'll be able to see patterns with your readings and speak to your team about changing your doses.

Over time you will almost instinctively know when you need to adjust your doses to suit your daily readings without guidance, but of course please follow your teams advice at this stage, a good book to help you get your head round things is 'think like a pancreas' written by a type 1.

 

[MisplacedIdentity]

Thank you @Juicyj
I keep a daily log and also upload to diasend. My diabetic team can see my daily logs and check on them when I make my weekly call.

I seem to have a regular pattern of 5 days with readings between 5.2 and 9.1 then 3 or 4 days between 7.6 and 14.3 which is when I'm allowing myself a few extra carbs, mainly over a weekend so I need to plan meals better.

 

[Juicyj]

You're already doing well with keeping a log, I used to use Diasend too when I was first diagnosed and emailed them to my DSN, it was really easy to use and good to get the re-assurance with checking my numbers.

It looks as though as and when things do change that you'll be on top of this so that's also good, don't worry about the odd rogue reading, I get anything from 2.9 to 15 however I can correct with quick acting insulin if the numbers go high - using quick acting insulin means you can take insulin to cover the carbs by matching your carb intake with your insulin dose and correct the high readings too.

I don't get stressed though if the numbers do go high, otherwise it would be a pain to live with this, but I do take it one day at a time, it's getting used to the daily routine of testing and monitoring really at this stage.

 

[Bluey1]

Welcome to our exclusive club. All T1’s here have been where you are. Many here have done it in a more dramatic way. It’s very common to be on an emotional roller coaster to start with. For most of us we were started with low doses and we increased over time. It will take a while, but once things settle down it won’t be a big deal and life will become normal. Most D1’s don’t survive, they thrive. There are very few things we can’t do.

 

[EllieM]

I'm glad that I now know my official condition but still confused as to why I can't go back on the daily insulin. I have an appointment with the consultant in July which will be my 6 month review.

Well, I've got to say I'm wondering about this too.

This now means I'm type 1 and will eventually be insulin dependant but for now I need to keep doing what I'm doing but reduce carbs even more and drink more water.

So they want you to go down to zero carbs before they'll put you on short acting insulin? Did they actually say this? In your position, I'd be tempted to ring up your diabetic nurse and get clarification on this.

A cynical person might say they just don't want to make any changes without a specialist's/consultant's input, and getting you to go increasingly low carb is a way of delaying the evil moment till June.

In any case, it will all be sorted out eventually, and you'll be able to choose how low carb you want to go, because you'll be able to match your insulin to your needs. Good luck.

(Ps I'm not criticising low carb here, I'm go pretty low carb myself, but given that most T1s aren't insulin resistant, they should be able to make the choice as to how much carbohydrate to take.)

 

[MisplacedIdentity]

Well, I've got to say I'm wondering about this too.

So they want you to go down to zero carbs before they'll put you on short acting insulin? Did they actually say this? In your position, I'd be tempted to ring up your diabetic nurse and get clarification on this.

A cynical person might say they just don't want to make any changes without a specialist's/consultant's input, and getting you to go increasingly low carb is a way of delaying the evil moment till June.

In any case, it will all be sorted out eventually, and you'll be able to choose how low carb you want to go, because you'll be able to match your insulin to your needs. Good luck.

(Ps I'm not criticising low carb here, I'm go pretty low carb myself, but given that most T1s aren't insulin resistant, they should be able to make the choice as to how much carbohydrate to take.)

When I was rushed into hospital it November I was sent home on 5 units fast acting per meal and 12 units base. By the end of January they took me off fast acting, put me on Metformin and told me I was most likely type 2.

So in order to stay as I am they advised that I reduce carbs even more to get my readings lower.

I still have my fast acting insulin but not allowed to use it.

 

[JMK1954]

Like EllieM, I am a little puzzled as to exactly why they have decided to tell you to reduce your carb intake even more, rather than telling you to use a small amount of fast-acting insulin to cover a heavier carb meal. It sounds as if you don't understand it either. I would be querying this when you next have an opportunity.

If you want to eat more carbs, just tell them. There is no reason for them to force you onto a lower carb diet than you are happy with. Type 1 people have to manage their insulin, their diet and their exercise and maintain the balance between them to stay healthy. This means that we need to discuss things, rather than blithely accept whatever is said by one particular individual. To start with, the HCPs are obviously the experts, so we have to accept their advice, but we always need to question what we don't understand or advice that doesn't meet our needs. It is always possible that the person you speak to can overlook or misinterpret something you say.

Best wishes for a happy and healthy future. I've had type 1 54 years so far and most useful thing I have learned is that if you don't agree with what is said, you need to say so.

 

[EllieM]

When I was rushed into hospital it November I was sent home on 5 units fast acting per meal and 12 units base. By the end of January they took me off fast acting, put me on Metformin and told me I was most likely type 2.

So in order to stay as I am they advised that I reduce carbs even more to get my readings lower.

I still have my fast acting insulin but not allowed to use it.

OK, so they haven't actually given you advice based on the fact that you are T1 not T2. The "reduce carbs" advice was because they thought you were T2.

To put it simply (and grossly generalise). T2s don't process carbs well and end up producing more and more insulin to attempt to cope with the carbs they eat. It makes sense for them to go low carb. (Just as a gluten intolerant person avoids bread).

T1s gradually stop producing insulin so their issue is that they don't have any insulin to process the carbs they eat. Early on in the process, they still produce some insulin, so lowering carbs helps. But in the long term they produce no insulin at all and so have to inject insulin. Going low carb will delay the point at which you have to inject, but you will have to inject, and carb count,eventually. (Leave it long enough and the lack of insulin will kill you.)

So you're still on the T2 advice, even though you're T1. T2 and T1 are completely different illnesses, despite the similar symptoms. In your position, I'd push for T1 advice now, not wait till June for the appointment.

 

[MisplacedIdentity]

OK, so they haven't actually given you advice based on the fact that you are T1 not T2. The "reduce carbs" advice was because they thought you were T2.

To put it simply (and grossly generalise). T2s don't process carbs well and end up producing more and more insulin to attempt to cope with the carbs they eat. It makes sense for them to go low carb. (Just as a gluten intolerant person avoids bread).

T1s gradually stop producing insulin so their issue is that they don't have any insulin to process the carbs they eat. Early on in the process, they still produce some insulin, so lowering carbs helps. But in the long term they produce no insulin at all and so have to inject insulin. Going low carb will delay the point at which you have to inject, but you will have to inject, and carb count,eventually. (Leave it long enough and the lack of insulin will kill you.)

So you're still on the T2 advice, even though you're T1. T2 and T1 are completely different illnesses, despite the similar symptoms. In your position, I'd push for T1 advice now, not wait till June for the appointment.

Ok thank you for you advice, I'm calling the clinic on Friday to update them with my numbers and my food diary so will push for more t1 support then.