Rising glucose levels on low carb

[myrak]

I can’t understand why fasting blood sugars arealways 17. 2 or higher. I don’t eat after 8. Pm and have started low carb diet.
I used to have fasting levels 9 . I’m taking metformin and linogliptin. The metformin doesn’t seem to help anymore. I have autoimmune disorder. I wondered if I was not type 2 after all. My Doctor said I don’t need test to confirm that as treatment the same ie end up on insulin. I would like to know though. Any helpful advice would be appreciated.

 

[EllieM]

My Doctor said I don’t need test to confirm that as treatment the same ie end up on insulin. I would like to know though. Any helpful advice would be appreciated.

I can think of at least two reasons why it's a good idea to know whether you are T1 or T2
1) Treatment is not the same. Some of the pathway to insulin treatments for T2s are not suitable for T1s and it is not inevitable that T2s move to insulin.
2) The NHS has a number of technological benefits that are available to T1 and not T2. If you are on insulin you are better with a T1 tag on your medical record.

The diagnostic tests are c-peptide and GAD.

Having said that, how long have you been on a low carb diet and how low is it?

 

[myrak]

Sorry posted reply in wrong way in email. I’ve been on low carb for about 9 months. Lost 2 stones. Ate more protein ok at first though sugars not normal but ok. Then fasting sugars started to rise. I have an autoimmune disorder and wondered if pancreas not working . I’m going to have to discuss issues of type 1 or 2 again with GP. I’m trying to cut down protein. To see if helps.

 

[EllieM]

If (and it is a big if) you are LADA (slow onset T1) then you'll need insulin eventually, as your own production goes down. Many LADA folk can manage for a while on low carb because they need less insulin on a low carb diet.

You started posting here in 2018. Was that when you were diagnosed T2? Progression to insulin in just 3 years is quite fast for a T2 (not impossible though).

I'm going to tag in some LADA folk who might have suggestions on how to persuade your GP to do the tests @Daibell @searley

Can't comment on whether cutting down protein will help. Most of the T2s here seem to just concentrate on the carbs. But there are plenty who might be able to advise on how low carb your diet is and whether it's worth reducing your carbs further.

Has your doctor discussed the next stage of medication with you? 17 is a high fasting level.

 

[username3]

I can’t understand why fasting blood sugars arealways 17. 2 or higher. I don’t eat after 8. Pm and have started low carb diet.
I used to have fasting levels 9 . I’m taking metformin and linogliptin. The metformin doesn’t seem to help anymore. I have autoimmune disorder. I wondered if I was not type 2 after all. My Doctor said I don’t need test to confirm that as treatment the same ie end up on insulin. I would like to know though. Any helpful advice would be appreciated.

I agree that is very high for fasting blood sugar levels. If I were you, I would contact your GP on Monday and push for an immediate evaluation of your treatment. In the meantime to increase your comfort, you could do exercises that bring your heart rate up, and eat as few carbohydrates as possible.

Message edited by moderator - Removal of medication advice

 

[searley]

HI
The fasting bg is not the be all and end all, you really need to know some numbers throughout the day.. pre meal ones are always good..

17 is very high.. but many have liver dump in the morning.. and if your average through the day is 9 to 10 then its feasible a liver dump of 7 could happen.. i was initially told don't test in the first hour of getting out of bed due to this.. so having an overall picture would be better before assuming the worst.. if you are only in the 9-10's in the day and you are doing all you can diet wise then a medication tweak could be possible.. and getting the daytime numbers will help with the FBG.

if however you are doing what you can diet wise and you numbers are sky high in the day then it *could be* LADA instead of T2.. if this is the case you'd need to get your GP to refer you to a consultant who can order a cpeptide test and probably a gad test to get a certain diagnosis

 

[Andydragon]

I agree that is very high for fasting blood sugar levels. If I were you, I would contact your GP on Monday and push for an immediate evaluation of your treatment. In the meantime to increase your comfort, you could do exercises that bring your heart rate up, and eat as few carbohydrates as possible.

Message edited by moderator - Removal of medication advice

Just to say, exercise at higher blood glucose levels can be risky, you need to be careful

https://www.diabetes.co.uk/diabetes-sport-and-blood-sugar.html

 

[Daibell]

Hi. Sadly your GP doesn't seem to know much about diabetes so you will need to press for the tests or insist on a referral to the diabetes clinic. If no success you can get the tests done privately as I did.

 

[myrak]

HI
The fasting bg is not the be all and end all, you really need to know some numbers throughout the day.. pre meal ones are always good..

17 is very high.. but many have liver dump in the morning.. and if your average through the day is 9 to 10 then its feasible a liver dump of 7 could happen.. i was initially told don't test in the first hour of getting out of bed due to this.. so having an overall picture would be better before assuming the worst.. if you are only in the 9-10's in the day and you are doing all you can diet wise then a medication tweak could be possible.. and getting the daytime numbers will help with the FBG.

if however you are doing what you can diet wise and you numbers are sky high in the day then it *could be* LADA instead of T2.. if this is the case you'd need to get your GP to refer you to a consultant who can order a cpeptide test and probably a gad test to get a certain diagnosis

Just to say, exercise at higher blood glucose levels can be risky, you need to be careful

https://www.diabetes.co.uk/diabetes-sport-and-blood-sugar.html

Thanks for helpful advice.

 

[myrak]

Hi. Sadly your GP doesn't seem to know much about diabetes so you will need to press for the tests or insist on a referral to the diabetes clinic. If no success you can get the tests done privately as I did.

I will ask for referral Thanks

 

[sgm14]

My history sounds sort of similar. Diagnosed Type 2 and started on metformin which initially worked great but a few years later it stopped working, my blood sugar levels started rising and I started losing more weight (going from slightly underweight to nearly 2 stone underweight.) I did spend some time trying to 'fix' this by tweaking my diet, but nothing seemed to help.

So after 3 years, on metformin, I was switched to insulin which works well. At that stage I did ask my endo if I could be tested to see if I was Type 1 or Lada instead of Type 2, but he said that it was too late, as after 3 years on metformin, the tests would now longer be accurate. (Don't know whether that is true, but just repeating what he said). He also said that treatment was the same, i.e. if tablets, diet and exercise do not work, then you need insulin regardless of what type you are.

So I am still considered Type 2, but I am lucky in that I live in Northern Ireland where the NHS rules give the diabetic consultants more leeway when prescribing treatments and so I get the Freestyle Libre on prescription, whereas if I was in England, I think the type 2 label would automatically exclude me.

So I would also push to get a revaluation and also try to see if you can get tested to see if you could be type 1 (I would be interested to see if you get told the same thing as I was told).