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What am I, T1, T1.5, T2,

D

davestretty

Member
Messages
13
I was diagnosed about 7 years ago but I don't know whether I'm T1 late onset, T1.5, T2 or whatever! My diabetes doctors/nurses/hospital consultant have never tested (apart from hba1c which last time was in the 80's whatever that means now - no-one explained) never had a OGTT either. BMI about 36 and tried Metformin (3x500 stopped due to kidney problems), Glyclaside (same), Byetta (didn't work and made me v sick but lost 10kg in a month), Victoza (same as Byetta), Levemir (basal 180 units per day), Victoza with Levemir (sick again), Humulin 3 (put on 15 kg in 3 months then lost again when I went back to Levemir) . Reduced carbs intake along time ago none of which really worked properly. Next was Humulog 50 (nightmare of Hypers and Hypos and gained 10kg in two months), now on levemir (120 per day) and Novorapid . Still struggle to get fasting glucose to single figures, use 10-15 morning with a slice of toast/butter/marmalade and still see BG rise to mid teens during morning, and have to use 25 -30 after each meal just to get back into single figures.
It seems my bolus/carb ratio is about 1:2 on Novorapid, and BMI now about 40.
Incidenteley my BMI prior to Diabetes was about 34 and I developed Diabetes soon after trying Atkins diet for 6 months (during which I lost about 5kg but had to stop due to stomach and bowel problems). My current diet is not too bad, lowish carbs, high white meat and fish, middling fat, no sugary soft drinks or alcohol, no bread or cakes or puddings, never smoked either. Always had high blood pressure and now have depression/anxiety but still work full time - thank God for Prozac.
Tried for years to lose weight unsuccessfully, played many sports (rugby, football, tennis,squash,badminton until arthritis struck at 45 and had to stop) when weight gain really took hold. Can't even walk more than 30 meters without pain now so exercise is very difficult.
Totally fed up with all this and resigned to never getting sorted - Do I choose to gain even more weight and even more insulin resistance as my D consultant wants or keep weight down (as GP wants and every expert suggests) but have high BG levels. I dont seem able to have both.
Apparently I don't qualify for a pump or for weight loss surgery or any other much help from NE Lincs trust.
Ready for a Hayley I reckon
 
Its sound really disappointing that you have not been given a final diagnosis.......

its sounds as though you haven't got on well with the standard type 2 meds that help insulin production etc, so that could indicate that your insulin production ability is gone, but who know unless you get the right tests.....terrible....

I think now that your on Levemir and Novorapid is helpful as it means that your insulin production is pretty much gone and that whether your type 2 or 1, there are steps you can take to evaluate your insulin needs in a methodical manner allowing you to adjust to your lifestyle and diet.....

Is there any chance of you going on a dose adjustment learning course at your hospital.........this would help.....

Its sounds like you have been really let down here......

its good you have came online for advice as there are many here that can help you....
 
Neither the DSN's, GP, nor the D consultant have ever mentioned this. My GP sent me for hospital consultant care. I see a consultant every 6 months(ish) who just tells me I use too much insulin and my hba1c is too high, changes medication (maybe) and tells me to come back in 6 months - that's about the sum total of my diabetes care. I should add that due to my job (meetings, travelling, projects etc) my eating regime is very erratic leading also to poor testing and injection control. The only meal that is fairly consistent is breakfast (1 toast/butter/marmalade). Lunch could be any time between 12-2pm (or sometimes missed altogether) and dinner 6-8pm. I have so much on my mind (and poor memory) I often forget altogether to test and inject and I never really get hungry so it's easy to miss a meal. I also have very sore fingers and stomach from testing/injecting, neuropathy, retinopathy, ED, and memory loss. Mind you my teeth are still good!
I guess I must have been diabetic for much longer than I realised as when diagnosed I was totally energyless, falling asleep all the time and drinking and weeing constantly. My first BG test (finger prick) was high 30s.
I suppose I am typically T2 fat with large waist - mostly visceral (internal) fat. It seems I need to put more weight on (or lose height) to increase my BMI for bariatric surgery and increase my BG and hba1c to get a pump -------------- or just give up.
 
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As Novorapidboi says using a basal bolus will really help but you need to learn how to use it. Getting that right will be that you can make adjustments to your food intake without worrying so much about hypos If you don't have to 'feed ' the insulin then you have a better chance of being able to lose weight.
This book is from the US but is one of the most helpful. Think Like a Pancreas Garry Scheiner.
 
Hi. I can only guess a bit from your post but I assume you are still overweight? If so the implication would normally be a T2 with insulin resistance but you could also have an underperforming pancreas as well; possibly due to damage from the high blood sugar (you don't say what your blood sugar readings are?). In your situation I think you need to seriously low carb until the weight comes into the right area; toast and marmalade for breakfast are a no-no. Try eggs and bacon? The very high levels of insulin you are using imply that you have insulin resistance which is best reduced by the right diet. Set a limit of, say, 150gm of carbs/day and see how you go. Levemir and NovoRapid, same as me, should control your blood sugar well with the correct balance. Note that a low-carb diet (not zero carbs!) with a good mix of food should not cause stomach problems any more than a 'normal' diet should.
 
Correct (ish) . BMI now ~40. Last hba1c 80 -90, consultant not really interested in daily BG readings but generally 7-10 morning fasting, 10 -12 pre-lunch, mid teens or above afternoon (though occasional hypo before dinner). Can't eat that much in a morning. Consultant suggested a bowl of cereal or muesli instead of toast but that would more carbs (toast etc probably <20g). Try to make lunch <50g carbs and dinner generally meat/fish with plenty veg and a few potatoes/chips. Rarely eat pasta/pizza/rice based meals - not even weekly. Veg's mainly peas, cabbage, cauli, sprouts, mushroom combination sometimes beans sometimes salad. Trying also to reduce portion size but would never be able to eat a three course meal for instance.
 
davestretty said:
Correct (ish) . BMI now ~40. Last hba1c 80 -90, consultant not really interested in daily BG readings but generally 7-10 morning fasting, 10 -12 pre-lunch, mid teens or above afternoon (though occasional hypo before dinner). Can't eat that much in a morning. Consultant suggested a bowl of cereal or muesli instead of toast but that would more carbs (toast etc probably <20g). Try to make lunch <50g carbs and dinner generally meat/fish with plenty veg and a few potatoes/chips. Rarely eat pasta/pizza/rice based meals - not even weekly. Veg's mainly peas, cabbage, cauli, sprouts, mushroom combination sometimes beans sometimes salad. Trying also to reduce portion size but would never be able to eat a three course meal for instance.
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have you tried some eggs for breakfast ?
 
davestretty said:
I don't know whether I'm T1 late onset, T1.5, T2 or whatever!
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Dave, I found out recently that having one type of diabetes doesn't mean you can't have another too. My brother and I both have an underlying T1.5 problem (late and slow onset, impaired insulin production (=T1) rather than insulin resistance (=T2), and to this day that is my problem. But he has a similar job/lifestyle/eating pattern to yours, which has led to a high BMI and insulin resistance. So he would always have been T1.5 but is now also T2. Low carbing helped him enormously in terms of both weight loss and blood sugar, and while he stuck to it his readings were under 10. Sadly work stress and crazy travel schedule combined with unsupportive home cooking led him to go back to his old diet and weight, despite keeping up the metformin.

Sorry this example can't give you any practical tips since you can't tolerate low carb, but if your meds aren't working you need to see an expert who is prepared to investigate further. Have you tried applying workplace-style assertiveness to your medical appointments?

Kate
 
Sorry I'm a little confused are you choosing a grain bread over white.
Also low salted butter or low chol version, And marmalade ????? Unless it's no sugar then museli or a slow releasing breakfast is far better.
You really need a dietician to help you with these choices as the breakfast yes it's fast and easy on the go but it's not the right choice. Plus is sugar completely cut out ? What's your morning drink ?


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Already eat too many eggs (high cholesterol - (is diabetes worse long term than high cholesterol?) Been advised not to eat more than 3 eggs per week. I like multigrain bread but it's generally twice the weight and twice the carbs as thin sliced white per slice. Even tried Bergen bread but its like chewing carpet (and still twice the weight per slice). As I said before, breakfast carb intake not the problem, tried no sugar muesli but no improvement in + 2hour BG. BTW my BG measurement rises 3-5 points during the morning even if I miss breakfast! low salt butter and low chol spread is a totally different subject to glucose control. Haven't added sugar in or on anything for many many years, only drink water or NAS squash or tea with artificial sweetener + semi milk. I am a scientist and appreciate good scientifcally proven advice but there is far too much subjective "it works for me so it must work for you" opinion on here. Dietary advice from the professionals is conflicting and confusing to say the least and of course is dependent on other medical conditions. And for those who say "it's your own fault you only need to lose weight" I agree totally but for some people losing weight is as difficult as stopping smoking or kicking heroin is for others.
 
Hi. Well, I'm an engineer and have been with the forum for several years now and although posts vary, the majority will say to keep portion sizes sensible and reduce the carbs. It doesn't take much science to work out that as carbs are converted to glucose quickly in the blood then keeping them down will help control blood sugar; fact. Reduced carbs will also normally help with weight reduction. There is an enormous amount of discussion on the web and this forum on the subject but the majority view on this forum and more recent research is that 'fat doesn't make you fat' it's the carbs. It's one of the reasons that despite the low-fat mantra in recent years obesity is ever increasing; its the carbs. Although eggs contain cholesterol it has nothing to do with cholesterol in the blood; that is produced by the liver, so my advice would be to have eggs 7 days a week as I do! I would challenge your finding that white bread has less weight and carbs than multigrain. My finding is that for the same slice thickness they are very similar. BTW a lot of the dietary advice from HCPs is not based on good science. If you dig down you will find much of it can be traced back to one or two very questionable research papers. Google Dr Briffa if you want to see some interesting discussion on the subject with many research references
 
Regardless of what type you are it sounds like your main issue is with insulin resistance which is fighting the insulin you are using and / or any insulin you are still producing. So you need to get your weight gain under control then you would have a chance. The only way is to be pretty insistent with your health care team that they are not providing you with adequate support and options and keep hassling them until they take your problem seriously. Prozac is good stuff at reducing anxiety but recognise it might be doing too good a job and that you may need to be legitimately shouting at people to get some action.
 
Thanks Diabell and xyzzy I think you both have valid points. We have been driven down the road of lower fat (which invariably means higher sugar) by a mixture of bad science and vested interest science (sponsored research by the food industry). It now appears that the sugar/fat mix is the problem particularly in processed foods. We have evolved to crave both fat and sugar and the food industry knows this. Did you see the Horizon fat vs sugar prog last week - very interesting. My point with bread was that i can buy thin sliced white bread, whereas grain breads always have much thicker slices and therefore much heavier per slice (sadly I've weighed them to compare!) I now have scrambled eggs and ham/chicken for lunch (no bread) when I can and never take or buy sandwiches, but this is difficult to stick to if I'm travelling to meetings etc. When you only see a DSN or Consultant for 10 mins every 6 months (or even longer gap - if I have to cancel an appointment it can be 9 months or more) it can be difficult to be insistent.
BTW I finally had my first retinopathy check for 3 years last week (apparently they forgot me - even though I kept asking) and guess what ------ I have early retinopathy.
So yes it appears I have no pancreas function, early kidney problems which stops me taking metformin etc, early retinopathy and severe weight gain response to quick acting insulin - not to mention severe insulin resistance. And of course osteoarthritis.
If I was a race horse i'd be dog meat by now! But on the bright side the weather's nice today (i see from my office window)
 
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I'm no insulin expert but it sounds like you need to get your background insulin dose sorted out first. Presumably you know how to carb count to calculate the amount of fast acting you need etc. Perhaps some of the experienced T1's and insulin users can give you some good advice. To help combat the weight gain caused by having to inject a lot of insulin look to reduce your carbs overall then you shouldn't need so much but again a T1 or insulin user is in a far better position to advise than me. Good luck !
 
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