Down the rabbit hole...

[Skinto McGinto]

Hello...! Long time lurker, but now looking for guidance and support.

Basically I was diagnosed just over 3 years ago as Type 2, aged 37 and just after the birth of our first child. I put the weight loss down to me stopping drinking, but had suspicions of something not being right.

3 years later, and now just over 4 stone lighter than my heaviest, I'm extremely active and have went down the 'sort of' low carb route, having been diet controlled since the start (I felt the docs wanted to put me on drugs at the outset with no recourse - refused and managed to get HbA1c down from about 82 to 49 in 9 months). Had maintained this until just after my 40th-this year's annual check had me up and over 82 (84).

Had three months to try and get this down-kept on the bike and watched what I was eating, but I'm struggling to understand why as all of the good things I had been doing seem to have been undone. I've also had a few feelings of hypo rather than hyper in the last few months.

I'm now about to start metformin and the doctor has asked me to monitor bloods after a chat last week - but why the hell do I feel so bad about all of this? I'm even debating whether my readings are right, I'm 4 stone lighter than I used to be, fitter than most folk I know and yet...don't want to start taking the drugs at all. I have irrational fears of being like my gran (late onset type 1-ended up losing her eyesight and both legs) and feel like once I start on the meds, I'll be sucked down the rabbit hole and could end up like her despite trying my damnedest not to...

Sorry for the rant, but looking for guidance...

 

[Pipp]

Hello, @Skinto McGinto

I see you have been here a while, but as this is your first post, I will say "Welcome".
Have you read the info for new menbers from @daisy1?
You say you have been eating 'sort of low carb'. Can you explain further?
Regarding medication, there is no need to believe that Metformin is the start of an ever increasing medication load. People with T2 can come off all meds if they manage to gain and maintain good blood glucose control. If you do need help to control your blood glucose by meds surely that is better than allowing uncontrolled levels that you are aware can be so damaging.
Well done on your weight loss. Unfortunately, though, exercise cannot beat a bad diet, so you really do need to monitor the effect of what your diet on your blood glucose. Your doctor wants you to monitor your blood, hopefully that means doc will have provided a meter and test strips. You can make good use of these by keeping records of what you eat, and the blood glucose numbers just before eating and at 1 hour and 2 hours after. That way you should be able to see a pattern, and know which foods are to be avoided.

Btw, I don't blame you for feeling like ranting, it can be scary, but there is plenty you can do, and there are plenty of good folks here to guide and support.

 

[Diakat]

Alice made it out of the hole, so can you.
You are not your gran - you can control your destiny.
It may be that carb creep has raised your numbers so monitoring blood and carb counting will help you spot that. Or it may be that you are a type 1 and checking blood may help doc decide if they need to do more tests.
Be careful about things labelled eat me and drink me... avoid mad queens and come back up to the riverbank.

 

[Bluetit1802]

Basically I was diagnosed just over 3 years ago as Type 2, aged 37 and just after the birth of our first child. I put the weight loss down to me stopping drinking, but had suspicions of something not being right.

Did you have any tests for Type 1 (LADA) ? There are very many members on here that were incorrectly diagnosed as T2. Weight loss before diagnosis is a symptom of T1.

You managed well for 9 months and got your HbA1c well down, so what do you think has gone wrong? Have you changed your eating habits at all? If you have been eating low carb and avoiding the worst culprits such as bread, pasta, rice, potatoes and breakfast cereals yet still see such a big increase, it may well be worth asking your doctor for the T1 tests (GAD and C-Peptide).

If you haven't been watching the carbs, then I'm afraid to say it is time you started. You have seen your gran and what uncontrolled diabetes (of any type) can do, so let that be your motivation.

 

[Skinto McGinto]

Hello, @Skinto McGinto

I see you have been here a while, but as this is your first post, I will say "Welcome".
Have you read the info for new menbers from @daisy1?
You say you have been eating 'sort of low carb'. Can you explain further?
Regarding medication, there is no need to believe that Metformin is the start of an ever increasing medication load. People with T2 can come off all meds if they manage to gain and maintain good blood glucose control. If you do need help to control your blood glucose by meds surely that is better than allowing uncontrolled levels that you are aware can be so damaging.
Well done on your weight loss. Unfortunately, though, exercise cannot beat a bad diet, so you really do need to monitor the effect of what your diet on your blood glucose. Your doctor wants you to monitor your blood, hopefully that means doc will have provided a meter and test strips. You can make good use of these by keeping records of what you eat, and the blood glucose numbers just before eating and at 1 hour and 2 hours after. That way you should be able to see a pattern, and know which foods are to be avoided.

Btw, I don't blame you for feeling like ranting, it can be scary, but there is plenty you can do, and there are plenty of good folks here to guide and support.

Yep, read up quite extensively on the forum just after I was diagnosed and had intended to post before now but thought I had a grip on things...!

By me saying that I was 'sort of low carb', I basically re-evaluated my diet completely. I cut out bread, rice, pasta, potatoes etc alongside getting serious about cycling. I've been 'trading off' on elements of my diet ever since - what I thought I had control over. Basically I aimed to have between 80-120g of carbs a day due to my levels of exercise. However, I'm now of the opinion that I need to hit the LCHF approach. Issue being is that I've also been advised that my cholesterol has increased as well...

I've probably not been honest with myself-I had 2 years of absolutely dream readings and thought I had cracked it, only for the goalposts to move again. Doesn't help that I have a picture in my head of what could happen based on personal experience and worry that no matter what I do that I'll end up there. Which doesn't help.

I don't want to start taking Metformin until I get the meter (picking this up on Thursday). That and the fact that I'm doing a long ride on Sunday and I don't want to jeopardise my ability to complete it. I'm doing a 2-day 200 mile ride in August for charity and worry that by starting the medication that it screws me right in.

 

[Skinto McGinto]

Did you have any tests for Type 1 (LADA) ? There are very many members on here that were incorrectly diagnosed as T2. Weight loss before diagnosis is a symptom of T1.

You managed well for 9 months and got your HbA1c well down, so what do you think has gone wrong? Have you changed your eating habits at all? If you have been eating low carb and avoiding the worst culprits such as bread, pasta, rice, potatoes and breakfast cereals yet still see such a big increase, it may well be worth asking your doctor for the T1 tests (GAD and C-Peptide).

If you haven't been watching the carbs, then I'm afraid to say it is time you started. You have seen your gran and what uncontrolled diabetes (of any type) can do, so let that be your motivation.

I have approached this with my doctor in the past and she's suggested that it won't be that. But yes-have the motivation, just need to count carbs far more closely. The monitor will help I think-but if things don't improve in 3-6 months I will go down the GAD/C-Peptide test route. Which would obviously worry me even more if they came back bad...

 

[Diakat]

Why do you think type 1 would be worse?

 

[Bluetit1802]

I have approached this with my doctor in the past and she's suggested that it won't be that. But yes-have the motivation, just need to count carbs far more closely. The monitor will help I think-but if things don't improve in 3-6 months I will go down the GAD/C-Peptide test route. Which would obviously worry me even more if they came back bad...

The meter will indeed help you - use it wisely to test each meal, before and 2 hours after first bite. Keep a record of these levels alongside the food you ate and watch for patterns emerging. If this isn't working, then you do need to consider the tests, for the sake of your health. GPs are quite reluctant to do these tests (probably for cost reasons) but will do them if pushed.

I wish you luck

 

[Skinto McGinto]

Why do you think type 1 would be worse?

Mainly as the goalposts would have moved and in my head I'd be closer to ending up like my gran was. Which is where I fear I'll end up anyway. Which is balls (obviously) and I shouldn't think like that, but I cannot get it out of my head. It's not me saying that it could be worse regardless-it's just a fear that I have.

 

[Pipp]

Just to reassure you, @Skinto McGinto I had Metformin for 5 years, and was able to exercise for 2 x 1 hour sessions daily. Admittedly those exercise sessions were in water, but they were intense.

 

[Skinto McGinto]

Just to reassure you, @Skinto McGinto I had Metformin for 5 years, and was able to exercise for 2 x 1 hour sessions daily. Admittedly those exercise sessions were in water, but they were intense.

Cheers-just a bit of a panic merchant! Did a 65 mile ride on Good Friday over 5 hours and know that I still need to eat carbs when out but limited compared to others riding with me. It's one of these things where I start looking inward and became a bit anxious when I really shouldn't. Did for a bit just after I was diagnosed-I'll hopefully push through it again like I know I can...

 

[Pipp]

Why do you think you need to eat carbs to exercise?
Lots of people fuel up on fat instead.

 

[Bluetit1802]

Mainly as the goalposts would have moved and in my head I'd be closer to ending up like my gran was. Which is where I fear I'll end up anyway. Which is balls (obviously) and I shouldn't think like that, but I cannot get it out of my head. It's not me saying that it could be worse regardless-it's just a fear that I have.

Sir Steve Redgrave is an insulin dependent T2 and look what he has achieved. Let him be in your head, not your nan

 

[chalup]

If you have never taken metformin before I would suggest you wait to start until after your bike race. Some people get explosive and frequent digestive issues at first and that would be beyond terrible while riding a bike all day. Not all people have this but I would not take the chance . Welcome to the forum

 

[Pipp]

If you have never taken metformin before I would suggest you wait to start until after your bike race. Some people get explosive and frequent digestive issues at first and that would be beyond terrible while riding a bike all day. Not all people have this but I would not take the chance . Welcome to the forum

Good advice, @chalup. I didn't have that problem, (could have been embarassing in the swimming pool if I had) so I forgot to mention some have that difficulty for the first few weeks.

 

[Diakat]

How long ago was your gran diagnosed? If it was a while back there have been huge improvements in monitoring and insulins.
AnywAy, fingers crossed for you that monitoring and diet fix things so you don't have to face any medication.

 

[Rustytypin]

Cheers-just a bit of a panic merchant! Did a 65 mile ride on Good Friday over 5 hours and know that I still need to eat carbs when out but limited compared to others riding with me. It's one of these things where I start looking inward and became a bit anxious when I really shouldn't. Did for a bit just after I was diagnosed-I'll hopefully push through it again like I know I can...

Hi, just a thought, I seem to remember reading a while ago that there is a move among some sports people away from fueling with carbs. Doesn't one of the football clubs do this? I am LCHF and I did 30 miles on my bike last week with no problems (I am nearly 30 years older than you). Could be worth looking into.

 

[Indy51]

Many endurance athletes these days are using LCHF/keto. A good place to start is the book by Steve Phinney and Jeff Volek on the Art and Science of Low Carbohydrate Performance. Or the second film by Donal O'Neil ("Run on Fat") about Sami Inkinen and his wife's rowing marathon.

 

[Skinto McGinto]

Cheers for the replies, all. I think I've just needed to get *something* out there in the open to people that know what I'm going through and who have the experience to get over it and can help others. I'll need to get my head down again and do things the right way, but I need to stop fighting to 'fail' in my head first.

Cracking advice re not starting the drugs until after this Sunday though...even with black cycling shorts on, don't want to be compromised when out and about...!

 

[daisy1]

@Skinto McGinto

Hello and welcome I am glad that you have started to participate on the Forum. Here is the Basic Information we give to new members and I hope you will find it useful, if you haven't already seen it in your travels here. Ask more questions when you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.