Doctor "thinks" I have type 2

[ickihun]

Hi thanks for your response.

I was also thinking about if the Hba1c would be a true reading due to the ups and downs of my sugar levels.

Just taken them now before lunch and 3.6 which is a massive drop from 2 and half hours ago when it was over 12.

I will take all these readings with me when I visit the nurse which isn't for a few weeks so may have a pattern by then that she may make some sense from.

Jennie

Yes 12s are worrying but hypos (2s and 3s) more.

 

[DCUKMod]

KingJ8 - It looks like you could do with trimming the peaks off those highs and slowing up the rollercoaster lows. How quite a few folks have tackled this is to cut back on the carbs, and concentrated on protein and fats with leafy green veggies.

I think if you tried this, you would find yourself going less high, but then not having the overshooting low. Those who adopt this way of eating also sometimes comment that they find themselves feeling less hungry that they were before, and often comfortably able to miss meals (deliberately) or even fast, without unpleasant impacts.

Funnily enough your breakfast question is really common. Toast and/or cereal are really quick, but then so are lots of other things. I'm thinking of hard boiled eggs, cooked bacon, cooked high meat content sausages, greek yoghurt, cheese, cold meats. Some folks even have leftovers from the previous night for brekkers.

I don't work in a traditional way any more, but if I were still doing my historical bonkers days of leaving home very early and getting home late, I think I'd do some little crustless quiches (the fillings in other words), done in muffin tins for several days on the trot.

If you have a look at the "What have you eaten" threads where members describe what they've eaten that day or the day before, there are masses of ideas on there from people live varied lives, with all the usual challenges to be addressed.

https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/page-672#post-1752727

 

[Alison Campbell]

Hi there are lots of lower carbs breads that are discussed on the forum if you want toast with butter or cheese, some lower carb porridge, muesli from Aldi which have worked for some, full fat greek yoghurt with nuts and berries.

The idea is the fat keeping you fuller for longer and more level than a big rise and drop in glucose which I know does not feel great.

This has worked for me and may be worth a try?

 

[Brunneria]

Hi and welcome @Kingj8

I agree with what the others are saying, about swings of 12 - 2s not being good, or normal, and how reducing foods that cause those swings (carbs) may help.

However, I want to add a few other comments.

Firstly, I think it is GREAT that you are recording your test results for your nurse.
So i strongly recommend that you don’t make any dietary changes until you see that nurse.
If you do, your testing would likely show improved numbers, then you would be FAR less likely to get taken seriously, get tested, and get a diagnosis.

Something else worth bearing in mind is that most healthcare professionals are trained to believe that hypos are only a problem if they happen as a result of diabetic medication, forcing blood glucose down too low. What they fail to realise is that hypos are horrible things, no matter what causes them. And that cyclical high/low blood glucose, rapidly changing and out of control is a horrible experience. Exhausting. Emotionally wearing. And if it goes on long enough it can be depressing. Hypos are also symptomatic of severe glucose dysregulation, even if it isn’t as cut and dried as type 2 diabetes.

So, while I think that going low carb could well help you a lot, i would suggest that you make sure you have the evidence to demonstrate the problem, and try to get your nurse to refer you for tests, before you make any major changes that could disguise the situation.

 

[ickihun]

Hi and welcome @Kingj8

I agree with what the others are saying, about swings of 12 - 2s not being good, or normal, and how reducing foods that cause those swings (carbs) may help.

However, I want to add a few other comments.

Firstly, I think it is GREAT that you are recording your test results for your nurse.
So i strongly recommend that you don’t make any dietary changes until you see that nurse.
If you do, your testing would likely show improved numbers, then you would be FAR less likely to get taken seriously, get tested, and get a diagnosis.

Something else worth bearing in mind is that most healthcare professionals are trained to believe that hypos are only a problem if they happen as a result of diabetic medication, forcing blood glucose down too low. What they fail to realise is that hypos are horrible things, no matter what causes them. And that cyclical high/low blood glucose, rapidly changing and out of control is a horrible experience. Exhausting. Emotionally wearing. And if it goes on long enough it can be depressing. Hypos are also symptomatic of severe glucose dysregulation, even if it isn’t as cut and dried as type 2 diabetes.

So, while I think that going low carb could well help you a lot, i would suggest that you make sure you have the evidence to demonstrate the problem, and try to get your nurse to refer you for tests, before you make any major changes that could disguise the situation.

I agree with gaining your diagnosis by monitoring your current regime.
However are your 12s due to over treating a 2 or 3 hypo? Overtreating hypos can cause those highs.
Let us know the foods that your eating/drinking when in hypo state. Do you drink alcohol regularly, as some can cause low bgs.
It may be just alcohol and over treating lows from alcohol?

 

[Kingj8]

Hi thanks for the responses

the 12.9 was after a bowl of Jordan's cereal and milk nothing else

The 3.6 was pre lunch reading hadn't eaten anything since breakfast was feeling hungry and just starting to get that I need to eat soon feeling.
Lunch was 2 cheese and chutney rolls and post lunch reading was 8.6

I'm exhausted all the time have and thirsty. I get the horrible low sugars feeling most days always in the morning after breakfast couple times before tea if I've had an early lunch.

I do then tend to over eat because I feel awful but never checked sugars after that before so not sure how it affects it.

To be honest I'm probably not eating normally as usually I'm a snacker and finding that currently I'm not as I didn't want it to affect the reading


Jennie

 

[LittleGreyCat]

Hi thanks for the responses

the 12.9 was after a bowl of Jordan's cereal and milk nothing else

The 3.6 was pre lunch reading hadn't eaten anything since breakfast was feeling hungry and just starting to get that I need to eat soon feeling.
Lunch was 2 cheese and chutney rolls and post lunch reading was 8.6

I'm exhausted all the time have and thirsty. I get the horrible low sugars feeling most days always in the morning after breakfast couple times before tea if I've had an early lunch.

I do then tend to over eat because I feel awful but never checked sugars after that before so not sure how it affects it.

To be honest I'm probably not eating normally as usually I'm a snacker and finding that currently I'm not as I didn't want it to affect the reading


Jennie

Best to eat what you have before and don't try and change your diet to fit in with the testing.

It sounds as though if you eat a load of carbs, your BG shoots up, then drops like a stone, so you feel rough and eat a load of carbs.

If you continuously snack on small amounts then this can potentially reduce both the highs and the lows.

I am with the others in not making major changes until you have recorded a food and BG diary to show what your body is doing. However if you have readings with big carb meals only, and then some days of snacking as well, this could be useful diagnostic information.

With luck they might give you an Oral Glucose Tolerance Test where they give you a glucose drink and then test to see how your body reacts. That should prove if you have a rapid high followed by a rapid low.

Hang in there. Diagnosis is the hardest part and can take some time. Once that is done you can concentrate on sorting out the symptoms and getting onto an even keel.

 

[Lamont D]

In my experience which is so similar to yours, you eat a normal breakfast of either cereal or toast.
From your post, I'm surmising what is happening.
Before that breakfast, your blood sugar will probably in normal levels.
After the high amount of carbs in the cereal or bread, your initial insulin response is not normal. Your blood sugar levels rise into double figures, then, your secondary insulin response overshoot and carries on producing more insulin, so you have too much insulin in your blood, then after a couple of hours or more, you get the symptoms and you test and you get the low readings which is Hypoglycaemia.

Thanks again for your responses.
Sorry about all the questions just trying to educate myself a little.

So yesterday toast caused blood glucose to raise to just over 10 this mornin cereal has raised it to 12.9 those are my usual choice for breakfast.
What does everyone else eat?
I'm a midwife that works shifts and have a busy family life so do not always have time to make breakfast from scratch.

Thanks for reading

Jennie

Of course you have to treat the low blood sugar, but then when you do, your blood sugar levels rebound back into double figures. Then you have fluctuating blood sugar levels all day. Once you eat in the morning and the meals throughout the day are carb laden, you will not get stability in your blood levels.

The trick to stop this, is to avoid the carbs as much as possible.
But if you do hypo, then have a small amount of carbs, (a plain biscuit with a cuppa) followed by a small low carb meal fifteen minutes later.

What do you eat? well you have to find out what you can tolerate.
Your tastes, ethnic background and availability is a huge factor in how you get your dietary balance.
I work full time, and I take fresh meat, boiled eggs, salad, anything that will not trigger the insulin response and reaction. If you can tolerate dairy, cheese pieces, full fat pots of yoghurt, small pieces of fruit, if you like strawberries, berries, Apple, pears.

Ok, to gain control, which might not be suitable for such long hours, is to eat small very low carb meals every three hours, that is a suitable treatment for Hypoglycaemia.
And I expect you to be told this, as its standard recommended diet for Hypoglycaemia, except you will be told about having complex carbs, but I have found, a carb is a carb! It will spike you.

If I may ask? If you go several hours between meals, do you get symptoms after a few hours?
The reason I ask, is because fasting may be a way to help control your blood sugar levels. I use intermittent fasting, when off work, or travelling, even during work. I don't need to eat, because being in very low carb, I'm never hungry.
Full fat foods satiate you better, so good full fat dairy can help. I do if in a rush have full fat yoghurt and bits of fruit in the morning and I may not eat till evening meal.

I would again advise you to get your doctor to refer you to an endocrinologist who specialises in Hypoglycaemia.

Hope this helps.

Best wishes

 

[Kingj8]

In my experience which is so similar to yours, you eat a normal breakfast of either cereal or toast.
From your post, I'm surmising what is happening.
Before that breakfast, your blood sugar will probably in normal levels.
After the high amount of carbs in the cereal or bread, your initial insulin response is not normal. Your blood sugar levels rise into double figures, then, your secondary insulin response overshoot and carries on producing more insulin, so you have too much insulin in your blood, then after a couple of hours or more, you get the symptoms and you test and you get the low readings which is Hypoglycaemia.



Of course you have to treat the low blood sugar, but then when you do, your blood sugar levels rebound back into double figures. Then you have fluctuating blood sugar levels all day. Once you eat in the morning and the meals throughout the day are carb laden, you will not get stability in your blood levels.

The trick to stop this, is to avoid the carbs as much as possible.
But if you do hypo, then have a small amount of carbs, (a plain biscuit with a cuppa) followed by a small low carb meal fifteen minutes later.

What do you eat? well you have to find out what you can tolerate.
Your tastes, ethnic background and availability is a huge factor in how you get your dietary balance.
I work full time, and I take fresh meat, boiled eggs, salad, anything that will not trigger the insulin response and reaction. If you can tolerate dairy, cheese pieces, full fat pots of yoghurt, small pieces of fruit, if you like strawberries, berries, Apple, pears.

Ok, to gain control, which might not be suitable for such long hours, is to eat small very low carb meals every three hours, that is a suitable treatment for Hypoglycaemia.
And I expect you to be told this, as its standard recommended diet for Hypoglycaemia, except you will be told about having complex carbs, but I have found, a carb is a carb! It will spike you.

If I may ask? If you go several hours between meals, do you get symptoms after a few hours?
The reason I ask, is because fasting may be a way to help control your blood sugar levels. I use intermittent fasting, when off work, or travelling, even during work. I don't need to eat, because being in very low carb, I'm never hungry.
Full fat foods satiate you better, so good full fat dairy can help. I do if in a rush have full fat yoghurt and bits of fruit in the morning and I may not eat till evening meal.

I would again advise you to get your doctor to refer you to an endocrinologist who specialises in Hypoglycaemia.

Hope this helps.

Best wishes

Thanks for your reply

You've pretty much hit the nail on the head. If I'm busy on the ward then i can go some time without feeling shaky and low I did ask my gp about this a few years ago and he said it would be the adrenaline of my job keeping my levels up? Not sure if this is true or not.

I usually feel fine and then it hits me suddenly and I seem to get all the signs at once I have used those dextrose tablets in the past and they did ease symptoms until I was able to eat.

I probably do eat a lot of carbs and I am overweight so how would eating full fat food help if trying to loose weight?

Jennie

 

[Kingj8]

Best to eat what you have before and don't try and change your diet to fit in with the testing.

It sounds as though if you eat a load of carbs, your BG shoots up, then drops like a stone, so you feel rough and eat a load of carbs.

If you continuously snack on small amounts then this can potentially reduce both the highs and the lows.

I am with the others in not making major changes until you have recorded a food and BG diary to show what your body is doing. However if you have readings with big carb meals only, and then some days of snacking as well, this could be useful diagnostic information.

With luck they might give you an Oral Glucose Tolerance Test where they give you a glucose drink and then test to see how your body reacts. That should prove if you have a rapid high followed by a rapid low.

Hang in there. Diagnosis is the hardest part and can take some time. Once that is done you can concentrate on sorting out the symptoms and getting onto an even keel.

Thanks for your response


Probably a silly question but if you snack when do you take your readings? Do you do it just before and after your main meals?

I carry out oral glucose tests with the pregnant women I care for I wasn't aware that they were used other than that.

I've just been carrying out a log of the readings but I will also start a food diary so can compare the outcomes.

I was about to start weight watchers so I will definitely hold off from that until I've seen the nurse


Jennie

 

[ickihun]

Test on rising.
Before breakfast, then 2hrs after. (for your 3 meals/snacks)
I used to write all over my manual paper diary. It was a huge help to me.
I still revert to it when changing insulins or meds.

When are you seeing nurse again?

Have glucose tabs stopped your hypos, everytime?

With RH like @Lamont D and @Brunneria has, does hypos ever cause a medical emergency? Or does the liver save the day?

 

[Kingj8]

Test on rising.
Before breakfast, then 2hrs after. (for your 3 meals/snacks)
I used to write all over my manual paper diary. It was a huge help to me.
I still revert to it when changing insulins or meds.

When are you seeing nurse again?

Have glucose tabs stopped your hypos, everytime?

With RH like @Lamont D and @Brunneria has, does hypos ever cause a medical emergency? Or does the liver save the day?

I'm meeting with the nurse 30/04/18 after a night shift Will be the first time I talk to a professional about it as my Gp didn't even give me the results

Glucose tabs have stopped them every time but sometimes I've needed to chew 4/5

Never had a medical emergency but have felt so bad before that I haven't actually been able to see and felt confused sweaty needed to sit down

Jennie

 

[Lamont D]

Thanks for your reply

You've pretty much hit the nail on the head. If I'm busy on the ward then i can go some time without feeling shaky and low I did ask my gp about this a few years ago and he said it would be the adrenaline of my job keeping my levels up? Not sure if this is true or not.

I usually feel fine and then it hits me suddenly and I seem to get all the signs at once I have used those dextrose tablets in the past and they did ease symptoms until I was able to eat.

I probably do eat a lot of carbs and I am overweight so how would eating full fat food help if trying to loose weight?

Jennie

Contrary to the usual dietary advice, full fat foods are less carb laden than low fat foods, also, the fat in low fat foods is replaced by sugars used through production and other additives to get the taste. Despite being lactose intolerant, I can manage a few tablespoons of full fat yoghurt cos there are hardly any carbs. The lactose is the problem not the fat! Cream and butter is far healthier than milk and spreads like margarine.
I think the adrenaline, could have an impact as would all hormones, I couldn't say, but when working, I feel better and have more energy despite not eating or having very little. Keeping busy is good, as it helps your exercise and mind off food. It can become obsessive at times.
There has been a lot of people with many forms of endocrine conditions such as T2 diabetes, that have lost a lot of weight, we have a forum called the success forum.
Many of these will attest to the fact that changing your diet, lifestyle to low carb it works and controlling whatever condition you have, and of course the weight.
Myself, I lost nearly five stone, gone from nearly eighteen stone to stabilise around twelve stone.

Test on rising.
Before breakfast, then 2hrs after. (for your 3 meals/snacks)
I used to write all over my manual paper diary. It was a huge help to me.
I still revert to it when changing insulins or meds.

When are you seeing nurse again?

Have glucose tabs stopped your hypos, everytime?

With RH like @Lamont D and @Brunneria has, does hypos ever cause a medical emergency? Or does the liver save the day?

Both, I have been saved by my liver, I'm certain I have!
There has been times when I've just conked out! Woke up and felt really bad!
But not since diagnosis.
Once again before diagnosis, I was taken to the firm's surgery and thought I fell asleep, but thinking back, it was definitely not normal napping, or sleep.
Before I got the knowledge on how to stop those horrible hypos, I never realised how dangerous they can be.

If it is Hypoglycaemia, I would not recommend glucose tablets, they would just cause a rebound effect.

I'm meeting with the nurse 30/04/18 after a night shift Will be the first time I talk to a professional about it as my Gp didn't even give me the results

Glucose tabs have stopped them every time but sometimes I've needed to chew 4/5

Never had a medical emergency but have felt so bad before that I haven't actually been able to see and felt confused sweaty needed to sit down

Jennie

Ring your surgery, they are obliged to give you all your results.

You may not get the best advice from the nurse, I would not believe in my experience that she has come across whatever you have.
I have been seen by a number of GPs, dsns and even an endocrinologist that didn't have a clue.
I was lucky to find my current specialist.

Best wishes

 

[Brunneria]

Apologies @Kingj8 I don’t want to make any assumption about whether you have RH, or not.

Plus, regarding reactive hypoglycaemic ‘medical emergencies’ i wouldn’t like to speak for anyone else.

My own experience of RH is that i have most definitely been in situations where I was unsafe to operate machinery. Even a kitchen knife can be dangerous, can’t it? Driving when hypo can be very dangerous indeed.
Decision making may be affected.
I have never passed out, but I have been unable to stay awake. That has included having to stop the car to sleep.
A smaller example is a twisted ankle after temporarily becoming rather clumsy.

Diagnosed RHers are required to inform the DVLA of their condition, so it is recognised that reactive hypos can affect safe driving.

Of course, once I knew what was going on, it became relatively simple to prevent the hypos that caused these incidents.

So really, I would just caution you to be careful. Until this has been properly investigated, don’t put yourself behind the wheel, or make important decisions while your blood glucose is low. And please be gentle to yourself. Let yourself recover after a low, at your own pace.

 

[Kingj8]

Thank you for all your replies over the last few days I really appreciate it.

Feel very overwhelmed and unsure about everything.

I will start looking into low carb diet ready for after I've seen the nurse, I know it will take awhile to get my head around it as I've always been a low fat high carb diet person

Again thanks for all your help

Jennie

 

[Kingj8]

Apologies @Kingj8 I don’t want to make any assumption about whether you have RH, or not.

Plus, regarding reactive hypoglycaemic ‘medical emergencies’ i wouldn’t like to speak for anyone else.

My own experience of RH is that i have most definitely been in situations where I was unsafe to operate machinery. Even a kitchen knife can be dangerous, can’t it? Driving when hypo can be very dangerous indeed.
Decision making may be affected.
I have never passed out, but I have been unable to stay awake. That has included having to stop the car to sleep.
A smaller example is a twisted ankle after temporarily becoming rather clumsy.

Diagnosed RHers are required to inform the DVLA of their condition, so it is recognised that reactive hypos can affect safe driving.

Of course, once I knew what was going on, it became relatively simple to prevent the hypos that caused these incidents.

So really, I would just caution you to be careful. Until this has been properly investigated, don’t put yourself behind the wheel, or make important decisions while your blood glucose is low. And please be gentle to yourself. Let yourself recover after a low, at your own pace.

I can remember trying to park my car when feeling like that and having to get my husband to do it as I couldn't see straight and was shaking so much!

Such a horrible feeling, it's only happened at work a handful of times and usually when in clinic which is not as highly stressed, trying to take bloods when shaky and crossed eyed is not easy.

I am hoping the nurse has heard of RH so I can discuss it with her.

Jennie

 

[Kingj8]

Hi saw my doctor today as been feeling very unwell. I've tested my sugars every day and I have hypos every day.

Doctor not sure what is going on and very confused by my symptoms as they are not typical of type 2. He Feels the reason I'm feeling so bad is due to the hypos and not high sugars.

He is sending me to a specialist but also wants to take some bloods Monday just to check nothing else is going on.

What can I expect to happen at the specialist?

Thanks

Jennie

 

[Lamont D]

Hi saw my doctor today as been feeling very unwell. I've tested my sugars every day and I have hypos every day.

Doctor not sure what is going on and very confused by my symptoms as they are not typical of type 2. He Feels the reason I'm feeling so bad is due to the hypos and not high sugars.

He is sending me to a specialist but also wants to take some bloods Monday just to check nothing else is going on.

What can I expect to happen at the specialist?

Thanks

Jennie

If you get one that is thorough and knowledgeable about why hypos occur.
He will ask questions, ask if you have or will keep a food diary, ask for examples of what you regularly eat. Get a general idea of what symptoms you are getting.
Personal questions about, family, work, health history.
And more.
My first appointment, I had a hypo!
And was sent for a blood panel and given another appointment.

In subsequent appointments, he will arrange tests based on your blood panel and levels of your hormonal response to food. How your food diary will help the specialist in how to progress and more tests.
Possibly an eOGTT, extended oral glucose tolerance test.
Fasting test, food tolerance tests. Allergy tests, most tests are used to eliminate other conditions.

Be open and honest. You should also have a dietician recommended to you.

And as I said, if you get a good one!

Hope you are feeling better soon and good luck with your specialist.

Have you read the RH forum?