Nothing seems to work

[RainbowBrite]

I was diagnosed with type 2 diabetes 5 years ago. Result on result my hba1c increased every time and is currently recorded at 117!! My gp finally referred me to the diabetic clinic. The consultant now thinks I might be type 1....or lada? She asked me to make sure I test 4 times a day without fail - before breakfast, before lunch, before dinner and before bed. I have also been tracking my intake religiously to try and get this sorted. My numbers are below....I feel like my diet is ok but my numbers are never in single figures....

I am on humulin 12 units am, 10 units pm; 2 x 1000mg metformin daily.

11th April 16.2; 27.2; 21.2; 24.3 - 127g carbs
12th April 9.5; 16; 15.6; 18.5 - 183.7g carbs
13th April 17.7; 20;12.2; 14.1 - 83.5g carbs
14th April 14.4; 12.1; 16.1; 19.4 - 101.5g carbs. I also took a reading during the night as I woke up and felt unwell. I had jumped from the 19 4 at bedtime (around half 11) to 26.5 at half 1!!

I just dont know what else I can do right now. Should I go super low carbs or wait until results of blood test for type 1 are in?

Thank you x

 

[steveis36]

I was diagnosed with type 2 diabetes 5 years ago. Result on result my hba1c increased every time and is currently recorded at 117!! My gp finally referred me to the diabetic clinic. The consultant now thinks I might be type 1....or lada? She asked me to make sure I test 4 times a day without fail - before breakfast, before lunch, before dinner and before bed. I have also been tracking my intake religiously to try and get this sorted. My numbers are below....I feel like my diet is ok but my numbers are never in single figures....

I am on humulin 12 units am, 10 units pm; 2 x 1000mg metformin daily.

11th April 16.2; 27.2; 21.2; 24.3 - 127g carbs
12th April 9.5; 16; 15.6; 18.5 - 183.7g carbs
13th April 17.7; 20;12.2; 14.1 - 83.5g carbs
14th April 14.4; 12.1; 16.1; 19.4 - 101.5g carbs. I also took a reading during the night as I woke up and felt unwell. I had jumped from the 19 4 at bedtime (around half 11) to 26.5 at half 1!!

I just dont know what else I can do right now. Should I go super low carbs or wait until results of blood test for type 1 are in?

Thank you x

I was diagnosed with t2 2 years ago but even for me if i have anything carb wise over 50g my bloods would be 17 or 18mmol.

At moment im eating about 36g sometimes less

 

[Member496333]

Seems likely that you are extremely insulin resistant rather than deficient, but the two are not mutually exclusive, and can coexist.

Your diet seems high in carbohydrate if you are type 2.

 

[RainbowBrite]

Thanks for the responses however this is where i get confused. Everywhere you read it says that type 2 diabetics should have between 45-60g carbs per meal; 135-230g per day. So according to guidelines my daily intake isn't high. I think it's only high if I'm on a specific low carb diet. Ketogenic low carb - under 20g per day; moderate low carb - 20-50g per day and liberal low carb - 50-100g per day.

I only weigh 55kg and I am 5ft 3in so I really dont need or want to loose any weight. If I drop my carbs lower will that cause me to loose more weight?

 

[Member496333]

Everywhere you read it says that type 2 diabetics should have between 45-60g carbs per meal; 135-230g per day.

Which is why type 2 diabetes is commonly regarded as a chronic, progressive disease.

 

[steveis36]

Thanks for the responses however this is where i get confused. Everywhere you read it says that type 2 diabetics should have between 45-60g carbs per meal; 135-230g per day. So according to guidelines my daily intake isn't high. I think it's only high if I'm on a specific low carb diet. Ketogenic low carb - under 20g per day; moderate low carb - 20-50g per day and liberal low carb - 50-100g per day.

I only weigh 55kg and I am 5ft 3in so I really dont need or want to loose any weight. If I drop my carbs lower will that cause me to loose more weight?

Sounds like your more T1
Ive been as high as 26mmol but i could easily pin point why it was so high.

And i think with T1 u have to get the insulin level right with carb intake,

 

[RainbowBrite]

Sounds like your more T1
Ive been as high as 26mmol but i could easily pin point why it was so high.

And i think with T1 u have to get the insulin level right with carb intake,

The consultant definitely thinks I'm more type 1. I've had the cpeptide and gad bloods taken so waiting for results.

My reading first thing today was 14.4 and my breakfast was 6.73g carbs. Before lunch, my reading was 21.5!!

 

[Bluetit1802]

The consultant definitely thinks I'm more type 1. I've had the cpeptide and gad bloods taken so waiting for results.

My reading first thing today was 14.4 and my breakfast was 6.73g carbs. Before lunch, my reading was 21.5!!

It can take a while for the c-peptide and GAD results to arrive. I suspect it might help if you reduced your carbs a little while waiting for the results, but test religiously as you are on insulin and don't want any hypos.

 

[HSSS]

Thanks for the responses however this is where i get confused. Everywhere you read it says that type 2 diabetics should have between 45-60g carbs per meal; 135-230g per day. So according to guidelines my daily intake isn't high. I think it's only high if I'm on a specific low carb diet. Ketogenic low carb - under 20g per day; moderate low carb - 20-50g per day and liberal low carb - 50-100g per day.

I only weigh 55kg and I am 5ft 3in so I really dont need or want to loose any weight. If I drop my carbs lower will that cause me to loose more weight?

Lowering carbs doesn’t have to mean weight loss. As we lower carbs as an energy source we increase fats. Either from our bodies if overweight or diet if not. And no increasing fats doesn’t have to mean eating blocks of lard by the dozen nor increased cholesterol or impeding heart attacks. Ditching low fat rubbish that generally has higher carbs and chemicals and adding some things like nuts, olive oil, olives, normal meats not “lean” ones, dairy such as butter and cream keep us feeling full and having energy.

Despite advice to only test before meals I’d be testing afterwards as well. I can not recommend this enough. What the point of seeing where you start if you don’t see where you finish. This will show you what each meal is doing to your bloods. A rise of less than 2mmol is desirable, even less is even better. See if a very low carb meal has the same effect as a high carb meal. Eg if breakfast is usually cereals, porridge or toast see what eggs or bacon and eggs does instead? For lunch check a sandwich against a salad. I’d try 2hrs and then even 3hr or 4hrs possibly for delayed peaks. You may get your answers right in front of you.

Your body simply cannot process the amount of carbs you are eating even with the medication. This suggests strongly insulin resistant as most type 2 are, especially after years of forcing a broken system to do what it can’t (type 2; eat carbs) making the problem worse and worse. Flooding an already insulin overloaded system (type 2) with yet more insulin in an attempt to force it to work may short term achieve that goal but makes the underlying problem worse. Hence why type 2 has always until recently been seen as progressive.

If your numbers are high no matter what food you eat then perhaps a misdiagnosis is indeed what’s happened. Or perhaps your pancreas has just given up exhausted. In which case the further testing to see just what your own insulin levels are and if you have antibodies could give you answers. I hope you find clarity soon

 

[Smallbrit]

I only weigh 55kg and I am 5ft 3in so I really dont need or want to loose any weight. If I drop my carbs lower will that cause me to loose more weight?

I'm only answering this part of the question - I'm not on meds so I have no direct experience with those.

I am 5ft 0in, and weighed 51kg at diagnosis. But... I definitely had a tummy, or as my diabetic nurse said, I was 'diabetic shaped'.

One year on... on what would be counted as moderate low carb, over 20g but mostly below 50g, and I am 49.5kg (not any taller, sadly ). And have less of a tummy.

I did actually lose more weight than that initially, but looked for advice here, and everyone helpfully suggested eating more and including more fats (which seemed a bit odd), and I've stabilised now. And eat really quite big portions! But bread, cereal is a definite no-no for me - it's not only carbs, but also the type of foods, and that one is personal to each of us. I can oddly eat a packet of crisps and take a brisk walk and I'm fine. But I don't want a packet of crisps... I like bread.

 

[db89]

Your body simply cannot process the amount of carbs you are eating even with the medication. This suggests strongly insulin resistant as most type 2 are, especially after years of forcing a broken system to do what it can’t (type 2; eat carbs) making the problem worse and worse.

How are you reaching this conclusion with the data available? The doses that RainbowBrite has stated they take each day currently are not extremely high - they may just be insufficient. As they're not on a basal/bolus regime we've no data to go off which would show any relevant ratios or basal requirement.

As a Type 1 if I didn't take enough insulin each day my numbers would be similar or higher until I injected enough to match the carbs I'd eaten and meet my basal needs. It may be that RainbowBrite turns out to be Type 2 when their blood tests come back but as their consultant has ordered these tests to determine this there is obviously some doubt. They wouldn't be the first or last person to be misdiagnosed.

 

[Bluetit1802]

Thanks for the responses however this is where i get confused. Everywhere you read it says that type 2 diabetics should have between 45-60g carbs per meal; 135-230g per day. So according to guidelines my daily intake isn't high. I think it's only high if I'm on a specific low carb diet. Ketogenic low carb - under 20g per day; moderate low carb - 20-50g per day and liberal low carb - 50-100g per day.

I only weigh 55kg and I am 5ft 3in so I really dont need or want to loose any weight. If I drop my carbs lower will that cause me to loose more weight?

Every one of us reacts differently to differing amounts of carbs. If it turns out you are not T1 and are producing plenty of your own insulin, then your high numbers are down to diet. Some people can cope with 100g or more a day of carbs, most of us cannot. If you are T2 then it is clear you cannot, and will have to consider reducing the amount. That will be your only answer.

I started my journey over 5 years ago by eating around 100g a day. Gradually over the following months I reduced this amount, ending up on 30g a day before my blood sugars were where I wanted them. 100g was far too many for MY body. My meter told me this, and this was despite losing 33% of my weight.

Talking of weight, I am also 5ft 3ins and weigh 56kg. and have done for 4 and a half years, eating low carb and extra fats and protein. After losing my weight I simply increased the fats, mainly but not exclusively from protein sources and animal fats. It was a fine balancing act that took a while to sort out, but once sorted all has been well. There are many of us on this forum that maintain an ideal weight on this way of eating, so it can be done.

However, you need to know the results of your tests first.

 

[HSSS]

How are you reaching this conclusion with the data available? The doses that RainbowBrite has stated they take each day currently are not extremely high - they may just be insufficient.

In essence high numbers are caused by ingestion of carbs (predominantly but I accepted also proteins) which cannot be processed by the body for some reason, either insulin resistance or lack of sufficient insulin. Ie the body is failing to process the carbs even with the medication currently used.

What to do about it depends on why, ie which type predominantly.

As a diagnosed type 2 this does suggest that the still notable carb level may be too high. This is the most sensible avenue to consider first before assuming additional/alternative medication is required

I agree that it entirely possible that a misdiagnosis has occurred, as I acknowledge, in which case their treatment regime as a whole probably needs reassessing to meet these different circumstances to enable their body to process the carbs eaten.

 

[RainbowBrite]

Thank you everyone for your responses...I am now investigating a lower carb diet than the one I am currently on - good news is that butter and cheese are 2 of my very favourite things I am someone who has never paid attention to my weight and has never (until initial diagnoses) looked at a food label so ultra low carb is a minefield but I'll get there through research etc. I think it all comes from knowledge of how food affects my body as many of you have said so I am also going to start testing post food to keep an eye out for spikes.

Thanks again for all the advice x

 

[Member496333]

Thank you everyone for your responses...I am now investigating a lower carb diet than the one I am currently on - good news is that butter and cheese are 2 of my very favourite things I am someone who has never paid attention to my weight and has never (until initial diagnoses) looked at a food label so ultra low carb is a minefield but I'll get there through research etc. I think it all comes from knowledge of how food affects my body as many of you have said so I am also going to start testing post food to keep an eye out for spikes.

Thanks again for all the advice x

Please be extremely vigilant in your self-monitoring with regards to insulin dosing. Dramatically lowering carbohydrate consumption is likely to have a profound and potentially dangerous effect on your blood glucose concentration if you do not adjust your exogenous insulin accordingly. This applies irrespective of whether you are insulin resistant or insulin deficient, or both.

Hypos can kill. Be careful.

 

[RainbowBrite]

Please be extremely vigilant in your self-monitoring with regards to insulin dosing. Dramatically lowering carbohydrate consumption is likely to have a profound and potentially dangerous effect on you blood glucose concentration if you do not adjust your exogenous insulin accordingly. This applies irrespective of whether you are insulin resistant or insulin deficient, or both.

Hypos can kill. Be careful.

Thank you Jim. I will increase my monitoring. I'm probably going to spend a bit of time researching and might drop my diabetic nurses an email to ascertain their thoughts before I do anything drastic. But I do think I need to do something cos I cant keep going with these high readings constantly.

 

[RainbowBrite]

Saw this and couldn't resist given my current state....on my way home home to cook a low carb meal of pork shops, broccoli and garlic butter

 

[Traceymac23]

There always has to be a level of honesty about diet.......I reckon if you reduce your carbs and increase protein fats by 5% each week(stopping if you feel weak or have any other health concerns) for 4 weeks(i.e 5% less week1, 10% less week 2, 15% less week 3, 20% week 4) that you will either

1)reduce your numbers
2)be able to eliminate the 'too much carbs' argument

Please check with your Health Care Professional first....especially if you take insulin.

Good Luck