Newly diagnosed but questioning it!

[saudidave]

After some 4 years as pre diabetic with fasting readings of 6.2 - 6.6 and keeping it under control with vigorous cycling and dietary caution, I was made redundant, started a business and started working 70 hour weeks. The cycling stopped, alcohol and food intake increased and I got 2 readings of 7 and 7.1 so I am now ofiicially type 2

I am a 58 yr old male; 5 ft 9 " tall and weigh14 stone ( down from 16st 4 years ago)

Diagnosis was a month ago and it was a big wake up call. I immediately gave up booze and went on a strict diet. I'm back to cycling 70 - 100 miles a week at a fast pace (ave 14 mph). I'm now losing 3lbs a week with a goal of 12st

Last weekend I bought a meter and I'm now averaging fasting readings of 5.5 and within 2 hours of a meal I'm usually back to where I was before it, which averages about 5.8.

Yesterday I saw the practice nurse who revealed that my GTT was 7.0 before and after 2 hours was
5.8, so clearly my pancreas is spewing out insulin like there is no tomorrow when my plasma glucose gets a rush on.

Surely, if I've reduced fasting levels so easily and my insulin production is plentiful, I'm just a fat office worker producing toxins from the fats around my middle to resist the insulin, rather than a full blown type 2?

I have no real experience of this malarkey so can anyone who does have give me their opinion? Are these readings and this course of events really type 2 conclusively?

I realise that I have been rather silly not to have taken the action I'm taking now some years ago and I have an extremely good understanding of the physiology of the condition, having done considerable research and discussed it at lengthvwith my daughter who is a medical sciences graduate

 

[ClaireG 06]

Hi and welcome to the forum

I'm sorry but none of us can give you a medical opinion on if you are diabetic or not. That is something for your health care team to decide. I would say however that whatever your doing seems to be working, so keep up the good work

 

[Grazer]

HMMM, Claire is obviously right, but I thought the following held true:-
The fasting test levels were not conclusive of type 2
The GTT level didn't show type 2
What HbA1c did you show? This is perhaps a meaningful test for you.
On what you've told us, I'd have thought you were potentially still pre-diabetic, but we of course don't know what else your mdoctor might know, and can't challenge his diagnosis! It doesn't actually matter really though if you think about it. Wether you're full type 2 or not, your actions need to be the same. Get to a sensible weight, maintain reasonable levels of exercise and follow a healthy diet. Many of us cut down on starchy carbohydrates a bit to keep our blood sugar levels down.
If you really want to know, and I could understand why, challenge and ask for another test, and ask for the parameters under which the diagnosos was made. you can then check them against the normal parameters used which you'll find on many web sites.
Good luck
Malc

 

[sugar2]

Hi Malc,

It is difficult to say I am afraid.

The thing is, a none diabetic, and a ciabetic who is well controlled could have the same test results. Your GTT test result though, that was worth questioning with your Dr?

 

[Grazer]

Hi Malc,

It is difficult to say I am afraid.

The thing is, a none diabetic, and a ciabetic who is well controlled could have the same test results. Your GTT test result though, that was worth questioning with your Dr?

Hi sugar2,
Thanks, but I was actually answering saudidaves query!! I agree with you though - i thought GTT over 11 was conclusive for type 2? Saudidaves figures sounded enviable!
Malc

 

[Margi]

I don't know what the parameters are for diagnosis, but if your doctor says it's diabetes, then presumably it is. However, with good control, as you are doing ,the levels should come down to normal. That does not mean that you are now not diabetic, just that you are controlling it really well. If it is type 2, as your doctor says it is, then if you went back to lazing around and eating jam doughnuts, the BS would go back up.

Us type 1s, on insulin, can have perfectly normal readings when we are well controlled: that does not mean we do not have diabetes any more, simply that it is properly controlled. The same applies to type 2. So whether the readings your diagnosis was given from are the ones that are usually used or not, you have done the right thing and got it under control.

Live long and prosper: and keep from complications.

 

[Daibell]

Your readings indicate that you are at the early point of Type 2 and hence lots of exercise and a good diet should keep your BS at a good level. This is good advice to a non-diabetic anyway. As others have said, keep the carbs down to sensible levels and measure yourself with a meter to check what affects you. Looks like you shouldn't need to go onto tablets for a while yet which is good

 

[hallii]

I dislike the term "pre-diabetic", in my book you either have it or do not.

A predisposition to any sort of abnormal blood glucose readings, whether occasional high readings or more prolonged slightly elevated BGs are a strong indication that you may be diabetic.

Your doctor will have weighed the evidence and made a diagnosis based on what has been observed during examination and any tests.

When the doc. is not entirely sure of the diagnosis it is a cop out to use the term "pre-diabetic".

What they mean is you probably have it but it's not bad enough to worry about yet.

I would say you have T2 and have brought it under excellent control, and long may it remain so.

To add a more depressing note, I too had excellent control for 7-8 years, but slowly the sleeping dragon awoke and my BGs started to climb. A small dose of Metformin and a lowish carb diet have got things under control again. But I have no illusions, the dragon is not dead, merely sleeping.

H

 

[saudidave]

Thanks everyone for the replies, they are. Much appreciated.

The diagnosis was made by the practice nurse specialising in diabetes care, not a doctor. When I questioned the GTT, she looked puzzled and shrugged. In my opinion it hasn't been thought through. My GTT would suggest I don't have a problem producing insulin, but I have a problem utilising it. I have 2 stones of blubber producing toxins that inhibit the uptake of insulin by my body tissues, thus despite a pancreas doing its job well, i can't absorb it efficiently. I am not diabetic, I'm fat!

I am concluding that T2 is a combination of pancreatic failure and insulin resistance and can be any balance of the two. If you have a greater degree of the former rather than the latter, then sadly you are on a one way street of increasing medication. If the reverse is the case, then massive weight loss to reduce the toxins and allow the insulin to do it's job will result in reduction or even complete removal of the symptoms. The latter has been proven by the recent well publicised study at Newcastle Unuversity and countless bariatric surgery patients who lose their T2 after surgery.

 

[hallii]

Saudidave, you have obviously done your research and yes. 700 calories a day will bring most T2 under control.

This is not new science, starvation has been used for many years as a method of control and treatment for diabetes.

It is also true that any strict control of carbohydrates ( which will usually also control calorie intake) has much the same effect.

Bariatric surgery is just another way of achieving this control

 

[saudidave]

Many thanks for that, hallii and yes 700 calories a day will bring it under control.

The point I was trying to make (and the Newcastle University research paper, which I have studied, would appear to confirm this), is that it isn't the permanent calorie control that is the key, it is losing the fat permanently. If this can be achieved and maintained after an initial two months of extremely restricted calorie intake, the insulin response returns to normal and remains so, no matter what the diet, as long as the fat that was causing the issue of tissue resistance to the insulin via toxin secretion is permanently removed. The average loss of pancreatic fat in the Newcastle study was 2%, achieved by a reduction in body weight of approx 30-35 lbs during the eight week diet.

Once the fat is purged, normal food intake can be returned to as long as the body weight is stabilised at the new, lower level, yet still the plasma glucose remains at normal levels. Thus if you are like I would appear to be and have a pancreas secreting relatively normal insulin levels, you are effectively "cured" if you lose the weight and keep it off permanently. You don't have to stay on 700 calories a day for ever, you just can't get fat again.

There could be millions of people with normal blood sugar levels who haven't ever been fat who would immediately become T2 if they gained a couple of stones. They are not labelled T2 because they aren't fat. If they briefly gained the weight, became T2, lost it permanently then returned to normal glucose Levels, would they then be diabetics for ever? I think not!

 

[Daibell]

Hi saudidave

There are many conventions in the world of diabetes that are questionable but you have to break ranks to suggest them. 'They' say diabetes can't be cured, but as you have said by losing weight if you are overweight you may possibly be able to remove most if not all of the T2 symptoms. To me that is 'curing' diabetes if the measurements show normality, but the symptoms may return so you need to keep an eye on BS readings. I hate the term 'pre-diabetes' as it is rather unscientific. Diabetes embraces a whole range of BS ills and I can see no difference between someone labelled 'pre-diabetic' and somone labelled 'Type 2 with almost normal BS readings'; it's purely semantics as you suggest.

 

[saudidave]

Hi saudidave

There are many conventions in the world of diabetes that are questionable but you have to break ranks to suggest them. 'They' say diabetes can't be cured, but as you have said by losing weight if you are overweight you may possibly be able to remove most if not all of the T2 symptoms. To me that is 'curing' diabetes if the measurements show normality, but the symptoms may return so you need to keep an eye on BS readings. I hate the term 'pre-diabetes' as it is rather unscientific. Diabetes embraces a whole range of BS ills and I can see no difference between someone labelled 'pre-diabetic' and somone labelled 'Type 2 with almost normal BS readings'; it's purely semantics as you suggest.

Thank you Daibell, if you remove the symptoms permanently, then that is surely a cure!

 

[Grazer]

Thank you Daibell, if you remove the symptoms permanently, then that is surely a cure!

Yes and no!
That in effect is the difference between pre-diabetes (used to be known as borderline) and full type 2.
The effect Dave describes is correct for someone who is pre-diabetic. They can lose weight, adjust diet and exercise and return to a non-diabetic state. That is, they can then eat a normal diet again without raised BG. They would pass a GTT.
Once you go past pre to full Type 2, you can remove all symptons by eating low-carbs, losing weight and exercising. You are not, however, cured in that if you returned to a "normal" diet your BG would simply increase again - you wouldn't pas a GTT. For example, I produce Insulin, and my HbA1c is 5.5, seldom does my BG go above 7 after a meal and I'm not on medication. But that's because I'm strict about what I eat. If I suddenly had 2 or 3 roses orange creams, my BG would be in double figures.
Need to be wary of the Newcastle paper - it's early days and if you read some of the other threads on this site about it, we can see that results are not as clear cut as it might sound!
I think that in Dave's case, his figures suggest "pre-diabetes", and thus it's quite feasible he could return to a "cured" condition. The monster could still return though if he went back to bad old ways!
Good luck Dave!

 

[saudidave]

Thanks Malcysykes1. I think basically you are in agreement with me on this one. My personal situation is that my Glucose response appears to be superb, since the GTT had a reading of 5.8 after 2 hours.

The acid test will take time. I shall diet down to under 12 stone and as I return to a more normal diet we can see how my readings are then. That is the only way to draw any conclusion. I suspect that I will (hopefully) return to at least a pre diabetic state. That way the worst scenario is that I may prolong that situation and stay off medication for longer, i.e.dragging out the decline! If I can "cure" myself then that is a huge bonus. As you say it is early days for the Newcastle study but hopefully the publicity it has received will encourage research specific to it.

For now my reading are decreasing steadily and I'm now getting "normal" morning readings of below 5.4. All my readings are now below 6.

 

[Pneu]

Your readings are on the high side of normal... In most non-diabetics you will find that they have fasting blood sugars of between 3.6 - 4.5 mmol/l depending on the time of day... 2 hour post meal results will be below 5.5 mmol/l in the vast majority of individuals... although 7.8 mmol/l is considered the upper limit of 'normal'.

Stable and good blood glucose control is as important in type 2 diabetics as it is in type 1 as high blood sugars damage your beta cells that produce insulin... so long term poor control in type 2 diabetics can cause beta cell damage and then you are fighting against both insulin resistance and lack of insulin..

By the sounds of it you have taken the right steps to help improve your health and BG control.

 

[Snodger]

as a T1 I've found this very interesting. I know very little about T2. So thank you all.
we don't have 'pre-diabetes' in T1. We're healthy, then we're either dead or diabetic! 8) ah the simple life.

PS yes I know I'm oversimplifying but you know what I mean.

 

[saudidave]

A progress report!

It is now 5 weeks since my wake up call where the practice nurse claimed I had progressed from glucose intolerance to type 2. It's 3 weeks since I went on a very low calorie diet of chicken and veg stews supplemented with multivitamins, apples and bananas. My calorie intake is circa 800 per day. I also cycle some 10 to 15 miles per day at an average speed of 12.5 miles per hour, which for the uninitiated means I'm giving it serious stick for a 58 year old.

My average morning reading is now 5.8 ( down from 7.00)

My average reading before my evening meal is 5.50 and 2 hours after it is 5.50 also. I would add that if I eat a normal meal, i.e. Not the low calorie stew but a large portion meal of typically new potatoes, steak and
mxed veg, the result is the same, after 2 hours I'm around. 5.50

I have lost 11lbs in 3 weeks and now weigh 186 lbs or 13 st 4 lbs. I am 5'9" and intend to aim for under 12 st.

My morning blood pressure has fallen significantly from 130/80 which was OK to perfection - a repeated 120/70, so I'm well pleased with that.

Today I undertook my own glucose tolerance test. My reading on waking was 5.6. I then consumed 425 ml of lucozade and after working on my computer for 2 hours it had fallen back down to 8.00

My conclusion from all of this is that I'm still glucose intolerant rather than type 2. If I lose another 21 lbs and get rid of my still considerable toxin producing blubber then I suspect that my insulin response will continue to improve

 

[viviennem]

Saudidave posted:

My conclusion from all of this is that I'm still glucose intolerant rather than type 2. If I lose another 21 lbs and get rid of my still considerable toxin producing blubber then I suspect that my insulin response will continue to improve

I think you may be right, Dave - in that your "Type 2" may be caused more by insulin resistance than by failure of the pancreatic Beta cells. Getting to your preferred weight may well return you to a non-diabetic state. I'm hoping this will happen to me too! - though I have a lot more weight to lose than you

However, I would urge caution. Even if you are glucose intolerant rather than Type 2 now, this episode has shown that you have a tendency towards diabetes in the long term, and I think you will always have to keep a close eye on your blood glucose levels, and your diet.

I'm not burying my head in the sand, but I'm working on the principle that if I'm not full-blown Type 2 now, I soon will be, so I'm trying to behave as if I am Type 2 just to make sure it doesn't run away with me later.

Good luck with your diet - I'm sure you're going to succeed. But when you have, still keep testing occasionally, just so you know what's going on.

Viv 8)

 

[borofergie]

I have lost 11lbs in 3 weeks and now weigh 186 lbs or 13 st 4 lbs. I am 5'9" and intend to aim for under 12 st.

My morning blood pressure has fallen significantly from 130/80 which was OK to perfection - a repeated 120/70, so I'm well pleased with that.

My conclusion from all of this is that I'm still glucose intolerant rather than type 2. If I lose another 21 lbs and get rid of my still considerable toxin producing blubber then I suspect that my insulin response will continue to improve

Way to own your diabetes saudidave! It doesn't matter whether it's pre-diabetes or full-blown-diabetes, you've faced up to it, and it sounds like you are winning.

Diabetes is a great wake up call. While some people can talk about T2 diabetes knocking 10 years off your life, I'm convinced that my healthier approach to life since I was diagnosed will add at least 10 years to mine.