An awkward case...

[Luce13]

Hi,

I have had T2D for 13 years with gestational diabetes starting 30 years ago with my first child.

I have been on various meds over the years with my HbA1c climbing to 81 in December last year.

I was advised to take insulin and decided to try LCHF instead. I went keto March 2019.

I was taking maximum dose gliclicide until March when seeing an endocrinologist was advised they were doing too much damage and to immediately stop taking it. I continued with Metformin 2xdaily., however, cut to 1 about 6 weeks ago due to very upset tummy.

My sugar reading has now increased to 93. I have been told I must inject insulin as I am causing myself so much damage. I am reluctant to undo the work I have done reducing my insulin levels ( hopefully as no test done for this)

My thoughts are that having been diabetic for such a long time and in December 2019 a waist measurement of 37" I had a very fatty liver . I have lost 7". I feel my journey to health may be a long time and have now asked for a cpeptide test to see what my pancreas is actually doing. The nurse after much discussion has agreed, however, has told me the test will take 4-6 weeks and I must inject insulin or take other meds.

I would just like some advice on what to do from someone who has perhaps been in my situation. . I have an appointment this afternoon and would ideally like to do nothing until the results of the Cpeptide test come back, however, I am scared I'm doing the wrong thing.

The best thing for me would be if I could run it past Jason Fung or David Unwin!!!

Do you have any information that would reassure me?

Many thanks

 

[bulkbiker]

Are you monitoring your blood sugars regularly?
What sort of numbers are you seeing?
Presume you are still following keto?
How many carbs per day are you having?

Sorry for a barrage of questions but ....

 

[ianf0ster]

I was advised to take insulin and decided to try LCHF instead. I went keto March 2019.

I was taking maximum dose gliclicide until March when seeing an endocrinologist was advised they were doing too much damage and to immediately stop taking it. I continued with Metformin 2xdaily., however, cut to 1 about 6 weeks ago due to very upset tummy.

My sugar reading has now increased to 93. I have been told I must inject insulin as I am causing myself so much damage. I am reluctant to undo the work I have done reducing my insulin levels ( hopefully as no test done for this)

Hi Luce13,
Forgive me, but I haven't read all your posts yet in order to determine if you are actually doing what you think you are doing regarding Low Carb or Keto. It seems that even your Type of diabetes may be in some doubt.

If your pancreas is still working OK, then I would be amazed if even LCHF with occasional IF (eating to your BG meter) was not working at lowering your HbA1C results.
However I suppose (assume) that you are not comparing like to like since it appears that you were on Glic as well as Metformin before trying LCHF.

Can you let us know what your typical daily meals are and what your BG reading is before and 2hrs after first bite?

Stress, Illness, Lack of Sleep, even Depresssion have all been shown to elevate BG readings.

Edit:
I see that your were posting quite regularly in your thread but that you appear to have stopped posting in March. If your BG and HbA1C numbers have been so very poor, then that is a very long time to go without asking for help/advice/sympathy.

I also see that you seemed to be pinning your hopes on re-generating your pancreatic function (producing more insulin naturally). While it has been known for LCHF or Keto or even Fasting to do this in some cases you should never assume that it will definitely work for you, since we are all different.
At least the C-Peptide test may shed more light on this.

 

[KK123]

Hi,

I have had T2D for 13 years with gestational diabetes starting 30 years ago with my first child.

I have been on various meds over the years with my HbA1c climbing to 81 in December last year.

I was advised to take insulin and decided to try LCHF instead. I went keto March 2019.

I was taking maximum dose gliclicide until March when seeing an endocrinologist was advised they were doing too much damage and to immediately stop taking it. I continued with Metformin 2xdaily., however, cut to 1 about 6 weeks ago due to very upset tummy.

My sugar reading has now increased to 93. I have been told I must inject insulin as I am causing myself so much damage. I am reluctant to undo the work I have done reducing my insulin levels ( hopefully as no test done for this)

My thoughts are that having been diabetic for such a long time and in December 2019 a waist measurement of 37" I had a very fatty liver . I have lost 7". I feel my journey to health may be a long time and have now asked for a cpeptide test to see what my pancreas is actually doing. The nurse after much discussion has agreed, however, has told me the test will take 4-6 weeks and I must inject insulin or take other meds.

I would just like some advice on what to do from someone who has perhaps been in my situation. . I have an appointment this afternoon and would ideally like to do nothing until the results of the Cpeptide test come back, however, I am scared I'm doing the wrong thing.

The best thing for me would be if I could run it past Jason Fung or David Unwin!!!

Do you have any information that would reassure me?

Many thanks

Hi there, it does sound complicated but the bit that stuck out for me was when you said you had done the work to 'lower your insulin and didn't want to undo it'. Whatever is going on it would seem that either your insulin isn't getting through or you are not producing enough. That cannot continue for obvious reasons so I do hope you get it sorted. If you are eating under 50 carbs a day or maybe even lower then as others have said, it's time to find out what your pancreas is up to. I personally wouldn't be happy to do nothing for 6 weeks or more and it seems you're already on a low carb diet. If insulin (on a very short term basis) helps to reduce your current levels, surely that's a good thing? I know it's not great if you actually are producing enough or too much but as a temporary measure?

 

[DavidGrahamJones]

I was advised to take insulin and decided to try LCHF instead. I went keto March 2019.

It's only an opinion but I would have thought (hoped) that insulin would only be prescribed because it was needed and that low carb isn't an alternative at that stage. However, you have done the right thing by asking for a c-peptide test, not sure why it takes the NHS so long. That will at least be very clear in indicating what your pancreas is up to. If it's going to take 4 - 6 weeks I would do as I'm told in the meantime.

 

[HSSS]

It's only an opinion but I would have thought (hoped) that insulin would only be prescribed because it was needed and that low carb isn't an alternative at that stage.

Have you been reading this forum? Sadly lots of drs only ever escalate medications and don’t even consider low carb as an option. In my opinion any type 2 being moved onto insulin should be given the option of c peptide/insulin tests ( well actually it would be even better at diagnosis as well) and discuss low carb if not already explored.

 

[Lowcarb 2]

Hi,

I have had T2D for 13 years with gestational diabetes starting 30 years ago with my first child.

I have been on various meds over the years with my HbA1c climbing to 81 in December last year.

I was advised to take insulin and decided to try LCHF instead. I went keto March 2019.

I was taking maximum dose gliclicide until March when seeing an endocrinologist was advised they were doing too much damage and to immediately stop taking it. I continued with Metformin 2xdaily., however, cut to 1 about 6 weeks ago due to very upset tummy.

My sugar reading has now increased to 93. I have been told I must inject insulin as I am causing myself so much damage. I am reluctant to undo the work I have done reducing my insulin levels ( hopefully as no test done for this)

My thoughts are that having been diabetic for such a long time and in December 2019 a waist measurement of 37" I had a very fatty liver . I have lost 7". I feel my journey to health may be a long time and have now asked for a cpeptide test to see what my pancreas is actually doing. The nurse after much discussion has agreed, however, has told me the test will take 4-6 weeks and I must inject insulin or take other meds.

I would just like some advice on what to do from someone who has perhaps been in my situation. . I have an appointment this afternoon and would ideally like to do nothing until the results of the Cpeptide test come back, however, I am scared I'm doing the wrong thing.

The best thing for me would be if I could run it past Jason Fung or David Unwin!!!

Do you have any information that would reassure me?

Many thanks

Hi I had high readings for ten weeks last year over that time my doctor tried adjusting and increasing my meds I had mild Ketosis for that time and was eventually sent to hospital where they put me on insulin seeing my community nurse 3 months later she could not believe how quickly my levels dropped and sent !e for a c peptic test which showed that my pancreas was producing insulin but my antibodies were killing lt off

 

[HSSS]

Hi I had high readings for ten weeks last year over that time my doctor tried adjusting and increasing my meds I had mild Ketosis for that time and was eventually sent to hospital where they put me on insulin seeing my community nurse 3 months later she could not believe how quickly my levels dropped and sent !e for a c peptic test which showed that my pancreas was producing insulin but my antibodies were killing lt off

So if you have antibodies destroying beta cells doesn’t that mean you are type 1 not 2?

 

[EllieM]

Logically, given that T2 and T1 are two different illnesses, there's nothing to stop a T2 developing antibodies and eventually moving to insulin because their body no longer produces their own. Just as some T1s develop insulin resistance and therefore particularly benefit from a low carb diet....

 

[DavidGrahamJones]

Have you been reading this forum?

At what point does a type II get prescribed insulin in preference to the other medications available? In the list, I think Gliclazide comes under Sulfonylureas. Other meds include:

• Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. ...
• Sulfonylureas. ...
• Meglitinides. ...
• Thiazolidinediones. ...
• DPP-4 inhibitors. ...
• GLP-1 receptor agonists. ...
• SGLT2 inhibitors. ...
• Insulin.

We, the the type II members if this forum are special, we know that we do well to reduce carbs, and we do. We are in a minority with the majority of people being unable or incapable or just not going to, reduce carbs. I think GPs take the easy option and just dish out meds, knowing that a change in diet would not be adhered to by most.

 

[HSSS]

We, the the type II members if this forum are special, we know that we do well to reduce carbs, and we do. We are in a minority with the majority of people being unable or incapable or just not going to, reduce carbs. I think GPs take the easy option and just dish out meds, knowing that a change in diet would not be adhered to by most.

I have seen too many in this forum state they have gone straight to insulin or rapidly there without going through the list above for suitability which is what should happen but doesn’t always. Insulin will be appropriate for some cases but not as many as prescribed imo.

I agree entirely that we are a minority. But is that because the rest are unwilling to reduce carbs? Or is that because the very vast majority don’t know to reduce them or it’s benefits, how to do it without unpleasant withdrawal and how to do it without support? Sure it won’t be for everyone but I think it would work for a much much larger % if drs were advocating it as the best first line treatment rather than a fad diet that will harm you as sadly many do. And then provide the support and backup some need in the form of group support or online links to this place for one!

 

[Lowcarb 2]

So if you have antibodies destroying beta cells doesn’t that mean you are type 1 not 2?

I was told when I went on insulin that I am technically type 1.5 , since having the
c peptic test the consensus is that as I age i will become type 1 eventually , my pancreas is making insulin but because my antibodies are killing it off my pancreas will tire out over time , I was diagnosed aged 53 and I am now 56

 

[HSSS]

I was told when I went on insulin that I am technically type 1.5 , since having the
c peptic test the consensus is that as I age i will become type 1 eventually , my pancreas is making insulin but because my antibodies are killing it off my pancreas will tire out over time , I was diagnosed aged 53 and I am now 56

So you are type 1, LADA or 1.5 (they seem to be used interchangeably by various professionals) not type 2 (?) The main difference between the non type 2’s above is the speed at which it develops.

Type 2 is a different animal with different causes and potentially different treatment.

They can occasionally both happen to one individual but the lack of self produced insulin in a type 2 does not make them a type 1 (common misconception). They remain a type 2 but insulin injection dependent as they are non producing. Type 1’s have an autoimmune condition.

It might be best to consider changing your profile to more accurately reflect your diagnosis if it is indeed a type 1 (1.5 or LADA) so any advice or comments headed your way in future are more relevant.