Hello from a new(ish) Type 2

[Paulyw74]

Hello. My Name is Paul. I'm 45 years old. I was diagnosed with Type 2 in January. My HBa1c was over 100 upon diagnosis but was down to 70 about a month ago. I'm currently injecting insulin twice a day with my daily mmol/L numbers generally staying between 4 & 8. I've had Psoriatic Arthritis for over 20 years, so have been used to taking medication over the long term and on diagnosis I think I probably just assumed this would now be something else I would learn to live with.. I'm not massively unfit or obese (BMI of around 27) but have struggled to do as much proper exercise as I probably should due to the pain it causes and also having a busy life with 2 young kids, work etc. Strangely since starting on the insulin my Psoriasis has really improved as has my overall feeling and ability to do more exercise. I have just had a telephone conversation with a new Rheumatologist who expressed quite an interest in Diabetes, he has told me that I should start on a low carb diet and continue with the extra exercise. I have recently cut bread & pasta from my diet having already stopped drinking any fizzy pop, eating sweets, almost any chocolate etc straight after my initial diagnosis. I have also been talking to my diabetic nurses on a weekly basis and whilst they were aware and encouraging of the changes I was making to my diet habits they were not as upfront as the Rheumatologist on what I really need to do to turn things around. So now I am intending to go as low carb as is realistic in a busy life with kids etc. Any advice from people who have been through similar would be appreciated, especially on eating well whilst not always having a lot of free time. Its a reality I'm just starting to get my (and my wife's) head around but I am hopeful that I might soon be able to get off the insulin injections then on to Metformin tablets with a long term goal of getting off meds all together.

I would add that I have also checked with my healthcare team that I definitely have Type 2 and not type 1.5 (LADA) which we thought might have been possible due to my Psoriatic Arthritis but they have assured me it is something they checked and that the Type 2 diagnosis is correct.

Thanks. P.

 

[JoKalsbeek]

Hello @Paulyw74 ,

I can't say i have been through something similar, as I don't have PA nor a busy life with kids, but yeah, low carb... https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html is what I wish I'd been told at the start of my journey, but you seem to have clued in a lot quicker than I did at the time. Also, I don't know if you're getting steroid shots in your joints, but those will elevate your blood sugars for about a week at a time. Keep an eye on that if you get those eh.

You've come to a good place. Oh, and carbs are inflammatory by nature... Cutting them usually eases inflammation-related conditions as well.

Good luck,
Jo

 

[Paulyw74]

Hi Jo

Thanks for your reply. I've not had any steroid injections for years thankfully. My psoriasis and psoriatic arthritis are nicely under control with biologics and have been for a number of years now. I think that's why its quite surreal to now have this to deal with. Anyway hopefully changes to my diet will help both conditions as you say. I'm not ready to go full keto anytime soon but think I can make some realistic changes to my carb intake and do more exercise then see where that leads. One thing I have learnt over the years with my arthritis is not to get too worried about the long term. Treatments change and progress, I've got lots to learn but many of the things needed seem reasonable. I'm actually quite keen to get started with the changes but don't want to rush into anything whilst still on insulin.Thanks again. Paul.

 

[Stephen Lewis]

Hi Paul. Low carb is definitely the way to go. I definitely suggest going on the "low carb diet" available at this web site. If nothing else it provides a way of finding out the carbs in all the foods you are eating. As Jo said above, I wish I'd been told this 12+ years ago when I entered the pre-diabetic phase and then my A1cs went up and up as my medications went up and up.
I hope what happened to me a couple of years ago will happen for you. A few months after I was put on an ever increasing dose of insulin I found out about this web site and forum. I started a low carb diet, reducing them over a few months to a target of 50 gms per day and kcal of 1200 to 1500. Over the next 6 - 9 months I cut the insulin, cut or reduced other medications and lost about 40 lbs. (I didn't think I was over weight). I also go to the gym 3 times a week and this seems to help get rid of the liver fat available for a carb dump when my bgs drop. Gyms were closed here for over 3 months and I obviously increased this fat again as the first time I got back last Monday the bg level spiked quite high immediately after.
I have got my A1cs down to below 6.5 on a regular basis and I am now working on getting rid of the Metformin.
I don;t know much about PA so I am not sure how diet affects this condition so hopefully having to combine 2 diets will work for you. Keep coming back here with questions and read the information from others as this has been the best source of information for me to get my condition under control. I don't think I will go into remission or be cured without divine intervention but the control will help to prevent some of the nasty side effects.
Welcome to the Magical Mystery Tour of this journey,

 

[Paulyw74]

Hi Stephen. Thanks for your reply.

Its getting an idea of realistic carb amounts that I need to understand, especially while I'm on insulin and knowing when/if I'm ok to change the amounts I inject without risking any problems. I've cut bread and potatoes almost completely since the weekend and done quite a lot of exercise. The daily readings are staying really low so I'm speaking to my nurse tomorrow to discuss the amounts I take. I've just checked my level 2 hours after eating (2.5hrs after my injection) and the reading was 3.9 (twice) so thats quite low. Its 8:40pm now and I inject the Humilin m3 long acting, so I'm slightly concerned that the reading is so low right now. I'll check again before I go to bed and might eat something just in case.

Thanks again for your reply. I'm learning more everyday so any advice is appreciated.

Paul.

 

[VashtiB]

Hello and welcome.

It's great that your rheumatologist was able to put you on to the low carb way of life.

I assume that since you are also taking insulin you are testing frequently


Good luck and let us know how you go.

 

[Paulyw74]

Hi. Yes, he was quite clear on low carbs. My main worry right now is changing anything too quickly. I've been on the insulin since January, slowly increasing the amounts while lockdown was going on and with all the news about underlying conditions and co-morbidities I just went along with the Nurses guidance. Now I need to figure out how to move forward. Hopefully the nurses are able to help, I'm speaking to them again tomorrow. Also, yes I've been testing a lot more since making the changes to my diet. The figures have all been between 4&6 mmol/l before meals. However the readings 2 hours later have been quite low, down to 3.8 & 3.9 but back up over 4 half an hour later. I think I just need some clarity on how to adjust the levels of insulin accordingly until I can come off it altogether.

 

[HSSS]

Seems eminently obvious that if your medication is now stronger than your needs it should be reduced. If your team are uncertain (or god forbid suggest you increase carbs to enable you to take medication to counteract carbs ???.) then perhaps this document advising health care professionals how to adjust medication will help

https://bjgp.org/content/69/684/360

 

[Resurgam]

Low carb is very effective in reducing blood glucose levels, with the weekend coming you should really be getting advice on how to adjust your insulin levels as you obviously need less - this is not medical advice but a reaction to the numbers on your glucometer, as you should not really so so low under the influence of injected insulin - you could not drive, for instance, nor operate machinery in safety.

 

[sportyboston]

Hi. I was diagnosed Type 1 about nine months ago and now take insulin. I noticed that my psoriasis really improved. I find that really interesting.

 

[JoKalsbeek]

Hi Jo

Thanks for your reply. I've not had any steroid injections for years thankfully. My psoriasis and psoriatic arthritis are nicely under control with biologics and have been for a number of years now. I think that's why its quite surreal to now have this to deal with. Anyway hopefully changes to my diet will help both conditions as you say. I'm not ready to go full keto anytime soon but think I can make some realistic changes to my carb intake and do more exercise then see where that leads. One thing I have learnt over the years with my arthritis is not to get too worried about the long term. Treatments change and progress, I've got lots to learn but many of the things needed seem reasonable. I'm actually quite keen to get started with the changes but don't want to rush into anything whilst still on insulin.Thanks again. Paul.

Hey Paul,


The numbers you're currently seeing with just a few alterations in your diet, would mean going keto'd be a bad idea. You'd drop like a stone, as you're entering hypo territory as it is. Please adjust your insulin intake if you're going to proceed as you currently are, because the numbers you're seeing now are potentially dangerous.

Low carb is the, in my experiemce anyway, answer to T2, but mixing it with insulin can get scary. Hopefully your team'll adjust your dosage properly and promptly!

Keep testing, and stay safe!
Jo

 

[Paulyw74]

Hi everyone. Thanks for all the replies. They are really helpful.

I've just done an early morning rest and the mmol/l figure was 5.2. I'm planning to eat a couple of weetabix and some allbran for breakfast, which is what I've recently been having as I dont feel ready to adjust my insulin without speaking to my nurse quite yet. The decision I need is whether I can adjust my diet whilst still on insulin and adjust the amount i inject or whether I should wait until I can come off the insulin.

Thanks again to everyone for the advice.

P.

 

[JoKalsbeek]

Hi everyone. Thanks for all the replies. They are really helpful.

I've just done an early morning rest and the mmol/l figure was 5.2. I'm planning to eat a couple of weetabix and some allbran for breakfast, which is what I've recently been having as I dont feel ready to adjust my insulin without speaking to my nurse quite yet. The decision I need is whether I can adjust my diet whilst still on insulin and adjust the amount i inject or whether I should wait until I can come off the insulin.

Thanks again to everyone for the advice.

P.

Good on you for not jumping in blindly.

 

[Stephen Lewis]

Hi again.

It certainly sounds like you are taking this process carefully. A few weeks after I first went on insulin I was not hitting the pre-meal (that is several hours after last meal) desired bg level. My specialist said to gradually increase the insulin until I hit his target. I followed the same advice in reverse by myself when the bg levels started going down in the low carb diet. The result was that I took myself off insulin six months later. My experience is that many medical professionals do not (cannot?) work outside the protocols set by the health authorities and these protocols result in massive profit for the pharmaceutical companies supplying drugs and equipment for diabetics. At the same there has not been a great deal of research until recently into reducing the need for medical intervention. This forum and web site is one of these more recent developments.
The reason for the bg readings before meals being higher that the ones 2 hour after is that your liver is kicking in with a glucose dump when your bg levels get low. The pancreas actually prompts the liver to do this so part (the Beta cells?) is working!
Certainly listen to you medical helpers at this stage and read our experiences. Something you will often read here is that we are all different and react in different ways to the same foods. So listen to your body as well. For example as I exercised more and lost weight my liver dumps had an ever reducing affect in my bg levels. This can be dangerous if the body cannot produce enough 'emergency' glucose.
Living in Canada (but still a Welshman after 40 years) I have been lucky to get the Freestyle Libre on my pension's private health insurance. This has been essential since coming off insulin as it gives a graph of the changes in interstitial glucose and a manual reading whenever I want. This means I can see almost immediately the results of different foods and exercise on my bg levels and of the dawn phenomenon glucose dump in the 2 - 3 hours from before I wake up until a couple of hours after. I wish this had been available when I was first diagnosed.
Last year I was told by the diabetic clinic that I could not see them again because I had my condition under control and my doctor wished that all her diabetic patients would take control of their condition in the same way I have. You seem to have a strong desire to do this and have come to the best place to start getting the information, motivation and support. I really dislike the current usage, but 'we are all in this together' and we can help each other achieve our goals.

 

[KK123]

Last year I was told by the diabetic clinic that I could not see them again because I had my condition under control and my doctor wished that all her diabetic patients would take control of their condition in the same way I have.

Hi Steve, she sounds like an enlightened Dr rather than the kind that seem determined to KEEP someone on lifelong medication. Very well done to you. x

 

[Stephen Lewis]

Hi KK123: Could be enlightened or could be happy that I only take a few minutes for prescription renewal and she gets paid for the normal consultation time.. Probably a little of both.

 

[Paulyw74]

Hi everyone who's interested..

I've reduced my evening injection tonight after talking with my nurse. Its the first time I've been able to reduce the amount I inject so I am quite pleased to be making some progress. I have managed to massively cut back on the carbs this week and most of the meals were things we normally eat but I just had much less or no pototoes. So yes, I'm hopeful. Its the weekend so I'll have time to go out on my bike and go play with my boys at the park. Genuinely having moments where I'm excited about changes to my lifestyle but then worrying if I can do it forever. It reminds me very much of my initial arthritis diagnosis, it takes time to get it into your head, but I'm starting to think the penny is dropping.

Anyone reading this who feels they have anything to add please do.

Thanks again.
P.

 

[Paulyw74]

I've just checked mh mmol/l level 2 hours after eating dinner. The reading is 4.1, so low again even after reducing the insulin earlier. Going to reduce again tomorrow by the same amount and see what that affect has.

P.

 

[HSSS]

Test and test some more and make small but progressive adjustments and you’ll soon find things are significantly better.

 

[Daley01]

I've just checked mh mmol/l level 2 hours after eating dinner. The reading is 4.1, so low again even after reducing the insulin earlier. Going to reduce again tomorrow by the same amount and see what that affect has.

P.

I've just checked mh mmol/l level 2 hours after eating dinner. The reading is 4.1, so low again even after reducing the insulin earlier. Going to reduce again tomorrow by the same amount and see what that affect has.

P.