Diagnosed in Japan

[WasntMe]

First of all, I must say - fabulous resource!

I kind of knew something was wrong when I was necking down 2-3 litres of water and milk a day. That is unusual for me.

Fortunately I had a scheduled visit to the hospital for checkup on DVT from 2 years ago, doc said oh btw you seem to have diabetes (me - ***!). Saw specialist same day and she put me on insulin daily 8 units. One week later followup my numbers had improved slightly; have metformin hydrochloride 250mg tablets one after each meal, plus the needle.

I asked her if she recommended a blood sugar monitor, suggesting the sensor type (Freestyle) but 'we don't have those in Japan' doh! Nurse helpfully pricked my finger to show the approved type.

Then appointment with nutritionist, all same day in the same hospital. She took pains to point out that I should only confine myself to eating at regular mealtimes (no snacking) - is that the way to go? I have a fun little chart which I'll post later.

Next appointment in one month, hoping that means I'm not a serious case, but also the hospital is spreading out appointments to keep the number of visitors low to mitigate the Covid factor.

Comments welcome. Cheers

 

[WasntMe]

Yep, she's right. How do you cope with Japanese food (which I happen to love ) in terms of diabetes?

Well I adore tofu. Sure, can't have rice, but there are plenty of veggies widely available, fish of course, seaweed is wonderful stuff too.

For me, couldn't be in a better place.

 

[Geordie_P]

Strong Zero highballs are a nice low-carb treat from Family Mart. Good luck with it all!

 

[WasntMe]

Strong Zero highballs are a nice low-carb treat from Family Mart. Good luck with it all!

Do you think I'm safe there while on the insulin? Lilly's legalese instructs specificly not to indulge, though I'm not planning to sue anyone.

 

[EllieM]

Welcome to the forums.

I'm confused, have you been diagnosed T1 or T2? (OK, profile says T2). In other countries (UK, Europe, Australia, NZ, US) it's very unusual for a T2 to immediately be put on insulin.

Do you have an hba1c result to share?

And did they do the tests to ensure that you are T2 rathe than late onset T1?

Having said all that, diabetes types do vary according to racial types/ethnicity, so it may well be that your treatment is appropriate to the Japanese.

Good luck, it looks like you are doing all the research to allow yourself the best results from this illness.

 

[WasntMe]

Welcome to the forums.

I'm confused, have you been diagnosed T1 or T2? (OK, profile says T2). In other countries (UK, Europe, Australia, NZ, US) it's very unusual for a T2 to immediately be put on insulin.

Do you have an hba1c result to share?

And did they do the tests to ensure that you are T2 rathe than late onset T1?

Having said all that, diabetes types do vary according to racial types/ethnicity, so it may well be that your treatment is appropriate to the Japanese.

Good luck, it looks like you are doing all the research to allow yourself the best results from this illness.

T2. Not sure which tests these might have been but they were pretty firm about it. Last bloodwork prior to diagnosis said about 6.4% but on first diagnosis I believe it was about 14%.

I'm fairly sure that doc will give caucasian me the same treatment as the native population. I did read somewhere that adherence to a specific diet is greater in Japan than in the west, so that might carry a bit of weight. But also that's about cultural specifics. Anyhoo...

 

[EllieM]

Do you think I'm safe there while on the insulin? Lilly's legalese instructs specificly not to indulge, though I'm not planning to sue anyone.

I assume indulge refers to alcohol? T1 here, I've been indulging in alcohol for over 40 years... (diagnosed at 8, drinking at 18). The issue with insulin and alcohol is that alcohol can inhibit your liver from producing sugar if your blood sugar goes too low, and insulin can induce hypos (too low blood sugars). So probably best to normalise your levels before you drink, but not necessarily an issue once you've got on top of things.

 

[EllieM]

Last bloodwork prior to diagnosis said about 6.4% but on first diagnosis I believe it was about 14%.

That's a massive difference.

To put in perspective

Normal random blood glucose levels for a non diabetic 4-8 mmol/L

Hba1c of 6.4% is an average bg of 7.6 mmol/L and counts as prediabetic (barely) rather than diabetic.

Am hba1c of 14 corresponds to an average bg of 19.6 and I'm not surprised that they've put you on insulin.

With an increase that fast I'd want to know that they've checked you are not T1 but I guess it may not matter since you are already on insulin.

Good luck., whether you are T2 or not you should get help on these forums and going low carb is good for both types. (Though it may not be necessary for T1s).

 

[WasntMe]

Strong Zero highballs are a nice low-carb treat from Family Mart. Good luck with it all!

I give you Exhibit A m’lord

 

[LaoDan]

T2. Not sure which tests these might have been but they were pretty firm about it. Last bloodwork prior to diagnosis said about 6.4% but on first diagnosis I believe it was about 14%.

I'm fairly sure that doc will give caucasian me the same treatment as the native population. I did read somewhere that adherence to a specific diet is greater in Japan than in the west, so that might carry a bit of weight. But also that's about cultural specifics. Anyhoo...

I also live in Asia, diet can be a bit difficult with all the amazing noodle places lol.

 

[WasntMe]

I also live in Asia, diet can be a bit difficult with all the amazing noodle places lol.

I'm reading that soba noodles from buckwheat have a low gi, probably there are others?

 

[EllieM]

I'm reading that soba noodles from buckwheat have a low gi, probably there are others?

They may or may not be low gi but they do have quite a lot of carbs. As you're on insulin, you'll need to count the carbs in your food.

I asked her if she recommended a blood sugar monitor, suggesting the sensor type (Freestyle) but 'we don't have those in Japan' doh! Nurse helpfully pricked my finger to show the approved type.

You definitely need some sort of blood testing meter if you are on insulin (and I'd recommend it even if you were T2 not on insulin, so that you can check the effect of different foods on your blood glucose), but I suspect your nurse just doesn't want to give you a libre, as Dr google says it's been available in Japan since 2017...
Abbott's FreeStyle Libre wins reimbursement in Japan | Drug Delivery Business

If your doctor won't prescribe it, you could try self funding. Dexcom (another continuous glucose monitor) can also be bought in Japan, but I don't know whether you'd have to self fund.

 

[LaoDan]

I'm reading that soba noodles from buckwheat have a low gi, probably there are others?

Unfortunately, I had to cut noodles from my diet. I still have sushi with rice from time to time, usually after exercise. Mostly I live on fish and green veggies.

I play around with nutrient timings. If I’m absolutely needing gyoza, I time it right after exercise or near lunch when I’m most active.

 

[WasntMe]

Latest visit to the hospital revealed some good news

The figures on the right are what is considered to be normal.

substantially down from a month ago (14% iirc). Doc has reduced insulin to 6 units from 8.

Continuing Metformin, plus I had an eye test - apparently the (what she called) eye tension is something that needs to be monitored, though everything else was good. Apparently I should avoid looking down - so just like I’m doing at the moment lol.

 

[bulkbiker]

Latest visit to the hospital revealed some good newsView attachment 48787

The figures on the right are what is considered to be normal.

substantially down from a month ago (14% iirc). Doc has reduced insulin to 6 units from 8.

Continuing Metformin, plus I had an eye test - apparently the (what she called) eye tension is something that needs to be monitored, though everything else was good. Apparently I should avoid looking down - so just like I’m doing at the moment lol.

What's the top figure?

 

[oldgreymare]

Latest visit to the hospital revealed some good newsView attachment 48787

The figures on the right are what is considered to be normal.

substantially down from a month ago (14% iirc). Doc has reduced insulin to 6 units from 8.

Continuing Metformin, plus I had an eye test - apparently the (what she called) eye tension is something that needs to be monitored, though everything else was good. Apparently I should avoid looking down - so just like I’m doing at the moment lol.

Good that you are responding well! As mentioned above, ideally you should find out whether you are T1 or T2. If the latter and diagnosed recently, you may be able to wean yourself off insulin into 'remission', typically by a combination of low carb/keto eating (unusual, but not impossible in Japan - but little or no rice, noodles, breads, potatoes most of the time), plus exercise, weight loss if needed. Lots of info to explore on this site. Unfortunately for T1s insulin is a lifelong requirement as it is an autoimmune condition.

If possible find out what other tests were run in addition to your fasting BG levels and HbAC1. If you are able to continue to reduce both your HbAC1 and also your insulin requirements, you may wish to be tested for c-peptide to identify how much of your own insulin production you may have recovered.

"eye tension" sounds like your doctor has some concern re possible glaucoma. Perhaps read up on this and if any issues get back to the doctor. Do you have the next follow up appointment scheduled?

 

[michita]

What's the top figure?

113 on top is just an administrative number, reception number. Nothing to do with blood results

 

[bulkbiker]

113 on top is just an administrative number, reception number. Nothing to do with blood results

I meant the 72 mg/dl

 

[michita]

I meant the 72 mg/dl

I see.. that must be the blood sugar level at the time of taking the blood sample 72mg/dl = 4.0 mol/l quite good or close to having hypo

 

[bulkbiker]

I see.. that must be the blood sugar level at the time of taking the blood sample 72mg/dl = 4.0 mol/l quite good or close to having hypo

Exactly which hardly ties in with a high HbA1c.