Should I be asking for more help?!

[Carrotxo]

I’m 28 and was diagnosed as Type 2 in March 2020. My HbA1c was around 50 and I was told I could control it by diet. I next had it in August 2021 and it was 60. No follow up.

After experiencing symptoms i pestered my GP for another HbA1c this month it’s now raised to 75. My GP text me telling me they would prescribe me Metformin. I already have very bad stomach issues so am reluctant to start.

I have never had my blood glucose tested since I was diagnosed. My partner bought me a blood glucose monitor. Today before eating my blood glucose was 16. After eating it was 21.2. Why have they never taken this? Shall I not bother with this?

I also have a heart condition (SVT).


After prescribing Metformin the GP Just text me telling me to book another blood test in three months time. I feel like I’m not being monitored at all and I don’t know if this is normal.

I don’t want to annoy my doctors but I’m worried I’m just meant to take this medicine for 3 months with no idea if it’s working or my blood sugar is any lower?

 

[Ronancastled]

It's a disgrace the medical professional haven't supported you more.

Being picked up at only just over the diagnostic level of 50 would normally be seen as a blessing with still chance for quick improvement.

The fact that yours has progressed so quickly says 2 things to me, please note I'm not a medical professional but have read a lot of cases.

(1) You haven't adjusted your diet or lifestyle in the period since diagnosis. Have you read up on low carb & truly understand that carbs are not just obvious sugars ?
(2) You need a C-Peptide & antibody test to rule out T1,

Please report back as you're now in the best place for advice.

 

[ianf0ster]

I’m 28 and was diagnosed as Type 2 in March 2020. My HbA1c was around 50 and I was told I could control it by diet. I next had it in August 2021 and it was 60. No follow up.

After experiencing symptoms i pestered my GP for another HbA1c this month it’s now raised to 75. My GP text me telling me they would prescribe me Metformin. I already have very bad stomach issues so am reluctant to start.

I have never had my blood glucose tested since I was diagnosed. My partner bought me a blood glucose monitor. Today before eating my blood glucose was 16. After eating it was 21.2. Why have they never taken this? Shall I not bother with this?

I also have a heart condition (SVT).


After prescribing Metformin the GP Just text me telling me to book another blood test in three months time. I feel like I’m not being monitored at all and I don’t know if this is normal.

I don’t want to annoy my doctors but I’m worried I’m just meant to take this medicine for 3 months with no idea if it’s working or my blood sugar is any lower?

Welcome to the forum. Unfortunately, yes, that is what your doctor wants/expects. The question is: Are you prepared to actually do something to control your Type 2 Diabetes? - Most aren't, probably because they are not told that there are some things that they can do.

There are several variations on 4 different approaches to controlling Type 2 Diabetes. All 4 don't require medication and all 4 have around a 40% to 50% success rate of remission - normal or at least merely pre-diabetic HbA1C levels after 2 to 3 yrs (initial temporary success rates (at around the 3 to 6 month time are much higher - the problems lie in the sustainability of the approaches for the individual).

I chose to use my BG meter to test the effect of different food and eliminate (or cut down on) those which raise my BG too much (by over 2.0 mmol) 2 hrs after starting a meal. This approach is known as Low Carb or Keto. You can see for the figures you got, if they were at approx 2hrs after first bite were too high in sugars or starches i.e. more than your body can handle. All digestible carbohydrates tend to have this effect of raising BG in Type 2 diabetics. For non-diabetics they raise BG, but by the 2hr mark the BG levels have gone back down to being hardly higher than before starting the meal ( due to the natural insulin response).

Don't be fooled by the idea that all fruit and veg is good for you, or that whole grains are 'healthy'. While those may be true for non-diabetics, they aren't good for Type 2 diabetics, in fact tropical fruit, most grains and starchy veg are best avoided by Type 2 diabetics.
Unfortunately different people react differently to the exact same food - so it's a case of using a BG meter to find out which foods to avoid. All meat, fish, eggs, leafy green veg, most nuts, full-fat dairy and cheese has no effect on Blood Glucose because fat has zero effect and the effect of protein is only slight compared with carbohydrates.

Here is a link that's very useful about T2 Diabetes. The Nutritional Thingy. | Diabetes Forum • The Global Diabetes Community

The other approaches I mentioned are:
Very Low Calorie diet (around 800 calories for 8 to 12 weeks ) followed by low enough calories in order to keep the weight off.
Fasting - Here I mean 24 hrs or more (not just 'Intermittent Fasting' or Time restricted Eating)
Bariatric Surgery

 

[Andydragon]

I’m 28 and was diagnosed as Type 2 in March 2020. My HbA1c was around 50 and I was told I could control it by diet. I next had it in August 2021 and it was 60. No follow up.

After experiencing symptoms i pestered my GP for another HbA1c this month it’s now raised to 75. My GP text me telling me they would prescribe me Metformin. I already have very bad stomach issues so am reluctant to start.

I have never had my blood glucose tested since I was diagnosed. My partner bought me a blood glucose monitor. Today before eating my blood glucose was 16. After eating it was 21.2. Why have they never taken this? Shall I not bother with this?

I also have a heart condition (SVT).


After prescribing Metformin the GP Just text me telling me to book another blood test in three months time. I feel like I’m not being monitored at all and I don’t know if this is normal.

I don’t want to annoy my doctors but I’m worried I’m just meant to take this medicine for 3 months with no idea if it’s working or my blood sugar is any lower?

Good morning,

unfortunately it seems like there isn’t a lot of monitoring going on in your condition, covid isn’t helping much at the moment but we have to take control ourselves anyway, sounds like you are doing so with the blood meter so that’s good!

For T2, so the levels you quote are high, we aim for a raise of no more really that 2, 2 hours after eating but also that our levels to start with are lower. Sone guideline figures here: https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

so, when did you test after eating and what did you eat? That’s one thing to look at. Many of us find dropping carbs is a great step towards dietary control. Problem is much of “healthy” diet advice is similes towards healthy carbs, which doesn’t work so well

you are younger, that’s not as uncommon as it once once, and if you are carrying extra weight that won’t help. Lower carb has also lowered weight for people so that’s an added benefit. Not guaranteed but can help

the 3 month test isn’t unusual but as your levels are increasing, monitoring will help you see how foods are impacting, but asking for more support shouldn’t be a problem I hope, doctors know your history more than we could

 

[KennyA]

I’m 28 and was diagnosed as Type 2 in March 2020. My HbA1c was around 50 and I was told I could control it by diet. I next had it in August 2021 and it was 60. No follow up.

After experiencing symptoms i pestered my GP for another HbA1c this month it’s now raised to 75. My GP text me telling me they would prescribe me Metformin. I already have very bad stomach issues so am reluctant to start.

I have never had my blood glucose tested since I was diagnosed. My partner bought me a blood glucose monitor. Today before eating my blood glucose was 16. After eating it was 21.2. Why have they never taken this? Shall I not bother with this?

I also have a heart condition (SVT).


After prescribing Metformin the GP Just text me telling me to book another blood test in three months time. I feel like I’m not being monitored at all and I don’t know if this is normal.

I don’t want to annoy my doctors but I’m worried I’m just meant to take this medicine for 3 months with no idea if it’s working or my blood sugar is any lower?

I'm not going to repeat the good advice given above. You've had a really bad experience with the medical profession which unfortunately is not uncommon. I would be relaxed about "annoying your doctors". There is a view in the health services that T2 diabetes is incurable, needs medication, and inevitably gets worse. This is simply not the case.

Yes, use the meter. It will tell you what foods do to your blood sugar levels, and give you a snapshot of progress.
Yes, a low-carb lifestyle will reduce your blood sugar levels quickly and relatively easily.
Yes, you will have to unlearn a lot of what the health service, the media, and friends and family think is "healthy eating".

Have a look at the various success stories on this forum. There are large numbers of people (I'm one of them) who have addressed their T2 condition through dietary changes. Best of luck.

 

[Oldvatr]

Your glucometer is not a toy, it is the most powerful tool you could have. Eat To Meter as suggested above will guide you naturally to improve your diet to reduce those blood sugars. There are many ways to do that. Low Carb, Keto, Mediterranean Diet. Blood Suagr 800 diet, Newcastle Diet. These are all used by others on this Forum. I personally use a medium low carb diet based on the Mediterranean diet, which helped me survive Xmas without too much trauma. As suggested, read the Testimonials and Success Stories thread on this forum, and see what others have found that worked for them. I have not seen my GP for 3 years now, but I do not actually need him at the moment even though I too have CVD issues.

 

[NicoleC1971]

At 28 there's a lot of life to lead and you don't want that spoilt by the complications of type 2 diabetes.
As in you may feel not too unwell now and your body may well feel normal but under the surface some damage will happen eventually.
So yes time to help yourself and it will make a big difference to your health:
Eat to your meter (glad that your partner cares enough to get you that). as others have advised and if you don't get results or can't wean yourself own or off bread, pasta, rice and sugar to the extent that your hba1c reduces then keep asking on here and/or see Diet Doctor or the Freshwell Low Carb app (free).
If your sugars do continue rising or you feel a lot worse, insist on getting in front of a GP as it is possible you have LADA or type 1 where your insulin is decreasing hence the suggestion for the C Peptide test to check those.
Really sorry that you are not getting what might be expected but can still use the GP to run the routine tests to check if any changes you make are working in the long term.
If you need metformin (won't reverse t2) low doses//slow release are available which may not upset your stomach.

 

[bulkbiker]

I’m 28 and was diagnosed as Type 2 in March 2020.

I think we could do with some more info.

Have you lost weight recently without trying?

Have you ever had a c-peptide test to check up your insulin production.

Are you overweight?

What kind of eating regime do you follow?



Sorry for the rash of questions (some agreed rather personal) but without this info any advice could be wrong.

 

[Carrotxo]

Thank you for your replies everyone. Yes I am overweight. At the time of being diagnosed I was doing Keto and had lost 4 stone. I was told by 2 doctors I saw that I had to stop keto as it wasn’t healthy. Since then I’ve put the weight back on.

I’m a bit worried about doing keto again as I have essential hypertension (been waiting 2 years to see cardiologist as my referral was lost due to pandemic) and also has my most recent ecgs (which I also had to pester for) were abnormal.

I’ve never had c-peptide but I don’t think it would be Type 1 because my weight and I believe my biological mother has Type 2.

I’m sort of a fussy eater/eat too much processed food as I’m often depressed and lack motivation. In terms of food I probably have more like a child’s diet. I’m not sure which diet to do?


For dinner tonight for example I had microwave rice and pre-cooked chicken pieces. My BG 2 hours later is 21.5.

the Metformin I will start taking tomorrow morning. I am meant to increase it over 3 weeks to 4 tablets a day. But earlier in the year I was hospitalised for stomach issues and I’m worried it’s gonna make my existing issues worse.

Apologies this post is kind of all over the place. Thank you again.

 

[EllieM]

Hi @Carrotxo and welcome to the forums.

Yes, I would agree with the others that you deserve/(d) better support from your doctor, though it's unfortunately not an uncommon situation .

I would second @ianf0ster 's suggestion that you use a meter and test before and two hours after a meal. Then you will be able to tell whether your body is coping with the carbs in that meal. An hba1c of 75 corresponds to an average blood sugar of 11.7 over the last 3 months. Many T2s with higher levels than yours have got themselves into normal figures by reducing their carbs.

If you don't want to go full keto, have you considered just a carb reduction? eg ditch or reduce the obvious culprits such as rice, pasta, potatoes, bread?

Your meter will tell you whether the reduction is working for you.

And remember, weight gain is a common side effect of T2.

Finally, have you spoken to your doctor about your concerns about your stomach issues?

 

[bulkbiker]

I was told by 2 doctors I saw that I had to stop keto as it wasn’t healthy.

Oh dear such complete and utter nonsense and such a shame for you.

I'd get back on it immediatel,y you had great results and my hypertension resolved itself with significant weight loss through keto and intermittent fasting.

Lots of meat, fish, eggs and green veg if you like them.

 

[ianf0ster]

Thank you for your replies everyone. Yes I am overweight. At the time of being diagnosed I was doing Keto and had lost 4 stone. I was told by 2 doctors I saw that I had to stop keto as it wasn’t healthy. Since then I’ve put the weight back on.

I’m a bit worried about doing keto again as I have essential hypertension (been waiting 2 years to see cardiologist as my referral was lost due to pandemic) and also has my most recent ecgs (which I also had to pester for) were abnormal.

I’ve never had c-peptide but I don’t think it would be Type 1 because my weight and I believe my biological mother has Type 2.

I’m sort of a fussy eater/eat too much processed food as I’m often depressed and lack motivation. In terms of food I probably have more like a child’s diet. I’m not sure which diet to do?


For dinner tonight for example I had microwave rice and pre-cooked chicken pieces. My BG 2 hours later is 21.5.

the Metformin I will start taking tomorrow morning. I am meant to increase it over 3 weeks to 4 tablets a day. But earlier in the year I was hospitalised for stomach issues and I’m worried it’s gonna make my existing issues worse.

Apologies this post is kind of all over the place. Thank you again.

Please eat veg like cauliflower, broccoli, courgette or other low carb rather than rice, potato, pasta.

Low Carb /Keto reduce hypertension so much that Dr David Unwin said both he and his patients had to come off their hypertension drugs after they started a Low Carb way of eating because their blood pressure went low enough to make them light headed.
If Keto wasn't (in general) healthy then why have doctors been prescribing it for epilepsy in children since the early 20th century?
Can it be unhealthy - Yes if you try hard enough you can make any diet unhealthy - but most people are sensible. However if you have an eating disorder (other than carbohydrate addiction) I suggest you tread carefully.

 

[Geordie_P]

It's the strangest thing: if you say 'keto', people fret and frown. If you say 'Mediterranean' they nod in sage agreement. In both cases, I'm eating fish, meat, eggs, olive oil and green leaf veg. I know the two terms aren't actually synonymous, but I've been using Mediterranean as a euphemism for the scary 'K' word, and it works like a charm.

 

[KennyA]

At the time of being diagnosed I was doing Keto and had lost 4 stone. I was told by 2 doctors I saw that I had to stop keto as it wasn’t healthy. Since then I’ve put the weight back on.

I'm not surprised. Unfortunately a lot of "official" advice is simply wrong. The results of a keto diet will probably improve many/most underlying health conditions - hypertension included.

 

[chani111]

So sorry to hear your experience especially in relation to weight loss. I need to lose 2 stone and I use the nutra check app set to carbs so I can keep my carb intake down. I find it easy to use and really helpful too. So glad you have found this place, everyone is very helpful

 

[Goonergal]

I’m a bit worried about doing keto again as I have essential hypertension (been waiting 2 years to see cardiologist as my referral was lost due to pandemic) and also has my most recent ecgs (which I also had to pester for) were abnormal.

This article might aid a discussion with your cardiologist: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695889/

 

[EllieM]

I'm not particularly surprised that the doctors were anti keto either, but we have to be careful before dismissing their concerns, as they have access to @Carrotxo 's medical history and we don't. In her position I would push for a reason as to why it's unsuitable eg maybe her weight went down too low and she couldn't maintain it on keto or maybe there's a reason why keto diets are unsuitable for people with SVT??? Let me stress that I am not a doctor and I have no reason to suppose that either of those statements are true, I'm just giving examples of reasons why we might recommend keto and the doctors might not.

In any case no one has objected to lower carbs so that might be an option before further clarification on the keto issue?

 

[Oldvatr]

It's the strangest thing: if you say 'keto', people fret and frown. If you say 'Mediterranean' they nod in sage agreement. In both cases, I'm eating fish, meat, eggs, olive oil and green leaf veg. I know the two terms aren't actually synonymous, but I've been using Mediterranean as a euphemism for the scary 'K' word, and it works like a charm.

I use the name Pioppi Diet since (a) most people have never heard of it, and more importanrtly (b) it is a Low Carb variant of Mediterranean. It is promoted by the eminent cardiologist Aseem Malhotra, and is more common to see it recommended for cardio vascular patients than diabetics, but I find it works for me. I did use Keto for a while, but found I lost too much weight, and it was more restrictive than I actually need to be. I use mod carb with fasting to get low bgl.

However I changed my diet this Xmas to SAD+++ !!!!. Normal service will resume after tonight (NYE).

 

[Outlier]

Terrific article, Goonergal - thanks for posting.