Type 2 Newly diagnosed, many problems

[Blackwater5]

I was only diagnosed pre-diabetic last summer, then my hbA1c shot up from 47 to 55 and I was prescribed lipigliptin. I've had two hbA1c tests since then, each one increasing by a point on the last, and was taken off that med after getting bullus perhgould (blistering skin), and was given steroids with no meds. My waking bg rarely goes below 8 but although I stopped the steroids a few days ago I get spikes, from, 11 mmol/L to 23. This might be something connected with the steroid tablets. A recent urine test showed protein and I'm waiting for the results of a second.
but my weight is now close to underweight and I've started on a mostly low carb diet. I also take beta-blockers for tachycardia.
I am very worried as my DBN has told me I'll be started on slow release gliclazide twice a day next week. The beta-blockers can make it hard to notice a hypo, I may have kidney disease, My body reacts to a number of drugs. I can't take statins, it took 2 months to lose the side-effects of the beta blocker (and I'm on the lowest dose), lipigliptin could cause an autoimmune skin disease that I never get rid of completely and now I'm being given what is maybe the riskiest drug for me. Maybe because I've lost a lot of weight they've settled on that and was told I couldn't have metformin because of liver problems (don't think I have any, numbers are normal). Today I had the best bg readings ever, one was under 7, but I need to not lose any more weight and keep my cholesterol and BP readings good.
I suspect I've been diabetic for several years but nobody thought of checking until last summer. My BP varies, was too high at last check so now there'c talk of ACE inhibitors.

 

[HSSS]

I was only diagnosed pre-diabetic last summer, then my hbA1c shot up from 47 to 55 and I was prescribed lipigliptin. I've had two hbA1c tests since then, each one increasing by a point on the last, and was taken off that med after getting bullus perhgould (blistering skin), and was given steroids with no meds. My waking bg rarely goes below 8 but although I stopped the steroids a few days ago I get spikes, from, 11 mmol/L to 23. This might be something connected with the steroid tablets. A recent urine test showed protein and I'm waiting for the results of a second.
but my weight is now close to underweight and I've started on a mostly low carb diet. I also take beta-blockers for tachycardia.
I am very worried as my DBN has told me I'll be started on slow release gliclazide twice a day next week. The beta-blockers can make it hard to notice a hypo, I may have kidney disease, My body reacts to a number of drugs. I can't take statins, it took 2 months to lose the side-effects of the beta blocker (and I'm on the lowest dose), lipigliptin could cause an autoimmune skin disease that I never get rid of completely and now I'm being given what is maybe the riskiest drug for me. Maybe because I've lost a lot of weight they've settled on that and was told I couldn't have metformin because of liver problems (don't think I have any, numbers are normal). Today I had the best bg readings ever, one was under 7, but I need to not lose any more weight and keep my cholesterol and BP readings good.
I suspect I've been diabetic for several years but nobody thought of checking until last summer. My BP varies, was too high at last check so now there'c talk of ACE inhibitors.

That’s some heavy hitting meds for a hba1c of 55mmol. For reference I was the same when diagnosed and they were happy for me to have no medication at all to see if diet alone would do the job so no risk of any side effects.

Whilst undoubtedly the steroids made things more challenging hopefully the low carb is starting to have beneficial effects on your blood glucose. The way to not lose weight is to increase protein and healthy fats to maintain intakes and weight rather than just eliminate a large part of your diet (carbs). But you need to give it a chance.

If you don’t want the gliclazide (yet) that is your choice. The nurse can only offer it not force you. Perhaps agree to reconsider in 3 months if the low carb isn’t working and by which time the steroids should be out of your system and no longer messing up levels. I strongly suspect you won’t need it by then if you stick with low carb. Particularly as you have so many side effects and other conditions it seems a hasty decision in my opinion to go to a drug that forces more insulin when ultimately most type 2 already have way too much of the stuff, just that it’s a bit useless due to resistance.

 

[EllieM]

but my weight is now close to underweight

Do you know if they've checked for possible causes of weight loss (one of which is that you are a misdiagnosed T1, though that is fairly unlikely)? Or do you reckon you just haven't been having enough calories?

 

[Blackwater5]

That’s some heavy hitting meds for a hba1c of 55mmol. For reference I was the same when diagnosed and they were happy for me to have no medication at all to see if diet alone would do the job so no risk of any side effects.

Whilst undoubtedly the steroids made things more challenging hopefully the low carb is starting to have beneficial effects on your blood glucose. The way to not lose weight is to increase protein and healthy fats to maintain intakes and weight rather than just eliminate a large part of your diet (carbs). But you need to give it a chance.

If you don’t want the gliclazide (yet) that is your choice. The nurse can only offer it not force you. Perhaps agree to reconsider in 3 months if the low carb isn’t working and by which time the steroids should be out of your system and no longer messing up levels. I strongly suspect you won’t need it by then if you stick with low carb. Particularly as you have so many side effects and other conditions it seems a hasty decision in my opinion to go to a drug that forces more insulin when ultimately most type 2 already have way too much of the stuff, just that it’s a bit useless due to resistance.

I went from an hbA1c of 47 to 55 very quickly, why I was given lipigliptin. Before that it was diet, but no diet advice and so I was eating a lot of high sugar and carbs foods. The lipigliptin maybe slowed the rise, went to 56, then 57 on steroids but my diet didn't change. I'm now using a topical steroid as little as possible as well as having a low carb high protein diet but with one meal including complex carbs. Yesterday my BG was 6.9 after oats and berries, spiked (but not as much( after chicken and veg, was 7.3 on waking today.
I am sure that the promised med is wrong for me but it's the only one that can cause weight gain. Just about everything that advises against it applies to me. The diabetes check was made because I'd lost a lot of weight, but if I can't manage to gain weight on a low carb diet (which I can't afford to follow completely) I don't know which med would be best for me. as gliptins are out and gliclazide is a very heavy med. I've been tod I can't take metformin because of problems I'm sure I don't have, and if I did that would rule out gliclazide.
I have a phone consultation with my DBN on Thursday and he wants 4 fasting BG readings a day since I stopped the steroid pills. He's told me to keep away from the low carb diet but avoid sugar a normal balanced diet is fine he says.

 

[HSSS]

47 to 55 isn’t that huge a jump. Over what time period? And hardly surprising if the diet at the time was high carb and sugar filled. Only moving up 1 point to 57 despite steroids I’d say was a good result.

your dbn should be able to evidence why you should avoid low carb. Only avoiding sugar simply isn’t good enough for any of us. How are you supposed to get 4 fasted readings in a day unless you simply don’t eat all day. How does that show what effect the foods you eat are having? You need readings 2 hrs after the meal as well to see that. He’s asking you to go on gliclazide as a means to gain weight as a side effect? Seriously? He’s ignoring the indications that say you shouldn’t be on it? Quite frankly he sounds useless and way too quick to push drugs, especially in your situation.

Personally as you are seeing much improved results on low carb without risking side effects I’d stick with it because it’s working, and ignore him and see what the hba1c is in 3 months. But that’s me. You have to make your own decision. There’s people on here who had hba1c near 100 and had a 3 month diet trial before drugs were given for goodness sake and you at least know already it works.

Is there a reason you can’t add more fats to your diet to maintain weight or even gain? Proteins like chicken thighs, or mince are cheaper, slow cook cheaper meats as an option. Add olive oil or even butter to things. Is there a reason you are adding complex carbs deliberately? What ones and how many? The fewer carbs you have the faster you’ll see results. It depends on how insulin resistant you are how many you can cope with.

 

[Blackwater5]

Do you know if they've checked for possible causes of weight loss (one of which is that you are a misdiagnosed T1, though that is fairly unlikely)? Or do you reckon you just haven't been having enough calories?

I don't think I've been cheched for T1 and doubt I am as my changed diet is lowering my bg. I've tested for inflammation for yearsbut no other btests. TSH is normal.
Many years ago after a period of high stresss I became anorexic but got out of it with no diet, just eating properly, but I became overweight after a lifetime of being thin. Since last year I lost my appetite, ate small meals (mainly carbs and sugar) and wasn't eating enough calories. On a mostly low carb high protein diet my bg is better although still in the diabetic range, but low carbs are meant to lose eight or not put it on. I can't eat large meals, can't afford the foods I need for a good low carb diet, can't snack as I have to give 4 fasting levels a day to my DBN next week
Because of spikes I was given a meter + a repeat for strips and lancets so I'm lucky there. My BP is now high in the morning, low in the evening now. Last week (on steroid tablets) there was talk of high BP medication and my HR has increased. The bisoprolol is the lowest dose because of side-effects but maybe I need to increase it in spite of the fact it's supposed to lower BP.
I've just had a second urine test as the first had high protein (but not albumin)

 

[HSSS]

I don't think I've been cheched for T1 and doubt I am as my changed diet is lowering my bg. I've tested for inflammation for yearsbut no other btests. TSH is normal.
Many years ago after a period of high stresss I became anorexic but got out of it with no diet, just eating properly, but I became overweight after a lifetime of being thin. Since last year I lost my appetite, ate small meals (mainly carbs and sugar) and wasn't eating enough calories. On a mostly low carb high protein diet my bg is better although still in the diabetic range, but low carbs are meant to lose eight or not put it on. I can't eat large meals, can't afford the foods I need for a good low carb diet, can't snack as I have to give 4 fasting levels a day to my DBN next week
Because of spikes I was given a meter + a repeat for strips and lancets so I'm lucky there. My BP is now high in the morning, low in the evening now. Last week (on steroid tablets) there was talk of high BP medication and my HR has increased. The bisoprolol is the lowest dose because of side-effects but maybe I need to increase it in spite of the fact it's supposed to lower BP.
I've just had a second urine test as the first had high protein (but not albumin)

Did they take the blood pressure reading whilst you were stressed at the drs? Artificially high if so. Home readings are a much more reliable measure for anyone who dislikes the drs office etc. low carb often helps blood pressure too, did you know?

again I’d say low carb doesn’t have to mean weight loss. You adjust the non carbs to maintain or gain whilst controlling the blood glucose. snacking isn’t usually a feature of low carb. Sufficient food at meals is to allow insulin to fall and resistance to lessen as a result. It sounds like lack of food you can actually use is at least part of the reason for your weight loss. Which foods do you think you need but can’t afford? Are you afraid to eat natural unprocessed fats? Perhaps we can offer suggestions

What exactly does the dbn mean by fasting? Is it just the before meal readings? This is just one week not forever. Eating low carb meals won’t raise those levels as much as higher carb meals will.

 

[Blackwater5]

47 to 55 isn’t that huge a jump. Over what time period? And hardly surprising if the diet at the time was high carb and sugar filled. Only moving up 1 point to 57 despite steroids I’d say was a good result.

your dbn should be able to evidence why you should avoid low carb. Only avoiding sugar simply isn’t good enough for any of us. How are you supposed to get 4 fasted readings in a day unless you simply don’t eat all day. How does that show what effect the foods you eat are having? You need readings 2 hrs after the meal as well to see that. He’s asking you to go on gliclazide as a means to gain weight as a side effect? Seriously? He’s ignoring the indications that say you shouldn’t be on it? Quite frankly he sounds useless and way too quick to push drugs, especially in your situation.

Personally as you are seeing much improved results on low carb without risking side effects I’d stick with it because it’s working, and ignore him and see what the hba1c is in 3 months. But that’s me. You have to make your own decision. There’s people on here who had hba1c near 100 and had a 3 month diet trial before drugs were given for goodness sake and you at least know already it works.

Is there a reason you can’t add more fats to your diet to maintain weight or even gain? Proteins like chicken thighs, or mince are cheaper, slow cook cheaper meats as an option. Add olive oil or even butter to things. Is there a reason you are adding complex carbs deliberately? What ones and how many? The fewer carbs you have the faster you’ll see results. It depends on how insulin resistant you are how many you can cope with.

I went up from 50 to 55 in 2 months or so but couldn't but only got a meter a couple of weeks ago, so now I've been checking my bg after meals and all but the waking 'fasting' checks are 4 to 5 hours after a meal.

My DBN said he didn't believe in 'fad diets' and he'd had 30 to 40 years experience. Don't know if the bad meds idea came from him or gp, but gp likes giving powerful meds. The meds decision was made when taking steroid tablets which always push up bg. I've only been off them for 3 days today and my bg has dropped a lot with lower spikes already. I still have dermovate cream for local use as the gliptins caused incurable blistering. I don't know why he plans to give me what is often the last drug to try when I was on steroid pills so couldn't get a reliable reading.. At gis phone consultation I'll tell him I don't want to risk it.

I can eat some fats but I've had high cholesterol for years and can't take statins. I've now lost so much weight that my cholesterol is normal. I'm eating some high fat foods but not all foods.

 

[Blackwater5]

Did they take the blood pressure reading whilst you were stressed at the drs? Artificially high if so. Home readings are a much more reliable measure for anyone who dislikes the drs office etc. low carb often helps blood pressure too, did you know

What exactly does the dbn mean by fasting? Is it just the before meal readings? This is just one week not forever. Eating low carb meals won’t raise those levels as much as higher carb meals will.

I take BP readings at home, several times a day now. Usually they are a bit high, sometimes fairly high, but lower if I repeat them. Today I had one very low reading, one a bit high, average normal, but although I may be increasing muscle slightl I'm still losing weight.

With low carbs my problems are that I can't eat big meals, can only afford yoghurt, eggs, and chicken apart from veg. I'm living on yoghurt with a small amount of berries, eggs, chicken, a little olive oil and oats. I can't eat a lot of the recommended foods such as nuts, can't afford expensive meats such as lamb, beef and pork (my mince always tastes a disaster no matter what herbs I add) so today my meals were, breakfast, last of yoghurt and berries, oats for lunch (don't raise my bg that much), then salmon cooked in olive oil and mixed veg.

The dbn means readings before meals by 'fasting' . I don't know if the steroid pills are affecting things 3 days after I stopped them.

 

[HSSS]

I went up from 50 to 55 in 2 months or so but couldn't but only got a meter a couple of weeks ago, so now I've been checking my bg after meals and all but the waking 'fasting' checks are 4 to 5 hours after a meal.

My DBN said he didn't believe in 'fad diets' and he'd had 30 to 40 years experience. Don't know if the bad meds idea came from him or gp, but gp likes giving powerful meds. The meds decision was made when taking steroid tablets which always push up bg. I've only been off them for 3 days today and my bg has dropped a lot with lower spikes already. I still have dermovate cream for local use as the gliptins caused incurable blistering. I don't know why he plans to give me what is often the last drug to try when I was on steroid pills so couldn't get a reliable reading.. At gis phone consultation I'll tell him I don't want to risk it.

I can eat some fats but I've had high cholesterol for years and can't take statins. I've now lost so much weight that my cholesterol is normal. I'm eating some high fat foods but not all foods.

Most of us find out cholesterol improves on low carb regardless of the fat. Of which you are eating very little and the oats are likely causing your highest levels of the day as few type 2 can actually tolerate these well. Cheese? Other cheaper meat on sale you could slow cook? M not sure what’s going on with mince as it’s pretty much failsafe. How do you cook it?

Also are they looking at total cholesterol levels or individual breakdowns and ratios. T total figure is a bit of a chocolate teapot. The carbs and inflammation they cause raise levels more than fat does. There’s a LOT of new research supporting this including from drs and cardiologists. HDL (good) cholesterol almost always goes up. Triglycerides (the really bad stuff) almost always falls. The part that’s more unpredictable is LDL. But that comes in two types one bad and one good. They never measure which it is and assume it’s the bad type. But in low carb eating the better is much more common. I guess it depends which you feel is the bigger issues right now and if you feel you can take even just a few months to see what happens before taking medication you don’t want.

your nurse is out of the ark. He’s still going by what he was taught 40 years ago and hasn’t stayed up to date. low carb is not a fad. It was how they treated diabetes before insulin was discovered and is supported officially by the NHS. They even have training programs in in for drs and nurses. He obviously hasn’t done it.

 

[Outlier]

Homemade soup is really cheap and easy, and mine tastes different every time. Make a bone broth base, add a stock cube, shreds of meat from the bones and any diabetic-friendly vegetables, butter and/or olive oil (shop the special offers, then it isn't any more expensive than rubbish vegetable oils) add herbs and spices if you like them (not expensive and you don't need much) and hardly any cooking work - just load into a pot and simmer.

 

[HSSS]

Have a look at a few low carb recipe sites for inspiration too. A couple of my regular go to ones are dietdoctor.com and ditchthecarbs.com The recipes are totally free if you explore the sites. The only paid parts are optional meal plan programs (which I’ve never used). There also a lot of free articles (with medical references) about all aspects of low carb, fats, ketones, cholesterol, kidneys etc etc that might be relevant a diabetic eating low carb.

 

[Blackwater5]

I am on benefits so have a limited buget. My goal was trying to eat the best quality food i could afford. Breakfast i just eat 4 eggs and cheese omellete (eggs are cheap and a block of cathedral extra mature cheese is £2.50). From ice lands i get angus beef burgers, lamp chops and 4 steaks and that comes to £22. Pork loins from morristons butchers cost upto £1.80 for 2. Bag of brocolli cost £1. Just find what works for you and your budget. I would like to eat fish like salmon but its just not alot unless i spend £5 or more so i try and get the best i can to fill me up as cheaply as possible

There is a link below to the diet and food advice i followed when i first came to this great forum and just adapted it to my needs

Read all the links here and try to follow them. Must be doing something as my waking bg was 6.3 and early evening before eating 5.5 but my eggs and cheese lunch took it up to 10 4 hours after eating.
I didn't think that any shop-bought burgers were good, and my attempts at mince patties or burgers are a disaster. People say I'm making them right but they always end up as eggy mince.
Oily fish should be in the diet and I buy pieces of fresh salmon (frozen). Cheaper than most meats and are baked in 20 to 25 minutes from frozen. I add olive oil and herbs, but the fillets need to be bigger or you need at least two.

 

[ultradad]

Deleted my post as i didnt think it was helpful. Hope you find what works for you

 

[Blackwater5]

Deleted my post as i didnt think it was helpful. Hope you find what works for you

It was helpful as I'd kept away from burgers thanks to all the 'junk food' media. Now I've found Tesco have one that look good judging by the label but it's their 'finest' range of course.