I'm a type2!!!!!!!!!!!!!!!

[manxangel]

yeah just found out in a letter.

"your recent blood test (insulin and c=peptide) have confirmed you have diabetes mellitus type 2. therefore, i think there is scope to treat you with tablets, once your blood sugars and metabolism have settled. we will see you in the clinic as planned"


(as planned is december 11th, so i will be left on insulin till then)

am i wrong to be angry? why are they doing this to me? i know diabetes isn't really an exact science but i've only just got settled on my insulin, doing my diet, and finally got my head around the thought of being diabetic. and now they are going to change me and mess me up yet again. last time i was on tablets i took 1 then 2 then 4 metformin a day. the one and two had no effect whatsoever and the 4 made me throw up. i also was taking diamicron and they didn't appear to have any effect either. my levels were still sky high and there was nothing i could do to get them down.

what can i do? yes i don't want to be injecting insulin for the rest of my life, who the hell does!!!, but i'm finally stable, i'm finally used to the idea and now they are gonna mess me about just before christmas and then what?

i thought i had myself settled and i was going to stunn them all and be this amazingly well controlled diabetic who was a real please to work with. and now?? now?? now they are going to send me back on tablets and i'm going to feel like rubbish all over again.

help me

 

[sugarless sue]

I think you should really try and get an appointment sooner than that if possible and talk to your doctor,asap.

 

[manxangel]

i think you may be right, time to get on to the nurse methinks. i want copies of my tests

 

[DiabeticGeek]

The important thing is to be involved in the decisions about your treatment. It is your life, so don't just accept what the medics tell you blindly. Get all of your test results (usually they will give you a printout if you ask for them), make sure that you understand them and discuss various possible treatment options (preferably with a diabetes specialist).

The first thing to discuss is why they think you are indeed a T2. This may well be the case, but do ask them why they have ruled out LADA (or other possibilities). If you are indeed a T2 then you need to discuss treatment options. In the long term it might well be possible to come off insulin, but since you seem to be getting on well with that I wouldn't rush in that direction. Last time you were on metformin you had horrendous side-effects - discus this with the doctor. Some people avoid this by building up the dose very slowly - so it might be worth starting off on an ultra low dose and working up to a more useful dose gradually over several weeks. If you really can't tolerate metformin, then there are other drug that might be helpful.

It is good news that you have a solid diagnosis, but don't be shy about demanding to be involved in decisions about your treatment. It is, after all, your body.

 

[manxangel]

thank you for your advice, to be honest i needed to hear that.

it is my body and i am getting on well. i've actually lost nearly half a kg in a day ( doesnt sound a lot but i've never monitered my weight before, i know it flutuates but i like seeing it change)from doing low carb and i went swimming this morning. 30 lengths and i wsa pooped. used to to 150 and not be tired so thats my aim now get back to that level. and i've not taken over 6 units of insulin beacuse i'm trying to be so so careful. my results are pretty good fairly stable to be honest. i know its only been a day but i am so positive about this.

knowing that there are other options is good, i do want to be involved but they are the experts and know waht they are doing but it is my body so i guess i need to be more in control i guess.

i am going to get my test results, i'm gonna call on monday and ask for them to be posted out. I want to know what they are doing sending me a letter like that. sent me into a panic and i had a really bad night because of it. they need to either give the figures and let me find out waht is going on on my own or explain it a little more you know? it's been sent by the "locum staff grade in diabetes and endorinology" i think when i see the real man (Dr Kahn, really nice fella and lo carb advocate, so not afraid to go against the rules) i will be able to talk to him properly.

Thank you for your advice, i'm gonna take some notes and take it with me to work on monday so i know what to ask my nurse about.

i'm good, thank you. i'm sorry that i just paniced so much, just i remember the reaction i had to metformin and i honestly can't have that again. maybe building up my tolerence is the answer. i mean my body build up the resistance to the really high levels i was having and the large amount of ketones i had so there is no reason i can't do the same with metformin.


i Can and will do this. thank you. i am going to be amazing and lose loads of weight and cope so amazinly well on my insulin that if i don't see them till december they are going to be amazed and shocked at what i can do. i will suceed i will win.

bring it on!

 

[jopar]

manxangle

You can ask for a copy of all communication sent to your doctor from your consultant to be sent to you as well.... This can be helpful because when they've done any blood tests you get the results as well...


It might be that even though you are a T2, that your treatment is better suited to insulin rather than tablets or a complination of a long acting (background insulin) and support of tablets to over come resistence to insulin...

It isn't uncommon for T2's to be on insulin as over time oral medication can become less effective... But if you can't get an eariler appointment with the clinic why don't you book into see your GP, who might be able to go through your options with you?

 

[manxangel]

jsut a quick note to sy i've been onto the clinic and i am going up there this thursday afternoon.

Time to find out what is going on.

Thanks for you help"!

 

[chocoholic]

Hi manxangel,
I can really sympathise with you. Having being wrongly diagnosed twice by my surgery, I know how it can make you feel so angry. Like you, I felt finally sorted after 5 years and then, wham, let's mess you up and start from scratch again. But it IS important to know exactly where you stand, so hopefully, now you have that diagnosis, you'll get the correct treatment and advice. At least the folks on this site, whether Type 1 or Type 2, can offer support and be here when you need to let off steam!
All the best,
Chocoholic.

 

[veena148]

I am a newly diagnosed Type 2 Diabetic wanting more advice o

Please can someone advice me how I can control this condition with diet only.I am a vegetarian and would like some help in reducing my carbs and love yogurt.Please can someone help.I am due to have my 2nd bloodtest in a couple of weeks and would also like to reduce some weight.

Many Thanks,

 

[Dennis]

Hi Veena,
By control I presume that you mean control of your blood sugar level. As it is the carbohydrate that we eat that creates blood sugar, the only way you can have control over your levels is to control the carbs that you eat. There are a number of low carb diets and diet books written specifically for vegetarians, such as
The Vegetarian Low Carb Diet by Rose Elliot
Low Carb Vegetarian by Celia Brooks Brown
Carb-Conscious Vegetarian by Robin Robertson

If you look them up on Amazon they have all had very good reviews from their readers. If you are not sure about buying one why not order all three from your local library and compare them to find the one that you feel comfortable following.

 

[Dennis]

Hi again Veena,
Forgot to mention that this is a site you might find useful, both for low carb recipes and where to buy low-carb food items.

http://www.lowcarbmegastore.com/

 

[LittleSue]

Hi Maxangel

In addition to what others have said, I'd point out many type 2s will do anything to avoid going onto insulin, and for some using insulin has implications for their job. So the doctor who wrote to you probably assumes you'd rather avoid it. Suggest you make your preferences clear, for example say you'd rather be well controlled with good quality of life on insulin despite the apparent inconvenience than feeling rotten on tablets.

 

[DiabeticGeek]

@manxangel

i do want to be involved but they are the experts and know waht they are doing

Hmm... one would hope so, but although I don't mean to disrespect medics, sadly this isn't always the case. I have known a lot of medics in my time (I used to work in biomedical research, and although I don't have a medical degree myself I do have a PhD in this sort of thing), and I can assure you that medics are a pretty mixed bunch. There are good ones and bad ones; some have very up to date knowledge, some don't; some are motivated entirely for the benefit of their patients, some have all sorts of other vested interests. In short they are fallible humans, just like anyone else, and even the very best of them can make mistakes. It is tempting to assume that the experts always know what they are doing - and this is probably right far more often than it is wrong. However, they aren't always right. It is quite possible for well-read patients to know as much about a condition like diabetes as do many specialists (their motivation is certainly more pressing), and very many patients know as much about it as do GPs. In order to get the very best healthcare I think that it is important that you learn enough to be able to hold your own in an intelligent and informed conversation with a specialist. Remember to ask "why" and "what" a lot - why do they think you have T2? why are they recommending one particular approach to treatment? what other treatments are there? what do they think about other approaches to treatment that you have read about? So long as you are polite and well-informed most doctors won't object to this sort of conversation, and good ones will welcome it. Ultimately, if you disagree with something that they say then don't be afraid to ask for a second opinion - as you said, it is your body!

 

[DiabeticGeek]

@veena148

While you might have to be a little more careful about your diet than us carnivores, it is quite possible for a vegetarian to eat a healthy low-carb diet. You need to work out a few mainstay foods that are low in carbohydrate and acceptable to you. Assuming that you eat eggs and cheese, then they are a great source of protein. Mycoproteins such as Quorn are quite good and some (though not all) TVP and tofu products are lowish carb. If you add lots of green vegetables, nuts and seeds to this sort of diet then you should be able to eat pretty well on as low a carb diet as you want to go.

Life is more difficult for diabetic vegans. It is probably not possible for them to follow an ultra low carb diet, but it is still possible to manage T2 diabetes by diet alone. You might be interested in the How far can you reverse diabetes type 2 thread - which tells of how someone has achieved a very effective long term control of T2 diabetes on a vegan diet. If you are vegan then you will probably need to eat a lot of brown rice and pulses.

Lastly, don't forget vitamins and minerals - especially if you are vegan. Make sure that you are getting enough vitamin D, B12, calcium and iron, and if in doubt take multi-vitamin/mineral supplements.

 

[manxangel]

Diabetic Geek,

Thank you for the post, yes i have been planning what i am going to say to the Dr, you are right i mean i think i have realised that i know my body and what works, but they know the different treatments available and what tricks might work. I have a limited knowledge of the treatments. but i am learning more.

i have a list for him, think he will fall out with me!

1. Why type 2? what were my c-peptide readings, could this be honeymooning? What factor ruled out the other types of Diabetes?
2. i want a copy of my results
3. If i am put back on Metformin, how do i handle my Lantus, how should i reduce it? what do i do about it?
4. How long do i have to leave the Metformin or other medications they want me on to work before i have to start thinking about maybe changing my options? i do not what to give up my insulin just yet because it works. how do i balance it out?


and a million more

 

[Dennis]

Hi Manxangel,
One extra question I would suggest for your list is to ask what other meds would they want to switch you onto instead of insulin. Once you know which ones they are thinking about we can probably help you because there will inevitably be people on the forum who have experience of whatever they suggest.

 

[manxangel]

ooooooooo good one! yes thanks i will ask them that too!

i'm so reluctant to change what is obviously working, but i'll try it and see what happens. and if it doesn't work find out more.

Thanks for all your help, it is really appreciated.

 

[manxangel]

"we must apologise Mrs Faragher that letter should never have been sent to you. we do not know what type you are but we would like to try the tablets again just to see how you are doing"

so i'm not a type 2 but i might be.

sooooooooooooo annoyed

 

[DiabeticGeek]

You are obviously unusual enough to confuse a specialist. There are lots of rare variants of diabetes (for example, there are eight known types of MODY), and LADA must also be a possibility for you - all of which means that diagnosis can be very difficult. However, you should make certain that you get all of your test results - then you can compare them with published figures in the literature. You should also discuss them with your specialist and find out why he is confused.

If it is T2, then intensive insulin therapy can sometimes put it into remission - at least for a while. The theory is that the insulin-producing beta cells get a chance to "rest" and can, to some extent, recover. If that is the case, then it might be that now the diabetes is under control you no longer need the insulin. You need to talk to the specialist about this sort of thing and find out what his thinking is. It may also be that he wants to try metformin again as a diagnostic aid - if you responded to that, then that would immediately rule out some possibilities. Also, has he said that the tablets he wants to try you on are indeed metformin? There are various other drugs that he might be thinking of. In short you need to find out what he has in mind, what his thinking is and what information he is basing this upon.

If he does want to try metformin again, then there are a few things that you should discuss with him. First of all I would ask (very strongly) for one of the slow release formulations. They are often reported as having fewer side-effects, but they are a lot more expensive and so doctors are often reluctant to prescribe them. Given your history, though, you really should be able to justify getting them. Secondly, take it really slowly. People tend to tolerate metformin much better if you build up to an effective dose very slowly. From what I remember last time you quite quickly were put on a very high dose to try to get your BG down. Now, since it is already under control, there should be no need for that. You could start off with something like half a 500mg tablet per day, and go onto a whole tablet per day after a week and then maybe higher. Again, this is something to discuss. Also, if you do this then make sure that you have a bail-out option. If you come off the insulin then keep a supply in the house in case your BG goes up drastically, and if the metformin seems to be doing bad things to you the stop it quickly.

 

[manxangel]

Hi, yes i am back on metformin. i have to build my dose over the next 6 weeks to take 4 tabs a day. i'm only on one at the moment and yeah i have been feeling permanently sick since i started them but it does seem to be easier today for the first time.

i am still taking my lantus, but that is going to be reduced as the metformin goes up.

i do have my stock of insulin and i always carry it in case.

i have the SR metformin. so i'm just going to see what happens.

to be completly blunt, i'm terrified that when i drop my Lantus dose my levels are going to shoot up again, i can't go back to the way i was i really cant. i'm scared of what will happen, i'm going to try it though..

i have been looking into the different kinds of diabetes and i appear to fit the LADA description. i dont know what is confusing them so much. i'm waiting on a eyelet? test result. apparently that will help. my c pep is ok, bicarb is ok, even with the high levels of ketones i was experiencing, there was another on, erm GAD antibodies, she said that my body was attacking my pancreas but it looked as though it was only a recent development as my c pep was a little low but still ok.

oh it will work out, i have my escape route. i told the dr that if the tablets make me throw up again or if i cant hack the side effects i will be calling him and asking not to take them. he understands that. but he really wants to get me on them. the ******!

onwards and upwards"!