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A few questions

fairylights

Well-Known Member
Messages
185
Type of diabetes
Type 1
Treatment type
Pump
Recently went for my first consultant check - had a list of questions which I asked but have now got more and it's 6 months until I go back!

Can I have both type 1.5 and type 2? They say I probably have LADA as I was diagnosed with BGL of 33 and ketones. They also did some tests and I have strong anti-GAD antibodies. But I also have a measurable C-peptide.
I would say I fit the profile for what they seem to say is type 2 - i.e. 50, overweight, (was) eating low fat, tired all the time.

After trying me with insulin when I was hypoing every day and having to eat masses of extra carbs, the DSN suggested I tried byetta & 2000mg of metformin. So I've been on this for a few months and so far so good. In the 3 months between my hospital appointments my HbA1c has gone from 12% to 6.8%. I have also lost over 3 stone. And I've acquired an underactive thyroid so I am also taking 100mg levothyroxine. I actually feel better than I have for years.

But I am concerned as I feel my BGL is creeping up it's now in the 6's & 7's whereas it was in the 4's & 5's. I HATED being on insulin and I would like to put that off as long as possible. At the moment I'm eating about 100g carbs a day - I'm not sure I can manage to motivate myself to eat less.
Is this the only thing that might help?
How low would I need to go?
How do you keep your motivation when you feel okay and it's only going to affect you in the future?

Also I don't have a breakdown of my cholesterol but the total is 5.4 it was 6.2 3 months ago. They don't break it down further not even on the my diabetes my way site so I don't know what this really means.
The Dr. wants me to go on a statin - why does everyone seem to be so against statins?
 
Can I have both type 1.5 and type 2?
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Simply put, yes, but I don't quite see why you suspect T2 (not every overweight person is T2 diabetic).

GAD antibodies means it's T1.5/T1 spectrum (i.e. absolute insulin deficit). Ketones on diagnosis are consistent with that*. High C-peptide means that you have left quite a bit of pancreas function left.
That's why the T2 drugs help - byetta causes the pancreas to make more insulin, so it will control T1.5 for a while, until you've lost too much of your insulin production. Metformin reduces endogenous glucose production (which 2-3x normal in T2 patients).
This could well be why your levels are creeping up now; reducing carbs may "work" for a while but it's just prolonging the inevitable.

On the positive side, I suppose, insulin should work better now as you'll need higher doses - how much did they start you on?

How low would I need to go?
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Eventually, your pancreas will stop producing insulin entirely. The result is DKA.

why does everyone seem to be so against statins?
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Arguably, denial. Or the same reason homoeopathy and similar quackery thrives:
 
Fairylights
The Dr. wants me to go on a statin - why does everyone seem to be so against statins?
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Not everyone is against statins. Most of use question the use of them, do the research, and make our own decision for our own health. It may be the amount of advice on here is about the problems with statins, so it seems like people are against them. But if you look at the signatures of many posters, quite a few take them.

Its something only you and your Doctor can decide on based on all the information available.

Ending up on insulin is not always inevitable if you are a type 2 . Read the stories of all those on here who have been diet only and controlled for decades. Ask as many questions as you like, and share your eating habits with us. I have found that people on here are very happy to share their experience and offer non-medical advice.

Good luck :wave:
 
fairylights said:
How do you keep your motivation when you feel okay and it's only going to affect you in the future?
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No one can be expected to be good all of the time but you should aim for the vast majority of time in my opinion . Next time you eat something bad for no good reason try this technique. Shut your eyes for at least two minutes. While they're shut constantly repeat to yourself "this is going to be all I will see for the rest of my life and it can happen at any moment unless I stop doing this."

As for statins my attitude is as T2 you have to balance risks to your health. First on my list comes BG's then weight, then blood pressure and finally cholesterol. Personally I would accept moderately raised cholesterol levels as long as the other 3 are fine. If you can take statins without suffering any ill effects they will lower your cholesterol levels. I took them for two and a half years without a problem but have recently stopped as my levels have normalised on my low carb diet The blanket prescription of them if your levels aren't that bad seems wrong. There is also debate about what the safe level is. A recent large Norwegian study has shown a total of around 5.5 seems to give the lowest incidence of deaths rather than the under 4 diabetics are told to get. The same study seemed to show that statins have very little effect on women. It is only one study and others show different results.
 


Insist on a fasting cholesterol check next time you have your bloods taken, the total figure is pretty pointless without knowing your HDL, LDL and Triglyceride levels; keep in mind that you do need to fast for 10-12 hours before having your blood taken but it's fine to drink plain water.

I wouldn't listen to what anybody says about statins and just do your own research and make your own mind up, the best people to speak with are your HCP's who are privy to your past and present medical history.
 

Okay - maybe I am still hopeful it might be type 2 - I expect because I hated taking insulin so much. They had me on humulin M3 a 30/70, I started on 10 units morning and evening, worked up to 20 then dropped back to 10 before coming off it. I hated having to eat when the insulin required me to - which seemed to be every hour - insead of when I wanted to. But the consultant did say they would put me on a basla/bolus next time so perhaps that would be easier to cope with.



Today was fairly typical, cup of coffee and 2 boiled eggs for breakfast, salad with hard boiled egg, pork chop and cheese with coffee for lunch, homemade chicken tikka with a table spoon of basmati rice fo tea, and an apple and a coffee. But then I tend to pick at stuff in the evenings, maybe a low carb cake from one of the recipes on here, coffee, sometimes a beer or glass of wine, nuts or cheese or a piece of toast. I guess the answer is there - I need to stop doing this!



What a good idea - think I will try this - I have a timer so i can set it for 2 minutes.

As for statins my attitude is as T2 you have to balance risks to your health. First on my list comes BG's then weight, then blood pressure and finally cholesterol.
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Think I have all of these so cholesterol is probably the least of my worries!


I did ask about a fasting test and she said there was no need. I guess I will have to try and read up on statins then before I go to my GP in a couple of weeks and maybe ask again. I do find it a bit confusing though.
 
I will speak to the GP about this when I go - it doesn't seem right that they want to put me on medication for something that they haven't even tested right!
 

OK, then. What are your 'denial' arguments ?

If they are as thin as your analogy with 'homeopathy and similar quackery' then they are rather thin.

The number of times I've read about symptoms that statin-takers experience, they take those concerns to their doctors who say the two can't be linked, the statin-takers stop their statins and the symptoms go away !
That's the equivalent of patient quackery, I guess.

I can hear others applauding your dismissive comment, but for those looking for smarter debate on this forum, your level of argument doesn't cut it.

Geoff
 
noblehead wrote
I wouldn't listen to what anybody says about statins and just do your own research and make your own mind up
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I couldn't agree more, but noblehead doesn't actually mean 'anybody' as he is about to show :

the best people to speak with are your HCP's who are privy to your past and present medical history.
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I totally disagree. I don't say keep these people out of the loop. Just don't consider them 'the best people.' And yes. obviously, your past and present medical history should impact on your decision.
HCPs, for my money's worth, aren't the best at keeping up-to-date with modern research, and are usually at the mercy of their (probably out-of-date) training.

When considering your health, simply ask yourself this question : do the nation's HCPs do a good job keeping the population largely free from a host of complaints we never used to suffer from at the level we do now

Research and self-education is the way

Geoff
 
Well said Geoff !

Especially this

" When considering your health, simply ask yourself this question : do the nation's HCPs do a good job keeping the population largely free from a host of complaints we never used to suffer from at the level we do now "

It is largely the herd mentality that gets people swallowing drugs along with HCP myths.

Roy
 
fairylights said:
I did ask about a fasting test and she said there was no need. I guess I will have to try and read up on statins then before I go to my GP in a couple of weeks and maybe ask again. I do find it a bit confusing though.
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There's every need to know your lipid breakdown fairylights, by rights you should have a full lipid breakdown once a year and I would mention this to your gp when you next see him/her.

What I do when ringing up to book an appointment for bloods is to tell the receptionist that it's for a 'fasting blood test', then when you attend tell them you want a full lipid breakdown of your cholesterol.

The British Heart Foundation is an excellent place to ask for advice on heart health and medication, if you ring them they can let you talk with a qualified Cardio Nurse who will discuss with you anything you need to know, here is their website:

http://www.bhf.org.uk/
 
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