A probable type 2 diagnosis, and totally unhelpful GP

First thing,Tulip,cut down on any carbohydrate you are eating to very small portions.You need to get that blood sugar (BS) under control fast.If you can get hold of a blood testing meter start testing your BS every morning and before and 2 hours after a meal to see which foods are putting your levels up this high.Collins Gem do a very good pocket Carb counter which will give you a good idea about how much carbs are in certain foods.Doing this you will probably lose more weight but once you get the BS under control then we can help you regain the weight lost.Hope this helps.

Hi tulip87,
Sorry to hear of your rough baptism! In your doctor's defence, it sounds as if he probably doesn't have a great deal of knowledge about diabetes. That's where we come in.
The glucose tolerance test is the standard masure of diabetes, but one look at your blood sugars tells us you are diabetic. Ask your doc for a c-peptide test to properly establish whether you are type 1 (insulin deficient) or type 2 (insulin resistant).
In the meantime there is much you can do to help yourself. Cut the empty calories, the sugars and starches, from your diet as far as you can. It's these carbohdrates that are driving your blood sugar upwards and there is no necessity for them at all. Avoid as far as possible bread, pasta, potatoes, rice and flour and you will see an immediate improvement in your bs readings.

All the best,

fergus

I worry so much about people who are (casually?) diagnosed as Type 2's when they could be Type 1's.

Tulip, you can suddenly get very ill indeed if you're an undiagnosed Type 1, and I mean intensive care in a matter of hours once things really 'flip'. So please do as Sarah says and check for ketones - if you have more than a trace go to A + E, this qualifies as a medical emergency. You can buy Ketostix without a 'script at pharmacies. Equally if you start feeling worse: vomit, have stomach pains, headache, in addition to being very thirsty, weeing loads, tiredness etc, don't hesitate, get help!
Sue

i totally agree as when diagnosed i was told id have a gtt test in two wks after id first been to lloyds for test,i got feeling iller n iller bought my own monitor and i was 26mmol i phoned drs(first time theyd spoke to me ) and was told to go to a & e,within minutes i was admitted with bg of 34mmol and 4 plus ketones so definately dont hang around waiting if u feel so bad
good luck

Totsy, what you are desribing sounds like DKA diabetic -ketoacidisis, which is a life threatening condition. It's very rare in T2 diabetes, although it can happen. It needs treatment fast, probably in an ICU

With a bmi of under 15 I imagine your doctor was at a loss of what else to suggest ... you do need to take this very seriously as you are most likely T1 (ie, you need insulin injestions to get your body to work to metabolise ANY food) ... if your medical care team fail to treat you adequately (ie, they don't listen to your concerns; it happens) then admit yourself to hopital and MAKE yourself a pain until you are properly advised by somebody with in depth knowlegde of the condition. Don't put it off. If you go into casualty and present them with your symptoms AND emergency care worker will have to refer you far more quickly to preoper care - good luck and be well xoxox

fergus said:

Sorry to hear of your rough baptism! In your doctor's defence, it sounds as if he probably doesn't have a great deal of knowledge about diabetes.

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This is true. All that many GPs know about diabetes is what is in standard medical textbooks - and that is generally both minimal and out of date, even in some modern books. This is understandable, but still very bad. A good doctor will know his limitations and not be afraid to admit ignorance. He probably is at a loss as to what to do, but rather than palming you of with (potentially dangerous) vague advice, he should have referred you to a specialist. You really need to either get another GP or else DEMAND (as a matter of urgency) to see a specialist. It is vital that you find out what sort of diabetes you have (and there are more than just the common two types - it is quite a complex group of conditions). This is important because although there are some similarities, the progression and treatment is completely different in the different types.

As others have said, the immediate danger is that if you have T1 you could get DKA. The onset of this can be extremely rapid and life-threatening, so make sure that you know the symptoms (typically abdominal pain, vomiting, dry mouth and skin, extreme thirst, an increased heart rate and shortness of breath). If you have even the slightest suspicion that you are coming down with this then don't mess about waiting to see your GP. Go straight to the nearest hospital. Call an ambulance if necessary.

Assuming that you don't suddenly deteriorate, then you should start making changes to your diet and exercise more - whether you turn out to be T1, T2 or something more unusual this will help you. Have a look around the past threads on this forum for more detailed advice - you might like to start by reading the Newly diagnosed and so confused thread. Then, give your doctor grief until you get to see a specialist - or at least another GP who knows what he or she is talking about.

tulip87 said:

Meanwhile I'm feeling steadily more ill, and today's check of my BM (I work in a hospital) was 13.4 which is surely not good. Is waiting 2 weeks with a BM like that sensible? I'm just not sure if I'm being paranoid, or if my GP is rubbish. I feel pretty upset at having been diagnosed, and feel as if I've just been abandoned and made to feel awkward for complaining that I haven't been given any information and want tests quicker.

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I've been told that the average doctor gets about ten minutes on diabetes (all types) out of a four year course. If that happened many years ago, obviously they will be clueless about all the modern research.

I agree with the others, and since you work in a hospital I'd be twisting arms and calling in favours to get a GAD and c-peptide test ASAP, also a full lipid panel. It's possible you have a fast acting form of Type 2 but so far it's sounding a lot more like LADA.

How are you getting on Tulip?

It does sound a lot more like insulin dependent diabetes rather than type two.

If you still feel hellish there would be some sense in going straight to A and E.

Just to make life more confusing, there are other metabolic errors, which aren't truly diabetes, but have similar properties, these include reactive hypglycaemia, which causes low BGs, often a sudden drop soon after eating.
You say your Bgs are averaging 8. Whatever the cause, this is too high.
You should be able to get it down by severe cutting back of carbohydrate intake. It's simple. If it contains a significant proportion of carbohydrate, say more than 1 -2 % Don't eat it.
Essentially, if you follow the Atkins diet Induction phase for a week or so, you should feel a lot better. This will work even for T1, but obviously not as well as proper treatment with insulin.
I suggest Atkins, because it will work for you and the book is easy to get hold of. Don't worry about the high fats. They won't hurt you.
Although you could report to an A&E department, it would be better if you walked in of your own choice, rather than be stretchered in as an emergency.
Good luck and I hope they sort you out soon
Hana

hanadr said:

Just to make life more confusing, there are other metabolic errors, which aren't truly diabetes, but have similar properties, these include reactive hypglycaemia, which causes low BGs, often a sudden drop soon after eating.

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Raises hand. Yes it can be a stage on the progression, first you produce no Phase 1 insulin immediately after eating so your BG jumps up. Your pancreas can still produce plenty of Phase 2 when it gets its act in gear, so you can drop precipitously an hour or two after eating.

http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

best protocol for doing some intensive testing, with RH you will need to test out for 3 - 4 hours after eating, see what sort of curve your BG follows.

It's also plausible there's something else going on elsewhere in the endocrine system. If in doubt (and the local doctors sound like post-operative brain donors) go to Casualty. At least try to get a second opinion.

Hi, I have a doctor who is a diabetic himself and he knows NOTHING about diabetes. Some of the things he has told and asked me to do would scare you to death.

Take care

Hazey

hazey276 said:

Hi, I have a doctor who is a diabetic himself and he knows NOTHING about diabetes. Some of the things he has told and asked me to do would scare you to death.

Take care

Hazey

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Well at least he won't be around long enough to damage too many patients <sad grin>

I don't have the knowledge to advise you on what passes for "dangerously high" but what I would ask you is:

1. what did you eat within the previous two hours?

2. what did you eat within the previous 24 hours?

3. have you taken any medications?

4. do you feel unwell or exhibit any symtoms of other illness such as a cough or flu?

answering those questions may well give the really smart people on this forum a chance to help you.

sorry I can't offer anything more useful though

all the best, JEm xox

hi tulip87

my bg is coming down slowly but i started at 21.6, now averaging about 12 over a day but i do notice that certain things shoot the results really high

eg last weekend had nachos out for lunch but left most of the tortilla bits and ate the toppings, had been seeing bs in 13 range and within 3 hours it was over 17

i have found by self testing that i am now able to tell if i have eaten something i should not or if the bs is dropping. last night had sausages and veg for tea (no carbs) this morning back to 14.4 whereas it has been around 12

i know to many these figures are still way too high (and for me) but in about 6/7 weeks i have reduced my bs by about half and in normal no carb eating i am starting to see drops to 10, i am aiming for below 10 in the next few days which will chuff me no end!

we are all different and for me the best bit has been the self testing so i can work out for myself what is happening and why. i am really working hard on the no visible carbs but beware those lurking in sausages :lol:

all the best jacqui

Hopefully somebody with a lot more knowledge will soon rush to your aide ... and give you some relevant advice on who to talk to and how to best deal with your situation - or at least take charge and make some informed choices.

I'm type 2 and been diagnosed for little under 2 months. I've gone from a blood sugar of 14 post eating ro now no more than 8 at the most, and this through reducing my carb intake. Now I wouldn't want to be seen as being pushy or anything, but reducing your carb intake (it terms of cutting potatoes, rice, bread and pasta to a more limited amount) is a viable option for somebody like me. The added benefit of this is that I've now lost a stone in 7 weeks

Some examples of MY experimenets:

I ate two slices of oat based (lowest carb for "normal" bread) toast for breakfast (with peanut butter) and my pp bg level was 12.something *eeek*

Eating one very small and very green banana has NO detrimental effect on my BG

Eating one very small yellow banana had my pp BG at about 10

I had one small (2") new potato with an otherwise low-carb dinner and my PP BG was over 10

Eating a nice easy diet of slightly more protein and much less carb I reduce my BG to no more than 8, although it has to be pointed out that I'm vegetarian so my dietary choices may differ from many others.

However, you will need to work with your HPCs to correctly diagnose your situation, I just want you to know that the meals you described, although they may be "reduced" carbs compared to what you were formerly consuming may not be considered "low carb" --- for instance, if you look at some figures available online or in some cheap and easily available carb counting books you can find that actually houmous isn't as low carb - even though it is good for you - the chick peas are quite carby. This doesn't mean that you have to stop eating houmous if you want to go low-carb - it means thinking about your other food choices - such as, remove the bread and apple from the equation, ensure your banana is barely ripe instead of over sweet ... replace the bread either with crackers or fill up on cruditees ... there are many options IF you want to follow that course

I'll stop blabbering on - and suggest you wait for advice from one of the longer term members of the forum regarding your questions

All the best Jem xox