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Advice for type 2 and insulin.

S

Scotland16_

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3
Hi there, I will apologise now for how long this will be but I could do with some advice for my mum. November 2015 my mother was unwell after suffering a fall at work and was told she was a type 2 diabetic (no symptoms for it apart from steady weight loss for 3 years) she was put on metformin 500mg once a day. Fast forward to 10th of January 2016 mum was very ill all day, she kept being sick with no signs of it stopping so when blood started appearing in her sick I phoned NHS out of hours, 4 hours later I was told to take her to the hospital out of hours bit, where she was then told she was a very sick lady and had of the scale ketones (had never heard of them before that) they took her in as a patient and had her on a Insulin sliding scale for 2 days, she was then taken of this for a further 2 days and then asked numerous times if she had been on insulin as due to the ketones etc she told them no and then was told that she must be a type 1 diabetic. The diabetes team weren't happy and said they should have been brought in straight away given the circumstances. 2 weeks after going into hospital my mum came home with a prescription for insulin etc with all health professionals involved so far believing she was type 1. She was told that she would have clinical appointments etc to help her cope, this didn't happen but me and her worked together researching what she could eat etc and how to deal with the hypos and hypers. Fast forward a couple of weeks a blood test was carried out to see if it definitely was type 1 but it came back as type 2 so they asked her to do a special pee test to see what the results of that were. For anyone who doesn't know she had to have a very high carb dinner and pudding and 2 hours later pee in a pot and it got sent away. The first one was lost and she had to do another, the results of this test confirmed her body was still producing insulin but the doctor that told her this also stated that even though she is still producing insulin she will continue to take insulin injections which was fine by me as I didn't want the risk of her ending up in hospital again! After this she has never seen any diabetic nurses or clinics etc. Fast forward to today she was attending as diabetic clinic with her friend who had a very similar experience to her a few weeks ago, the nurse seeing her friend said to mum you look familiar so mum told her her name and she asked how mum was getting on so mum said not well so the nurse said aye and you've gained weight! Which fair enough she has gained some so mum said yes she's struggling to loose it since being on insulin. The nurse then said why are you on insulin your a type 2! Mum then explained what the doctor said last year and now this nurse wants to take mum off the insulin and back onto metformin without consultation from a doctor as all diabetic doctors in our area are off for the next month!! Obviously Im extremely concerned she is going to end up back in hospital and I am wondering if anyone has any advice or similar experiences? Thanks and again sorry its so loooong!
 
But there are type 2s who need insulin - so you are quite right to be concerned - I'd be contacting the GP, the hospital, the diabetic team at the hospital - anyone and everyone who had any dealings with the original diagnosis.
I'd also be requesting the contact details for the nurse herself, with the warning that if your mother begins to feel ill that you'll be informing her straight away.
Yes, the original diagnosis of type 1 might not be correct, yes your mum might be type 2 - but needing some insulin but possibly needing more evaluation and help with that - does she take a fixed amount of insulin or does she calculate the amount from what she eats? It all seems to be very badly managed.
 
You mum would be hypoing all the time if she was on too much medication.
How much does she take?

Metformin works differently to insulin. I need both.
Because I have a lot of full fat cells I need a lot of insulin. As I am severely insulin resistant.

I think a good idea to get gp to have your mum referred back to a consultant for you and your mum to receive some idea of what's truely going on.
I hope it is explained better by a decent gp or someone similiar.
 
Resurgam said:
But there are type 2s who need insulin - so you are quite right to be concerned - I'd be contacting the GP, the hospital, the diabetic team at the hospital - anyone and everyone who had any dealings with the original diagnosis.
I'd also be requesting the contact details for the nurse herself, with the warning that if your mother begins to feel ill that you'll be informing her straight away.
Yes, the original diagnosis of type 1 might not be correct, yes your mum might be type 2 - but needing some insulin but possibly needing more evaluation and help with that - does she take a fixed amount of insulin or does she calculate the amount from what she eats? It all seems to be very badly managed.
Click to expand...
Hi thank you so much for replying! Upon researching type 2 and insulin recently I did come across an interesting page that listed 2 reasons why someone who is type 2 may require insulin. So when my mum was told that today I was very shocked, from what my mum told me it sounds like the nurse she was speaking to is set in the mind frame that type 2s are self inflicted by their weight and eating habits, the nurse also stated they dont deal with type 2s in the diabetic clinic and thats why my mum had been forgotten about which doesn't make sense.
She is on a fixed amount of insulin, 34 in the morning and 26 at dinner time (humalog mix). It's increased this year from last year as her blood sugars where starting to climb again and she was told by her gp to increase by incraments of 2 till they got a bit better.
When my mum came out of the clinic today I phoned the gps surgery to try and get her an appointment unfortunately though her gp is going on holiday for next 2 weeks and they won't be able to talk to my mum until the letter comes back from the diabetic clinic. I will however pass on your advice and hopefully we can get some answers. Thanks again
 
ickihun said:
You mum would be hypoing all the time if she was on too much medication.
How much does she take?

Metformin works differently to insulin. I need both.
Because I have a lot of full fat cells I need a lot of insulin. As I am severely insulin resistant.

I think a good idea to get gp to have your mum referred back to a consultant for you and your mum to receive some idea of what's truely going on.
I hope it is explained better by a decent gp or someone similiar.
Click to expand...
Thanks for replying. Insulin is 34 in the morning and 26 at night, slight increase from this time last year. She has had a few hypos when she hasn't eaten enough but shes had more high blood sugers than lows over the past few months, the past couple of weeks have been good blood sugars average 8-9 compared to 11+ before she increased insulin.
How did you find out you was severely insulin resistant?
Thanks again
 
Hi @Scotland16_ ,

Welcome to the forum.

I feel your mum needs to consult her GP (or another GP in his absence?)
If insulin is working for your mum then that's her prescription.. The weight loss may have been due to ketoacidosis (at a guess.)
The weight gain put back on due to healthier/lower BS.

Tagging in @daisy1 & @AM1874 with some fact sheets.

Also tagging in @Daibell he may help..
There are many other forms of diabetes other than just "1" & "2".

Wishing you & mum all the best!
 
Scotland16_ said:
Hi thank you so much for replying! Upon researching type 2 and insulin recently I did come across an interesting page that listed 2 reasons why someone who is type 2 may require insulin. So when my mum was told that today I was very shocked, from what my mum told me it sounds like the nurse she was speaking to is set in the mind frame that type 2s are self inflicted by their weight and eating habits, the nurse also stated they dont deal with type 2s in the diabetic clinic and thats why my mum had been forgotten about which doesn't make sense.
She is on a fixed amount of insulin, 34 in the morning and 26 at dinner time (humalog mix). It's increased this year from last year as her blood sugars where starting to climb again and she was told by her gp to increase by incraments of 2 till they got a bit better.
When my mum came out of the clinic today I phoned the gps surgery to try and get her an appointment unfortunately though her gp is going on holiday for next 2 weeks and they won't be able to talk to my mum until the letter comes back from the diabetic clinic. I will however pass on your advice and hopefully we can get some answers. Thanks again
Click to expand...

Hi. your poor wee mum has had a tough time of it. I hope it gets resolved very soon. I, myself am Type 2 an not on insulin (I manage my blood sugar without any other meds but through diet alone..which took time). My brother is also Type 2 but did for a time have to use insulin. It can be very confusing for family members, particularly if things are badly explained. If your mum's nurse does hint at some point that Type 2s cause their own diabetes through "lifestyle choices", you can ask about people lie myself and my brother. I have never been overweight in my life. My brother is a personal trainer, competed in Scottish strongman competitions and was a karate instructor for years. We both got type 2 diabetes from steroid treatment following kidney transplants that were necessary due to an inherited renal condition. We are certainly not alone in this. It is called Steroid Induced Diabetes. I wonder how perfectly slim and fit this nurse is and how many sticky buns he/she eats. I hope it all get sorted and your mum is a lot better very soon.
 
@Scotland16_

Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope this will help you to help your Mum. Ask as many questions as you want and someone will be able to help, in addition to the replies you have already received.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 245,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.
  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
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