Am I being treated right

[Fox1001]

Hi all,
I continually struggle to keep my bs low, so I phoned for an appointment with my nurse, she couldn't see me but phoned me, and put me on another med, so now I take 2, I asked about the c-peptide test, she said definitely no, she phoned me a couple of weeks later asking how I was getting on, I said it had come down, but not anywhere near the levels it should be, she suggested taking insulin, I said you wouldn't offer me the c-peptide test so you wouldn't know whether my body was producing enough insulin or how much, I'm confused, is offering insulin to a type 2 without any blood tests normal, was I wrong to ask for the test, plus the GAD test, I'm on low carb diet, which is helping, but medical professionals are confusing me. I know you all are a lot more knowledgeable than me, I think I have had bad advice from day one.
Thanks.

 

[asparagusp]

My antibody tests were carried out this July almost a year after meeting my nurse and starting Lantus ..... I really don't know the answer to your question. However speak with your GP or Consultant directly. If they still don't think it necessary, have one done privately if need be.

 

[Avocado Sevenfold]

Hi @Fox1001 I thought I read your numbers were moving in the right direction during your recent low carb holiday. Do you think maybe the nurse is being hasty and that you could give low carbing a longer trial before moving on to more meds?

 

[catapillar]

A cpeptide test is used to see if you are making any of your own insulin. Common sense suggests that it would probably be sensible to do a cpeptide test on a type 2 diabetic prior to commencing insulin. But then "clinical sense" might argue that whether or not a type two diabetic is producing any of their own insulin isn't necessarily the determining factor in whether they need insulin, because even if the are producing a decent amount of their own insulin it might not be enough due to insulin resistance. So the determining factor might be whether it is possible to achieve blood sugar control with other methods or not. I don't think you were wrong to ask for the test at all, it might be worth asking for it again - if you know you are producing insulin, that might let you exhaust the other methods first. Whereas, if you aren't producing any or much insulin then insulin would be the best option.

A GAD test is used to see if you have antibodies associated with type 1 diabetes. It's done when there is a query over type of diabetes. Things that might raise a query over type of diabetes in someone who has been diagnosed as type 2 would include young age on diagnosis, low BMI on diagnosis, sudden untried for weight loss, very high blood sugar (30+), dka. If any of those sound familiar, then a GAD test might be worthwhile. But they aren't ordered as standard and I would have thought it would be a pretty unusual test for a GP practice nurse to be ordering

 

[chalup]

I am a firm believer in testing to see how much insulin you are producing before adding more insulin to the mix. That would be a c-peptide test. If you are not making enough of your own then going on insulin may be the best choice. If you are already making huge amounts then giving the low carb diet more time might be better. Either way you will have the information you need to discuss it with your health care team intelligently instead of them just guessing.