Type 2 Am I ready for Insulin??

[rob cannell]

I’ve been battling the health pros on and off for a few years. Diagnosed T2 - 4 or 5 years ago and suspect I’ve had it much longer. Also hypertension and hyper cholesterol. On big doses of Metformin and 2 other SU’s. Diet has been reasonable to good. Fitness ok, weight just slightly over target bmi but I’m broad and deep chested and built. Tea total and non smoker.
To prove a point I have been near zero carbs (just odd pulses etc) for a few weeks. Very modest portion of fruit and a bit of dairy. Tried fasting the other day, went into Ketosis, blood sugar still no lower than 8 .
Numbers always above 8, usually above 11. After a strict meal 13.
If I had a banana 17+
Bowl of porridge up to 15+ for a couple of hours.
I have NEVER had a hypo!
I’ve upped the fitness for past few weeks. Just got off the treadmill having done 5km in 30 minutes- first time I have ran for a couple of years…..but I can do it! Walked 8 miles yesterday.
Last doctor I saw told me to loose weight and up fitness and improve diet. He didn’t really listen.

 

[HSSS]

Welcome.

A few things here. One day of ketosis isn’t a magic bullet and if your bloods have been up in the teens regularly then 8 is an improvement. And the longer you cut out those carbs the more it’ll come down. Right now your liver expects to be high and will do what it can dumping glucose into your blood to maintain that. Part of what you need to do is retrain it to expect lower levels and stop throwing a tantrum. When you start fasting it’s quite common for this to happen too. But it’s a good thing then as it’s draining the glucose swamp in your liver.

What point were you trying to prove? What’s the dr not listening too? What was the Diet previously to the last few weeks?. I know you said reasonable to good but that very much depends on what your concept of good is. Pulses can be quite high as can some fruits So when you say low carb for a few weeks how confident are you that is really is low? A banana or oats are rocket fuel to quite a lot of us.
What is an Su? I’m assuming some sort of medication. Hypos are not caused by diabetes. They are caused by diabetes medication, most commonly insulin but also things like gliclazide. Unless you are on something that actively lowers glucose in your blood (which metformin doesn’t) your not really any more likely than any non diabetic or person not on hypoglycaemic medications to have a hypo (barring some rare conditions that are not diabetes).

Hypertension and hypercholestemia are common alongside type 2. They are all part of metabolic syndrome. As is a big belly (not the actual rib cage)

There is a chance that something else could be going on (LADA/slow onset adult type 1) which they tend not to test for unless there’s some pretty big red flags but I’m not sure we’re at that assumption yet. Nor do I think jumping onto insulin is the way i’d go right now either. More insulin circulating makes us more insulin resistant and the underlying problem get worse even whilst blood glucose is patched up for now and things look better for a while it doesn’t usually last.

if you’re on the website you should be able to see some stuff (my signature) in red below this message. These links have loads of really useful stuff to have a read of and come back and ask questions about. Lots of us have them and it’s worth looking at them. The app doesn’t show them I think so just in case they are here too.
Low carb info
Intro to T2 and low carb. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html
All the things I wish I’d been told earlier https://www.diabetes.co.uk/forum/th...ish-i’d-been-told-at-type-2-diagnosis.173817/

 

[rob cannell]

Thankyou. Some interesting stuff there. I’ve not given it my best for a few years and maybe I can stick with and tweak the current diet and see some better results in time.
I have 2 pounds to loose to achieve “normal” BMI range.
I’m trying to prove to a somewhat dismissive Gp that I am active and my diet is nowhere near as bad as he thinks. The advice I got was pretty ignorant.
There was however room for improvements.
Sorry SU is Sulfonyurea-Gliclazide, but I’ve not been on those for a while. Now taking both Canagliflozin and Alogliptin with a slow release Metformin.
I wasn’t too clear, I have been testing reactions to different foods. Not part of daily diet at the moment. I was advised by a nurse not long ago to snack on a banana, have whole grain cereal, brown bread etc…all of which I cannot eat without a massive spike. Shoddy advice which I think steamed from a belief I was living on junk food.

 

[HSSS]

Thankyou. Some interesting stuff there. I’ve not given it my best for a few years and maybe I can stick with and tweak the current diet and see some better results in time.
I have 2 pounds to loose to achieve “normal” BMI range.
I’m trying to prove to a somewhat dismissive Gp that I am active and my diet is nowhere near as bad as he thinks. The advice I got was pretty ignorant.
There was however room for improvements.
Sorry SU is Sulfonyurea-Gliclazide, but I’ve not been on those for a while. Now taking both Canagliflozin and Alogliptin with a slow release Metformin.
I wasn’t too clear, I have been testing reactions to different foods. Not part of daily diet at the moment. I was advised by a nurse not long ago to snack on a banana, have whole grain cereal, brown bread etc…all of which I cannot eat without a massive spike. Shoddy advice which I think steamed from a belief I was living on junk food.

It’s the standard shoddy advice that is nhs policy I’m afraid. Some more enlightened nurses/drs do much better. Please read the links as they give the advice those of us living with this finds actually works. Because as you’ve found the advice you had previously is best ignored. Eating the foods we can metabolise (proteins and fats) and not just store (carbs) will likely mean you lose a bit of weight weight unless you eat a lot of them. Proving to that dr you are active will achieve what other than satisfaction? Finding the solution “for you” is a better motivator usually.

So you're no longer on the meds with a hypo risk but are on a flozin (sglt2). The issue with those is that they don’t play nicely with very low carb or keto in some rare but real circumstances. They can raise the risk of a dka without the usual high blood glucose warning. Usually if you are serious about attacking this with diet (or at least trying this) the advice is to not have that class of medication. Discuss this with your dr etc. People have come off more medication than you in here. Why not give it a good shot before you’re any further down the medication route. It’ll either work brilliantly (likely), help a bit which is still better than nothing or show you really do need more help and in that case I’d be asking for tests to ensure I wasn’t a slow type 1 and to check just how much insulin I produce and if I have any antibodies

 

[6 toes]

Great advice being given also with regards to fitness have you tried to do weight training to build muscle with me that has reduced my sugars along with diet and losing body fat at same. Low carb with protein, fats and berries and veg is what I stick to

 

[PenguinMum]

Hi Rob take a look at DietDoctor website and the info graphics for different types of food (fruit, veg, meat, etc) and the carbs they contain. It is quite helpful.