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Am I type 2 or Type 1 diabetic

C

clearhead

Member
Messages
6
Type of diabetes
Type 2
I have been Type 2 diabetic since 2010 and on increasing dose of metformin until last year . Last December Forxiga (dapagliflozin) was added to 4 x 500 mg metformin, and although I have lost weight ( 65 kg ) my sugar level HbA1c has not changed at all and remains at 64 mm/mol ( 8%) . I am really disappointed as I thought my weight loss would reduce my insulin resistance. But apparently , I am not producing enough insulin rather than being resistant to insulin. Does that mean that my Type 2 diabetes has changed to type I ? Has anyone else experienced a similar thing
 
clearhead said:
I have been Type 2 diabetic since 2010 and on increasing dose of metformin until last year . Last December Forxiga (dapagliflozin) was added to 4 x 500 mg metformin, and although I have lost weight ( 65 kg ) my sugar level HbA1c has not changed at all and remains at 64 mm/mol ( 8%) . I am really disappointed as I thought my weight loss would reduce my insulin resistance. But apparently , I am not producing enough insulin rather than being resistant to insulin. Does that mean that my Type 2 diabetes has changed to type I ? Has anyone else experienced a similar thing
Click to expand...

The 2 types of diabetes have different causes and one cannot change into the other. However, the number of instances of mis-diagnosis is quite high due to the problems with providing accurate diagnosis.

You don't give your age, but younger people are statistically more prone to being T1 and the condition often develops quickly. T1 can develop at later stages in life (I was 54) and is sometimes referred to as LADA. In this situation, progression of the illness is often expected to be slower.

With T2, a person becomes resistant to insulin, the body tries to make more of the stuff to compensate and this eventually tires the pancreas out. If you cannot manage the condition by diet then injections may be required to supplement your body's insulin production.

There are tests that can be done to help pinpoint the 'type' but ultimately the treatment may end up the same as a T1 - insulin injections, although this is not a foregone conclusion.

You need to press your medical team for a more accurate diagnosis.

@daisy1 may be able to give you some more pointers, especially with diet. What types of food are you eating?

Good luck and welcome to the forums.
 
clearhead said:
I have been Type 2 diabetic since 2010 and on increasing dose of metformin until last year . Last December Forxiga (dapagliflozin) was added to 4 x 500 mg metformin, and although I have lost weight ( 65 kg ) my sugar level HbA1c has not changed at all and remains at 64 mm/mol ( 8%) . I am really disappointed as I thought my weight loss would reduce my insulin resistance. But apparently , I am not producing enough insulin rather than being resistant to insulin. Does that mean that my Type 2 diabetes has changed to type I ? Has anyone else experienced a similar thing
Click to expand...

@urbanracer has given you an excellent answer. May I ask if you have been relying on your medication alone to improve your blood sugar levels, or have you also been following a diet suitable for type 2 diabetics - reduced carbohydrate? Maybe if you can tell us what you typically eat we may be able to spot something. It isn't just sugar that needs reducing!
 
You may have both but I do understand because I'm a skinny person and I've lost weight because I was 10 stone 8 then it went yo 8 stone 3 but I'm quiet tall and my nurses and family were worried about me but also my HB1C was very low because not much insulin going in because insulin helps you gain weight
 
urbanracer said:
The 2 types of diabetes have different causes and one cannot change into the other. However, the number of instances of mis-diagnosis is quite high due to the problems with providing accurate diagnosis.

You don't give your age, but younger people are statistically more prone to being T1 and the condition often develops quickly. T1 can develop at later stages in life (I was 54) and is sometimes referred to as LADA. In this situation, progression of the illness is often expected to be slower.

With T2, a person becomes resistant to insulin, the body tries to make more of the stuff to compensate and this eventually tires the pancreas out. If you cannot manage the condition by diet then injections may be required to supplement your body's insulin production.

There are tests that can be done to help pinpoint the 'type' but ultimately the treatment may end up the same as a T1 - insulin injections, although this is not a foregone conclusion.

You need to press your medical team for a more accurate diagnosis.

@daisy1 may be able to give you some more pointers, especially with diet. What types of food are you eating?

Good luck and welcome to the forums.
Click to expand...

Thank you for your reply, I was 47 when diagnosed first as Type 2 diabetic and was 73 kg then. My weight has fluctuated between 67-70 kg until last year when I was put on Forxiga and I now weigh 65kg. I eat healthily and became a vegetarian last January. I do 2- 3 keep fit classes per week . My diabetic nurse has now put me on 100 mg Januvia instead of Forxiga, as it works by stimulating the pancrease to produce more insulin. I will see if this makes a difference to my glucose level.
 
I am not tall only 5 feet 3 inches in height and weigh 65 kg now. I think my diabetes was stress related rather than weight related as at the time I was diagnosed I had been in a stressful job for 4 years and it effected my health.. What puzzled me was that recently although I lost weight, my glucose level was unchanged .
 
clearhead said:
I am not tall only 5 feet 3 inches in height and weigh 65 kg now. I think my diabetes was stress related rather than weight related as at the time I was diagnosed I had been in a stressful job for 4 years and it effected my health.. What puzzled me was that recently although I lost weight, my glucose level was unchanged .
Click to expand...
That may be because whilst you are having a "low carb" diet it may not be low enough in carbs to bring your levels down. Do you know roughly how many cabs per day you have?
 
clearhead said:
I am not tall only 5 feet 3 inches in height and weigh 65 kg now. I think my diabetes was stress related rather than weight related as at the time I was diagnosed I had been in a stressful job for 4 years and it effected my health.. What puzzled me was that recently although I lost weight, my glucose level was unchanged .
Click to expand...

Hi Clearhead, can you give us a typical weeks food? It's not that we are particularly nosy (well we are) but it means we can spot anything that might unwittingly be causing the problem. If we can't spot anything then people might be able to come up with something else. x
 
bulkbiker said:
That may be because whilst you are having a "low carb" diet it may not be low enough in carbs to bring your levels down. Do you know roughly how many cabs per day you have?
Click to expand...

I have maximum 2 pieces of brown bread in a day. I don't eat rice, potato or pasta. But I do have fruits an apple or pear , avocado eggs, cheese , salad, vegetables etc. I think fruits may have more carbs than I think they do
 
clearhead said:
I think fruits may have more carbs than I think they do
Click to expand...

Fruit is a funny food, and not very advisable for us. It is full of fructose, and this particular type of sugar is dealt with by the liver. The liver regards it as toxic and turns it into fat that surrounds the liver. It is a bit like alcohol in some ways. What we do not need as T2 diabetics is a fatty liver as this contributes towards insulin resistance. The best fruits to eat are strawberries and raspberries, but not many at once.
 
Bluetit1802 said:
Fruit is a funny food, and not very advisable for us. It is full of fructose, and this particular type of sugar is dealt with by the liver. The liver regards it as toxic and turns it into fat that surrounds the liver. It is a bit like alcohol in some ways. What we do not need as T2 diabetics is a fatty liver as this contributes towards insulin resistance. The best fruits to eat are strawberries and raspberries, but not many at once.
Click to expand...

Thanks for this reminder, I will cut down on the fruit, and just concentrate on vegetables, nuts, dairy and fish. Low carb without meat is a bit more difficult but I really want to get my glucose levels down.
 
clearhead said:
Thanks for this reminder, I will cut down on the fruit, and just concentrate on vegetables, nuts, dairy and fish. Low carb without meat is a bit more difficult but I really want to get my glucose levels down.
Click to expand...
Lots of green veg, avocados, olives, nuts maybe would be my suggestions. Ditch the fruit and bread apart maybe from a few berries.
Do you eat vegetarian for moral reasons or because you think it's healthier? If not morally I would seriously consider re-introducing some meat to get more fats and protein into your food.
 
Consider.... Lose the brown bread.
Lose all bread, except almond/coconut flour low-carb low-GI breads (and the like).
You might get away with Ezekiel bread.
 
@clearhead

Hello Clearhead and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will be able to help.

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 235,000 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 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. Most of these are 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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