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Borderline slim diabetic, no help from GP

Hi again. It's a bit typical of the NHS to delay treatment until it becomes vital. When I was slim and still losing weight despite low-carbing and full dose Gliclazide my diabetes specialist GP said I should be having a normal healthy diet and not starving myself! She refused to believe I could be T1. I had my GAD and C_Peptide tests done privately and the latter showed I was below normal on insulin. I was finally started on insulin. So, take full control yourself. I have never seen a diabetes consultant. Get your own tests done if needed. I have found the DNs in my surgery know far more about diabetes than the two diabetes specialist GPs who proved to be useless. Keep testing, suggest Gliclazide if needed and so on. Make sure you have online access to your full medical results so you can look at them and show them back to the GP/DN if needed to give them a history.
 
Hello dear Ambera 1,
I hope you are well.

Firstly, the problem with doctors is that they crunch the numbers like accountants do.

For example, if your overall 3-month HbA1c is at a good or acceptable level, then they rarely care if you hit 12mmol on a carbohydrate spike or crush to 3mmol on a hypoglycemic episode. It is in rare occasions that they check that the numbers are balanced and in equilibrium.

Even more so, in your case, when you haven’t been accepted in the hospital in a diabetic coma (like most of us have). In relation to someone who has been hospitalised with a blood sugar incident of 22+, your 12mmol spike is a walk in the park… I don’t wish to discourage you and I understand your concern but, chances are your case isn’t their priority… It is sad, but it happens.

Secondly, as a type 1 diabetic for the past 7 years, I cannot emphacise enough that the Keto-diet works for some people but not for everyone. It, certainly, has never worked for me. I belong to the kind of diabetics that EVERYTHING turns into sugar; protein, fat, carbohydrates. Meat, fish, eggs, Greek yogurt, cheese, they all raise my blood sugar. Particulalry dairy (cheese and yogurt) are as bad as chocolate, they raise my blood sugar and the fat content keeps my sugar high and I have to inject several corrections to normalise my levels. Therefore, Keto works for some but not for everyone.

Thirdly, to manage your blood sugar without any medication (including metformin) you have to “play” with your food and your exercise.

Use the glycemic load index, choose food groups that don’t spike your sugar, have a very low glycemic load and break down into sugar very slowly. For example, nuts are an excellent source of healthy fats, they are calorie bombs (most diabetics avoid them because we have to be mindful of our weight) and they break down into sugar very slowly.

As an example, for breakfast, don’t have oats or all bran with milk; Have Alpro unsweetened yogurt and nuts and seeds with a tbs of canderel (for some sweetness) or eat dark rye bread instead of white bread.

Try to create meal combinations that don’t spike.

Let me know if you need more options – happy to offer suggestions. Btw, these will work for cases like yours, not for type-1 diabetics like myself. The low glycemic foods are a bolus surfing for me – and I prefer to avoid 2-3 injections to balance a low glycemic meal.

Fourthly, test in the morning, your fasting glucose. This has to be 5.5-7.7.
2 hours after breakfast, test again. You should be no more than 8.0
Test before lunch/dinner, you have to be 4.5 – 7.7
Similarly 2 hours after lunch you have to be no more than 8.0
Pre-bed you need to be 6.5 – 8.0
Again when you wake up in the morning, 5.5-7.7

Check at what times during the day you have an elevated sugar. Come back to inform us so we can feedback you.
If your sugar spikes 2 hours after meals, then after your meal go for a brisk walk to burn the sugar down.

Furthermore, the more you stress about it, the more you bring your sugars up. Calm down, relax, you will get it under control..

Remember that epinephrine, cortisol, and growth hormones help maintain blood sugar levels. They, along with glucagon, are called “stress” or “gluco-counter-regulatory” hormones – which means they make blood sugar rise.

Also, don’t be afraid of metformin. If you can avoid it, do it.
But, if you have elevated fasting sugar in the morning, chances are you will have to take it.
However, Metformin kept me on a prolonged honeymoon for 2 years. I only have good words about it…
Doctors prescribe metformin even for gestational diabetes so, don’t be afraid of it.
There are type 1 diabetics who take metformin to help them regulate their weight. Metformin also helps with osteoporosis, arthritis and can help promote ovulation among nonobese women with PCOS. Trust me, amongst the medications we have to take, Metformin is like ***** bears (minus the sugar).

Finally, don’t be frustrated. Chances are, the community here will give you good guidance.
Calm down, take care of yourself, stay safe and be optimistic and happy. You will handle this.
 
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Hi Ambera, I'm getting the impression that since your first hb1ac you have been low carbing? The problem with going low carb immediately is that it can interfere with the ongoing diagnosis. You go low carb, your numbers reduce perhaps to a level that pops you just beneath diabetes. They check your hb1ac a few months later and it's showing lower than before, however who knows what it would be showing had you not immediately gone low carb? I see this all the time, people rush to change their normal eating in a panic (and I fully understand why) but then they appear as if they are normal for a short while. For some, their levels eventually keep rising despite low carbing because they were not type 2 in the first place but type 1. I do hope this doesn't apply to you but please keep on at them. As others have said, maybe test after a higher carb meal and see what your results are. I was diagnosed 'pre diabetic' 3 years ago with a reading of around 48 I think...carried on for 3 years and wham, turns out I was actually a slow onset type 1 and ended up rushed to hospital with DKA. x
 
Not sure why you brought meter if blood test shows your ok any symptoms you have could be related to other problems not diabetis unlike me who could ha r been diabetic for years it wasn't until I
 
Hi if doctor say blood test ok why buy testing meter your just scaring yourself your symptoms could be related to other things. I was told I could have been diabetic for years without knowing and was only diagnosed because I had thrush that would,t clear up diagnosed 3.5 years and was oblivious to my diabetis for years as I didn't have clear symptoms that needed investigating , so I never even thought about the fact that I could be diabetic, stop worrying you really do not want all the things you have to do that are associated with diabetes enjoy your life i was diagnosed with a ha1bc of 64 and have managed to get in down to 48 which is really good and maintaining with medication and two types of insulin , there are times i long to be as healthy as you and not have to deal with this but my fate may have been written in the stars as mine could be related to me having infectious hepatitis as a five year old, something I never knew anything about until I was diagnosed
 
ambera1 said:
I already eat low carb and as explained in my post I am not overweight so this does not apply to me. To put in context, I am 7 and a half stone and 5 ft 5 in height.
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hello Ambera1, am similar height and weight to you, and also used to have IBS. to maintain weight I need to eat fats and protein. Low Carb, not keto, has been effective in lowering BG levels. It helps me to eat a good breakfast, get a decent amount of calories in early, and although the idea is not to count calories, until you know how to get sufficient its a good idea to check daily consumption.
When I tried this found that some days calories were less than 800. Unsurprisingly was losing a lot of weight.
Do you know what triggers your IBS?
 

Hey yes I’m in the UK. I’m also baffled that the consultant has only offered a glucose tolerance test for ‘academic reasons’ but eventually the GP decided against it as the treatment, according to them, would be Metformin either way.

I’m a healthy weight again now (8 stone, 5 ft 5) as I’ve reintroduced carbs again. However I dropped down to 7 stone when I was following a strict high fat, low carb diet. I’ve also been exercising much less since lockdown, my exercise will naturally pick up again once I am back in the office during the week.

Like you, my concern is that this could be MODY or LADA rather than T2 and it looks as though I’m going to have to be on deaths door in years to come before they take this seriously.

I’ve had another HBA1c test carried out on Friday so when I get the results for that, if it hasn’t gone down at all, I will speak about the T1 tests. Although the GP is keen to go down the hormonal route and put me on Metformin.

Nightmare!
 

The foods that tend to trigger my IBS are veggies and legumes. Veggies have been considerably increased since I’ve been following a lower carb life style. I.e bowl of cauliflower with my meals instead of rice for example.

My fat intake has always been high. I’ve never counted calories. I 100% eat well over the 2000 calorie amount every day. This is how I keep my weight up!
 

Please be insistent and don't take no for an answer. Read the NICE guidelines as well. None of us can diagnose you of course but you are 28 yrs old and very slim. If your results are still higher than they should be then hopefully they will do the proper tests, I know that anyone can be a type 2 regardless of how they present but my own Consultant did those extra tests for me based solely on my physical appearance (slim) and I was 56 never mind 28. It's a good job they did as well as it proved I was type 1, my Dr on the other hand said 'type 2 because of your age'. WRONG. x
 
ambera1 said:
Like you, my concern is that this could be MODY or LADA rather than T2 and it looks as though I’m going to have to be on deaths door in years to come before they take this seriously.
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The good news is that if lack of insulin is the problem you'll know about it because you will get symptoms.and your blood sugar will rise. At this point any competent doctor should be all over the possibility of T1 (in the very old days, before something (sugar?) caused the massive uptake of T1, the assumption was always T1 under 30, T2 over, so even an incompetent doctor should at least be considering T1.)

Good luck again.
 
Buzzer81 said:
Intermittent fasting may also help. I’ve set a window to eat in between 12-8 per day. Early days but this has seen a reduction in blood sugars across the board. Now my figures are often in the 4s, nothing previously had achieved such results.
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Ah I’ve just had my latest hba1c come back, 47 again! After intermittent fasting for the last 6 months and drastic dietary changes.

But because it still falls within the borderline levels, the DR isn’t interested.
 
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