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Confused and worried by diagnosis

S

Sally_8873

Active Member
Messages
28
Hi Everyone,

I've been getting a bit worried recently that my diabetes management attempts aren't working...

I was diagnosed in Feb 19 with T2 with an HbA1c of 48, then 51 - no symptoms. I was a bit surprised as I eat quite well and exercise and am slim and only 36 although there is a lot of diabetes in my family and I am South Asian. I tested negative at the time for GAD antibodies.

Over the next few months I lost about 5kg to bring my weight down to 48kg, BMI < 21. I cut out carbs and snacking a lot - although would occasionally fall off the waggon - chocolate my real weakness. HBA1C in June was still 51, which I was disappointed by. My GP suggested Metformin but I am reluctant.

I bought a libre which shows a persistent fasting glucose of around 6 - 7.5mmol/L even when I haven't eaten for more than 12 hours. What I eat doesn't seem to make much difference! My blood sugar spikes but then tends to come down. Everything else is healthy - blood pressure, cholesterol, triglycerides, vit and min levels, liver enzymes. Most of the weight I've lost is from my abdomen which I thought would make a difference but hasn't.

The only other possible thing is my thyroid which I recently found out was underactive.

I really wanted to manage this with lifestyle changes rather than medication - I was aiming for Newcastle diet style reversal. But nothing seems to work.

Has anyone been in this situation or can anyone offer any advice?
 
Has the doctor also done a c-peptide test? Plenty of T1 and LADA show up negative on antibodies but still have failing insulin production.
 
Sally_8873 said:
Hi Everyone,

I've been getting a bit worried recently that my diabetes management attempts aren't working...

I was diagnosed in Feb 19 with T2 with an HbA1c of 48, then 51 - no symptoms. I was a bit surprised as I eat quite well and exercise and am slim and only 36 although there is a lot of diabetes in my family and I am South Asian. I tested negative at the time for GAD antibodies.

Over the next few months I lost about 5kg to bring my weight down to 48kg, BMI < 21. I cut out carbs and snacking a lot - although would occasionally fall off the waggon - chocolate my real weakness. HBA1C in June was still 51, which I was disappointed by. My GP suggested Metformin but I am reluctant.

I bought a libre which shows a persistent fasting glucose of around 6 - 7.5mmol/L even when I haven't eaten for more than 12 hours. What I eat doesn't seem to make much difference! My blood sugar spikes but then tends to come down. Everything else is healthy - blood pressure, cholesterol, triglycerides, vit and min levels, liver enzymes. Most of the weight I've lost is from my abdomen which I thought would make a difference but hasn't.

The only other possible thing is my thyroid which I recently found out was underactive.

I really wanted to manage this with lifestyle changes rather than medication - I was aiming for Newcastle diet style reversal. But nothing seems to work.

Has anyone been in this situation or can anyone offer any advice?
Click to expand...

The first thing I would ask myself, is which foods make me spike (you say you spike after eating but always come down again) and how long is it before you are back to an acceptable base level - ie the same as before you ate. How high are you spiking?
Sorry to ask these questions, but they are all relevant.
 
Hi. Don't rely too much on fasting blood tests as the overnight liver dump can influence them. Test 2 hours after a meal to see how you are doing. Yes, the GAD test when negative isn't conclusive (mine was) so ask for the c-peptide test if your BS keeps going up. Metformin is very safe drug but won't have much effect. If you are T1 sadly you will need meds beyond that.
 
Thanks everyone - helpful tips. I'm just wondering if there is anyone with a profile like mine who has found that weight loss was not effective? Or does it take time and I need to persist to see an effect? Or do I need to lose a bit more weight? Or could I be misdiagnosed?
 
Sally_8873 said:
Thanks everyone - helpful tips. I'm just wondering if there is anyone with a profile like mine who has found that weight loss was not effective? Or does it take time and I need to persist to see an effect? Or do I need to lose a bit more weight? Or could I be misdiagnosed?
Click to expand...
Hi again. In your original post you said you were slim? Can you give us some idea of your BMI?
 
Yes, 20.3 on Friday - 47kg. I am tiny - female dress size 6.

I was 52.5kg at diagnosis. I though the excess fat (mainly abdominal) might have been the reason because I used to be as above in my 20s and early 30s.
 
Sally_8873 said:
Yes, 20.3 on Friday - 47kg. I am tiny - female dress size 6.

I was 52.5kg at diagnosis. I though the excess fat (mainly abdominal) might have been the reason because I used to be as above in my 20s and early 30s.
Click to expand...
Abdominal fat is a symptom of diabetes, not a cause. And while losing that abdominal fat can impact your insulin sensitivity/resistance, it is not a cure for diabetes. I lost 25 kilo's and I'm still diabetic, technically. I have to eat low carb because practically all carbs turn to sugar once ingested, and will spike me. So @Rachox 's question is a good one. What do you eat? What does a typical day look like? If you still eat a lot of carbohydrates, complex ones or otherwise, those will impact your bloodsugars. As for the Newcastle diet, it is a diet that uses meal replacement shakes, and the shakes used, honestly, they contain more carbs than I eat in a day. It is a way to get weight down fast because you're skipping a lot of other macro nutrients, but I think if you're relatively petite already.... Possibly not your the best option. Besides, it takes a few weeks and then you'll have to switch to real food and low carb anyway, as it's not a for-life thing, and T2 is. Might as well skip the expensive meal replacements and just go for the real foods straight in.

https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ might also help you suss out where things are going wrong. Then there's this forum's website, diabetes.co.uk (NOT .org!!!) and dietdoctor.com.

Good luck, and welcome!
Jo
 
Sally_8873 said:
Hi Everyone,

I've been getting a bit worried recently that my diabetes management attempts aren't working...

I was diagnosed in Feb 19 with T2 with an HbA1c of 48, then 51 - no symptoms. I was a bit surprised as I eat quite well and exercise and am slim and only 36 although there is a lot of diabetes in my family and I am South Asian. I tested negative at the time for GAD antibodies.

Over the next few months I lost about 5kg to bring my weight down to 48kg, BMI < 21. I cut out carbs and snacking a lot - although would occasionally fall off the waggon - chocolate my real weakness. HBA1C in June was still 51, which I was disappointed by. My GP suggested Metformin but I am reluctant.

I bought a libre which shows a persistent fasting glucose of around 6 - 7.5mmol/L even when I haven't eaten for more than 12 hours. What I eat doesn't seem to make much difference! My blood sugar spikes but then tends to come down. Everything else is healthy - blood pressure, cholesterol, triglycerides, vit and min levels, liver enzymes. Most of the weight I've lost is from my abdomen which I thought would make a difference but hasn't.

The only other possible thing is my thyroid which I recently found out was underactive.

I really wanted to manage this with lifestyle changes rather than medication - I was aiming for Newcastle diet style reversal. But nothing seems to work.

Has anyone been in this situation or can anyone offer any advice?
Click to expand...
PS: Extra dark chocolate is still on the menu. ;)
 
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