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Confused Newbie

P

Paul_S_M

Member
Messages
5
Type of diabetes
Type 1
Treatment type
Insulin
Hi everyone.
I visited the doctor last week as I was drinking an awful lot and had the blurred vision etc. Had my blood sugar measured at 18.2. The doctor managed to arrange for me to visit the diabetes clinic at the local hospital straight away so off I went expecting a simple chat with a specialist and not much else. I had my blood measured again at the clinic and it had risen to 22. Within the space of an hour I'd been given injector pens, 2 types of insulin and my own blood sugar meter! It all happened so fast that I am still struggling to believe it.
I've been on the insulin for 5 days now and I've already had 2 occasions where my blood has measured below 4 (2.8 and 3.6) but it's averaged out at about 10. I still haven't had the full proper blood test but the medical people seemed to have decided that I'm definitely type 1. I'm 30 years old and I am not overweight.
What I am struggling to accept is that I haven't been given the opportunity to control the condition without medication before the insulin was merrily handed out (I.e by diet and exercise).
I typically eat healthily and exercise regularly although for the past few months, I haven't exercised due to work and I've eaten loads of chocolates and biscuits over the Christmas period. My symptoms only started after a heavy night out at the beginning of December (work Xmas party).
Does this 'assumption' that I am type 1 (and immediate treatment with insulin) seem right?
As with anyone who has recently been diagnosed, I'm experiencing every emotion at the moment.

Thanks for taking the time to read this.
 
hi, welcome, hmmmm, it depends why they think your type 1? they must have a reason, i was 25 ith keytones in my wee but was diagnosed type 2 or not really but they guessed at that because i was overweight and 43, are you over weight? do you know what tests they did? if you are type 1 i think you definatly need insulin, but if not.... i dunno, this is not my area of expertease, not that i have one lol, im only answering because its late and you may not get an answer till the morning, but my advice for now would be to take your insulin until your sure one way or another or a type one person comes along with something useful good luck!
 
Thanks for the reply. I am taking the insulin because I wouldn't want any conditions to get worse just because I was being stubborn. I am not overweight and to be honest, up until around 8 weeks ago I considered myself to be quite fit. I was into weight training and mountain biking.
I'm just so confused at the moment and I know of several people who have reported initial blood sugar levels way in excess if mine yet they have been diagnosed as type 2.
If my diagnosis was on the back of several tests or after a failed diet-exercise trial period I would accept it.
As it isn't, in still in the land of denial and anger!
 
its understandable mate, its all very overwhelming at first but there are many extremely knowledgeable folks here that can help you out, and its not as bad as it looks right now, theres no reason for this to stop you enjoying a full and happy life whichever type you are, it just means you wwill need to make some adjustments, it sucks dont get me wrong but once you get your head around things, it will all seem ok, dont panic mate, take a breath, try to relax and have a read of some posts on this forum, it should help, lots of people have been where you are now, it may help to see your not alone
 
Early days yet and as andy said if type 1, insulin is definately needed. when you get levels sorted you can then adjust both your insulins to suit your excercise, diet routine. Your basal insulin will act as a background one and keeps your level stable when not eating, and overnight. This one is usually lantus or levemir. Your qa is the one you have at meals and will cause more sudden drops/rise in levels if wrong. I would suspect they.have put you on set doses at meal times. Keep on touch with your readings/doses and they will slowly guide you through adjustments.


Sent from the Diabetes Forum App
 
Paul, if you've been told you're T1, you can't control with diet and exercise
Unfortunately. Your body doesn't produce insulin ( if in Honeymoon Phase you may produce some ) so you need to inject. It is a shock but as Andy says, a little knowledge and education and it's controllable. Trust me, it's not the end of the world. Learn as much as you can. Good luck !
Mo


Sent from the Diabetes Forum App
 
Hi Paul.
I was just wondering if they had told you that you are T1, or not. Some people on insulin are T2, they may have put you on insulin to bring you down and stabilize you. I think you need to make some inquiries and try to get some answers.

You are definitely doing the right thing by taking the meds, and by investigating things, Keep us informed, and keep asking us questions, like Andy says, we will do our best to help, even though most of us dont know a lot ;)
 
Thanks very much guys. I really appreciate the support. I know you have all been there so you probably know exactly how I'm feeling right now. I've got my first clinic on Wednesday so will see what happens then. In the mean time I'll check out the rest of the content on this forum as it all looks really useful.

Thanks again.
 
Paul_S_M said:
What I am struggling to accept is that I haven't been given the opportunity to control the condition without medication before the insulin was merrily handed out (I.e by diet and exercise).
Click to expand...

I am not a T1 so I am not in a position to offer advice from experience but I have been reading a couple of offerings from T1's where they low carb to reduce the amount of insulin required. In the case of one of them she said that her son only uses a minimum amount of insulin now and if he makes a mistake then the error is that much smaller.

This sounds like the more advanced stuff but you can't do much harm if you drink less, do some exercise and don't eat junk food.
 
Hi Paul and welcome to the forum...

A few things sprang to mind when I read your post, firstly 80% of those diagnosed with T2 are overweight so simple maths will tell you that 20% of all T2's are not overweight so being a slim T2 is not as unusual as the media stereotyping would have everyone believe.

Diabetes does not necessarily afflict the unfit either, another misnomer I'm afraid, there are plenty of diabetics of all types that were quite fit and engaged in regular exercise and or sports prior to diagnosis, Sir Steve Redgrave springs to mind as a famous T2 diabetic who used insulin to help control his diabetes while he fought his way to what was it, 8 Gold Medals?. So not all diabetics are the "fat lazy porkers" that the national press would have everyone believe us to be. Yes a large percentage of T2's were overweight at diagnosis and some of those may have been overweight for some time but others will have put on weight because of their inability to utilise insulin properly, insulin is the growth hormone after all so it should come as no surprise that a surfeit of it will tent to cause weight gain.

T1 diabetes is a condition where the pancreas has been attacked and the insulin producing beta cells effectively killed off so they can no longer produce insulin.
T2 is caused by insulin resistance. Insulin is the key that unlocks the door to allow the glucose in the blood to enter the bodies cells. Insulin resistance stops this so glucose builds up in the blood which in turn tells the pancreas to produce more and more insulin, this can lead to premature wearing out of the beta cells and even permanent damage to occur meaning that some T2's will have the double whammy of insulin resistance and a lack of enough insulin being produced.

Insulin resistance is caused by visceral fat which accumulates around the organs, this internal fat can not be seen nor drastically affect a persons BMI meaning that you dont need to be overweight to develop T2 diabetes.

Many T2 diabetics who run very high blood sugars are treated with multiple daily injections (mdi) of insulin, I was myself but managed to wean myself off insulin after about 12 months, of cause if you are a T1 diabetic you will have to continue to use insulin for life as you will no longer be producing your own.

Type 1 diabetes is usually diagnosed by a combination of high blood glucose (bg) and the presence of ketones in the urine and often when weight loss is experienced prior to diagnosis as it is the burning of fat that causes ketones in the urine, this can be confirmed by a C-Peptite test which determines how much insulin is being produced by the pancreas as insulin and C-Peptide are produced at the same time.

To confuse things further often after MDI treatment is started it can give the pancreas a temporary boost but this generally only lasts for a few months to around a year in T1's and is known as the "honeymoon period". All this can and does lead to a certain blurring of lines were diagnosis is concerned, some will be diagnosed as T2's when they are in fact T1 or even T1.5 MODY or other sub types. All types of diabetes will lead to diabetic complications if left uncontrolled so the better control we have over our bg levels the better our chances of living a long and healthy life and many diabetics do indeed live long and healthy lives :)

Every newly diagnosed diabetic will have felt exactly as you do after being given the "good news" feelings of anger, confusion, self pity and total and utter bewilderment are far from uncommon and most of us have gone through the range of emotions you are currently experiencing, you will start relax and come to terms with this but it will take a little time and the best thing that you can do right now is to learn all you can about your condition as knowledge is power, no one knows much about diabetes until they are diagnosed. Sadly even doctors and nurses often dont know as much about diabetes as they could simply telling diagnosed patients to go home and eat a healthy diet which of course means different things to different people and is largely useless as advice for a diabetic.

The Good news
You have been lucky in one respect as you have been referred to a specialist diabetes team just as I was, and you will get much better care from them than you could ever hope to get from your GP's surgery as their knowledge is far far better than any general practitioner could ever hope to know,

Hopefully it will not take you long to get to grips with your new lifestyle and you will start to relax and realise that there us still life after diabetes :)
 
Sid Bonkers said:
Hi Paul and welcome to the forum...

A few things sprang to mind when I read your post, firstly 80% of those diagnosed with T2 are overweight so simple maths will tell you that 20% of all T2's are not overweight so being a slim T2 is not as unusual as the media stereotyping would have everyone believe.

Diabetes does not necessarily afflict the unfit either, another misnomer I'm afraid, there are plenty of diabetics of all types that were quite fit and engaged in regular exercise and or sports prior to diagnosis, Sir Steve Redgrave springs to mind as a famous T2 diabetic who used insulin to help control his diabetes while he fought his way to what was it, 8 Gold Medals?. So not all diabetics are the "fat lazy porkers" that the national press would have everyone believe us to be. Yes a large percentage of T2's were overweight at diagnosis and some of those may have been overweight for some time but others will have put on weight because of their inability to utilise insulin properly, insulin is the growth hormone after all so it should come as no surprise that a surfeit of it will tent to cause weight gain.

T1 diabetes is a condition where the pancreas has been attacked and the insulin producing beta cells effectively killed off so they can no longer produce insulin.
T2 is caused by insulin resistance. Insulin is the key that unlocks the door to allow the glucose in the blood to enter the bodies cells. Insulin resistance stops this so glucose builds up in the blood which in turn tells the pancreas to produce more and more insulin, this can lead to premature wearing out of the beta cells and even permanent damage to occur meaning that some T2's will have the double whammy of insulin resistance and a lack of enough insulin being produced.

Insulin resistance is caused by visceral fat which accumulates around the organs, this internal fat can not be seen nor drastically affect a persons BMI meaning that you dont need to be overweight to develop T2 diabetes.

Many T2 diabetics who run very high blood sugars are treated with multiple daily injections (mdi) of insulin, I was myself but managed to wean myself off insulin after about 12 months, of cause if you are a T1 diabetic you will have to continue to use insulin for life as you will no longer be producing your own.

Type 1 diabetes is usually diagnosed by a combination of high blood glucose (bg) and the presence of ketones in the urine and often when weight loss is experienced prior to diagnosis as it is the burning of fat that causes ketones in the urine, this can be confirmed by a C-Peptite test which determines how much insulin is being produced by the pancreas as insulin and C-Peptide are produced at the same time.

To confuse things further often after MDI treatment is started it can give the pancreas a temporary boost but this generally only lasts for a few months to around a year in T1's and is known as the "honeymoon period". All this can and does lead to a certain blurring of lines were diagnosis is concerned, some will be diagnosed as T2's when they are in fact T1 or even T1.5 MODY or other sub types. All types of diabetes will lead to diabetic complications if left uncontrolled so the better control we have over our bg levels the better our chances of living a long and healthy life and many diabetics do indeed live long and healthy lives :)

Every newly diagnosed diabetic will have felt exactly as you do after being given the "good news" feelings of anger, confusion, self pity and total and utter bewilderment are far from uncommon and most of us have gone through the range of emotions you are currently experiencing, you will start relax and come to terms with this but it will take a little time and the best thing that you can do right now is to learn all you can about your condition as knowledge is power, no one knows much about diabetes until they are diagnosed. Sadly even doctors and nurses often dont know as much about diabetes as they could simply telling diagnosed patients to go home and eat a healthy diet which of course means different things to different people and is largely useless as advice for a diabetic.

The Good news
You have been lucky in one respect as you have been referred to a specialist diabetes team just as I was, and you will get much better care from them than you could ever hope to get from your GP's surgery as their knowledge is far far better than any general practitioner could ever hope to know,

Hopefully it will not take you long to get to grips with your new lifestyle and you will start to relax and realise that there us still life after diabetes :)
Click to expand...



Perfect!
 
Hi Paul,

I was taken to hospital a couple of months ago just like you. My BS was 31.7 and I was originally told by the hospital that I was T2. two days later at the diabetic clinic I was reassessed and told I was T1. If I'm honest on hearing that news I cried, right there and then in the hospital. I was horrified.

The good news is, a couple of months on, I feel better than I can ever remember. I've lost almost 2 stone in weight. My life hasn't been affected anywhere near as much as I feared it would and if anything the whole thing has had a positive effect. I'm conscious of my diet now, I've made subtle changes in lots of areas but it's all for the better. I'm sure you will too. In many ways, I suppose T1 is easier to control than T2 (this is only my opinion). I'm lucky to have a great team at my local clinic, speak to them as much as you can. Learn to carb count ( much easier than you'd imagine) and most of all don't get despondent. Correctly controlled you can avoid complications and live as normal a life as you did before.

Good luck
Steve
 
Hi0 Paul - I think probably because you are only 30 and of normal weight, they weren't going to take any chances especially as your blood sugars were continuing rise. The last thing you would want would be to risk dka which is very dangerous. Now you have time to stabilise and get things checked properly, ie autoimmune antibody tests etc. I was diagnosed t2 in October with blood sugar level of 33 and am of normal weight and active - the next doctor I saw thinks I am a slowly evolving type 1 so at the moment I just keep taking the tablets, upped my exercise and eat healthy carbs ( still thinking about low carbing, but haven't made my mind up yet). It is a big shock to the system, but while they make up their minds as to which type I am I have found this site to be a wealth of good information and am learning more each day. Good Luck to you as you come to terms with your condition.
 
Hi. I think your team were right to conclude that you are likely to be a Late onset T1 (LADA) as you are young and not overweight. They should be doing a GAD antibody test as well as the C-peptide. The former is a conclusive test for the most common islet cell anti-body and the c-peptide shows your natural insulin output. It may be possible for you to come off insulin at least for a while. If T1 is indicated then you would probably stay on insulin. If they think it's T2 (unlikely?) then you would be given tablets. The key indicator for T1 rather than T2 is not being overweight at diagnosis. Although, as Sid Bonkers says, visceral fat can be a hidden cause of T2, if you are not overweight and have had a reasonable diet then the level of hidden visceral fat should be quite low implying that a failing pancreas is the likely cause. Note that a GAD test doesn't pickup all forms of pancreatic destruction, but the most common ones.
 
Hi guys. First of all a massive thank you for all of the responses. I am overwhelmed that so many of you have taken the time to reply.
I am continuing with the insulin and to be honest, the biggest problem I've had over the weekend has been my blood sugar level dropping too low. I am on 6 units of of novo rapid before each meal and 6 units of levemir before bed but I've had 3 instances over the past 2 days where my blood sugar has measured below 4.
I'm really paranoid about what I eat at the moment because I don't want to have anything which will send my blood sugar level up. As such I'm tending to avoid food so I'm hungry a lot and hence I'm worried about losing weight. What's also strange is that before starting on the insulin, I wasn't lacking energy. Since I've been on the insulin however, I do feel quite drained and a little hollow.
I can't deny that some things are undoubtedly better even after only 6 days on the insulin. I no longer have any excessive thirst and my blurred vision has disappeared. Barring that however, I would have said that I generally felt better in myself before starting the treatment. All questions for the clinic I suppose.

Many thanks again for everyone's responses.
 
Forgot to mention, had around 6 tests for ketones and never so much as had a trace. Interesting about the visceral fat. I will be certainly asking that question at the clinic!
 
Good news, the drained feeling may be a direct response from the insulin lowering your levels from the highs you would of had pre~ insulin. Your body will adjust over time. As to the hunger feeling, usually a symptom blood sugars are dropping (for me) indicating too much insulin was administered at previous meal or basal too high. Either way, check your levels and if under 5, and its only 2~3 hours after you last had your insulin with your meal have a small carby snack to last till next meal. It is known as "feeding the insulin" but something you would need to do to prevent the lows between meals.
If you are under 4, have a few sips of a fast acting sugary drink such as lucozade, followed by a small carby snack, this erik get you out of hypo land very quickly.
If you do drive, always above 5 prior, and notify dvla and insurance if you have not already. Always have some fast acting on you when out and about.
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Hi Paul,

Get back to the clinic and ask about carb counting. The only reason that you are having lows is that you insulin dosage is too high for the carbs you are consuming in the meal that follows. As you are newly diagnosed then it's somewhat of a guessing game really initially but it will calm down. There's a free online course about carb counting at Bournemouth Uni. If you do a Google search for it you'll find it. You can do the entire course in a couple of hours and it'll give you a greater understanding of what's happening with you. In the short term don't worry too much about your sugars being slightly raised. Try to ensure that you're going to bed with over 7 at the minute until you've got a grip of things. Get some glucose tablets or some lucozade sport. If you do dip below 4 then either of these will bring you back up quickly, either 3 or 4 glucose tablets or half a small bottle of lucozade.

I and many others on this forum have been where you are now, rest assured it all becomes clear and much easier quite quickly.

Best Wishes
Steve
 
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