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Discussion in 'Ask A Question' started by Jackie0022, Jun 12, 2019.
At your appointment ask for a c-peptide test. That should show how much insulin you make.
Thanks. Would that not have been done at the hospital before?
You certainly need some clarity.
Keep testing if you aren’t taking the insulin especially after dinner tonight as it was fairly high before eating and I’m concerned that if you ate a carby meal it will have gone even higher. If this is going to work without insulin you have got to avoid the carbs, whether it’s a friends house or not. Eating the carbs without the insulin or any other medication will send them back up, possibly into dangerous waters if the ketones go back up too.
If it’s all too much, then take the insulin for the next few days and ask your doctor for a plan to reduce it more slowly and possibly consider some tablets. In the mean time do some study about low carbs and preparation so you can stick to it. It can be a process rather than an all at once thing.
@Diakat, I think the c peptide may well have been done and type 2 clarified already, hence the consultant referring back to the gp and requesting metformin rather than insulin moving forward. It seems some of the conversations with nurses in the intervening times have been contradictory leading to the op’s confusion unsurprisingly.
Jackie clearly needs to talk to her doc and go from there.
I’m not able to open these links.
No idea what was in the sausages (high meat content yes or no), but you could always ditch the bread. People and restaurants would rather you decline bread than having to throw it out. So in case you go to a restaurant (or friends), just request bread or potatoes to be left out, and replaced with more veggies, salad or meat. Restaurants are very accomodating, and if you let your friends know beforehand it'll make their shopping a little easier.
McDonalds, Five Guys, Burger King and places like that will gladly serve you a bunless burger for instance. They won't bat an eye at the request. The restaurant around the corner knows me by now and the kitchen always makes me an amazing little side salad with no extra charge. I tip the heck out of that place. It's a bit of an adjustment, and my family and friends now kind of know what I can and can't eat, but sometimes they'll asl just to be sure... I'm fine not eating birthday cake and fasting through a party, but I do appreciate it if there's cheese and/or walnuts or something. Not because I crave anything, but because people tend to feel guilty if they can't offer you anything, haha.
But do yourself a favour and don't mess about with your insulin and such before you talk to your doctor AND have a good grasp of what a T2-friendly diet entails, exactly. Don't risk your health.
One question I have is
If I ask the GP to run through all the blood result etc that I had done so I can be clearer in my head as to whether I’m producing enough insulin or not enough so insulin resistance will he be able to tell me, will he know what they all mean??
Also if I’m producing too much so resistance, how does injecting more insulin work? I don’t understand? Or am I just being thick and stupid??
No you most certainly aren't being either thick or stupid.
You've been given insulin because your blood sugar is high.. they are trying to get them down so in the short term insulin will help. You are right though if you are T2 with high insulin resistance then more insulin long term won't help.
Putting in lots of carbs won't help either as yesterdays "experiment" has shown.
By cutting carbs to an absolute minimum you'll do you body a favour by allowing it to deal with the high blood sugar on its own but it will take weeks maybe months to "normalise". That's assuming your T2 diagnosis is correct.
That’s another thing. When I went to hospital they actually told me that because I wasn’t over weight (9st 10), I lost 1.5 stone, and because of all the other symptoms I had they were testing for type 1, even the DN’s said that in there opinion they felt it was type 1. They gave me all the info on type 1, the results came back but I had to have more done which they came back at type 2. They phoned me to tell me but gave me no other info. I asked the nurse if I was producing insulin and she said “you are producing some but not enough”. So how 6 weeks later is the dr saying I’m producing too much?? Sorry to rant. These are all questions I have listed for the GP but will he know the answers?
Well if he has the test results in front of him he might.. whether he's savvy enough to understand them is another question.
It would be very worth your while getting a print of all the results you have from the tests they have run so you can do some research yourself.
And in the meantime if you are still experiencing high blood sugar levels then reducing the carbs you are eating won't do any harm.. but please remember to keep testing as the last thing you want is to go too low (sub 4 mmol/l)
If you have the tests and printout and still walk away confused there’s enough in here that have had the tests that they may be able to explain it in different ways that make it clearer to you.
Odd that the links in post #45 don’t work for you, they seem fine. @DCUKMod can you see if there’s a problem with links please
Thanks. I’ll ask for a print out and hope he lets me have one. I’m guessing the diabetic nurse at the surgery won’t know as much as the hospital DNS
A few words on insulin production, and adequacy.
There is a standard range for insulin production by a healthy individual (read that as fully working pancreas and no Insulin Resistance).
If your insulin production is tested, for example using a C-peptide test, then the medical team have a value for how much insulin you are producing.
"Virtually none" suggests a T1 diabetic where the pancreas has failed.
Normal or high suggests a T2 diabetic.
"Not enough" is in fact glaringly obvious (but can be confusing). If you have high blood sugar levels then you are not producing enough insulin to keep your blood sugar levels under control.
However there can be at least three reasons for "not producing enough".
[Please note that this is simplified, and aimed at initial diagnosis.]
Your pancreas is failing/has failed and you are T1
Your pancreas is producing normal amounts of insulin but you are Insulin Resistant
You pancreas is producing huge amounts of insulin but you are very, very Insulin Resistant
In all three cases, if your BG is really out of control you may be prescribed insulin because, as you say, you are not producing enough to get your BG back down to normal. High BG levels are not good.
OK - the indications are that you have been tested and found not to be T1, although your BG control was so bad (and your ketones were up) that you were initially diagnosed as T1.
So we can guess that you are producing insulin but are Insulin Resistant.
In the longer term you may be able to stop taking insulin if you reduce your insulin resistance enough that your own insulin is able to control your BG levels. Plenty of people on the site have achieved this.
The first step is usually to cut out virtually all carbohydrates because these are the main source of blood sugar in most people.
The second step it to work on the IR. One of the things Metformin does is help reduce IR.
As others have said, we do not give medical advice.
However you have been diagnosed in a fairly drastic way - high BG and ketones at 4 or higher - which makes you at a lot more short term risk than may others (such as myself) who were diagnosed through high BG and weight loss but weren't in the range which presented as typically T1.
If I were you I would listen to your medical team and take the insulin as prescribed, and work on identifying lifestyle changes which may help you come off the insulin in the medium term.
I think you may be falling into the trap of many newly diagnosed and trying to "fix it now!" when you might be better advised to take it slowly and gently and spend time reading and learning about the condition before tinkering with the treatment.
Above all, Don't Panic and take things gently, a little bit at a time.
Thank you. This has made it clearer, I still need to ask the GP what my results actually mean and take it fro there. Which category do I fit into etc? The result I told the hospital that I wanted to stay on the insulin is that in my eyes it has worked to bring my levels down and stabilise them so I know it has worked. So therefore now they are under control I can concentrate on changing the meds for my psoriasis? Does this make sense?? But now I’m thinking should I have changed over to the metformin and spent a bit longer on sorting out the diabetes and whether other medication would work? I suppose I can go back to that when my skin is under control again maybe 6 months down the line? I think because I’ve had so many people telling me different things that’s what I’m so confused about which I’m hoping by being reffed back to the GP I can listen to just one person but start out from the very beginning by asking him what the results mean. If I don’t get anywhere then I’ll phone the DNS regardless of how she made me feel last week??
You might find help with both at the same time...
If your pancreas is working and not failing (as in type 1, but sometimes long term uncontrolled or later type 2) then insulin would ideally be only a short term measure to get immediate control at diagnosis whilst diet is addressed and other medications discussed and put in place if required. If you are insulin resistant in the long term insulin will quite possibly make the problem bigger and progressive.
If you address your diet (carbs!) to control the diabetes it may well have beneficial effects on your psoriasis too. That way you’ll have a stable and possibly improved platform to later sort out psoriasis treatment and maybe even less need.
Changing psoriasis stuff first then changing diabetes stuff could then easily need for a change to change the psoriasis stuff yet again.
I have had guttae psoriasis episodes a couple of times now. It was very unpleasant and I was very self conscious so I get the urge to control this but with such high diabetic levels I personally think that would be my priority not the psoriasis for right now.
A problem with what, please?
That seems to be it. I don’t know how much my pancreas is working, I don’t know if I’m not producing enough or I’m producing too much and insulin resistant. I guess once that question is answered (hopefully from the GP on Wednesday) I’ll be able to accept it better. It’s the not knowing and being told different things that I’m struggling with. Am I crazy in wanting to know or should I just accept that I type 2 diabetic and ask no more??
Thanks. I have had psoriasis since I was 9 yrs old,I’m now 47, so have tried many many different treatments for it and the cyclosporin has been the only thing that’s worked, I have been on this for 10 years, now they have to swap this for methotrexate. The doctor told me that he wanted to change to metformin but didn’t go through any other treatment plan options which is why I feel a bit isolated and don’t know what’s happening