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Confused!!

Jackie0022 said:
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
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Not crazy and I can understand the confusion on your part. In reality few of us type 2 get checked for which type we are. Assumptions are made and occasionally corrected later. So in a sense you’ve been lucky to get it confirmed one way or other at the beginning. Finding it all difficult to accept is also common, with or without the confusion. It passes in time so be kind to yourself. As for recommending metformin, that’s because it’s the first line (after diet) for most type 2 and others are only used of that isn’t producing the results desired or has side effects etc.
 
Jackie0022 said:
I have done some research and have an app with the dermatologist July 5th so will know more then. What has it done to your friends? Good or bad things? I have only heard bad thing from people who have used it for arthritis
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It has done "bad things" to my friends. It suppressed their immune systems, causing a lot of issues with infections, some serious. They were using it for arthritis, and were long time users of it.
 
Bluetit1802 said:
It has done "bad things" to my friends. It suppressed their immune systems, causing a lot of issues with infections, some serious. They were using it for arthritis, and were long time users of it.
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That’s what I’ve heard too, so sticking with the insulin gives me reassurance and comfort knowing that one of the diseases is under control. Is this wrong?
Then once I know how the methotrexate makes me feel, I’ll think about changing. But again this is something I need to speak to the GP about as unfortunately the dr hadn’t got any notes from dermatology. I know these are all questions I should have asked the diabetic doctor but I didn’t have them as questions when I saw him
 
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Jackie0022 said:
That’s what I’ve heard too, so sticking with the insulin gives me reassurance and comfort knowing that one of the diseases is under control. Is this wrong?
Then once I know how the methotrexate makes me feel, I’ll think about changing. But again this is something I need to speak to the GP about as unfortunately the dr hadn’t got any notes from dermatology. I know these are all questions I should have asked the diabetic doctor but I didn’t have them as questions when I saw him
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Whatever you decide, make sure it is your decision. Not ours. Not the doctors. We can only speak from experience. Doctors can only offer medications. :)
 
I’m not sure I’d see it as a one then the other scenario. Perhaps the dr and specialist can explain why you can only act on one at a time rather than address both issues.

Nor in your shoes right now would I see the insulin as “diabetes under control”. First aid applied more like whilst long term action to be decided.
 
HSSS said:
I’m not sure I’d see it as a one then the other scenario. Perhaps the dr and specialist can explain why you can only act on one at a time rather than address both issues.

Nor in your shoes right now would I see the insulin as “diabetes under control”. First aid applied more like whilst long term action to be decided.
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So although treated first with insulin to bring levels down quickly because of how high they were and the ketones, over time the insulin will make the diabetes worse quicker than the tablets and diet over time? Why haven’t the nurses or doctors told me this? I suppose this is another question for Wednesday visit!!

I know I’m harping on a bit but each one of you is shedding more light on things of questions that I feel should have already been answered! Thank you
 
Jackie0022 said:
So although treated first with insulin to bring levels down quickly because of how high they were and the ketones, over time the insulin will make the diabetes worse quicker than the tablets and diet over time? Why haven’t the nurses or doctors told me this? I suppose this is another question for Wednesday visit!!

I know I’m harping on a bit but each one of you is shedding more light on things of questions that I feel should have already been answered! Thank you
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Because some drs and nurses don’t know this, even those in diabetes care! They think type 2 is progressive and there’s nothing to be done other than take drugs. This is how it used to be seen. As progressive. This is outdated.

The nhs now support low carb eating as an effective strategy, either alone or with medications, to control and even put type 2 into remission. There are support courses they can prescribe such as those run by this website, there are training packages for gp’s written by gps (Dr Unwin) but they are all voluntary. There are research papers aplenty supporting it too. But again it all depends how current the medic in question chooses to keep their training on the subject.

They don’t know also how a blood glucose meter can be used effectively for type 2 not on insulin to identify safe foods. Or to meal and exercise plan and adjust to maintain good levels.
 
Jackie0022 said:
I think that’s half the problem, the DN said I was only producing some then the dr said I was insulin resistant and producing too much!! Which is it? That’s why I made an app with the GP so hopefully he can shed some light on it. I did ask the nurse after the app but she then said the same as the dr??
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Newly diagnosed T2D with insulin resistance will likely produce too much insulin 2-3x normal, but still not enough to handle the amount of carbs typically taken per meal. So if we do not adjust the amount of carbs taken per meal, we will simply need exercise, medication or more insulin to help move the excess glucose some where, eg burn it, pee it out of the system, store it as fats etc.

This is what researchers observed.... Glucose AND Insulin levels are higher than normal for up to 10 years after diagnosis.
gr2.jpg


Here is Dr Jospeh Krafts view on the issue...
Kraft-Curves-Cummins.png
 
Jackie0022 said:
That’s what I’ve heard too, so sticking with the insulin gives me reassurance and comfort knowing that one of the diseases is under control. Is this wrong?
Then once I know how the methotrexate makes me feel, I’ll think about changing. But again this is something I need to speak to the GP about as unfortunately the dr hadn’t got any notes from dermatology. I know these are all questions I should have asked the diabetic doctor but I didn’t have them as questions when I saw him
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Jackie - I have to say, Methotrexate wouldn't be my drug of choice, but then I'm not living with the underlying condition either, so I do understand the desire for some relief and improvement.

You might find this thread here to be an elightening read.

http://www.diabetes.co.uk/forum/threads/my-life-since-discovering-lchf.66929/
 
Jackie0022 said:
So although treated first with insulin to bring levels down quickly because of how high they were and the ketones, over time the insulin will make the diabetes worse quicker than the tablets and diet over time? Why haven’t the nurses or doctors told me this? I suppose this is another question for Wednesday visit!!
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I imagine you were treated first with insulin because your levels were very high at the time and they needed to act quickly. This is normal procedure and fine.

However, for someone with T2 that has insulin resistance (most of us have/did when diagnosed) insulin as an ongoing treatment is not always the best choice. Most T2s in this category already have too much circulating insulin. So much so that their bodies have become resistant to it so it can't do its job properly. A vicious circle then starts - the more circulating insulin we have the more insulin resistant we become, and the more resistant we become, the more insulin we secrete. (or inject). The more insulin resistant we are, the harder it becomes to keep T2 under control, and the more insulin we have circulating, the tendency is to gain weight.

It would make sense for doctors to do an insulin test on T2s before prescribing ongoing insulin or tablets such as Gliclazide that force the pancreas to produce more insulin. If the person is shown to have plenty of natural insulin, then why does that person need injected insulin or drugs such as Gliclazide? It just increases the large amount of insulin already being secreted and causes more resistance.

Of course, there are T2s that do not produce enough of their own insulin, and this situation is completely different.
Do you know if you had any tests to determine how much insulin you produce naturally? That is a question you could ask.
 
Ok so I spoke to the DN at the hospital and she has shed some light on things!! Yay!! I am producing some insulin and when the doctor said I was producing too much she seems to think he meant producing too much to be type 1. I asked if I could have the C-peptide test result which is 370! Does this mean anything to anyone?? I phoned the GP and he hasn’t had any referral letter from the hospital so as yet can’t advise on anything. Another question which I’m thinking in advance. Obviously I will have a review in 6 months or a years time who will that be with as I’m in insulin? GP or hospital??
 
I found this which seems the same scale as your result. Was yours taken fasted? Doesn’t show where a non diabetic would fall either so not sure what a “normal” c peptide would be

5CF84C16-ED3A-47EE-BABC-0306F30DB3D4.jpeg
 
HSSS said:
I found this which seems the same scale as your result. Was yours taken fasted? Doesn’t show where a non diabetic would fall either so not sure what a “normal” c peptide would be

View attachment 33728
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Not sure as I had some bloods fasting and more taken at hospital which weren’t so not sure if this test was from the first or the second batch!!
 
Bluetit1802 said:
It seems to make a difference whether it is fasting or random. Can you find out?
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I’ll ask when I next speak to them next. I also had a GAD65 test which came back negative (this was not a fasting as this was done separately)

I’m feeling more positive today as the GP agreed with me when I explained the reasons behind staying on the insulin. I feel I can now start looking forward to concentrate on starting the methotrexate! (Until tomorrow when I have another melt down!!!!).
 
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I have just found this, should I be worried? I have been prescribed metformin to work along side the insulin. Dermatology what me to change from cyclosporin to methotrexate. Does anyone out there know anything until I see the GP in the morning??
 
It looks like if you want any medication beyond diet change for your diabetes it is going to need to be considered in light of whichever psoriasis drugs you take. There are other options than metformin and insulin, they may be options.

Why not discuss with your gp trying the drastic carb dropping as a means of diabetes control for a trial period (whilst either stopping or closely monitoring/adjusting insulin) and then there’s no interactions with psoriasis drugs and maybe the diet will also help the psoriasis too.
 
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