Diagnosed but for some reason drs are being evasive to which type

Trudeewillz

Member
Messages
7
Type of diabetes
Type 2
Hi I have just been diagnosed last week as diabetic but the diabetic Dr and nurse are being really evasive as to which type!?? My hba1c was 103 and even though I'm on metformin and alogliptin my blood sugars wont come down the lower itit's een at all since a week last Friday was 10! i got cancer 4.5 years ago so My diet is healthy as I eat clean 95% of the time, we even grow our own veg organically and don't eat hardly any processed foods and i'm not a person that eats a lot of sweets n chocolate if any as cancer thrives on sugar. The only thing I can and have changed his my carbs ( root veg ) but this has not made any difference to my b.s.... my b.s before i went to sleep last night was 11.8 and that was hours after I'd eaten my tea and I woke this morning and my fasting b.s. were 13.4!!!?? My average b.s atm is around 17.....going up to 23.9. I am however disabled and was bed ridden for almost 2 years but for the last few months I've been the best that I've been in many years and I'm even managing to go on a walk with my relator walking frame ( so not fast walking! ) and hubby for half an hour every other day most of the time! That's 100% more exercise than I've had in the last 5 years! I'm not slim but not very obese either ( size 14/16 ) and have dropped a stone in weight in the last month. I'm doing everything right and not even medication is working and i don't understand it!!!?? the doctor said that it's not my diet or anything I've done to cause it and i could not have prevented it.... it just is. So what does that mean!? I am struggling to come to terms with this tbh and the fact that I can't lower it. in would greatly appreciate your input in this. Thanks in advance!
 

Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
I hope your doctors are doing the standard blood tests to rule in/out a diagnosis of Type 1 - namely GAD antibodies and c-peptide to assess how much insulin your body is producing?
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Hi and welcome,

Are you having some more tests? If the doctors are unsure which type you are they ought to be arranging for you to have a C-Peptide test and a GAD test. These will show if you are Type 1 and whether you need additional medication.

Clearly your numbers are too high, but maybe you haven't given your medication time to work properly. Certainly Metformin will have little effect. It helps in some ways, but does very little to lower BS levels. It is mainly an appetite suppressant, although it can help reduce the amount of glucose your liver produces naturally. Even at the maximum dose, it will take a few weeks to accumulate in your body. I can't speak for Alogliptin as I have no real knowledge of this.

You mention root veg, but what about grains and rice? Flour and anything made with or containing flour will raise BS levels.

I'll tag @daisy1 as she will post some very useful information for newcomers. I suggest you read it carefully and follow the links in the post. Meanwhile, do have a good read round the forums, and anything you don't understand, please ask.
 
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Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hi and welcome!

I would ask for a referral to the nearest diabetes specialist, and I would press for a couple of tests - the GAD test and the c-peptide test. Both of those will allow a better diagnosis and help to determine which type of D you have.

Most general practitioners rarely see any new diagnoses other than type 2, so you may need to keep pressing, because the assumption is often that all adult onset D is type 2 - and it isn't.

Meanwhile, believe me, you have come to the right place! Have a good read around, and you will find masses of information to help you. Ask anything you like. :)
 
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Trudeewillz

Member
Messages
7
Type of diabetes
Type 2
Hi and welcome,

Are you having some more tests? If the doctors are unsure which type you are they ought to be arranging for you to have a C-Peptide test and a GAD test. These will show if you are Type 1 and whether you need additional medication.

Clearly your numbers are too high, but maybe you haven't given your medication time to work properly. Certainly Metformin will have little effect. It helps in some ways, but does very little to lower BS levels. It is mainly an appetite suppressant, although it can help reduce the amount of glucose your liver produces naturally. Even at the maximum dose, it will take a few weeks to accumulate in your body. I can't speak for Alogliptin as I have no real knowledge of this.

You mention root veg, but what about grains and rice? Flour and anything made with or containing flour will raise BS levels.

I'll tag @daisy1 as she will post some very useful information for newcomers. I suggest you read it carefully and follow the links in the post. Meanwhile, do have a good read round the forums, and anything you don't understand, please ask.
Hi and thanks. I don't have grains or flour they'd been cut out of my diet years ago. Occasionally I may have basmati rice and some bread but it's fairly rare! The only thing that was left for me to work on was my root veg.... that's my staple diet mostly
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. Yes, do pressure for GAD and c-peptide tests as it looks like you could be LADA (Late onset T1). Loss of weight and not being obese are indicators. GPs can be reluctant to do these tests or aren't even aware of them. I had to have mine done privately. I assume you aren't on steroids or similar which can raise blood sugar a lot. It's possible you may need to go onto insulin eventually which is no big deal but works. Discuss adding Gliclazide to your meds with the GP. This is commonly prescribed for those with a failing pancreas to help produce more insulin for a while.
 

Trudeewillz

Member
Messages
7
Type of diabetes
Type 2
The doctor did say that within 5 years i will be on insulin probably sooner rather than later.I'm seeing them on Wednesday anti will ask for the tests. and no i'm not on any steroids. Thank you!
 
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Trudeewillz

Member
Messages
7
Type of diabetes
Type 2
Hi and welcome!

I would ask for a referral to the nearest diabetes specialist, and I would press for a couple of tests - the GAD test and the c-peptide test. Both of those will allow a better diagnosis and help to determine which type of D you have.

Most general practitioners rarely see any new diagnoses other than type 2, so you may need to keep pressing, because the assumption is often that all adult onset D is type 2 - and it isn't.

Meanwhile, believe me, you have come to the right place! Have a good read around, and you will find masses of information to help you. Ask anything you like. :)
Thank you! I will definitely press! Do i have a right to insist by any chance?
 
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daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
@Trudeewillz

Hello and welcome to the forum :) Here is the basic information we give to new members and I hope a lot of it will be useful to you. It includes advice on carbs and levels and a link to the Low Carb Program which you could try. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
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Trudeewillz

Member
Messages
7
Type of diabetes
Type 2
You can ALWAYS ask for a referral. :)

Have a look at this link.

http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/gp-referrals.aspx

You can't always GET a referral, but if you have your arguments in place, and can talk sense about your concerns, and request an expert opinion, then you stand a much better chance than just making a general request.

I'm so sorry, i didn't realise this was relevant to say doh! Lol I have already been referred to the specialist diabetic team in hospital. My McMillan team did it last week. I meant I was wondering if I could insist on my gp doing the gad and c-peptide blood tests
 
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Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Don't worry - it is a whole new language and way of thinking for all of us when we start on this road. :)

All I can suggest is that you ask your doc and see. And if they won't do the tests, ask again when you get to the diabetic team.

The problem is that the tests are more expensive than usual D blood testing, and (I believe) the samples have to be sent to a particular lab, which makes things slower and more complicated.

Plus, a lot of times these tests are seen as a waste of money, cos, you know, you are going to end up on insulin anyway, so why bother...? Which always strikes me as bizarre thinking, because (as you will see if you read our LADA/1.5 section of the forum) there are lots of ways that people can manage the progression, if they have the relevant info.

Hope that helps. :)
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. As @Brunneria says, the tests are expensive but you can always ask. The diabetes clinic may be more willing to do the tests. In practice I might argue that the c-peptide is the important one as it shows how much insulin your pancreas is producing. If it's a lot you are probably T2 and if it's little then you're T1. The GAD may show antibodies which are a major cause of T1, but there are other causes. My GAD was negative but the c-peptide showed a low insulin level. This info helped me know I was a LADA despite my diabetes GP saying I was T2 and initially refused insulin when I asked for it. A year later she said I needed to go onto insulin having forgotten who I was; the joys of the NHS and experts.
 

callyandy

Well-Known Member
Messages
3,394
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello @Trudeewillz , thank you for your post, as usual I've learnt something new. Everyday I'm amazed at how knowledgeable the members of this forum are, and they never make us newbies feel stupid when we ask fairly daft questions.

Good luck on you journey.