Doctor not 100% if I have type 2

[charlo98]

Hi. I’m 24 female, bmi 22 and no family history of any diabetes who’s hba was 35 in august and now it’s 58.
My Doctor doesn’t understand how I’ve ended up with type 2. She’s gone with that due to no
Ketones in urine. She’s put me on meds and sent a referral to endocrinologist as she’s worried she’s missed something. She was thinking LADA. I’ve currently got a libre in and it’s confirmed I’ve been Hypos which id suspected I’d been having for over a month (become very shaking before dinner, heart pounding ext). I’m unsure on what to do, I’ve had 5 hypos today. I can’t get my head around why I’d have type 2 either. Anyone got any advice?

 

[jonathan183]

If you are having hypos that sounds like a problem with the medication or medication dosing. You should try to get that sorted as a matter of urgency. What sort of blood glucose readings are you getting ? and what medication are you on ?

Ed: I suggest you do a finger prick test when suspected hypo, and seeing response to hypo treatment.

 

[charlo98]

I’ve only just started meds. I was getting hypos before this. Finger prick test confirmed. I would of had breakfast and lunch and by dinner would have sugars of 3.6 this was before meds. My Libre has also been going off a bit due to low bloods. I’ve only been on 500mg for a week..

 

[Lamont D]

Was it before or after food when you had hypos?

 

[Lamont D]

Can you mention the name of the meds? Is it metformin?

 

[catinahat]

Welcome @charlo98
Low blood sugar is not a symptom diabetes, when someone with diabetes has a hypo it is usually caused by their medication.
For any type of diabetes without medication or a strict diet in the case of a unmedicated T2's, their blood sugar would be high.
What sort of things are you eating, have you noticed that your hypos seem to come sometimes after an especially high carb meal?
What is the medication you are taking? I understand that you've only just started taking it and you have experienced the hypos beforehand but it would help us to figure out what's going on if we know the full facts

 

[charlo98]

Was it before or after food when you had hypos?

Before

 

[charlo98]

Can you mention the name of the meds? Is it metformin?

Yes 1 a day but from Saturday 2

 

[charlo98]

Welcome @charlo98
Low blood sugar is not a symptom diabetes, when someone with diabetes has a hypo it is usually caused by their medication.
For any type of diabetes without medication or a strict diet in the case of a unmedicated T2's, their blood sugar would be high.
What sort of things are you eating, have you noticed that your hypos seem to come sometimes after an especially high carb meal?
What is the medication you are taking? I understand that you've only just started taking it and you have experienced the hypos beforehand but it would help us to figure out what's going on if we know the full facts

Metformin 500mg 1 a day till Saturday then 2 a day. I noticed symptoms of high blood sugar so self tested. I had readings up to 24.8. But also noticed low blood sugar symptoms before mainly dinner where is somethings have 3.6.
So went gp and that’s where they discovered my hba jumping not even in 4 months. I’m so upset I was fine in august I’m struggling to understand how I have type 2 given the information in OP. I did have GD which even the midwife’s/consultants found odd given my age 23 and bmi 20 at the time. Sorry I’m trying to wrap my head around it and like I said the gp was shocked. But I think the meds aren’t helping with hypos as I’ve had a few lows (3,8-3,4) then eat a carb and go to 9.1 then back down.
Sorry hope this makes sense

 

[In Response]

When not on medication, my understanding is it is not considered a hypo above 3.5. The limit of 4 is imposed to reduce risk for people on blood glucose lowering medication like insulin.

For years before I had diabetes. I would occasionally get a bit shaky if I had not eaten for some time. I never tested my blood at the time but it would not surprise me if my levels were on the low side when it happened. Knowing this was a possibility for me, I would always carry food (usually a muesli bar) with me in case there was a delay between meals.

I never considered this to be related to diabetes and I never took any medical advice until I had the usual diabetes symptoms of high blood sugars such as frequent weeing, extreme tiredness, thirst and blurred eye sight. Still the GP I first saw thought it was a UTI. But that's another story. Thankfully, the second GP tested for diabetes and I was diagnosed as having Type 1.

 

[jonathan183]

The specialist will need to do further testing to establish what is going on.
You can treat the hypos with glucose tablets which I assume is what you have been advised to do. You may find one or two glucose tablets are sufficient to bring your blood glucose back above 4mmol/l.
You may find more protein and lower carbs helps reduce the blood glucose swings until you get to see the specialist.
Hope you get to see the specialist and get things sorted soon ...

 

[Lamont D]

I'm of the opinion you need to be seen by a specialist endocrinologist.
you need to ask your GP to recommend a specialist.

The thing that stands out in your description is the high spikes followed by the lows, which may or may not be hypos, but feel like it because you notice it.
If you have low blood sugar overnight or even normal blood glucose levels. Then through the day highs after food then lows. Am I right?
the metformin will not alter your blood glucose levels much.

it is bewildering until you unravel the circumstances of what is happening.

best wishes

 

[catinahat]

To be honest charlo98, your high readings would worry me more than your lows.
Metformin is not known for causing hypos, it doesn't work by reducing your blood sugar the same way as insulin or some of the stronger oral drugs. It mainly works by preventing your liver from releasing too much of its stored glucose.
I quite often see blood sugar levels of high 3's low 4's, as mentioned before it would only be a concern if I were taking medication that could force my levels dangerously low.
As you are getting highs between 9 and 28 and lows of around 4 it could be the drop that's causing your symptoms. It's called false Hypoglycaemia and can cause just the sort of uncomfortable symptoms you describe.
If it is false hypos you are experiencing the usual advice is to cut right back on the carbs so your levels don't get so high. Eventually your body will get used to the lower levels and false hypos should cease to be a problem.
Bear in mind that in the absence of hypo causing medication, false hypos while being uncomfortable are not dangerous. If you treat them with glucose, orange juice or some other high carb thing all you are doing is jumping back on to the high/low sugar roller-coaster.
If you feel you need to bring your blood sugar up a little, eat something low carb like nuts, cheese, maybe some natural yoghurt.

 

[charlo98]

I'm of the opinion you need to be seen by a specialist endocrinologist.
you need to ask your GP to recommend a specialist.

The thing that stands out in your description is the high spikes followed by the lows, which may or may not be hypos, but feel like it because you notice it.
If you have low blood sugar overnight or even normal blood glucose levels. Then through the day highs after food then lows. Am I right?
the metformin will not alter your blood glucose levels much.

it is bewildering until you unravel the circumstances of what is happening.

best wishes

Yesyes she’s referred me to the endocrinologist her words were she feels like she’s missing something as they don’t diagnose people like me with type two . My fasting was 14.7

Is this what you mean by them spiking -

 

[charlo98]

To be honest charlo98, your high readings would worry me more than your lows.
Metformin is not known for causing hypos, it doesn't work by reducing your blood sugar the same way as insulin or some of the stronger oral drugs. It mainly works by preventing your liver from releasing too much of its stored glucose.
I quite often see blood sugar levels of high 3's low 4's, as mentioned before it would only be a concern if I were taking medication that could force my levels dangerously low.
As you are getting highs between 9 and 28 and lows of around 4 it could be the drop that's causing your symptoms. It's called false Hypoglycaemia and can cause just the sort of uncomfortable symptoms you describe.
If it is false hypos you are experiencing the usual advice is to cut right back on the carbs so your levels don't get so high. Eventually your body will get used to the lower levels and false hypos should cease to be a problem.
Bear in mind that in the absence of hypo causing medication, false hypos while being uncomfortable are not dangerous. If you treat them with glucose, orange juice or some other high carb thing all you are doing is jumping back on to the high/low sugar roller-coaster.
If you feel you need to bring your blood sugar up a little, eat something low carb like nuts, cheese, maybe some natural yoghurt.

Yes my readings don’t sit well with me I’m having to complete cut back on carbs. I can’t tolerate a lot of things that’s recommended to eat. I wasn’t really eating bad in the first place like I only eat wholemeal.
That’s interesting to know about false hypos. I deffo feel like I’m a rollercoaster, can’t win with what I eat.

 

[Lamont D]

Yesyes she’s referred me to the endocrinologist her words were she feels like she’s missing something as they don’t diagnose people like me with type two . My fasting was 14.7

Is this what you mean by them spiking -


View attachment 58288

Whatever did you eat drink the previous evening to get the 21 reading?
If you ignore pre midday readings, I assume you eat at noon? This would be similar to one of my high carb meals. Not eating till around 6pm? Is that right. Because the readings definite driven drop down by insulin but it takes so long or did you have something to eat around 3-5pm?
the spikes are very high for some reason, I would hazard a guess at first phase insulin or/and insulin resistance. But I may be totally wrong. It could a pancreatic issue, but whatever, you do need to cut out the carbs. Those spikes will cause issues.
Don't forget to take those readings to your specialist. Hope you get a good one.
a food diary would really help as well.

 

[MrsA2]

. I wasn’t really eating bad in the first place like I only eat wholemeal.

The "healthy" eating, or Eatwell style of eating is no good for anyone with intolerance to carbs, and, unfortunately, brown or wholemeal carbs are as bad for our bodies as the white versions. So too is most fruit. We can mostly only tolerate a very few berries. All high sugar fruit, grapes, tropical and especially juices are out too. So too are starchy veg such as potatoes and parsnips and carrots.
It's good you've got the libre, keep a food diary in the notes too and you will soon see what foods are causing you those high spikes .
Choose from Meat, fish, eggs, dairy, a few nuts and olives and a very few berries and see how it goes for a couple of weeks and your roller coaster should be smoother and more undulating.
Just be aware that although doc seems to be dismissing type 1, it may well come back into discussion at some point as may several other rarer forms. Do you have keto sticks to test your urine, just in case.

 

[MrsA2]

I, too, would be interested to know what you ate and drank, and did as regards activity, stress and sleep on the day of that graph

 

[catinahat]

I wasn’t really eating bad in the first place like I only eat wholemeal.

I can relate to this, I have always been active, relatively fit and tried to look after myself. I considered my diet to be healthier than most people around me, lots of fruit, veg, lean meats, wholemeal and low fat everything.
Who knew I would get T2, I suppose everyone who ever gets any illness asks why me, what did I do to deserve this. Took me a while to realise that everything I thought I knew about healthy food has changed. My body can no longer handle carbs, as far as my body is concerned there is no difference between a juicy apple or a doughnut, they are both full of carbs I can't handle. Bread, pasta, rice, all carbs, my body can't see brown, white, wholemeal or sourdough, all it can see is carbs.

 

[charlo98]

Whatever did you eat drink the previous evening to get the 21 reading?
If you ignore pre midday readings, I assume you eat at noon? This would be similar to one of my high carb meals. Not eating till around 6pm? Is that right. Because the readings definite driven drop down by insulin but it takes so long or did you have something to eat around 3-5pm?
the spikes are very high for some reason, I would hazard a guess at first phase insulin or/and insulin resistance. But I may be totally wrong. It could a pancreatic issue, but whatever, you do need to cut out the carbs. Those spikes will cause issues.
Don't forget to take those readings to your specialist. Hope you get a good one.
a food diary would really help as well.

I’ve had breakfast late around 10.30 I believe, wholemeal toast with cheese to help pair and it completely failed lol. I think I may go back to following the GD diet till I can get all under control. Yet my levels today have been much better but you can see when I’ve had a carb/fruit for example I had rice with my curry but looks like it’s back to cauliflower rice for me and berries instead of melon Would you say my readings match a type 2 then?