Doctor not 100% if I have type 2

[charlo98]

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.

The libre is amazing, though unsure how I’d afford them in the long run. One of my issues is I’m a veggie which doesn’t help my choice of foods. No I don’t think I can tolerate them at all! I’m a diet drinker and never have full sugar never have, don’t have juice ect.
She wasn’t 100% and gave me ketone sticks. Talked about Mody but agreed no family with diabetes so probably not and she suggested LADA. She brought me back in for GAD antibodies but said they take awhile and the endocrinologist would be awhile also

 

[charlo98]

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

Drinks are always diet or sugar free squash don’t have juice/energy drinks/ full sugar. I had spag Bol and then a small roll with cream to pair for pudding if I’m thinking of the right day. I’m fairly active as I have a very hyper 5 year old, though my sleep is shocking due to have a 7 month old who wakes every two hours still

 

[charlo98]

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.

I think I may be the same, what do you do if you want a treat? It’s annoying seeing have a wholemeal sandwich or porridge for breakfast as that should be fine when it clearly isn’t! I feel stuck for ideas

 

[Jaylee]

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.

Hi,

Or possibly “lower” in relation to what you may possibly have been cruising at? With nothing for you to gauge at the time to find out.
Not wishing to disparage. Could also have been a false hypo..?

Oddly, on the occasions I drift. Then correct with bolus insulin, the effects in an hour can feel similar. (I think, hello. Can I be? Before I test.) Though I’m not testing in any danger zone by sensor or meter.

@charlo98 , with Libre readings on lows. There can be a lag with the sensor before they return within desirable range. Do you test 20/30 minutes after treating the low? (With the meter.)

 

[EllieM]

She brought me back in for GAD antibodies but said they take awhile and the endocrinologist would be awhile also

Can your GP order a c-peptide, which measures the amount of insulin you produce? Normally they do that at the same time as a GAD.

You really need to see an endocrinologist I feel. (Plus forum rules don't allow us to diagnose so we have to be a little careful what we say.)

 

[mariavontrapp]

I'm not sure if we can give you much meaningful advice at the moment. I think you need to see the endocrinologist first to find out what's really going on. Try to keep yourself as stable as you can x

 

[Brunneria]

Hi and welcome @charlo98

It sounds like you have been told to eat very high carb for someone who has such high blood glucose readings and is only on one Metformin!

A meal of spag bol followed by a roll, especially if it is vegetarian spag bol is actually very high carbs - carbs in the pasta, carbs in the veggie sauce (and some protein) and then carbs again in the roll. All of those will cause spikes, even if wholemeal. So will any foods containing bread, rice, pasta, potato, sweet fruit, sugars, juices, etc - whether those foods are 'healthy' brown, or 'unhealthy' white.

Heck, even 'sugar free' and 'no sugar added' drinks have been proven to mess up/spike some unlucky people's bgs, because the sweetness can trigger an insulin release.

The only difference between white bread/pasta/rice and brown has a smidge more fibre and a smidge less starch. This means that it digests a little slower (cos of the fibre) and spikes your blood glucose a little less (less starch). But the reality is that you will still get significant blood glucose spikes.

You mentioned going back on the GD diet, but don't explain what that is. Did you mean Gestational Diabetes Diet? If so, what was it?

As others have said, it is far more likely that your hypo symptoms are being caused by rapidly dropping blood glucose, rather than being actual hypos, and from the graph you have attached, it looks like the sharp spike in bg, followed by the sharp drops in bg are more of a problem than your lowest readings.

As a vegetarian, have a look through the vegetarian section of the forum for ideas and recipes that are lower carb.
This link will give you a free 7 day vegetarian meal plan that is seriously low carb, as well as being delicious.

Free 7-day vegetarian diet meal plan – Diet Doctor

Are you eating the same veggie low-carb meals every day? Spice it up with our easy and delicious plant-based meal plans!

www.dietdoctor.com

At the moment, you are in limbo. Until an endocrinologist runs tests and gives you a clear diagnosis, you won't have your medication sorted, and you will be left to your own devices, so until then, any dietary control that you can achieve will help.
I have experience of wildly swinging blood glucose, so I know how draining and stressful it can be - so avoiding spikes from carbs, and keeping your blood glucose as steady as possible, will make a huge difference to the way you feel, and reduce the anxiety, as well.

 

[sue512]

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

Currently in our area with different criteria meaning we screen far more women in pregnancy for diabetes, there is a 12 % rate, which includes all diabetics and mainly gestational diabetics. Far higher rates than in the past, that were known about anyway. Personally I wonder if it has more to do with our highly processed diets rather than family history or BMI being elevated. Having said that the body is a complicated machine that we still have a lot to learn about

 

[Lamont D]

It is typical of T2 in most aspects of your graph.
however the spike after eating at 12pm is a long hour plus to reach up. And the low is between two hours till 8pm when your bg soars up and keeps going....
5 times you went below 4mmols. Wether that is the cgm or did you verify the readings? It does seem your body does respond to a low reading, probably from glucogenisis, which is your glucose stores from your liver, helps you prevent hypoglycaemia.
off the top of my head, could you test the cgm. To see if it is at the correct settings?
If those results are true, I would definitely bin a lot of carbs.
I would also like to see how your cgm records a fast, if you can? The reason is to see where your continuous fasting level would be if you don't eat for a morning say.
I can't comment on a GD diet. Having no experience as I'm a fella, however the fact that it mentions healthy carbs puts me off completely. In my experience and what so called healthy carbs did to me. I would look at a very low carb dietary regime. The wholemeal bread is defo off my list. I would be very ill!
A carb is a carb and your body will thank you, if you can maintain blood glucose levels control in or around normal levels.
it will also prevent you needing more meds other than the metformin.
Bottom line you need tests, your readings say you are glucose intolerant/ carb intolerant, and it is affecting your heslth, if the tests say something more, then the endocrinologist will use more tests to get a true diagnosis.
If he suggests an OGTT, ask if can be an extended test over five hours to show the lows of hypos! A two hours OGTT according to your cgm is not going to show the drops.
A mixed meal test may be used.
Make sure you get a c-peptide and GAD test.
And your insulin levels test during the OGTT test or especially after eating fasting tests.
Insulin tests are really important, because of your graphs.
It is a lot to take in and you should be prepared for your endocrinologist appointment. Knowledge is important, especially for someone like me, who has a rare condition, and only finding a true treatment to my condition in here.
I don't believe you have a Hypoglycaemic condition.
But you never know!
A carb is a carb, and it is how your body responds to something that causes symptoms and makes you feel awful.

Best wishes, keep asking.

 

[charlo98]

Can your GP order a c-peptide, which measures the amount of insulin you produce? Normally they do that at the same time as a GAD.

You really need to see an endocrinologist I feel. (Plus forum rules don't allow us to diagnose so we have to be a little careful what we say.)

I’d like to think she’s ordered c peptide but I also thought she’d ordered GAD antibodies, till I was asked to come in for more bloods. I know but all the information regardless is helpful!

 

[charlo98]

Hi and welcome @charlo98

It sounds like you have been told to eat very high carb for someone who has such high blood glucose readings and is only on one Metformin!

A meal of spag bol followed by a roll, especially if it is vegetarian spag bol is actually very high carbs - carbs in the pasta, carbs in the veggie sauce (and some protein) and then carbs again in the roll. All of those will cause spikes, even if wholemeal. So will any foods containing bread, rice, pasta, potato, sweet fruit, sugars, juices, etc - whether those foods are 'healthy' brown, or 'unhealthy' white.

Heck, even 'sugar free' and 'no sugar added' drinks have been proven to mess up/spike some unlucky people's bgs, because the sweetness can trigger an insulin release.

The only difference between white bread/pasta/rice and brown has a smidge more fibre and a smidge less starch. This means that it digests a little slower (cos of the fibre) and spikes your blood glucose a little less (less starch). But the reality is that you will still get significant blood glucose spikes.

You mentioned going back on the GD diet, but don't explain what that is. Did you mean Gestational Diabetes Diet? If so, what was it?

As others have said, it is far more likely that your hypo symptoms are being caused by rapidly dropping blood glucose, rather than being actual hypos, and from the graph you have attached, it looks like the sharp spike in bg, followed by the sharp drops in bg are more of a problem than your lowest readings.

As a vegetarian, have a look through the vegetarian section of the forum for ideas and recipes that are lower carb.
This link will give you a free 7 day vegetarian meal plan that is seriously low carb, as well as being delicious.

Free 7-day vegetarian diet meal plan – Diet Doctor

Are you eating the same veggie low-carb meals every day? Spice it up with our easy and delicious plant-based meal plans!

www.dietdoctor.com

At the moment, you are in limbo. Until an endocrinologist runs tests and gives you a clear diagnosis, you won't have your medication sorted, and you will be left to your own devices, so until then, any dietary control that you can achieve will help.
I have experience of wildly swinging blood glucose, so I know how draining and stressful it can be - so avoiding spikes from carbs, and keeping your blood glucose as steady as possible, will make a huge difference to the way you feel, and reduce the anxiety, as well.

So the spag Bol sauce is homemade don’t buy jars, higher protein veggie mince and small portion of pasta but if that’s still too carby then I’ll try find a pasta replacement the roll was one of them small ones (lunch box) cream inside and on top which I pairs with cream in hope it would slow down the glucose realise but next time I’ll skip!

Yes gestation diabetes sorry for not being clear! It’s very restrictive. A lot of pairing any carbs sugar (small amount) with fats and protein. I thought it T2 wouldn’t be like this but looks like it is. The diet made me quite low as I could barley touch carbs or sugar.

That would make sense, I will keep an eye and then tell doctor. I’ve got no follow ups with gp just waiting on endocrinologist which with current waits I hold no hope for seeing till summer.
Brill thank you!

I will be very careful with carbs now. Even the carby veg! Though I am breastfeeding so unsure if such low carb diet would cause issues with my milk.
Yes they aren’t fun! I feel very moody feel bad for my partner

 

[charlo98]

Currently in our area with different criteria meaning we screen far more women in pregnancy for diabetes, there is a 12 % rate, which includes all diabetics and mainly gestational diabetics. Far higher rates than in the past, that were known about anyway. Personally I wonder if it has more to do with our highly processed diets rather than family history or BMI being elevated. Having said that the body is a complicated machine that we still have a lot to learn about

I wasn’t screen, I had to push when glucose started showing up in my urine.. my midwife was like oh should be fine tou shouldn’t have it.. I do wonder, though I don’t have a highly processed diet, lot of cooking from scratch May as well have a bad diet!

 

[charlo98]

It is typical of T2 in most aspects of your graph.
however the spike after eating at 12pm is a long hour plus to reach up. And the low is between two hours till 8pm when your bg soars up and keeps going....
5 times you went below 4mmols. Wether that is the cgm or did you verify the readings? It does seem your body does respond to a low reading, probably from glucogenisis, which is your glucose stores from your liver, helps you prevent hypoglycaemia.
off the top of my head, could you test the cgm. To see if it is at the correct settings?
If those results are true, I would definitely bin a lot of carbs.
I would also like to see how your cgm records a fast, if you can? The reason is to see where your continuous fasting level would be if you don't eat for a morning say.
I can't comment on a GD diet. Having no experience as I'm a fella, however the fact that it mentions healthy carbs puts me off completely. In my experience and what so called healthy carbs did to me. I would look at a very low carb dietary regime. The wholemeal bread is defo off my list. I would be very ill!
A carb is a carb and your body will thank you, if you can maintain blood glucose levels control in or around normal levels.
it will also prevent you needing more meds other than the metformin.
Bottom line you need tests, your readings say you are glucose intolerant/ carb intolerant, and it is affecting your heslth, if the tests say something more, then the endocrinologist will use more tests to get a true diagnosis.
If he suggests an OGTT, ask if can be an extended test over five hours to show the lows of hypos! A two hours OGTT according to your cgm is not going to show the drops.
A mixed meal test may be used.
Make sure you get a c-peptide and GAD test.
And your insulin levels test during the OGTT test or especially after eating fasting tests.
Insulin tests are really important, because of your graphs.
It is a lot to take in and you should be prepared for your endocrinologist appointment. Knowledge is important, especially for someone like me, who has a rare condition, and only finding a true treatment to my condition in here.
I don't believe you have a Hypoglycaemic condition.
But you never know!
A carb is a carb, and it is how your body responds to something that causes symptoms and makes you feel awful.

Best wishes, keep asking.

Yeah the spikes are odd. I did skip breakfast today as I was running late to meet friends. Until I ate at lunch the libre kept going off low glucose to I believe lowest being 3.2. If that’s what you’re wondering ?
I will check with monitor when it happens again!

Sorry think I wrote it wrong. The advice for type 2 that I read said that stuff was fine. The GD is very restrictive, it was depressing! To the point that even certain veg with higher carb content needed to be paired and only that. So if you had carrot no other carbs, lots of protein and fats on your plate mainly green veg to fill. I was hoping never to be so restrictive again.

I will keep all that in mind thank you!
I wish I could see what’s been tested but I haven’t a clue and hate questioning doctors as I feel as if they feel annoyed.

I’m just hoping I can get it under control as I’m not enjoy theses constant highs and lows

 

[Lamont D]

Yeah the spikes are odd. I did skip breakfast today as I was running late to meet friends. Until I ate at lunch the libre kept going off low glucose to I believe lowest being 3.2. If that’s what you’re wondering ?
I will check with monitor when it happens again!

Sorry think I wrote it wrong. The advice for type 2 that I read said that stuff was fine. The GD is very restrictive, it was depressing! To the point that even certain veg with higher carb content needed to be paired and only that. So if you had carrot no other carbs, lots of protein and fats on your plate mainly green veg to fill. I was hoping never to be so restrictive again.

I will keep all that in mind thank you!
I wish I could see what’s been tested but I haven’t a clue and hate questioning doctors as I feel as if they feel annoyed.

I’m just hoping I can get it under control as I’m not enjoy theses constant highs and lows

You do have to question doctors,they have to make sure of how their words affect you.
I'm not on a vegan diet, I couldn't!
We do have a vegan forum and a GD forum, maybe have a look through them for low carb dieting advice.
Some great ideas and recipes.
Yeah, the spikes are odd and yeah, the not eating, fasting blood testing can be illuminating in how your normal blood glucose levels, can be measured. My average is around 4.7mmols until I eat in the afternoon.

I hope you get a decent endocrinologist.

keep asking
best wishes

 

[jonathan183]

I wish I could see what’s been tested but I haven’t a clue and hate questioning doctors as I feel as if they feel annoyed.

I’m just hoping I can get it under control as I’m not enjoy theses constant highs and lows

You should be able to get access to your records online, you can then review all the test results at any time you want to ... you probably need to pick up a form from gp reception to request it

Ed: you should share the CGM results with your GP - the hypos might move you up the priority list.
Metformin does not normally cause hypos does not mean it never causes them - I'd still treat genuine below 4mmol/l blood glucose with a glucose tablet.

 

[Oldvatr]

The two Libre graphs you have shared show a very robust falloff in glucose levels after the peaks. The rate of the graphs is interesting. I would suspect that you may be overproducing insulin, but may be missing the First Phase insulin rresponse. This is a characteristic common to Type 2 diabetes. I would hazard a guess that Insulin Resistance is not an issue in your case since your response to a meal appears to recover in the expected 4 hours. As has been pointed out, the 'hypo' events are not due to medication but are not far off those experienced by non diabetics so I would be more worried about the high spikes. I had one this morning from eating a croissant, so I am just as guilty of harming myself with carby treats. The advice to reduce carbs is sensible, and should help to reduce the swings.

 

[charlo98]

Hi. I’ve finally see consultant. Bloods done confirmed type 1 just never showed ketones ‍

 

[EllieM]

Hi. I’ve finally see consultant. Bloods done confirmed type 1 just never showed ketones ‍

Excellent news that you have a definite diagnosis. Though a new diagnosis of T1 can seem scary, modern technology is marvellous (don't know if you were self funding the libre before but you should get it free now) and insulin pumps are getting better and better should you want to go that route.

You might want to change your diabetes type on your account details, by the way.

Are you on insulin now?

 

[HSSS]

Thankfully your dr was aware of her limitations and referred you so you could get the correct diagnosis. What do they teach drs that so many think ketones are required for a type 1 diagnosis (or that gad must be positive as another common misconception). I’m not even a type 1 nor a dr and I know that much. I was reading through this thread to comment on this when I got to your update. I’m relieved to hear you finally got it sorted

 

[Resurgam]

So the spag Bol sauce is homemade don’t buy jars, higher protein veggie mince and small portion of pasta but if that’s still too carby then I’ll try find a pasta replacement the roll was one of them small ones (lunch box) cream inside and on top which I pairs with cream in hope it would slow down the glucose realise but next time I’ll skip!

Yes gestation diabetes sorry for not being clear! It’s very restrictive. A lot of pairing any carbs sugar (small amount) with fats and protein. I thought it T2 wouldn’t be like this but looks like it is. The diet made me quite low as I could barley touch carbs or sugar.

That would make sense, I will keep an eye and then tell doctor. I’ve got no follow ups with gp just waiting on endocrinologist which with current waits I hold no hope for seeing till summer.
Brill thank you!

I will be very careful with carbs now. Even the carby veg! Though I am breastfeeding so unsure if such low carb diet would cause issues with my milk.
Yes they aren’t fun! I feel very moody feel bad for my partner

I was warned that my low carb diet would stunt the growth of my baby, back in 1982 - I looked at his growth chart and thought that seemed most unlikely - he topped out at 6ft 3 or 4. I did not restrict carbs, just ate normally for me.
My second child was affected by the carbs I was told I had to eat - I kept a graph and the growth rate slowed in the days after my encounters at the clinic.