Does This Sound Like Type 1 Diabetes?

[handicapable]

I checked myself into hospital on 09/06/2018 after noticing I was drastically losing weight (2 stone in 4 weeks but that previous night I'd lost 3.3lb whilst sleeping), I was diagnosed as being a type 1 diabetic and suffering from DKA. The out of hours emergency surgery I was told to attend beforehand didn't have the equipment to measure my BG levels they were that high. Later when I was in A&E resus I overheard the nurses say that my ketones were at 27 and BG 136mmol/l, I know these are both off the charts but to be honest I didn't feel at all unwell.

I spent 4 days in hospital and have now been out for almost 3 weeks which have been spent micro-managing my diabetes, I've made many lifestyle changes. My diet has completely changed and couldn't be healthier, I'm lifting weights 3-4 days a week in an attempt to regain my weight and I've also stopped smoking. I know all these things plus the heat increase insulin sensitivity but 10 days ago I was on 3x6 units of NovoRapid and 26 units of Lantus, today all I had was 9 units of the Lantus and my average BG level (out of 7 measurements) was 7.6mmol/l.

That is with me halving my Lantus dose without asking my DSN (out of hours), I wasn't even told I could alter my meal time insulin at my discretion until Friday after calling the diabetes clinic. I was having hypo's 2 hours after eating forcing me to then eat an even bigger meal, being new to hypoglycaemia it has been an unpleasant few weeks.

Having spent this time soaking up as much information as I can about the condition, it came to my attention that I had experienced a number of the symptoms for around 6 months but thought nothing of it. Now I'm not going to try this without informing my DSN but I'm quietly confident that with the correct diet and amount of exercise I can keep my BG levels in check without using insulin, perhaps tablets instead I don't know.

I know that I'm going to get a response saying that I'm in my 'honeymoon period' but that isn't what I'm asking, with me being brand new to all this and many of you being experts. Is it possible that I have another form of diabetes such as 'LADA type 1' because some of the symptoms listed for that form I have had for years?

Any and all input would be appreciated because I'd prefer to leave injecting my insulin until it is absolutely necessary, ta.

 

[DCUKMod]

I checked myself into hospital on 09/06/2018 after noticing I was drastically losing weight (2 stone in 4 weeks but that previous night I'd lost 3.3lb whilst sleeping), I was diagnosed as being a type 1 diabetic and suffering from DKA. The out of hours emergency surgery I was told to attend beforehand didn't have the equipment to measure my BG levels they were that high. Later when I was in A&E resus I overheard the nurses say that my ketones were at 27 and BG 136mmol/l, I know these are both off the charts but to be honest I didn't feel at all unwell.

I spent 4 days in hospital and have now been out for almost 3 weeks which have been spent micro-managing my diabetes, I've made many lifestyle changes. My diet has completely changed and couldn't be healthier, I'm lifting weights 3-4 days a week in an attempt to regain my weight and I've also stopped smoking. I know all these things plus the heat increase insulin sensitivity but 10 days ago I was on 3x6 units of NovoRapid and 26 units of Lantus, today all I had was 9 units of the Lantus and my average BG level (out of 7 measurements) was 7.6mmol/l.

That is with me halving my Lantus dose without asking my DSN (out of hours), I wasn't even told I could alter my meal time insulin at my discretion until Friday after calling the diabetes clinic. I was having hypo's 2 hours after eating forcing me to then eat an even bigger meal, being new to hypoglycaemia it has been an unpleasant few weeks.

Having spent this time soaking up as much information as I can about the condition, it came to my attention that I had experienced a number of the symptoms for around 6 months but thought nothing of it. Now I'm not going to try this without informing my DSN but I'm quietly confident that with the correct diet and amount of exercise I can keep my BG levels in check without using insulin, perhaps tablets instead I don't know.

I know that I'm going to get a response saying that I'm in my 'honeymoon period' but that isn't what I'm asking, with me being brand new to all this and many of you being experts. Is it possible that I have another form of diabetes such as 'LADA type 1' because some of the symptoms listed for that form I have had for years?

Any and all input would be appreciated because I'd prefer to leave injecting my insulin until it is absolutely necessary, ta.

Gosh - That's an incredible fast turnaround, handicapable. Most people take weeks to recover from the shock to their system of DKA before they could consider exercising much, never mind lifting weights.

As you will see from other areas of the forum, we are not here posting as medical professionals, and therefore cannot diagnose, or rediagnose you. You need to work closely with your diabets team to go into that granularity where necessary.

Some do seem to find, however, that once their bodies receive the help it needs, from insulin, that their remaining beta cell function can cope much better for a period at least.

It's very, very early days for you - less than 3 weeks since you were dicharged from hospital, following DKA, so just take it steady.

Where, roughly, are you based, and what is the healthcare system like there?

 

[Jaylee]

Hi @handicapable ,

Welcome to the forum.

Sounds like you recently have been put through the grinder. You have my applause for the lifestyle changes..

Nobody can advise you to stop or change prescribed medication. That is a discussion for you & your HCPs.

A few weeks is a short time to draw these conclusions when the heart is still ruling certian aspects of the logical thought process..

Best wishes.

J>

 

[Daibell]

Hi. Sounds like late onset T1 (LADA) to me. Note that LADA is T1 but typically happens during adulthood and can appear slowly hence the so-called honeymoon period. The LADA acronym refers to auto-immune induced T1 but T1 can be caused by other things damaging the beta cells all with the same result. Yes, the NHS is remarkably stupid in not starting people on carb-counting from the start. It risks hypos and you don't need a 1 week course. My DN explained it all to me when starting my insulin and it took 15 minutes. She joined the local surgery from the Hospital Diabetes clinic and knew what she was doing. Just keep doing what you are doing and it will become obvious to you over the coming weeks what insulin adjustments are needed e.g. checking the Basal is balanced and then tweaking the Bolus ratio as needed. My honeymoon period is something like 10 years now (!) and it varies dramatically from person to person.

 

[Circuspony]

I am also LADA type 1. Diagnosed last Aug at the age of 43. My hba1c was very high so I suspect I'd been running high BG levels for months without realising. 2 antibody tests came back positive for me.

My initial insulin usage was tiny. When we went on holiday to Spain 2 weeks after diagnosis the heat meant I needed even less. In fact I kept hoping they'd made a mistake! But no, sadly not.

Taking insulin now acts a a buffer for your remaining beta cells, so don't dismiss it.

 

[handicapable]

Gosh - That's an incredible fast turnaround, handicapable. Most people take weeks to recover from the shock to their system of DKA before they could consider exercising much, never mind lifting weights.

As you will see from other areas of the forum, we are not here posting as medical professionals, and therefore cannot diagnose, or rediagnose you. You need to work closely with your diabets team to go into that granularity where necessary.

Some do seem to find, however, that once their bodies receive the help it needs, from insulin, that their remaining beta cell function can cope much better for a period at least.

It's very, very early days for you - less than 3 weeks since you were dicharged from hospital, following DKA, so just take it steady.

Where, roughly, are you based, and what is the healthcare system like there?

I'm right on the border of 2 different NHS services (I have Bolton's postcode / Wigan's area code) but where I am is counted as being a part of Bolton. One of the nurses who I spoke to whilst in hospital told me that her son lives in Wigan and was recently diagnosed as type 1. He was given a constant glucose monitoring device (CGM) on prescription that lasts for a fortnight but they aren't available in my area, I could really use something like that because I'm taking BG readings 7x a day (not including hypo's) so I'm trying to get treated by Wigan, Wrightington & Leigh's NHS services.

Could you advise me if the CGM is a reliable method of measuring my blood glucose levels or should I continue stabbing my fingers until they fall off?

 

[DCUKMod]

I'm right on the border of 2 different NHS services (I have Bolton's postcode / Wigan's area code) but where I am is counted as being a part of Bolton. One of the nurses who I spoke to whilst in hospital told me that her son lives in Wigan and was recently diagnosed as type 1. He was given a constant glucose monitoring device (CGM) on prescription that lasts for a fortnight but they aren't available in my area, I could really use something like that because I'm taking BG readings 7x a day (not including hypo's) so I'm trying to get treated by Wigan, Wrightington & Leigh's NHS services.

Could you advise me if the CGM is a reliable method of measuring my blood glucose levels or should I continue stabbing my fingers until they fall off?

Thanks for clarifying.

Like meters, the constant monitors, to comply, must test to a +/-15% tolerance. Some find the Libre (which I think could be what is being described to you) more accurate than others. It is useful for insights into blood glucose activity.

 

[handicapable]

Hi. Sounds like late onset T1 (LADA) to me. Note that LADA is T1 but typically happens during adulthood and can appear slowly hence the so-called honeymoon period. The LADA acronym refers to auto-immune induced T1 but T1 can be caused by other things damaging the beta cells all with the same result. Yes, the NHS is remarkably stupid in not starting people on carb-counting from the start. It risks hypos and you don't need a 1 week course. My DN explained it all to me when starting my insulin and it took 15 minutes. She joined the local surgery from the Hospital Diabetes clinic and knew what she was doing. Just keep doing what you are doing and it will become obvious to you over the coming weeks what insulin adjustments are needed e.g. checking the Basal is balanced and then tweaking the Bolus ratio as needed. My honeymoon period is something like 10 years now (!) and it varies dramatically from person to person.

I went in to my GP's last August to get a referral to a specialist ADHD/ADD consultant (still haven't heard anything back, think my GP ignored me) because I've had it my entire adult life but found a way to deal with it until recently. It's got to the point of me not being fit to work because I couldn't concentrate and I would be yawning at 10am despite me being pumped full of caffeine. Only after being diagnosed with diabetes have I noticed how similar the symptoms of both conditions are - a doctor probably should have known but this one obviously didn't - so in an ideal world this could have been picked up on last year and I could have avoided spending time in a hospital bed.

To be fair to my DN, I did take about 4 pages of questions into my first appointment and she spent over an hour answering all she could (her next patient was waiting a half hour to be seen). Carb-counting was never an issue for me and I too turned down the group learning program I was offered on the subject, personally I think I was just on too much insulin to begin with.

Today I've not touched my NovoRapid, taken 9 units of Lantus again and up until now my average reading has been 7.9mmol/l so I guess it wasn't a bad decision on my part halving the dose. The last couple of days I've been eating less than I would usually due to the heat but I haven't been going hungry or anything, do you think it would be wise to ask my DN about getting off insulin and onto the tablet form medication or is it too late for me now?

 

[handicapable]

Thanks for the responses, I know there are certain aspects of my posts only a trained healthcare professional can answer but it's a long wait for your next appointment when newly diagnosed with something like diabetes, reading your own opinions and experiences takes a bit of the edge off.

 

[Daibell]

I went in to my GP's last August to get a referral to a specialist ADHD/ADD consultant (still haven't heard anything back, think my GP ignored me) because I've had it my entire adult life but found a way to deal with it until recently. It's got to the point of me not being fit to work because I couldn't concentrate and I would be yawning at 10am despite me being pumped full of caffeine. Only after being diagnosed with diabetes have I noticed how similar the symptoms of both conditions are - a doctor probably should have known but this one obviously didn't - so in an ideal world this could have been picked up on last year and I could have avoided spending time in a hospital bed.

To be fair to my DN, I did take about 4 pages of questions into my first appointment and she spent over an hour answering all she could (her next patient was waiting a half hour to be seen). Carb-counting was never an issue for me and I too turned down the group learning program I was offered on the subject, personally I think I was just on too much insulin to begin with.

Today I've not touched my NovoRapid, taken 9 units of Lantus again and up until now my average reading has been 7.9mmol/l so I guess it wasn't a bad decision on my part halving the dose. The last couple of days I've been eating less than I would usually due to the heat but I haven't been going hungry or anything, do you think it would be wise to ask my DN about getting off insulin and onto the tablet form medication or is it too late for me now?

Hi. As I'm sure you realise I can't advise what you should do with your medication. However, some users after discussion with their DN do stop their insulin when it's agreed it's no longer needed so it's never too late as taking insulin doesn't directly affect your pancreas and can sometimes protect it from further degradation. Moving to tablets may be all that is needed if your insulin dosage becomes low enough to be worth stopping but agree this with the DN