End of honeymoon period?

[Jadellis]

Hope someone can help me with this. Does anyone know what signifies the end of the honeymoon period in T1.5?
I was diagnosed T2 in march 2010. BG levels were in the stratosphere (33+), I had lost around 2 stone and had high levels of ketones in my urine. I was put on oral meds. I managed to get a referral to a diabetic specialist about a year later and he did a GAD test which came back high (500) and indicated T1.5 although he wasn't certain. Because I had cut out any snacks and all sweet food and taken up daily walking (and with the help of the meds) my BG levels had come down to decent levels. Over the next 2 tears I came off all meds and managed my condition with diet and exercise alone. About 18 months ago and in the face of increasing BG levels I was put on 500mg meteor in. I am now on 1000mg. Daily.
The specialist discharged me about 3 years ago because my hba1c was good and seemed stable. He did however say I could phone if and when I needed to and that I should have my hba1c check done every 3 months.
My December check was at 47 but my result last week was 52 and I don't know if a rise of 5 points is significant or not. Does anyone out there know? Also my BG levels seem to be rising and not falling back to acceptable levels and I'm having high fasting levels. Yesterday a.m. My fasting glucose was 9.2. My pre-bedtime level was 13.3 (3.5 hours after food) and I didn't go below 6 all day despite going lightly on carbs and exercise. I don't want to phone the hospital unnecessarily so hope someone can help?.

 

[urbanracer]

Hi Jadellis and welcome to the forum. @daisy1 will send you some info.

Personally I don't think you'd be phoning the hospital unnecessarily - you need to contact your care team in case you need different medication now.

 

[Robinredbreast]

Hope someone can help me with this. Does anyone know what signifies the end of the honeymoon period in T1.5?
I was diagnosed T2 in march 2010. BG levels were in the stratosphere (33+), I had lost around 2 stone and had high levels of ketones in my urine. I was put on oral meds. I managed to get a referral to a diabetic specialist about a year later and he did a GAD test which came back high (500) and indicated T1.5 although he wasn't certain. Because I had cut out any snacks and all sweet food and taken up daily walking (and with the help of the meds) my BG levels had come down to decent levels. Over the next 2 tears I came off all meds and managed my condition with diet and exercise alone. About 18 months ago and in the face of increasing BG levels I was put on 500mg meteor in. I am now on 1000mg. Daily.
The specialist discharged me about 3 years ago because my hba1c was good and seemed stable. He did however say I could phone if and when I needed to and that I should have my hba1c check done every 3 months.
My December check was at 47 but my result last week was 52 and I don't know if a rise of 5 points is significant or not. Does anyone out there know? Also my BG levels seem to be rising and not falling back to acceptable levels and I'm having high fasting levels. Yesterday a.m. My fasting glucose was 9.2. My pre-bedtime level was 13.3 (3.5 hours after food) and I didn't go below 6 all day despite going lightly on carbs and exercise. I don't want to phone the hospital unnecessarily so hope someone can help?.

Honestly a phone wouldn't be unnecessary at all, it's your health, well being and peace of mind.
Good luck and all the best.

RRB

 

[dannyw]

Give hospital a call. You've very well holding insulin off for 5 years. It's inevitable that this time would come and your BG levels are certainly too high to ignore. It's possible they may start you with just a low dose of background insulin but they will discuss options with you. Good luck.

 

[Jadellis]

Thanks for the replies and I will do something about it tomorrow. BG was 14.2 after a light breakfast this am. Done 2.5 mile walk and it came down to 5.9 pre a light lunch. I confess I'm a bit scared of insulin injections. (My mother was T1 from age 28 and as a child I was unable to wake her a couple of times because she was having a bad hypo and I had to get help urgently. ) thanks again for your help.

 

[urbanracer]

Injections take a little getting used to, but the needles are very fine and don't usually hurt unless you hit a nerve or something.

The hypo thing is a concern of course but only if it turns out that you have poor awareness. The majority of people feel something happening, like getting a bit shaky and can correct easily before BG's get too low. At the moment it's more important to get those glucose levels down.

Good luck and keep in touch. There are a lot of very experienced people here if you need advice.

 

[daisy1]

Hi Jadellis and welcome to the forum. @daisy1 will send you some info.

Personally I don't think you'd be phoning the hospital unnecessarily - you need to contact your care team in case you need different medication now.

@Jadellis

Hello Jade and welcome to the forum

Here is the information we give to new members and I hope you will find it helpful. Ask as many questions as you like and someone will be able to help.



BASIC INFORMATION FOR NEW MEMBERS

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 over 140,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.

 

[Jadellis]

Thanks Urbanracer for your reassurance and thanks Daisy for the guidance. My BG levels are almost never below 9 after food.
My local GP practice nurse told me I knew more about my condition than she did and my GP said to ' micro manage' it - hence my thinking about contacting the local hospital specialist - and my concern about it.