Exhausted all the time, no appetite and queazy.

Hi Kjell and welcome to the forum.
It would help us to help you if you could tell us what changes you have made since diagnosis. What do you eat in a typical day and have you started on any medication? Also do you know the exact results which made your diagnosis?
Here is a link to our useful info which we provide for all newbies:
https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/

Kjell said:

I’m recently diagnosed with T2 and the pattern of exhaustion, no appetite and queasiness that led me to get tested in the first place continues. I was active, low weight and no family history of diabetes before this year and I wonder if anyone else starting from this position has found ways to overcome the exhaustion problem. I lost 6kg unintentionally in the period prior to diagnosis and am keen to get it back again. A lot of the diet and behaviour advice seems to be aimed at losing weight and starting exercise. I’m in the opposite situation and am wary of doing the wrong thing. It would be good to get a bit of energy and appetite back.

Click to expand...

I lost weight, was extremely fatigued and unwell before diagnosis. More often than not the weight loss'd be a sign of T1, not T2. (I tend to be one of those exceptions to the rule, though I was severely overweight). You might want to get C-peptide and GAD tests done, make sure you actually do have T2. The treatment is completely different and you really need to know. Strangely enough, in this day and age, doctors still presume T1 is reserved for children only, while it can certainly be adult onset. (or LADA/Mody).

What are you eating at the moment? What does a typical day look like? Do you have a meter? And what meds are you on? The diet a lot of T2's here use has losing weight as a side effect, as the weight gain is caused by the high glucose/insulin levels, and with those gone, you happen to lose weight as well. If you, as a confirmed T2, lower your bloodsugars with diet, you don't absolutely have to lose weight. Just eat more often than someone who does need to lose weight would, (about 3 meals and 3 snacks a day) and up the fats and protein.

Just go back to the doc's and get those tests done. They really are vitally important.

Good luck!
Jo

Like the others I am concerned that you have many symptoms that are associated with T1/LADA and unfortunately many doctors assume that anyone over a certain age must be T2.

Whether T1 or T2, once your blood sugars are under control then you should get your energy back. Your continuing symptoms suggest to me that your illness may not be under control and you need to go back to your doctor for further tests/treatment.

Of course, if you are indeed T2, then going the low carb high fat route may well sort out your issues, but I would recommend that you get a blood testing meter, because if you don't know what your levels are then you won't know whether you are feeling ill because of your diabetes or because of some (possibly non-related) issue.

Whatever you decide, welcome to the forums.

And if you let us know what your current medication and diet consists of, there are many knowledgeable folk who will be able to give further advice.

Hello and welcome,

My advice would be pretty much what the more experienced people have already said- just wanted to welcome you and say you have found an excellent resource no matter what type of diabetes you have. There are helpful people with different types of diabeties who are willing to help and support you.

Well, the good news is that though an hba1c of 54 is definitely diabetic, it's in the very low end of that region. As a T1 diabetic (ie I produce no insulin at all so need to inject it), my specialist would prefer me to keep my levels slightly lower, but only slightly, and I've spent decades at levels higher than that with no significant ill effects.

Honestly, if you're willing to reduce the carbs in your diet, you can probably reduce your levels to normal without any need for medication at all. I'm surprised that they didn't suggest diet and exercise as an option before putting you on metformin, though maybe your low weight is the reason why (as weight loss is not going to improve your symptoms).

Hopefully some T2s will advise soon, but if I were in your position I'd scrap the metformin and concentrate on lowering the carbs.

On the diet front - be careful of bread, potatoes, rice and pasta - they are all packed full of carbs. You also have to be slightly careful with fruit - berries are fine but a lot of other fruit is packed full of fructose - one of the worst forms of carb for a T2 diabetic. But I'll leave the diet advice for T2s, as a T1 I can inject for carbs. If you list the typical food/drink you consume in a day you'll get a critique which will probably make drastic reductions to your blood sugar.

The good news is that a blood sugar of 6.9 is still within the normal range, so it makes the T1/LADA diagnosis less likely. If you stop producing insulin then your blood sugar will shoot up to much higher levels than that.

Hi and welcome @Kjell

I won't talk about the possibility of T1, LADA or MODY because other people have mentioned that, or the self testing. Although you can buy your own test kit and check your own blood glucose at home. Just ask if you want brands and info on that.

However, I will talk about Metformin.

The usual advice is to start Metformin gradually. One tablet a day for the first week, then add the second the week after. If you get side effects, such as nausea or gut rumbles, or constipation or loose bowels, then hold off adding the additional tablet until after they have subsided. Also, if you read the patient info leaflet, you will see that Metformin should be taken with meals, and discontinued when/if fasting.

My personal interpretation of that is that I would only take it with, or slightly after food, and never on an empty stomach. If you are taking your Metformin between or before meals, then switching to taking it during or after the meal may make a big difference on how well you tolerate it.

Hope that helps!

Which sites did the nurse recommend?

as well as this one (there’s a lot more to the site than just the forums. Click home in the top left and take a look around)
Diet doctor.com
Ditch the carbs.com
Were both very helpful to me in the early days.

Kjell said:

Many thanks for your replies. I’ve read through the links you kindly pointed to as well as all the other info on the website. Here’s more background, as requested.

I went to the GP with a severe tiredness complaint, going back two months. He arranged a blood test. It came back with a glucose reading of 6.9. He ordered another blood test. It came back with an HbA1c of 54 and a diagnosis of type 2 diabetes. The diabetic clinic nurse recommended two websites to help me get started with adapting my diet and a doctor prescribed Metformin 500g twice a day.

You ask if Type 1 has been considered and if I’m using a glucose monitor. The answer is no to both. I don’t know if age is significant. I’m 74,

You asked about eating changes. I received the diagnosis last Friday so I’m still finding my way with eating changes. I’ve cut out sugar and am groping my way to reducing carbs and increasing veg and fruit and protein and fat. I haven’t developed a pattern yet. In fact I was hoping I might hear from someone who had started off in my situation (no energy, severe weight loss) in the hope there might be indications of how I should go about doing things from the start.

However there is one change. I’m getting very nauseous after the second Metformin and it is discouraging further eating. Previously any appetite there was developed towards the end of the day but now the nausea replaces it. The leaflet says this is common at the beginning and if it continues stop taking it. Any idea how long to persevere? Thanks.

Click to expand...

Hello again,

I'll echo the "careful with the fruit" sentiment, because it's not known as nature's candy for the heck of it. Personally, I responded very, very badly to metformin, which is why I went looking for a different route: the low carb/high fat diet, and later the more thorough version of that, Keto with Intermittent Fasting, has kept me in the normal range for 3 years now. No diabetes meds, no statins for cholesterol, no complications.... I am on other medications for other non-diabetic issues, but even some of those I could reduce. You're on two a day already, that's quite a bit, and far too fast an increase....! Also, your HbA1c isn't THAT high. A change in diet -and don't worry if you don't get it 100% right overnight, we all had to learn!- will hopefully get you back down to normal levels. Metformin doesn't do anything about what you eat, besides supressing hunger... Your liver dumps glucose in the morning to get you some energy to start the day. Metformin reduces that output by about 75%. And that's about it. I remember my T2 gran eating pastries all day because "her pill" would take care of it somehow. That's not how it works, but that was long before google and forums... And none of us knew any better, 25 years ago.

You can get on top of this without feeling miserable. I'll not say ditch the meds, but I can say, get yourself a meter. You'll have to self-fund, alas, as many of us do, but then you'll know what your bloodsugars are up to... And you can discuss coming off the metformin with your doc, with numbers coming down through diet. (As in, hopefully going diet only rather than having more medication perscribed).

If you need any help with your diet, give a shout. Tell us what you eat, what you like and don't like, if there's anything you don't eat due to religious or moral objections... And we'll see what we can do. You're not alone in this.
Hugs,
Jo

Kjell said:

What an incredibly helpful set of responses. Thank you. It makes such a difference.

t."

I didn't know you could get these yourself, I thought you had to have a prescription, so yes please.

I do take the Metformin with meals so it makes your suggestion even more relevant. The nausea is so persistent I'd ike to stop completely till I'm ready again to start on the one a day regime. Does this make sense?

Click to expand...

You can get a meter from your pharmacy or amazon.co.uk, or... Just about anywhere. I think it was the Tee2 and the Codefree that had the cheapest strips.... That's just it, the meters aren't the investment, the strips are, so you want the meter with the cheapest strips. Someone'll be along soon with links and codes for discounts and whatnot. You'll test a whole lot on the outset, but once you know what foods agree with you and which don't, you'll test a lot les frequently. Me, I only do it when I'm feeling off (like after a flu jab, or steroid shot), or when i ate out and have no clue what I just had.

Keep in mind, you don't actually have to get back onto metformin if you lower your bloodglucose via diet. You can avoid medication altogether that way. There's a lot of people who love the stuff, and then there's people like me who just go through hell with it. It's a choice, you do have options... And if you don't ever want to take it again, you most likely won't have to. If, for instance, you absolutely hate the diet and decide to go back to medication, there is actually more to choose from than metformin! It's just the first one they try, but there's others, like Gliclazide and the like... Only drawnback being that without a diet change, complications are more likely. But again... It is your choice. Your health, your body, your quality of life.

Kjell said:

Thank you, that was encouraging. I certainly will get back on the diet specifics. It's all a bit overwhelming at the moment and the persistent nausea on top of the exhaustion has hit me for six.

Click to expand...

Take your time. It took me a few months to get it figured out. But then, I didn't find this place until much later, otherwise I would've been a lot better, a lot sooner. It's a massive amount of information to take in, what with the diagnosis, the implications for your day-to-day life, and dealing with all that while feeling ill... Cut yourself some slack and ask whatever you want, when you want. We'll be right here.
Hugs, and I hope you feel better soon!
Jo