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Feel I am wasting away!

J

John47

Member
Messages
7
Type of diabetes
Treatment type
Tablets (oral)
I am not overweight and never really have been. I have always exercised at least 3 times a week in the gym, now walk for 2 hours a day and hill walk once a week for 5 hours minimum. I was diet controlled since diagnosis a few years ago until January when I started to feel unwell, was peeing so many times a day I lost count, had HbA1c test and had gone from 6.3 to 7.4. Random BG test at GP surgery was 370!!
Started Metformin 850mg x 2 day, was told no starch, as low carb as possible, watch amount of fat, no alcohol, test blood twice a day before meals and see GP again in 2 weeks. By then BG averaging 130 from over 200 in the morning but GP added another metformin 850mg to push down further. After 10 days felt awful, diarrhoea worse, light headed and had a strange night fever with uncontrolled shaking. Saw GP again as I had decided to go back down to 2 metformin a day. He isn't happy I have reduced the medication and just shrugged when I said I was "muscle wasting away". I weigh 76 kilos, having lost 2 kilos or more in last month. Worse still, I seem to have lost what little arm and leg muscle I had left, my face looks gaunt and my hands are constantly cold. I ache all over most of the time and am generally pretty fed up!!

Question! Am I burning muscle due to very low carb dieting and my exercise regime? I have completely cut out bread, pasta, rice, potato,, fruit, root vegetables, alcohol. All I eat is fish, chicken, lean meat, cabbage, cauliflower, salad. All I drink is water (I don't like tea or coffee) and occasional diet lemon drink.
 
Firstly, you may need to add some fat to your diet, that might help. When low carbing you need sustenance from other sources and fat is guaranteed not to raise bg so it is safe.

Secondly, you should make an appointment with your Dr. You may need to go on insulin.
 
Hi John.

How did you originally get your Type 2 diagnosis? Many of us LADAs were originally misdiagnosed as Type 2s. We tend to be slim, fail to respond for long to oral medication and have high after food spikes with relatively good HbA1c and fasting BG in the early stages.

If you haven't been tested for LADA, ask for a c-peptide test to measure the amount of insulin you are producing and a GAD antibody test to see if you have the antibodies that attack the beta cells. These tests can help to make sure your diagnosis is correct. If you are actually LADA, you will progress to insulin eventually as it is a slow onset form of Type 1.

Take care

Smidge
 
Hi Smidge,

My sister was diagnosed type 1 diabetic at 40 years old following glandular fever. I was visiting her and as a bit of a joke really, asked her to check my blood glucose and it read 11.7 although I hadn't eaten anything. Went to GP, had a glucose tolerance test and told type 2 but could control with diet and exercise. I have been doing so for the past 5 years though admit that the last year I have pretty much ignored it and eaten and drank whatever I felt like, maybe that's why I started with the peeing problem around Christmas!! Have never had a meter prescribed and always told by GP and nurse in UK that didn't need to monitor, just HbA1c twice a year. Bought meter a month ago as I am working in Spain and GP here told me to test twice daily before meals when he prescribed the metformin.
Perhaps I have had high readings for a long time.....will never know. Just that my muscle loss is very noticeable, cold hands and often feeling tired is recent. I have no idea what is "acceptable" morning and evening BG readings, GP just says that I must try to get it down to levels of a non-diabetic as soon as possible.
 
Hi John,

A Glucose Tolerance Test (GTT) just demonstrates whether you are metabolising sugar properly - it enables a diagnosis as diabetic, but does not tell you what type of diabetes you have. I was diagnosed diabetic as the result of this test, but I was misdiagnosed as Type 2 and told not to test - control with diet and exercise. I became very ill with serious weight loss within a year and after a lot of arguing, finally got to see a consultant who rediagnosed me as Type 1 (LADA). This was later confirmed by a positive GAD test. Like your sister, I was in my early 40s.

The last year of eating and drinking whatever you wanted will certainly not have helped matters whichever type of diabetes you have.

I strongly suspect you have LADA and that you have reached a tipping point whereby you are not producing sufficient insulin for your needs. If you are producing insufficient insulin, you must deal with this urgently - it is a very serious situation. Insulin is required for converting your food into energy and if you do not have enough, your body will develop something called ketones which will lead to a life-threatening condition called ketoacidosis in which your muscles are broken down and used for energy and your blood becomes too acidic. As I say, ketoacidosis is a very serious, life-threatening condition. Please see you doctor urgently and get tested for ketones - if you cannot get to your doctor then buy some ketostix and test yourself.

A c-peptide test will tell you the level of insulin you are producing. If it is not sufficient, you will probably need injected insuliln. A GAD antibody test will tell whether you have an autoimmune form of diabetes such as LADA.

A fasting (waking or before food) BG for a non-diabetic is between 3.5 and 5.5 mmol - the 11.7 you spoke of above is way too high. You should test your BG before and two hours after food. You need to see what your post-food spikes are like - your aim is to be no more than 8.5mmol after food if you are Type 2.

Smidge
 
Hi. I agree with Smidge that you are very likely to be a LADA. Do ask the GP for a GAD and c-Peptide test. If the GP won't do it then ask for a referral to the diabetes clinic. I had mine done privately as my diabetes GPs hadn't a clue. When they finally realised tablets weren't working I went onto insulin which is the solution. BTW are you on Metformin SR, the Slow Release version as it is kinder on the stomach? Many of us with LADA will have Gliclazide added for a while to stimulate the pancreas and also Sitagliptin to prolong the insulin after a meal. Insulin will finally be needed but it is not a problem.
 
Hi all,

Thank you for all your input.I am back in UK tomorrow evening and have made an appointment at GP surgery (was difficult as the "diabetes clinic" was full for next 3 weeks!!!) Seeing nurse on Monday but may try and see GP before this to force the issue on blood tests I need to get a true diagnosis. Have increased Metformin back to three times a day (only reduced it last Friday) and will put up with any side effects until I can get a prescription for the SR version from GP. Back in Spain middle of next week so may need to get GP here to do tests privately if not time/inclination for it to be done at UK GP on Monday.
 
Ok, tested before breakfast and 7.2, had 2 shredded wheat with milk and hot water to drink. After hour and half tested again and 11.2. This is with metformin 850mg three times a day. Cant really understand why morning readings average around 7.5 despite evening meal at 7pm usually fish or lean meat with cauliflower and broccoli only. Is this the "dawn phenomenon" or am I kidding myself and really do need a re-diagnosis and insulin? I am tired all day with or without exercise. My pre-evening meal readings are better and average about 6.1.
 
John47 said:
Ok, tested before breakfast and 7.2, had 2 shredded wheat with milk and hot water to drink. After hour and half tested again and 11.2. This is with metformin 850mg three times a day. Cant really understand why morning readings average around 7.5 despite evening meal at 7pm usually fish or lean meat with cauliflower and broccoli only. Is this the "dawn phenomenon" or am I kidding myself and really do need a re-diagnosis and insulin? I am tired all day with or without exercise. My pre-evening meal readings are better and average about 6.1.
Click to expand...

Those levels aren't great, John, but they're definitely not as high as I was expecting. If they are your normal levels, I doubt they'd be causing the muscle loss you are experiencing. Your breakfast was probably about 45g carb and that has risen your BG by 4mmol at the 1.5 hour mark. That means if you were at a better starting point e.g 5mmol before breakfast you would have been at 9mmol afterwards.

The fasting level could well be dawn phenomenum - it is the last and most difficult of the levels to get down, but it does come down if you lower your carbs and reduce your BG overall. Personally, I would still be getting the correct tests done so that you know where you stand.

Incidentally, in your opening post, you say you have a very low-carb diet - your breakfast has almost the same amount of carbs that I have all day. Cereal is very high carb, so maybe look for an alternative breakfast to help with lowering the overall levels?

Smidge
 
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