Getting the correct diagnosis of diabetes type?

Mynameiskez

Well-Known Member
Messages
67
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
finger pricking and maths at every meal
How exactly do they know which type you are?

I'm really struggling with management.
I was diagnosed three years ago, prescribed 1000mg of metfomin and sent on my way - fully discharged and no follow up.
Luckily i has health insurance at a work and am a curious type. I used the insurance to get a diagnostic test - they told me they could't do anything i hadn't already had doe but at least did highlight that i shouldn't have been signed off. it was agreed i would go to the private consultants NHS clinic as my insurance didn't cover treatment. At this time i was about 3.5 stone overweight so according to them this was the cause, end of lose, the weight.

I was then prescribed 2000mg of metformin. This didn't do much and the hospital was too far to travel so i was transferred again.
This time i got a really nice consultant who i worked well with - but he was retiring soon!!
He put me on Gliclizide with the Metformin, for a short while until I put on about a stone in 4 weeks. he then took me of gliclizide and added Sitagliptin x 100mg to the metformin. this didn't do much. I was accused of not trying hard enough with my diet. eventually 100mg of canoglifazin was added. this did seem to have a positive impact for some time and afforded some carbohydrate allowance. Otherwise i couldn't eat any carbs. Over a year i brought my weight down and all seemed well.

At this point i experienced a very difficult tradgedy and for 18 months had to prioritise care of my mental health over diabetes checks - was already taking a lot of time out of work for therapy, had a horribly unsupportive manager and assumed that the diabetes was in control as i had finally had a positive HBa1c result. i didn't have any diabetes checks in that 18 months.

in around sept i noticed that i had been suffering severe lethargy again and decided to go to the gp. a full bloods said everything was fine but my HBa1C was though the roof. 98!!! this was in december. I then severely cut back my carbs - i'm talking no carbs. very little carbs. and i started finger pricking again. my readings have been between 10 - 15 same meds, virtually no carbs.

yesterday they threatened insulin and upped my canglifazin to 200mg per day. As i was on the run yesterday i had one sandwich in the morning - on high protine bread (9g of cards per slice) and some wholemeal bread on a sandwich for dinner, then at 5pm i did my bloods and got a 6.2 i was over the moon and thought the extra canaglifazin must be working. today however not so.

Same breakfast, some lentils at dinner and meat and veg for my evening meal. i tested before my evening meal - 12. and 2 hours after 15!!!

What i want to know is how do they really know what type you are?
how do all of these drugs work. I just found out that metformin is for insulin resistence - how do they know i'm insulin resistent.

I know canaglifazin literally flushes sugars out.

If canaglifazin has been the only one to make a real difference then how do i know if i even need the other two meds. Perhaps i'm not insulin resistant at all but the rare good readings i get are from flushing and abstinence? I do find i really can't eat any carbs if i want a good reading.

what does sitagliptin do? why has that been given to me?

What if i actually have LADA?
i've not had any sudden wight loss or ketosis that i know of. But then i was totally symptom free before diagnosis anyway.

I'm honestly really worried I have been misdiagnosed and have been taking loads of meds for ages and getting no where.
I have another month before my next set of bloods. it's not long compared to the 3 years I've already been going through this - but really after three years of consistently high blood sugars another month isn't something to be shrugged off.

i've kept the weight off and they are happy with that at least. cholesterol is high though because of all the meat consumption!!!
 

13lizanne

Expert
Messages
8,262
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
The Gym, + unkindness and rudeness
You're having a tough time of it. All that I can offer from personal experience is that when I changed my diet to LCHF www.dietdoctor.com I was able to stop medication very quickly. I think, and reading round the forum many people seem to agree, that a low carbohydrate diet is the most effective way of keeping blood sugar in the low ranges. Everyone is unique and what works for one doesn't for another, however, you seem to have the best results when eating very low carb. I wish you success in finding a solution to keep your diabetes under control.
 

BrianTheElder

Well-Known Member
Messages
574
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Snide people
Hi, welcome to the forum.
I really think you're going to have to change your diet.
You probably need to cut bread out completely and lentils are not good either. These will raise your blood glucose even if they don't cause weight gain.
Please look on the low carb diet forum for help and explanations of what foods are good to eat.
Good luck!
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
If you want to know how sitagliptin works, have a read on medical sites.
In a nutshell, it is a dpp4 inhibitor, it helps lower the high readings post prandial by changing the glucogenesis from your meals. It changes the chemistry of your glucose to help lower your blood glucose levels.
In layman's terms, it helps reduce your post prandial spike, therefore your two hourly reading will be much better. It reduces the blood glucose levels steadily. Avoiding eventually the high blood glucose levels that will cause the horrible problems down the line!
But, to help the meds work, you will have to do the low carb as it seems your tolerance to them is high!
You do need to keep battling on!
I had years of ignorance to my symptoms, I was lucky enough to find an endocrinologist who diagnosed me properly!
I would certainly insist on getting a referral, most GPs haven't got a clue about metabolic conditions!
 

Diakat

Expert
Retired Moderator
Messages
5,591
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
The smell of cigars
The GAD test will test for autoimmune attack of your pancreas- if positive type 1, but negative does not mean not type 1! A c-peptide test can show how much insulin you produce, which is indicative of type.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. As you say you have excess weight and you may be having a lot of carbs you are most probably T2. Most GPs just guess like mine did and got it wrong. Metformin is a good start but only has a small effect so the low-carb diet remains the main start point. Gliclazide is only really of use if you have a failing pancreas as it stimulates it to produce more insulin but if you have insulin resistance thru excess weight you may already have too much insulin. The c-peptide test would show where you insulin is but it's expensive and few GPs will do it unless they suspect T1. Sitagliptin suppresses an enzyme which in turn suppresses insulin output after a meal. Again this is only really useful if you have a failing pancreas. In summary go for a low-carb diet; perhaps 150gm/day total or less. The fact that you gained weight with Gliclazide implies your carbs may be too high. If the low-carb diet with Metformin doesn't work for you then do discuss further with the GP.
 

fairylights

Well-Known Member
Messages
185
Type of diabetes
Type 1
Treatment type
Pump
You can be overweight and type 1 - or more often LADA - at my clinic and in a recent Balance magazine - LADA is a late onset type 1 but also with insulin resistance - so often a late developer and overweight type 1. It is also possible and common to be a thin type 2. The way to find out is to get a GAD antibody test - high anti antibodies show type 1. So although I am overweight, because I had ketones when I went to my GP I got sent to the hospital clinic (Iwas lucky) and got GAD and antibody tests and was immediately put onto insulin. After a couple of weeks I was able to stop insulin for a couple of months but my honeymoon only lasted a couple of months. My hospital treat me as a type 1, although diagnosed with LADA so I attend type 1 clinic hve attended DAFNE and have a pump, and a libre scanner supplied although only a couple of sensors, and all my care is at hospital clinic. I still struggle with spikes if I eat ANY carbs at all!
 

Mynameiskez

Well-Known Member
Messages
67
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
finger pricking and maths at every meal
Hi. As you say you have excess weight and you may be having a lot of carbs you are most probably T2. Most GPs just guess like mine did and got it wrong. Metformin is a good start but only has a small effect so the low-carb diet remains the main start point. Gliclazide is only really of use if you have a failing pancreas as it stimulates it to produce more insulin but if you have insulin resistance thru excess weight you may already have too much insulin. The c-peptide test would show where you insulin is but it's expensive and few GPs will do it unless they suspect T1. Sitagliptin suppresses an enzyme which in turn suppresses insulin output after a meal. Again this is only really useful if you have a failing pancreas. In summary go for a low-carb diet; perhaps 150gm/day total or less. The fact that you gained weight with Gliclazide implies your carbs may be too high. If the low-carb diet with Metformin doesn't work for you then do discuss further with the GP.
i don't have excess weight any more - i haven't for about 2 years - i was 3 stone over weight when diagnosed but lost that in a year by not eating any carbs. I have days sometimes weeks with no carbs and other days with very low carbs
 

Mynameiskez

Well-Known Member
Messages
67
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
finger pricking and maths at every meal
i
You can be overweight and type 1 - or more often LADA - at my clinic and in a recent Balance magazine - LADA is a late onset type 1 but also with insulin resistance - so often a late developer and overweight type 1. It is also possible and common to be a thin type 2. The way to find out is to get a GAD antibody test - high anti antibodies show type 1. So although I am overweight, because I had ketones when I went to my GP I got sent to the hospital clinic (Iwas lucky) and got GAD and antibody tests and was immediately put onto insulin. After a couple of weeks I was able to stop insulin for a couple of months but my honeymoon only lasted a couple of months. My hospital treat me as a type 1, although diagnosed with LADA so I attend type 1 clinic hve attended DAFNE and have a pump, and a libre scanner supplied although only a couple of sensors, and all my care is at hospital clinic. I still struggle with spikes if I eat ANY carbs at all!
except im not overweight
 

JohnEGreen

Master
Messages
13,189
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Tripe and Onions
I recently suggested to my diabetes specialist that I should possibly have a C-Pep test as it had never been done his response was no, as he did not find the C-Pep very useful. But he did order the GAD test I have recently found out this is because they consider the GAD to be more accurate.
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
It is possible to have the c-peptide and GAD tests done privately if your doctor refuses to do them. In your shoes I would be pushing for these tests.
 

AndBreathe

Master
Retired Moderator
Messages
11,322
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
i don't have excess weight any more - i haven't for about 2 years - i was 3 stone over weight when diagnosed but lost that in a year by not eating any carbs. I have days sometimes weeks with no carbs and other days with very low carbs

It's quite hard to have no carbs in reality, so I'm interested to hear what you actually eat on those days?

It could also be useful for us to understand what you're having when you talk about "some veg" and what you meant by one of your drugs allowing you "at least some carbs".

I'm not suggesting you're doing anything wrong, but there can be some popular misconceptions when discussions start around carbs.

I hope you find a way forward soon.
 

Mynameiskez

Well-Known Member
Messages
67
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
finger pricking and maths at every meal
I recently suggested to my diabetes specialist that I should possibly have a C-Pep test as it had never been done his response was no, as he did not find the C-Pep very useful. But he did order the GAD test I have recently found out this is because they consider the GAD to be more accurate.

Have been doing a lot of research into this. The reason why some feel it's not a suitable measure is because if your sugars are high at the time and you are producing insulin it might give a false low c peptide reading as the insulin is used up by the sugars so blood glucose should be done at the same time and shouldn't be more than 150 (whatever the measure is).
 

Mynameiskez

Well-Known Member
Messages
67
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
finger pricking and maths at every meal
It's quite hard to have no carbs in reality, so I'm interested to hear what you actually eat on those days?

It could also be useful for us to understand what you're having when you talk about "some veg" and what you meant by one of your drugs allowing you "at least some carbs".

I'm not suggesting you're doing anything wrong, but there can be some popular misconceptions when discussions start around carbs.

I hope you find a way forward soon.

Obviously you can't avoid carbs in your veg like greens. But I avoid all grains, rice, potatoes, pasta and starchy food.

I tend to either cook up some bolognais (no idea how to spell that) and eat it without pasta or do a big pot of something with chicken. I throw in things like board beans, mushrooms, onion, broccoli and colly. (In the winter) in the summer I will have chicken, makrel or salmon with salad.

I eat a lot of omelets and scrambled egg too.

There is so little variety though and I tend to go through phases of having the same one or two meals.

For snacks I have nuts, precooked meatballs, pork scratchings (though very bad for my high cholesterol).

On days where i am fed up with everything and done in by it all I will be naughty and have a small portion of chips. I know this isn't good but sometimes I'm so fed up I can't be normal and do this almost like self harm. It inevitably makes me worse.

On low carb days I'll have as described above but I might have a wholemeal wrap with bacon or scrambled egg for breakfast and no carbs the rest of the day.

If I am on the go (which is often) and in a situation I have to rely on the shops I will try and go for a wrap over a sandwich. Malted or wholemeal bread sandwich or ideally a salad from subway. Or pick up some awful processed meat product like Matheson chicken bites or a peperami (yuk)

If I don't get time to meal prep or forget my chicken pot dinner from the freezer I'm doomed. Relying on the work's canteen is not good and never provides any safe options.

With the amount of meds I'm on i would expect to be able to at least have one portion of cars per day without elevated readings the next morning.

I've been told now (last thursday) that indefinitely need insulin. My research shows that it is only after many years that t2 need insulin. It seems I am definitely LADA. But I have been left in limbo on the same mwds until my c peptide results are back. They also want to do a GAD test too but I'm awaiting an appointment for that.

My anxiety is very high at the moment. Moods swings and emotions all over the shop. Lethargic. Depressed. I can't carry on like this :(
 

AndBreathe

Master
Retired Moderator
Messages
11,322
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Obviously you can't avoid carbs in your veg like greens. But I avoid all grains, rice, potatoes, pasta and starchy food.

I tend to either cook up some bolognais (no idea how to spell that) and eat it without pasta or do a big pot of something with chicken. I throw in things like board beans, mushrooms, onion, broccoli and colly. (In the winter) in the summer I will have chicken, makrel or salmon with salad.

I eat a lot of omelets and scrambled egg too.

There is so little variety though and I tend to go through phases of having the same one or two meals.

For snacks I have nuts, precooked meatballs, pork scratchings (though very bad for my high cholesterol).

On days where i am fed up with everything and done in by it all I will be naughty and have a small portion of chips. I know this isn't good but sometimes I'm so fed up I can't be normal and do this almost like self harm. It inevitably makes me worse.

On low carb days I'll have as described above but I might have a wholemeal wrap with bacon or scrambled egg for breakfast and no carbs the rest of the day.

If I am on the go (which is often) and in a situation I have to rely on the shops I will try and go for a wrap over a sandwich. Malted or wholemeal bread sandwich or ideally a salad from subway. Or pick up some awful processed meat product like Matheson chicken bites or a peperami (yuk)

If I don't get time to meal prep or forget my chicken pot dinner from the freezer I'm doomed. Relying on the work's canteen is not good and never provides any safe options.

With the amount of meds I'm on i would expect to be able to at least have one portion of cars per day without elevated readings the next morning.

I've been told now (last thursday) that indefinitely need insulin. My research shows that it is only after many years that t2 need insulin. It seems I am definitely LADA. But I have been left in limbo on the same mwds until my c peptide results are back. They also want to do a GAD test too but I'm awaiting an appointment for that.

My anxiety is very high at the moment. Moods swings and emotions all over the shop. Lethargic. Depressed. I can't carry on like this :(

Well, your diet looks fine. Obviously, in an ideal world none of us would ever have anything normal, but I don't live in an ideal world, any more than you do!

To be fair, it seems like your medical team seem to be trying to be thorough, rather than gung-ho, so it's difficult to criticise thorough, but I can empathise with your frustration.

In the meantime, all you can do is do your best and keep reminding yourself that there's light at the end of the tunnel.

Good luck with it all.
 
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azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
@Mynameiskez If you are LADA - and it certainly sounds a possibility - then insulin should be a big help to you. Although the whole idea of insulin sounds frightening, in reality it is a relief to feel better and to be able to,control your blood sugar.
 
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