Help please, can't bring levels down

Caroline2688 said:

After starting so well and reducing hba1c from 78 to 58 doing Fast800 (lost 33lbs so far) for some reason the last month or so I can rarely get levels into single figures despite eating well and not many carbs at all, and only complex carbs if I do have any. I walk every day and also have an exercise bike and and still my levels are in double figures most of the time at the moment. I drink plenty of water.

Where am I going wrong can anyone offer any pearls of wisdom please as it's doing my head in! Thanks in advance.

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where around is your number of grams of daily carbs ? are you under 100 grams ?

Caroline2688 said:

Yes I'll prepare to squeak! Less than 20g carbs yesterday, walked 3 times, still 11.1 this morning - it just isn't coming down!

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Once you have this sorted I would change doctors if you can, I have Hashimotos and Type 1 LADA diabetes Best wishes

I try and follow what I think is a comparatively low carb diet (I don't weigh what I eat, but I do steer clear of the obvious things - rice, root crop veg, bread, beer, pasta - in fact pretty well everything with refined flour in it (or ANY flour for that matter) and anything else I find is on the Do Not Eat If You're Diabetic list). My one guilty secret is Staffordshire or Derbyshire oatcakes (yum yummy yum yum) and only then one a day. I do drink the occasional glass of wine and (a little more frequently) a glass or three of whisky. I'm 6' 1" tall and I weighed in at just under 12 stones this morning. I exercise regularly, I exercise a LOT for a man of my age (well, I think I do), I cycle 100 - 150 miles a week, every week, either on the road, a trail or static. AND STILL I CAN'T GET MY BG DOWN INTO SINGLE FIGURES WITHOUT STARVING MYSELF!

Caroline2688 said:

Thank you all so much for all advice and guidance offered...waiting on a call from GP.

So tired and buzzing...no food until 1.30pm today and currently sat at 14.5 from 11.1 this morning. I had 100g greek yogurt 5 raspberries and 10g oat bran...and I've walked to work and back too!

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Hope they finally agree to a GAD antibody test for you best wishes

Maybe you need to point out that by dealing with your non type two symptoms she will have one less patient needing her attention.
Sheesh!!

Caroline2688 said:

Quick conversation with GP (she didn't have time to listen to issues as she had very ill patients waiting for a call - oh ok then!)

Hba1c being done again tomorrow and suggested maybe I should consider taking the gliclazide I was given!

I suggested perhaps they might like to test to make sure I am T2 as low carb was working and now after 33lb weight lost it isn't and I'm back to square one!

So I'll go in tomorrow hba1c will have gone up and I'll ask for a referral to endo.

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That’s an awful response by the GP, I would leave. Good luck with them

Hertfordshiremum said:

That’s an awful response by the GP, I would leave. Good luck with them

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It's not always possible to leave a GP. My little rural surgery is the only one for miles.

Hi, I believe it’s possible to be type two as this happened to me, I had amazing success for years with very low carb and extreme exercise, I had better numbers than non diabetics but alas my numbers started to creep up and it didn’t matter what I did or ate, high teens when being good is very frustrating.

I was diagnosed at 43 eight years ago, I only went onto insulin about 2.5 years ago (very ish) and I have a belly so classic type two, oddly I’ve been referred to a consultant for the first time and they are doing a c-peptide test this morning but that’s to see if I’m producing any or much of my own insulin.

Sorry not meaning to make this about me, just wanted to empathize as been there, done that. Hope you get some answers, best of luck.

Hi @Fenn I'm glad they are running the C peptide, they probably want to know if you are producing any insulin still. What seems to happen after time I believe is the pancreas can give up, wear out? and a type 2 can then be insulin deficient, Although I believe it's rare that they stop altogether. And even when a type 2 is not deficient in insulin production and is over producing, a type 2 can respond well to injected insulin. But a type 2 losing actual insulin production abilities is an over time, years thing.

I think the difference here is she was just barely diagnosed last year, so it's doubtful that as a type 2 she lost the ability this soon unless she's a type 1 instead.

But it would be nice if they ran an antibody test on you too. The honeymoon phase in a type 1/LADA can last years, 8 years or more. Change of diet, medications work at first because you still produce some insulin. Some theories out there suggest if you low carb you ease the burden of the pancreas and it lasts longer before it gives out, people purposely do that to stretch out the honeymoon phase and avoid insulin for longer.. Sometimes that works and sometimes it doesn't.

In my case I was misdiagnosed for over 8 years. My Bg starting to be elevated was caught very early and at lower levels. I ended up on medications that made me sick so I refused them and was then put on insulin, but not until after 4-5 years from initial diagnosis. I was put on insulin even though they thought I was a type 2 because my blood sugar levels started to shoot up and I had refused the meds. It's highly possible to go that long without insulin because you still make some for years as a type 1/LADA a lot of the time. And while most need insulin within 3 years of diagnosis that is not always the case. If you were put on insulin after about 5 years of diagnosis, you could still be a type 1 instead of a type 2. I have now run across other people that were misdiagnosed a lot longer than me.

Honestly I would ask about a test for antibodies if your c peptide comes back low.

It is possible to be a double diabetic.

https://www.diabetes.co.uk/double-d...en someone,resistance can be reduced somewhat.

Caroline2688 said:

So bloods taken and as predicted hba1c has gone back up! Was 78 then 58..and now after 34lb weight loss with waist measurement decreased by 22cm my hba1c has gone up to 70! So frustrating!

The nurse who took bloods was the diabetic nurse and she was great, totally got where I was coming from and that low carb, exercise and weight loss was working but isn't any longer and will do me a referral should it be indicated on test results etc.

Likely to have to go on to meds but it won't be gliclazide, she removed it from my script and couldn't understand why it had been prescribed! Metformin likely as she suspects insulin resistance. Although I also have PA and metformin reduces B12 so that could be tricky.

Seeing her next week to formulate a plan and in the meantime I'm just hopeful that I can get out of double figures as I feel dreadful

Thanks again for all the advice, much appreciated x

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Seems like you found someone who actually listened to you! Excellent.

@Caroline2688 I would ask for a C-peptide and antibodies test for possibly being a type1. You are already very low carb and added metformin. I would be really suspicious it's type1 and not type 2 but the tests will help tell which.


C-peptide test. This test tells if you are making insulin. It is not influenced by insulin that you take, only by what your body makes. Low or low normal is a sign of type 1/LADA as you are losing the ability to make insulin. But high or high normal is the sign of type 2 because you are insulin resistant and don’t utilize insulin right and your body will try to make more to make up for it.

An antibody test, The most common is a GAD test. But there are other antibodies so it’s best to be tested for the whole panel.
If an antibody test comes out positive, it is a sign of type 1/LADA. It means you have the antibodies that are attacking the beta cells that make insulin. There are some rarer cases where someone has no antibodies but still doesn’t make insulin and they don’t know why.