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Hospital appointment and don’t know what to expect

Carbs4life

Member
Messages
5
Type of diabetes
LADA
Treatment type
Tablets (oral)
Hi. I’m new to this forum, but have been reading for a while. My question is. I have now been referred to a diabetic consultant at the hospital and I’m wondering what will be said/done/advised. I’m currently on metformin, sitagliptan and gliclazide and my bgs are ridiculously high. 13-15 on waking no real decline and going to bed 19-27. The doctor has said I’ve exhausted all their medication options so I am now under the hospital for my ongoing care. Will I be out on insulin now? Or will they try incremin mimetics first?? I’m not too concerned what the outcome will be because I need to have control now, I’m thoroughly exhausted with it all. It’s taking it’s toll. But I need to be prepared in my own mind if they do suggest insulin. Work may be affected etc, I need to drive as part of my job description etc.
 
Welcome to the forums.

Your displayed info says LADA, so long term you're going to be on insulin, though I don't know whether they'll put you on that straight away, (I am not a doctor). I'm surprised you're not on insulin already, to be honest, as you're definitely at risk of diabetic ketoacidosis (DKA). Do you have access to ketone testing strips? (You can buy them from the chemist). If your ketones are high and your blood sugars are high you should call 111, as an appointment next week could be too late.

As regards the driving, are you talking trucks/lorries or just cars. Normal car shouldn't be a problem (you just need to inform the DVLC) HGVs etc may be more of an issue as there are more stringent requirements for keeping your license. Basically, the DVLC nees to be sure you won't go hypo at the wheel.

Good luck.
 

Hi. I check for ketones regularly I have a dual meter. No ketones present. I’m regards to driving I’m a rehabilitation coach and I am at times required to drive clients to and from various locations. I didn’t know if I was allowed to have passengers in a professional capacity? Insurance issues maybe? It has been suggested I am LADA although I haven’t had the relevant testing as yet, GAD or antibodies etc. I’m assuming they may do this when I go. I’m just a bit apprehensive really. Fear of the unknown etc. Thank you for replying.
 
They usually will get some blood tests done, such as GAD antibodies (ask for this and c-peptide), another HbA1c, liver and kidney function, lipid profile. With your high blood sugars, they may suggest you start on just basal (long-acting) insulin which will be one or two injections a day and show you how to do this, with some training. Or they could start you on MDI from the outset, where you also inject short-acting insulin before meals. They will give you a DN contact details that you can phone or email for support. They could enrol you on a DAFNE course if they're offering which is dose adjustment for normal eating. I hope it all goes well and you get the support you need.
 
Thankyou @ert what is mdi? Is that where you inject for meals as well as have the long lasting? I am armed with all my readings and diet plans. So I’m hoping they may pin point what my body is doing.
 
My liver function is bad, I have nafld but my kidneys are perfectly fine. Cholesterol is okay but they said I don’t have enough of the good cholesterol? So need to eat oily fish and the likes. I’m just relieved I’ve been referred now. I’m feeling positive about everything from here on in. It’s been a bumpy ride so far.
 
Carbs4life said:
Thankyou @ert what is mdi? Is that where you inject for meals as well as have the long lasting? I am armed with all my readings and diet plans. So I’m hoping they may pin point what my body is doing.
Click to expand...
MDI is a multiple dose insulin (long acting/short acting or basal/bolus).
 
They tend to do their own blood tests, even if you've just had them done in your surgery. I hope things improve soon. You must feel unwell with those high blood sugars.
 
Hi. I've been down the same route with the same tablets. I should have been diagnosed as LADA earlier and been given insulin earlier. Make sure the clinic does a C-Peptide test as well as GAD as you can be LADA even with a negative GAD as viruses can cause T1 (LADA). I suspect you will be placed on MDI and even if not I would push for it as it is the best solution when LADA and will give very good BS control compared with those tablets
 
if your blood sugars are that high on waking up then you definitely need insulin
 

With blood glucose that high you definitely need a basal insulin and a bolus. I’m so surprised your doctor just thought he can get away with prescribing oral anti-diabetic medicine as your blood sugars clearly indicate a need for insulin.

I’m a type 1 diabetic so I produce barely any insulin and I remember having a fasting blood sugar of 19mmol/L and they put me straight on insulin. You definitely need insulin
 
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