How do they know if I am type 1 or type 2 ?

floridagal

Member
Messages
22
Hi everyone I was told by my GP nurse last week that my random blood glucose came back high at 19mmols..she booked me for a 15 minute session and read out the basics of diabetes type 2 to me. I never told her I used to be a nurse myself before becoming full time mum..didnt want to really as was bit upset with diagnosis...anyway she never asked me about my symptoms or well being at the time ..said come back next week.
I didnt tell her that my early morning blood test at the surgery which was meant to be a random blood glucose was actually a fasting one because I hadnt had time to eat that morning. I have extreme thirst, urination, appetite, tiredness and persistent thrush :oops: This has all happened in the last three weeks..
How does the nurse know I have type 2 ? I have followed my diabetic diet this week as instructed but still have the symptoms. Why hasnt she repeated my blood sugar or tested for ketones ? Just worried she has left me to try diet when | could need treatment now..do they not check your kidney function or anything when diagnosed ?
Thanks
 

Pneu

Well-Known Member
Messages
689
The short answer is that she doesn't she's assuming that you are which appears to be the common stance for anyone diagnosed as an adult these days. If you are concerned then you will need to push for either a c-peptide or GAD test but I suspect unless you make a fuss they will try and put you down the standard treatment route... i.e. diet + metformin... leave for a bit then onto one of the other myriad to type II drugs.

Also reference diet I suspect they have given you the standard avoid starchy carb line... in which case I would change instantly to a low-carb diet you will see much better results... I would also get yourself a test meter and begin to record your readings pre and 2 hours post meal so you can arm yourself if you do want to push for a better diagnoses.
 

Grazer

Well-Known Member
Messages
3,115
I'd agree. Cut the carbs and test. If they don't come down (BGs) with diet and exercise, or with Met, then look for further diagnosis
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
The short answer is they don't and as others have said they often try to deal with the most common possibility first. As it is the most common it is the easiest. Many non specialists seem to still think that T2 is the only possible diagnosis after childhood. It isn't, there are several variants, but the odds are that an adult will be T2.
Nevertheless, as you have symptoms that have materialised very quickly and also fairly high fasting glucose, I would keep a close eye on things.
If you are able, get yourself a meter and keep a check of your fasting glucose levels at the minimum, 19mmol/l is , I think, already quite high. You could also get some ketone strips from the chemist, with those you can see what your ketone levels are. If you see more than trace ketones, keep an even closer eye on them and if they start rising seek medical advice. Also if you begin to have other symptoms like stomach pain, sickness, unusual (rapid) breathing then again seek advice.
 

xyzzy

Well-Known Member
Messages
2,950
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Undeserving authority figures of all kinds and idiots.
Was in a remarkably similar situation as you 6 weeks ago when I was diagnosed. Like you I am not happy with them blindly assuming a Type 2 diagnosis (although it is the likeliest outcome) as there is late onset Type 1 in my family. Am pushing my GP for a a c-peptide and GAD test but I suspect this is going to take weeks if not months.

In the meantime like me you need to get control of your levels.

I did this by cutting carbohydrate to around 50 to 60g / day and am taking the Metformin 2 x 500g / day the nurse has prescribed. Initially I didn't bother too much about where the carbs came from so was eating loads of bacon, eggs and cheese as I found reducing carbs was critical not reducing calories or fat. Started off with levels like you and now 6 weeks later they are in the 4.5 to 6.5 range and I'm now able to vary my diet somewhat but I still restrict to around 60g carbs a day .

If you start doing this and don't start to see an effect within a few days or have keytones in your urine go back to the doc and don't take any nonsense.

Testing is important so takes Pneu's advice. Getting a meter and adequate test strips prescribed is a post code lottery and is one of the biggest issues for Type 2's. Play the "I use to be a nurse" card, keep a food diary and record your levels as the NICE guidelines state that a Type 2 who shows they are benefiting and understanding what they are testing for should get them.

The NHS has out of date dietary dogma on carbohydrate intake in many peoples opinion on this forum. When the nurse questioned my low carbs I was able to show her my BG levels falling and said I'd eat more carbs when they prescribed me drugs that allowed me to eat more safely.

Putting yourself in control is the key!
 

floridagal

Member
Messages
22
Thank you all for your knowledgeable replies. I went back to the Diabetic nurse today and took my first dose of metformin this morning. The nurse advised try this for a few days then add an evening dose.
I followed your advice and purchased a blood sugar monitoring kit. I was dissapointed to see two hours after my breakfast cereal that my blood sugar was 14 mmols as during the last week since diagnosis I have reduced my sugar intake down massively (ok one little episode with some **** tempting wine gums ).
Anyways tonight I thought I would get used to doing my own blood sugars and did it again. It was 20.5 mmols.

I realise getting control of my sugars may take a while but I was hoping to see some more improvement. I am now going to have a good read of the low carb dietry advice on here. The diabetic nurse was like eat carbs with every meal...Anyway thanks for your replies great to hear you all ahve such good control of your sugars.
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
Hi floridagal and welcome to the forum :) I think you would benefit from seeing this advice, regardless of what your type turns out to be. This information was written for new members and could help you. Your DN is not giving you the best information on diet. Ask as many questions as you need to as there is always someone here to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.