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

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 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
 
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.
 
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
 
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.
 
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!
 
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.
 
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.

 
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