Misdiagnosed with type 1 for 11 years- now type 2

[lcarter]

Hi all,

I won't bore with all the details again as I've already posted so much on here

The latest news is that I went for genetic testing at the hospital, and the specialist there immediately told me I was a type 2 based on my answers to a questionnaire, my blood results and symptoms. She also saw signs of insulin resistance with the dark skin appearing around my neck and underarms. She gave me a different type of metformin as I was struggling gastro wise with the normal slow release. She also told me to stop taking novarapid, and to reduce my usual 50 units of toujeo down to 25 over the course of 6 days.

Bizarrely, my levels are the same. They haven't gone high, like I expected. I'm not as hungry, and I am genuinely stunned. She has requested more bloods to be taken and she has said I can have the GLP-1 after checking my kidney function.

I just wondered if anyone has gone through something similar?

 

[Diakat]

@lcarter I guess it’s good to have an answer and not have to inject.
Have they been supportive emotionally over this as it must be a huge shock.

 

[ianf0ster]

I have not experienced anything close to your situation, so the following is just my opinion based on my experience of being a TOFI Type 2 using LCHF and IF. Plus my study of the subjects of Diet, Way Of Eating, Fasting, Insulin and the Type 2 condition.

It comes as no surprise to me that you are not feeling as hungry after eliminating the novorapid because that was always going to be a likely outcome.
Taking a rapid acting Insulin has the same effect as a Type 2 eating high processed carbs (unless your BG is really High):
One of the main mechanisms which drives hunger is a rapidly dropping BG. This is one of the reasons why people find it so difficult not to over-eat highly refined carbs. The rapid processing of refined carbs spikes BG which in turn drive the body to produce lots of Insulin to deal with it. This then does its job and the BG plummets making the person hungry again.

I would assume that your BG levels are about the same because you are eating less (at least less Carbs and Protein) than when you were taking the fast acting Insulin and were more hungry.

I see that in another thread you are talking about dieting. Asking about whether WW or SW.
Personally I feel that both of them (and nearly all other diets) have it wrong and are setting people up to fail. Because if you restrict Calories without first converting your body to fat burning or Keto mode, the body will think there is a famine and reduce your metabolic rate. Thus making you need to cut calories even more in order to maintain current weight never mind continued weight loss!

But if the body is fat adapted (either by LCHF, LCHP or by IF or longer Fasting) meaning having low Insulin levels for much of the day, then the hunger won't be there since your body will have a huge energy store (your body fat) available to it - so no need for reducing the metabolic rate.

 

[lcarter]

I have not experienced anything close to your situation, so the following is just my opinion based on my experience of being a TOFI Type 2 using LCHF and IF. Plus my study of the subjects of Diet, Way Of Eating, Fasting, Insulin and the Type 2 condition.

It comes as no surprise to me that you are not feeling as hungry after eliminating the novorapid because that was always going to be a likely outcome.
Taking a rapid acting Insulin has the same effect as a Type 2 eating high processed carbs (unless your BG is really High):
One of the main mechanisms which drives hunger is a rapidly dropping BG. This is one of the reasons why people find it so difficult not to over-eat highly refined carbs. The rapid processing of refined carbs spikes BG which in turn drive the body to produce lots of Insulin to deal with it. This then does its job and the BG plummets making the person hungry again.

I would assume that your BG levels are about the same because you are eating less (at least less Carbs and Protein) than when you were taking the fast acting Insulin and were more hungry.

I see that in another thread you are talking about dieting. Asking about whether WW or SW.
Personally I feel that both of them (and nearly all other diets) have it wrong and are setting people up to fail. Because if you restrict Calories without first converting your body to fat burning or Keto mode, the body will think there is a famine and reduce your metabolic rate. Thus making you need to cut calories even more in order to maintain current weight never mind continued weight loss!

But if the body is fat adapted (either by LCHF, LCHP or by IF or longer Fasting) meaning having low Insulin levels for much of the day, then the hunger won't be there since your body will have a huge energy store (your body fat) available to it - so no need for reducing the metabolic rate.

Thank you.

I asked about the dieting prior to this new information which I got this week. I will have a good read up on the things you have mentioned, thanks.

 

[lcarter]

@lcarter I guess it’s good to have an answer and not have to inject.
Have they been supportive emotionally over this as it must be a huge shock.

Not exactly, no

 

[Diakat]

Feel free to share here, we have some wonderful T2s who are hugely supportive and can help you get to grips with things.

 

[Rachox]

Hi @lcarter and welcome to the type 2 club.
I have been type 2 for over two and a half years and just take Metformin and eat a low carb diet (30 - 50g per day), so my carb counting is different to what you’re used to I expect. I have achieved non diabetic HbA1cs for the majority of that time. Are you aiming to use diet as well as meds to treat your type 2?

 

[DCUKMod]

Oh boy, @lcarter , this really has been going on a bit.

I appreciate it's probably good to have had a definitive diagnosis, although I'm sure, it also brings a lot of turmoil, questions, and maybe even anger about the last 11 years. It's quite something to get your head around.

Where have things been left for you now? Do you have another clinic appointment

 

[lcarter]

Hi @lcarter and welcome to the type 2 club.
I have been type 2 for over two and a half years and just take Metformin and eat a low carb diet (30 - 50g per day), so my carb counting is different to what you’re used to I expect. I have achieved non diabetic HbA1cs for the majority of that time. Are you aiming to use diet as well as meds to treat your type 2?

Well done! Yes, I am going to try to combat it with what I eat.

 

[lcarter]

Oh boy, @lcarter , this really has been going on a bit.

I appreciate it's probably good to have had a definitive diagnosis, although I'm sure, it also brings a lot of turmoil, questions, and maybe even anger about the last 11 years. It's quite something to get your head around.

Where have things been left for you now? Do you have another clinic appointment

I know

I have a clinic appointment this friday to get the once weekly injection GLP-1.

Then I think I'm being put back into the community with an awesome DN.

I'm now on empagliflozin- started yesterday.

It's crazy!

 

[DCUKMod]

I know

I have a clinic appointment this friday to get the once weekly injection GLP-1.

Then I think I'm being put back into the community with an awesome DN.

I'm now on empagliflozin- started yesterday.

It's crazy!

Lcarter, I know we don't always get our own way on these things, but if referring you back to GP services is mooted, in your shoes, I'd be appealing to remain in secondary care until my treatment was stabilised - at least.

My feeling is your situation (diagnosed T1, instead of T2) quite unusual and, in my experience, there may not be the knowledge and expertise to see you through at least the earlier stages of that in the community.

When it comes to medical treatment of any sort, much of how it goes depends on how we feel about it and how confident we are in the treatments offered.

If we believe the tablet/injection/diet/person or whatever, won't help us, the chances are we'll be looking to find fault, whereas if we believe the tablet/injection/diet/person or whatever is the way forward we will be looking to find ways to make it work. Such is the human condition, in my experience.

With the flozins, please ensure you keep the fluids up, as you'll be weeing more.

 

[ringi]

Empagliflozin is a SGLT-2 inhibitor, hence be very carefully if you combine it with a very low carb diet, as there is a risk of DKA without BG first becoming high. Personally I would strongly request a blood ketone meter and test strips so you can get to A&E if you start to develop DKA. Remember dehydration and low salt intake also increases the risk of DKA.

(A SGLT-2 inhibitor puts much of the post meal BG spike down the WC, very lowcarb prevents much of the post meal BG spike, hence personally I question if there is much benefit of SGLT-2i for anyone who is willing to keep to a very low carb diet.)

 

[Goonergal]

Hi @lcarter

What a tricky situation for you being misdiagnosed for so long. Will doubtless be a big readjustment. I’m another managing type 2 via diet - and enjoying the way of eating, but I don’t have any meds to take into account.