Type 2 My T2 worsens every winter any ideas why?

Around late October my BG numbers begin to steadily rise. I notice the desire in September/October to want to eat carb laden food. I am careful what I eat in relation to carbs, but no matter what, my BG still rises and I’m on a low carb diet. I am on Metformin 2000mgs, Gliclazide 120mgs (m.r.), Pioglitazone 30mgs (just upped from 15mgs) and Atorvastatin 20mgs per day. I don’t have any other underlying health conditions.

Has anybody else experienced this sudden BG rise at this time of year? I’ve been a T2 for 3 years now. My HbA1c in September came back as 58 and deemed as acceptable, I’d rather it was lower. I’m having an HbA1c done next week which will come back higher.

Alan.

EllieM said:

Are you sure you are T2 and not LADA/slow onset T1? Many T1s get initially misdiagnosed as T2. But many T1s find they need more (or less) insulin in winter, so it's not surprising that T2s might have bgs that also change in winter...

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Hi Ellie, I don’t know whether or not I’m lada. I’m being treated as a T2. Your post to me is interesting and I have now booked to speak to my GP. I will raise the points in your post. Thanks for your input. Alan.

bulkbiker said:

When you say a "low carb diet" how many carbs per day do you usually consume?
With the amount of medication you are taking I would have expected a far lower HbA1c if you are really T2
As @EllieM says might be worth trying to get a c-peptide test to see how much insulin you are producing to check that you haven't been misdiagnosed.
Statins have been know to lead to elevated blood glucose in some so might be worth querying why you have been put on them with your GP. If they just say "diabetes" maybe suggest trying a period without them and see what happens.

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Hi Bulk Biker, I’d be lying if I said I knew my exact carb intake, but no bread, rice, pasta, potatoes, porridge, fruit etc. I also try and eat veg and food prepared by me rather than factory made things. My diet is certainly lower in carbs than it ever has been. I had a C-peptide test done well over a year ago and this came back with a very low reading, but still within the acceptable range. I believe my pancreas is on its way out. I was prescribed gliclazide (full dose now) and this brings up insulin production (?). I’d like a GAD test, but not sure this would prove inconclusive or be approved by my surgery. Thanks, for your reply and input. Alan.

DCUKMod said:

@Alan9009 - When you say your diabetes gets worse every winter, does it improve again through the summer, then repeat the cycle come winter? Or is it a case that you have your periodic run of checks and tests during winter, and each year it's slipping a bit further?

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Hi DCUKMod, my diabetes becomes increasingly worse and does not improve. It is slipping further each year. More medication, less energy etc. Thanks for your reply, much appreciated. Alan.

bulkbiker said:

In that case you are very likely not T2... odd that your doc is treating you in this way as forcing your pancreas to create yet more insulin might not be the shrewdest move in your armoury.
Might be worth asking them to review both your medication and diagnosis.

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Hi Bulk Biker, I’m speaking to my GP tomorrow and will collate notes to back up fellings of what is going on given my meds, diet etc. I have no knowledge of medicine which makes things difficult, but very much appreciate your input. Alan.

Resurgam said:

I suggest going to the doctor and really emphasizing your low carb intake and your progressively worse test results, maybe with a rather pointed, 'so I am obviously not a type two' - because you obviously are not.
There is no sense waiting for things to get really bad before getting a more accurate diagnosis.

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Hi Resurgam, thanks for your wisdom. I’m speaking to my GP tomorrow and will bear your input in mind. Regards, Alan.

DCUKMod said:

Having read the rest of the thread, I think you need to revisit your GP and explain your concerns, and map out a timeline of your test results (including the C-Peptide, obviously), medications and examples of your daily menus, with matching blood glucose readings.

I would do at least one full week of comprehensive food diary, with bloods alongside.

It seems to me that HCPs deal with what is in front of them, rather than looking to the bigger picture, and with a 10 minute appointment, and no clue why you have an appointment, before you arrive and tell him/her they can't be expected to go back through your notes to familiarise themselves as you have obviously done..

I treat my medical appointments like business meetings. I prepare. I know what I want the outcome to be, but also consider what any acceptable compromises might be.

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Hi DCUKMod, sound advice. I’m seeing/talking to GP tomorrow and will bear in mind. Thanks, Alan.

LittleGreyCat said:

Reading this thread, my BG control gets slightly worse every year.
I think it is more noticeable in the winter because I am generally less active and spend more time inside near the fridge instead of outside in the sunshine.
I also ride my bike less because the weather is generally much worse and the days are much shorter.

I'm still on just Metformin - 2,000 mg - but each review a second medication looks more likely.

All indications are that my pancreas is getting less good at producing insulin and/or the balancing mechanisms which control release of glucose by the liver and generation of glucose by gluconeogenesis are not working as well.

I have been diagnosed over 10 years now, so I'm probably not a misdiagnosed T1 in my honeymoon period but what is the cut off?

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Hi Little Grey Cat, it’s interesting that the winter challenges our body more, less light, less activity, more cold, more carb (intake) etc. Our body definately has to work harder. If a person’s pancreas is not as strong as it could/should be I can see why diabetes may become more of an issue.

I have spoken to and read about some diabetics whose diabetes changes in a less rational or unacceptable way, meaning that their diabetes will become less controllable by the medication they are on. As diabetes is a progressive disease this is to be expected. It’s when their health is compromised or becomes damaged due to bad diabetes management or incorrect diagnosis that positive changes need to be made to correct these problems. It’s getting the right help at the right time, but diabetes is such a complicated disease which makes it hard to treat.

I have only been diagnosed for 3 years and am a lay person, but regular check ups with your hcp are important as are testing your blood and having a healthy diet. Exercise is really important also. Maybe you could put that question on the forum and see what response you’d get? Thank you for sharing your experience, it’s nice to know you’re out there and showing support. Kind regards, Alan.