New diagnosis but not a surprise

Hi all, I've just been diagnosed with presumably type 2. My hba1c was 66 and I was very symptomatic with increased thirst and fatigue. I'm overweight and 39 so assuming type 2.

I'm complicated in that I have a diagnosis of heart failure, which is well-managed. I have a specialist pacemaker and enough medication for it to open my own pharmacy. *waves to anyone who recognises me from that description as I know some of my friends are here. If you know me, no you don't *

I have a history of gestational diabetes, managed with insulin, and then I've been pre-diabetic on and off since I had my youngest child in 2015, which I initially managed with diet until Life got in the way.

I dipped a toe into potential type 2 territory during the pandemic when my hba1c was just one into the type 2 range. My heart failure was diagnosed around then so that was the priority and I put my latest symptoms down to that.

With hindsight, the extreme thirst should have given me a clue.

I am slightly complicated in that I'm already on a diabetes medication, dapagliflozin, as it's used for my heart failure. When I got the hba1c results, my GP put me on gliclazide rather than metformin, as I had gastrointestinal side-effects from that when it was tried for my gestational diabetes.

I sort of know what I'm doing but simultaneously also haven't a clue. My GP put me on the gliclazide, warned me about the hypo risk with being doubled up on the dapagliflozin too, and then said she didn't know how to get me a meter as she was new to the practice. I am to report back to her in a few weeks with how I get on. What a wonderful, hands-off approach, colour me surprised.

I bought my own meter and have been testing assiduously pre and 2hr post meals, plus morning fasting and occasionally at bedtime. It's confirmed I can tolerate very few carbs, so I'm in the process of experimenting with my diet.

It's looking increasingly likely I need to go low carb and cut out even the carbs with low glycemic load. I'm disappointed as I was really hoping I could manage with the odd wholemeal pitta bread with lunch. I haven't tried pulses like chickpeas and lentils yet and I will be truly gutted if they have to go too.

I have no idea what happens next in terms of diabetes care so my main job next week is bugging the GP practice for a glucose meter and strips so I don't have to buy my own. I did speak to a helpful receptionist who told me they have them in the practice and went to put one aside for me, but they were out of stock.

If you got this far, thank you for indulging my brain dump.

JoKalsbeek said:

You certainly have a lot to be dealing with, but... Yay, you got a meter, so you're off to a good start. Would be even better to get it funded eventually, but for the moment, that's the biggest help you've got.

The glic can indeed cause hypo's, especially when mixed with a low carb diet, so tread carefully, and test, test, test. Even if you feel the slightest bit off, whip out a finger pricker, see what's happening. If you can eventually get rid of the gliclazide, that'd be nice... You're young, so it'd be excellent if it doesn't, somewhere way down the line, wear your pancreas out before you're done using it. But all in all... A low carb diet could very well work for you. Just please, do be careful of hypo's. Adjust medication as needed, with your hands-off doc, or in lieu of her, whatever nurse or specialist they may refer you to as you're a "complicated case". (Which'd be a good thing, because a specialist may be a bit easier to reach than a GP these days! Feel free to suggest it, they might grab the referral-option with both hands).

And if it helps at all, I can tolerate a little bit of chick peas (in hummus), which I barely could when I started out. The longer I'm on my way, the better my insulin sensitivity became, so... I can have a bit of the things that used to be problematic. It's not a never ever again thing, in some cases. Your meter'll tell you whether something's right for you or not, but for the time being... You're at 66. I was a lot higher than than when I started out, so odds are you'll get your numbers back to good fairly soon, either on diet, meds or both. Probably within the next three months, as you seem quite motivated.

You can do this.
Jo

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The motivation comes from my ADHD. I do love a good problem-solve.

I'm riding the wave of motivation while it lasts and hopefully when it wears off, I'll have put enough in place so that low-carbing becomes second nature. I know enough about myself to make sure I always have something prepared that I can easily grab if I'm busy, and that will stop me from making poor food choices.

I already feel so much better than I have for ages, so I'm using that to remind myself that managing this properly IS worth it.

Lobsang Tsultim said:

After a year of low carbing, I now find I can tolerate pulses but not grain or potatoes. This is good since I’ve now returned to a vegetarian diet

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Thank you, that's really good to know. Hopefully I'll be the same. I can manage without grains and potatoes but I'll miss pulses.