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New type 2 diagnoses

J

Jackie0022

Well-Known Member
Messages
50
Type of diabetes
Type 2
Treatment type
Insulin
hi, I’m new to this forum so after some help and advice please.
5 weeks ago I went to my GP as I had lost 1 1/2 stone in 6 months, and I’d tested my bloods on my husbands machine which were 18.8 going up to 22.5 that evening. he sent me for blood tests and then I went back to see him only to be told I have diabetes. He checked my ketones which were 4 so the next thing I know he is phoning and sending me to the hospital. Here I had more bloods taking for testing and insulin given. They sent me home but I had to return the next day for another dose of insulin. I saw the diabetic specialist and have been injecting insulin ever since whilst I waited for confirmation of which type. Anyway 5 weeks later it has been confirmed as type 2. I inject 9 units morning and 10 unit evening. They are now talking about changing the insulin to Gliclazide but are saying that they may not work as the insulin I am taking is on ‘the cusp’! My husband takes this and has terrible on and off side effects. I have my reservations about taking this and am looking for advice and views about this. I am waiting to speak with the nurse but what are the pros and cons of staying on insulin against changing to Gliclazide.
 
As a type 2 you do have more potential options in treatment regime than a type 1. A large proportion of us in here achieve a great deal of control through diet. Sometimes with medication and sometimes without or reducing medication as control and diet improve.The way of eating we utilise is most commonly low carb to varying extents.

As a type 2 we generally are insulin resistant and as such actually already produce a huge amount of insulin trying to overcome this. We can’t get the glucose in our blood into the cells to be used as energy. Often this can lead to the symptoms of tiredness and weight gain along with the high blood glucose levels and thirst and urinating as the kidneys try and clear the glucose from the blood.

Virtually all carbs are turned to glucose in the body, not just sugar. This is bread, rice, potato, pasta, cereal, oats and anything with flour or grains most commonly. Drastically reducing these immediately lowers blood glucose levels so we either don’t need or need less medication. If we’re carrying extra weight (which in turn make sure the insulin resistance worse) getting the blood glucose levels down also has the very nice side effect of reducing the fat we store and helping us burn off that we’ve already stored.

Further information in the links below

https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple

And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation

and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.


Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3,6 or even 12 months and then have no idea what had what effect. Using a blood glucose meter is the only way to do this and see exactly what each food does to your levels. Ideally no more than a 2mmol rise from immediately before eating to around 2 hrs after.


IMPORTANT FOR ANYONE ON MEDS CONSIDERING LOWERING CARBS: if you lower your carbs then any glucose lowering meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc (this is not relevant for metformin on its own) than your new carb intake requires. Keep a close eye on your numbers and do this with your dr. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around.
 
Forgot to ask do you know what your levels actually are?

And did they check if you are still producing insulin of your own? The above advise assumes you are indeed still producing insulin. Some people in these circumstances can indeed come off insulin and other meds in time with drs approval.

If you’re not producing it then Insulin will remain a part of your treatment but fewer carbs may still assist. I’d be getting advice from other insulin using type 2 or type 1’s in that case rather than a type 2 like me that doesn’t use it.
 
Welcome to the forum, @Jackie0022.

Diagnosis comes as such a shock, doesn't it? Glad you found us though. There are lots of knowledgeable, friendly and helpful members on this forum, who will be only too happy to help.

Have you looked at changing your diet? Changing the way we eat, can really make a lot of difference to T2s. When I was diagnosed, my GP told me that there probably wouldn't be any option other than going onto insulin (with an HbA1c of 100). After three month low-carbing and metformin (a mild diabetes drug), my blood sugars were at normal non-diabetic levels.

Have to agree with @HSSS though if you are on insulin, it is probably best to do this in cooperation with your specialist as insulin combined with low carbing can lead to dangerously low blood sugar levels.

Have a read around the forum and fire away if you have any questions.

Also tagging @daisy1 for some super helpful introductory info.
 
Thanks, my levels have come down from between 18 - 20 (hba1c was 13) to between 7 - 9 sometimes going lower or higher. Apparently I’m not producing enough insulin that’s why, I think, they are saying the Gliclazide may not work even if I take the maximum dose. I’m thinking of staying on the insulin (if that’s an option) because I don’t like the sound of the side effect of the Gliclazide. I weigh 9 st 10 so I’m not over weight but I do take an immunosuppressive for a skin condition. I’m not even sure if this makes a difference or is relevant and would be interested to find out.
 

Would your immunosuppressive be steroid based?
 
At they moment I’m on a high carb diet of between 40-50g of carbs per meal. This was recommendation of both the nurse and dietitian in conjunction with the amount of insulin. If I was taking a couple more units of insulin then they would keep me as I am but I think they would like to try tablets but have told me they may not work and if they don’t work it’s back on insulin. Also I work in catering so can’t have the sickness and Diarrhoea side effects.
 
Jackie0022 said:
Steroid sparing agent, what ever that means. I have been taking them for 10 years.
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I've not heard that term before but a quick google says they are a class of drugs that reduce the dosage or need for steroid treatment. So not much clarity there, sorry. There are some members here with what is called steroid induced Diabetes, I am not saying this is the cause of your condition but they will have a greater knowledge base than I do about this. Hang fire, someone will comment soon on this and if not you can ask about it at your next appointment with your team. Good Luck.
 
Jackie0022 said:
Also I work in catering so can’t have the sickness and Diarrhoea side effects.
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If it's any consolation, taking gliclazide doesn't necessarily give you diarrhea, it's just one of the possible side effects. Honestly, if you read the side effects of almost any medication then you'd probably never take it.

Honestly, in your position I'd be tempted to go low carb just to give your system a bit more of a chance to cope, but you'll have to discuss this with your medical team, as too much insulin combined with too little carbs results in a hypo. Hopefully, your team have already explained these to you (I could give a long lecture about eg the danger of driving while hypo, but don't want to overload you.)

Good luck.
 
@Jackie0022
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

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 600,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
 
Hi @Jackie0022

In my not very expert opinion, if your pancreas is not producing much insulin then Gliclazide may make matters worse. It works by forcing the pancreas to secrete more insulin, and in doing so it is possible your pancreas will wear out much faster.

As type 2s, the less insulin we need the better we will be. The best way to reduce the need for insulin is to reduce the carbs that create the need for insulin. I would be tempted to speak to the nurse about lowering your carb intake and adjusting your injected insulin accordingly. What your nurse has said about eating those carbs is advising you to eat up to the medication levels she has set. What is much better is quite the opposite. It is better to medicate according to what you eat.

I also am not fully understanding why you have been diagnosed T2 when they know you produce very little insulin yourself.
 
Bluetit1802 said:
I also am not fully understanding why you have been diagnosed T2 when they know you produce very little insulin yourself
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Just yesterday I was told type 2 don’t produce enough insulin by my practice nurse responsible for diabetes. When I challenged this she backed down and agreed we generally produce a lot but can’t use much. If patients are being told inability to use it is the same as inability to produce insulin, it may be that some don’t actually understand what’s happening and take these explanations at face value. Not saying that’s the case here but in general.

@Jackie0022 do you know which tests they did (I assuming they tested not assumed) to confirm type and the results?
 

I asked the nurse today if it was a case of producing enough but the body not working with it or that I’m not producing enough, the answer I’m not producing enough therefore that’s why I lost all the weight as I was using body fat. I’d be interested to know at what % it is working but not sure if they’d tell me or if they know. I presuming that what ever treatment plan I have it will only get worse over time?? The tablets they recommend may not work anyway with the maximum dose being the same as the insulin I’m injecting (I think that’s how I understood it). I told my concerns to the nurse today and she has put that on hold and told to to speak to the doctor about it when I go in June, so until then carry on with the insulin, which is working fine. I my view, why change something that works for something that may not work!!! I more I read the more confused I get and I think I need to list all questions and talk to someone face to face.
 

Sorry I forgot to say they did all the normal blood tests, urine for the ketones and then I had to go back for 1A-2 bloods and GAD65 antibodies blood tests
 
Jackie0022 said:
Sorry I forgot to say they did all the normal blood tests, urine for the ketones and then I had to go back for 1A-2 bloods and GAD65 antibodies blood tests
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If they know you aren't producing much insulin, you probably had the c-peptide test and it might help if you obtain the result of that, including the measurement units used as these vary from place to place. You could also have had a fasting insulin test, but this is unlikely in the UK. The GAD tests just show if you have any antibodies and produce false positives and false negatives sometimes, but can be an indication of T1. I don't know what the 1A-2 bloods are.
 

I don’t understand it all either!! All the tests I had indicated type 1, the dietitian worked towards type one and a couple of the nurses said that all the symptoms suggested type 1 so I’d just got my head around that, then they confirm it’s type 2! I now feel I am back to square one and have to get my head around it all again.
The nurse told me today that yes it is a case of my not producing enough insulin. I’d be interested to know at what %. They say the tablets may not work with the maximum dose being the same as the insulin I’m taking, why change something that works for something that may not??
 

Would they know how much of a % my pancreas is working and how much insulin I’m producing?
 
Jackie0022 said:
why change something that works for something that may not??
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Exactly! If you are comfortable injecting, and would feel uncomfortable with Gliclazide, it's a no-brainer IMO. Hopefully you are T2, and in that case you can work towards getting off insulin completely, assuming you do produce enough of your own, or at the very least, injecting less.
 
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