New Type 2... maybe?

Can you clarify what you were told to eat?
Some dieticians seem hellbent on causing problems by advising their victims to eat carbohydrates.

Welcome to the forum.

The first thing is to get a firm diagnosis. T1 and T2 are to separate conditions and treated differently.

Whilst you are waiting, it wouldn't do any harm to cut back on carbs.

Read around the forum and ask questions.

Also note that statins raise blood glucose and most of us wouldn't take them unless we had had a cardiac event.

Redrewmac said:

Hi, I was initially diagnosed with Type 2 after a company medical in October with a blood sugar at 91mg/dl, up from 42mg/dl the previous year (I hope I'm getting the terminology right); I then had the test confirmed by my GP about a month later and it had gone up to 105mg/d, he immediately proscribed 2 x 500mg Metformin twice a day and 1 x Alvastatin per day. I haven't had any fasting or finger prick tests at all.

In retrospect it obviously made sense of a lot of symptoms and issues in the months before the medical and although I found the side effects from the Metformin were initially very unpleasant I'm mostly adjusted to it now and I do generally feel a lot better. I do worry that I'm still suffering some symptoms but I assume I'm tired and making excuses for normal fatigue, etc. (I have two young children) but things are definitely better since I started the medication.

I have had another blood test a couple of weeks ago and a visit to the Dietician and am now down to 82mg/dl (any amount down is good I assume but I have no idea if this is a large or small drop), however, she seemed to think I may have been misdiagnosed and may actually be type 1, so as of today I've been referred to the Endocrinologist for further tests. I've found a lot of the information from the NHS a bit vague and am always a bit wary of online medical advice.

I should probably clarify I'm 39 man, 6'6" and 88kg (although I was very overweight until my early thirties), I exercise regularly and I didn't eat particularly unhealthily until my diagnosis. I have been pretty strict with myself since I found out (Christmas was a struggle) but I've been told I'm doing the right things by the dietician and I thought I was adjusting to the situation but I am a bit worried about being re-diagnosed and what that might mean.

Now I get to the end of my little essay I'm not 100% sure why I started, I think I just wanted to get it out of my head or perhaps I just want some advice and reassurance. It's been a frustrating experience since diagnosis but I suppose if that's the worst thing I can say I'm probably in a better situation than a lot of others.

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Hi @Redrewmac , and welcome,

I hate to inundate you with questions right off the bat, but is there a reason the dietician thought you might be a T1? Did you lose a lot of weight without trying, for instance? Was a C-peptide and GAD test ordered? My nurse thought the severe side effects of the metformin were an indication of T1, while it's actually the most common thing, for your gut to go nuts. I am a little troubled that you're just now starting to "get over" it though... That should've happened in about 2 weeks after starting it. You doing okay? Also, you were put on a statin. Uh... Did anyone actually test your cholesterol and if so, what was the breakdown? For some reason newly diagnosed t2's are still put on statins as a matter of course, even if they don't have high cholesterol. And statins are known for their side effects... Which include fatigue, muscle and joint pain, and would you believe it... Raised blood sugars. In some people, statins actually cause diabetes. So you might want to think those over. Not saying you should ditch them blindly off of what someone on the 'net says, but... Just something you should know.

Want to hear more weird stuff? I'm going to tell you to eat more fat. Yeah. Well, advise you to anyway. It doesn't affect your bloodsugars at all, you see. And cut carbohydrates out. Sugar raises bloodsugars, which is a bit of a "duh", but so do starches. So... When you put all the worst foods for a T2 together, that'd be fruit, pasta, cereal, spuds, rice, corn, bread and related flour based things, starchy veggies like most beans too... I know, kind of sounds like you have to start gnawing on a twig instead or something, right? Wrong. I'm hoping you like eggs and bacon? Tuna salad, salmon salad, salad with warmed goat's cheese? You won't believe how versatile cauliflower rice is. (This is the part where you run screaming for the hills, haha). Meat, fish, poultry, even extra dark chocolate's fine. Seriously.... There's a lot to be gained through diet. So should the metformin still be giving you trouble (especially if it's of the gastro-intestinal kind, in which case, i feel your pain), well... My HbA1c was worse than yours, when I started... And I've been in the non-diabetic range for 3 years. No statins anymore, no diabetic meds whatsoever. I don't know what diet changes your dietician mentioned, but if it was the same eatwell drivel my own pushed, you know, the diet that actually got me to be a morbidly overweight T2.... Then you might want to take a different tack. Here's a quick-start guide if you're interested, though you might not be after the unbelievable things I just mentioned (No statins? BACON!?), but I promise you, it's not a waste of time. Also, with two kids in the mix... You're going to need to get back to good, and quick. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- hope that helps, and if it sort of makes sense to you, you might want to try reading Dr. Jason Fung's The Diabetes Code, dietdoctor.com and this forum's website, diabetes.co.uk (not .org).

One more thing: Get a meter. You'll have to self fund, I'm afraid, but it will tell you what is actually working for you, and what isn't. You're going to get a LOT of conflicting information, from the professionals, from the people who actually live with this every day, like me, and probably the thousands of websites you're going to be leafing through. Not to mention a lot of charlatans trying to sell you snake oil. (Or diets that just starve you, basically). A meter won't try to sell you on a diet or dogma, has no ulterior motive... it just tells you the spag bol was a bad idea and that the eggs were worth repeating. You want to test before a meal and 2 hours after the first bite, aiming for no more than a 2.0 mmol/l rise. If you hit that, you're killing it. There's no curing diabetes T2... I don't have high blood sugars anymore though, so no complications, and it's not going to cost me my legs or kidneys. If I can stop T2 in its tracks, and keep it from being the progressive condition people tend to think it is, then so can you.

Good luck!
Jo

Redrewmac said:

Hi, I was initially diagnosed with Type 2 after a company medical in October with a blood sugar at 91mg/dl, up from 42mg/dl the previous year (I hope I'm getting the terminology right); I then had the test confirmed by my GP about a month later and it had gone up to 105mg/d, he immediately proscribed 2 x 500mg Metformin twice a day and 1 x Alvastatin per day. I haven't had any fasting or finger prick tests at all.

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Hi, and welcome,

Please can you clarify your measurement units in your test results? Rather than mg/dl were they mmol/mol units? And was it an HbA1c test?

The Atorvastatin is not a diabetes drug. It is a drug to lower cholesterol.

Hello and welcome,

You've been given great advice above so I just wanted to welcome you to the forum. You will find a lot of great resources and information and the people here are willing to give help and support.

Good luck and make sure you ask as many questions as you want- it can be a steep learning curve but you will get there.

Welcome.

I use the Tee2 and have been happy with it.

Once you get your meter, the readings may surprise you following "healthy wholemeal" options.

Redrewmac said:

Thanks All,

Sorry it’s take so long to rustle up a reply, there always seems to be a lot more information to digest than I expect.

I'll apologise in advance if my answers are still a bit vague but with the exception of my first (private) blood test I haven't been given a lot of actual detail by my GP (and I can't seem to lay my hands on the first report to confirm the measurement units), my understanding still isn’t where it should be.

I did lose a lot of weight very quickly and with no real effort but I'd decided to cut some things out at the time (alcohol mainly) as I was struggling with any exercise/activity and assumed I was losing weight because I’d changed my diet a bit. In retrospect (along with a lot of other issues) I was clearly "fatigued" and obviously lost weight too quickly.

The test results from the private doctor were fairly comprehensive: cholesterol levels, iron levels, kidney/liver function, etc. and although my cholesterol is apparently on the higher side it is apparently mainly made up of "good" cholesterol, I also had some impaired kidney and liver function which I was told could probably be attributed to the diabetes diagnosis.

I booked a GP appointment for a confirmation test and then had to wait for the actual blood test which finally confirmed the initial test 105 up from 91 (sorry no measurement units) even after I’d cut added sugar out of my diet entirely. My GP put me straight on 2000mg of Metformin and the Alvastatin (because of my increased risk of heart-related problems apparently) and told me everything else on the test was okay. He gave me some very general dietary advice and I booked another blood test along with a trip to the dietician.

I built up to the full 2000mg dose over about 3 weeks and it was still pretty hard going, I had fairly severe nausea almost continuously along with some delightful gastro-intestinal issues and dealing with extreme flatulence at work is great fun! But I did start to feel the benefits when I wasn’t feeling sick and or/gassy, I did feel a lot better in myself and after about a month the worst effects had subsided and I'm generally fine now except for very occasional bouts of nausea (which are becoming even rarer).

My second blood test also gave me Flu and Pneumonia vaccinations (they also wanted to give me MMR as well) and my new score of 82 (sorry no measurement units again) for my trip to the Dietician and she was probably the most helpful person I've been to see so far.

As far as my diet is concerned, I’d cut out most of the obvious things, with wholemeal replacements where possible, avoiding low-fat and starchy food while trying to get meal proportions “right”. She thought I was doing the right things generally and to keep going as I am but was concerned that as I wasn’t overweight there might be a chance I could actually be a misdiagnosed T1 and wanted to refer me for a antibody test to check, which is due in mid-March.

I have noticed my own reaction to certain meals and off the back of the replies above I have started looking at meters over the weekend; they all seem broadly similar so I’m not sure if there are any recommendations?

Thanks Again

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Hello again,

Yeah, the wholemeal thing isn't all that, really... It's still starches. Contrary to common belief, there is no such thing as a "healthy carb". So there's that. As for meters, there's some variation, some are more complex than others, but what you really want to know is this: What do the strips cost? Because if you're going to be testing a lot (and you probably will in the first months/year), that's where the sting is. @Rachox has some excellent info on meters, so I'm tagging her in.

If your good cholesterol was up, they shouldn't've put you on statins... They up blood glucose and in some people, can even cause T2. So why they still prescribe that even when it's not called for... Tsk.

10% of T2's never were overweight to begin with, they just had a lot of fat packed onto their liver and pancreas, but you can't see that on the outside: only detectable with an ultrasound. Considering your blood tests it is likely you have non-aloholic fatty liver disease, which is part of Metabolic Syndrome. (That's a package deal with diabetes, high cholesterol, high blood pressure, obesity and diabetes. I had all of them except for high blood pressure, so you don't have to tick all the boxes to have it, but, you get the idea). I lost a lot of weight without effort too, while being extremely fatigued which is usually a sign of T1, but I was tested (c-pep and GAD), and I truly am a T2.... You're not 100% sure yet, but who knows... Could still go either way.

It is a lot to take in. But you've got time to wrap your head around this. Took me a couple of months and a lot of reading, taking notes, experimenting and testing until my fingers were raw, but... Got there eventually. If you have more questions, throw them out there, there's always people around with answers!
Jo

Thanks for the tag @JoKalsbeek , sorry been busy today!


Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned. For a meter with cheap strips go for the Tee2 + found here:

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here:

http://spirit-healthcare.co.uk/product/tee2-testing-strips/


With more expensive strips is the Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual


And to be totally transparent I used to use the SD Code Free which has the cheapest strips available. However I found it to be becoming less and less reliable. Here it is for anyone wanting to give it a go, just bear in mind it seems they are replacing it with the Navii, details below.

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips

http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.

5 packs 264086

10 packs 975833


Don’t forget to check the box that you have diabetes so you can buy VAT free. (for all meters and strips)


Home Health have recently bought out this one too, but I haven’t heard any reviews yet, links to strips and the meter:



https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/


https://homehealth-uk.com/all-products/gluconavii-blood-sugar-meter-glucose-monitor-starter-kit/

Redrewmac said:

Thank-you,

I have taken the plunge and ordered the TEE2; I have a moderate phobia of needles which will make things interesting but I've managed to cope with the blood tests and vaccinations so far so I imagine I'll cope (no choice really).​

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You'll be fine. My hair used to stand on end whenever I had to prick... About a week later it was routine, doesn't make me blink.

Redrewmac said:

I'm guessing I need to find a better breakfast...

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Eggs and bacon always a winner and minimal impact on blood sugar too.

If your rise before and after eating is more than 2 then your meal had too many carbs. I reserve the roasties for Christmas day.

Carbs are carbs whether “healthy whole meal” or not, as you have discovered this morning. All grains/cereals/breads/flours are likely to fall into this category as likely will rice and pasta things in any colour or variety.

The rise after dinner was more than I’d be happy with. It’s best to restrict the rise to 2mmol or less. The potatoes will be the culprits.

Redrewmac said:

Breakfast will be the most awkward meal

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I haven't had morning breakfast for over 4 years ( except on very rare occasions) you could always just skip it.
Coffee with double cream is a great replacement.