Newly diagnosed. Insulin so soon

taowen

Member
Messages
9
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi all

My first post on here. I am 32 years old.

November last year I was hospitalised with fever of unknown origin my blood glucose before was normal as was testing for work. During my stay in hospital glucose was discovered in my urine and bm hitting 18 at one point. From that night I stopped sugary drinks watched what I ate but was still getting fasting levels between 8 - 10.

I finally got to see a consultant was put on 1g metformin a day which stopped after food spikes but fasting still up. Due to side effects I was put on sitigliptin and I'm currently titrating upto 100mg. My GAD was negative and anti islets were negative which consultant says rules out LADA.

I am still getting high fasting and post meals of 7 - 10. I am following the diet advice and limiting my carbs.

I've emailed my consultant who's suggesting basal insulin. I just feel it's been very quick to go from diagnosis to needing insulin.

Any advice or ideas would be welcom.

Thank you.

Tom
 

dannyw

BANNED
Messages
430
Type of diabetes
Type 1
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Insulin
Welcome to the forum. You say you watch what you eat bit can you give us an idea of what that is ? Chances are, if you are following NHS dietary advice, your carb intake is too high. Try to reduce foods like bread, rice, pasta, cereal and potatoes.
 

noblehead

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Hi and a warm welcome to the forum Tom, hopefully @daisy will be along shortly with her advice to new members of the forum.
 
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taowen

Member
Messages
9
Type of diabetes
Type 2
Treatment type
Tablets (oral)
The diet advice from hospital was pretty much in line with modern thinking I think. She was suggesting 30g carb for breakfast 40 - 50 for lunch and dinner. Trying to stick to it that said probably less than that most days. Evening meals 60g pasta loads of veg etc. Lunch trying to make my own pot noodles and not have roles and crisps. So have cut lots of carbs out. Dietician is happy with my intake intrigued how her views may differ though.
 

daisy1

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Hi and a warm welcome to the forum Tom, hopefully @daisy will be along shortly with her advice to new members of the forum.

@taowen

Hello Tom and welcome to the forum :)

Here is the information mentioned by Noblehead above and I hope you will find it useful. As other members say, you need to watch your carb intake and you will find a lot of information in here about carbs. Carry on asking questions and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 130,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
The diet advice from hospital was pretty much in line with modern thinking I think. She was suggesting 30g carb for breakfast 40 - 50 for lunch and dinner. Trying to stick to it that said probably less than that most days. Evening meals 60g pasta loads of veg etc. Lunch trying to make my own pot noodles and not have roles and crisps. So have cut lots of carbs out. Dietician is happy with my intake intrigued how her views may differ though.
That's a lot of carbs you are eating..I have less than 50g a day.
you have a normal GAD, so you have plenty of natural insulin, so it may be a lot of insulin resistance.
it may take some time to work out what you think is best for you, most here have reduced carbs
 

taowen

Member
Messages
9
Type of diabetes
Type 2
Treatment type
Tablets (oral)
That's a lot less carbs. How do you cut them down. What do you have instead?
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. First a GAD test isn't a conclusive statement of your own insulin production capability. There are many causes of islet cell death and a c-peptide test is needed to measure insulin production. GAD is just one indicator of why. The number of carbs defined as 'low-carb' varies a lot. I have around 150gm/day and would describe that as low-carb. Some go way below 100gm/day and that I would describe as very low-carb. It's your choice, but if your insulin production is low then medication will be needed earlier the higher the carbs you have. If you are overweight then Metformin will help a bit but injected insulin may not due to insulin resistance; do discuss that with the consultant. You may or may not have a good level of natural insulin. If you are thin then you may well be LADA despite what you have been told. More tests are needed to exclude it so do ask for a c-peptide test. Many of us before taking insulin, if natural insulin is low, have taken Gliclazide and Sitagliptin to stimualte the pancreas before moving to insulin. As my diabetes GP said 'insulin is a last resort'. I didn't agree but it shows how much medics vary in their opinions. Note that in the latest NICE Diabetes DEC 2014 draft document they say that if tested early at diagnosis GAD result can be reliable but c-peptide not. Later after diagnosis GAD test can be quite unreliable but c-peptide becomes more reliable.
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
That's a lot less carbs. How do you cut them down. What do you have instead?
I have low carb, normal protein and more fats/oils...From the Southport gp who posts here
http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/March 2014/PP Unwin final proofs revised.pdf

it’s a long page and a few good video’s
http://www.dietdoctor.com/lchf
For me, the more carbs we eat the more carbs we want. they don’t give up easy
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm
 

taowen

Member
Messages
9
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Thank you all for your advice. I have had c peptide which suggests higher insulin production buy only just. This was whilst my CRP was still sitting at 70 so some resistance might be as result of sepsis. Metformin did help with after dinner spikes but not fasting results. But was taken off due to side effects. I worry about a higher fat diet due to risk of MI etc but understand good cholesterol etc.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. There is an increasing view that fat deposits in the arteries have more to do with carbs than the fat you eat, but views vary and I'm no expert. Perhaps if you have just enough fat with the lower carb and unsaturated fat where possible?
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
things are changing..also cholesterol has been taken off the 'do not eat list' you can eat as much as you want..no limit..dietary cholesterol does not inclease blood cholesterol
http://www.news.com.au/lifestyle/he...ncern-us-experts/story-fneuzkvr-1227229912653


American diabetic association

Position Statement

http://www.professional.diabetes.org/admin/UserFiles/0 - Sean/dc132042 FINAL.pdf

Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes;
therefore, goals should be individualized; fat quality appears to be far more important than quantity.


In people with type 2 diabetes, a Mediterranean-style, MUFA-rich [mono fat-rich] eating pattern may benefit glycemic control and CVD risk factors and can therefore be recommended as an effective alternative to a lower-fat, higher-carbohydrate eating pattern.
 

nigelho

Well-Known Member
Messages
227
Type of diabetes
Type 1
Treatment type
Insulin
The diet advice from hospital was pretty much in line with modern thinking I think. She was suggesting 30g carb for breakfast 40 - 50 for lunch and dinner. Trying to stick to it that said probably less than that most days. Evening meals 60g pasta loads of veg etc. Lunch trying to make my own pot noodles and not have roles and crisps. So have cut lots of carbs out. Dietician is happy with my intake intrigued how her views may differ though.
Good morning, Yes, carbs are the main problem for all diabetics. I'm type 1 and carb count with the help of the book Carbs and Cals sold on the diabetes shop and amazon etc Please real all food labels as food you think are ok contain lots of carbs, even the pot noodle.
 

taowen

Member
Messages
9
Type of diabetes
Type 2
Treatment type
Tablets (oral)
It's ok I make the pot noodle myself but was surprised how many carbs are in a nest of egg noodles. I got the book after appointment. It's a really handy book.
 

PatsyB

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Yes It is surprising what makes your blood sugar levels rise :eek: