Newly Diagnosed- Most likely T2

[Daz79]

Hi I’m looking for a bit of advice as to what happens or should be happening next. I am a 43 year old male that 4 weeks ago my GP diagnosed me as diabetic only said most likely t2 gave me medication and never told me anything else.
I have some concerns as my father was type 1 so I’m unsure if this effects me or not? I have been giving no guidance to diet etc. The GP put me on metformin and gliclazide, my fasting readings are 8.6mmol in the morning I then rise to between 10.8- 13 mmol 90mins after food and seem to sit between 7.6 - 8.6 at most other times.
I’m not sure what I should be doing as nothing has been explained to me. I am also still experiencing a lot of muscle weakness, dizziness, peeing and drinking a lot and a bit of blurred vision.

Any help or advice on where to go from here would be great.
Thanks
Darren

 

[Diablo T2]

Hi @Daz79

I had similar symptoms to you when first diagnosed. As well as being put on metformin I was also told the following would happen:

1) I would have an annual diabetic eye screening and I'd be contacted with an appointment
2) I would have an annual hand and feet check to check my sensation/feeling
3) I would be given details of support - it ended up being an online resource as face to face was not possible

I was also referred to a consultant I think due to the high level of my blood glucose (they were quite a bit higher than yours). Once my blood sugars came down the referral ended.

(1), (2) and (3) did happen and I think are, or should be, standard practice in the UK.

I can't really offer any experience regarding your concern about T1 diabetes. What I would say though is that my understanding is that T1 is when your body is not producing insulin. T2 is when the insulin being produced within your body is no longer performing its function of removing excess blood sugar from the blood.

One of the things I did immediately was to stop eating anything with sugar and eliminating carbohydrates from my diet as I had learned from this forum and other places that was effective for many new T2s. It made sense not least because if sugars and carbohydrates (actually sugar is a type of carbohydrate) are being consumed and raise blood sugar, reducing or eliminating them seemed common sense. My blood sugar did reduce quickly at first and then at a more moderate rate of reduction. My symptoms went away within the first couple of weeks with the reduction in blood sugar levels.

I would suggest contacting your GP to ask what support you will get if nothing of the above was mentioned, but I think you'll find really useful information on this forum. Its great that you're measuring your blood sugar as that is a key to managing it.

 

[HSSS]

This is a great place to start understanding how to control type 2 as is this resource https://www.dietdoctor.com/diabetes.

Keep an eye on your levels though. If they go low often after lowering carbs it means you are then taking more medication than you will need then and it’ll need reducing. I’m really hoping they explained gliclazide can cause hypos and what to do if that happens?

It seems you are still eating more carbs than the medication and your body are able to deal with. So it’s decrease the carbs or increase the medication. One has a reasonable chance of achieve normal levels and no complications the other will help short term but it just makes the underlying problem of insulin resistance and will likely get worse over time even though at a slower rate than without medication.

What did the dr say about the type 1 possibility? Do you have any means to test ketones? If lowering carbs doesn’t help that would be a red flag, as would higher ketones. Seek immediate help if ketones go up especially if you feel unwell. Be aware very low carb will also cause some lowish ketones under 4 but importantly with low glucose (nutritional ketosis) rather than high glucose and high ketones (DKA) and the two conditions are very different.

 

[Daibell]

HI. Just keep an eye on your BS with a meter as Gliclazide can cause low BS if your pancreas still has good beta cells. In general you need to keep the carbs down but if your BS does go low you may need to reduce the Gliclazide dose. Metformin never does that much in reducing BS but it's a safe drug many of us have. Bear in mind that some people diagnosed as T2 are actually late onset T1 so keep an eye on your BS and if it keeps going up and you aren't overweight do discuss the T1 tests with your GP

 

[Daz79]

Hi @Daz79

I had similar symptoms to you when first diagnosed. As well as being put on metformin I was also told the following would happen:

1) I would have an annual diabetic eye screening and I'd be contacted with an appointment
2) I would have an annual hand and feet check to check my sensation/feeling
3) I would be given details of support - it ended up being an online resource as face to face was not possible

I was also referred to a consultant I think due to the high level of my blood glucose (they were quite a bit higher than yours). Once my blood sugars came down the referral ended.

(1), (2) and (3) did happen and I think are, or should be, standard practice in the UK.

I can't really offer any experience regarding your concern about T1 diabetes. What I would say though is that my understanding is that T1 is when your body is not producing insulin. T2 is when the insulin being produced within your body is no longer performing its function of removing excess blood sugar from the blood.

One of the things I did immediately was to stop eating anything with sugar and eliminating carbohydrates from my diet as I had learned from this forum and other places that was effective for many new T2s. It made sense not least because if sugars and carbohydrates (actually sugar is a type of carbohydrate) are being consumed and raise blood sugar, reducing or eliminating them seemed common sense. My blood sugar did reduce quickly at first and then at a more moderate rate of reduction. My symptoms went away within the first couple of weeks with the reduction in blood sugar levels.

I would suggest contacting your GP to ask what support you will get if nothing of the above was mentioned, but I think you'll find really useful information on this forum. Its great that you're measuring your blood sugar as that is a key to managing it.

Thank you for your reply much appreciated. I have another appointment next week with the GP so will be asking lots.

 

[Daz79]

This is a great place to start understanding how to control type 2 as is this resource

Keep an eye on your levels though. If they go low often after lowering carbs it means you are then taking more medication than you will need then and it’ll need reducing. I’m really hoping they explained gliclazide can cause hypos and what to do if that happens?

It seems you are still eating more carbs than the medication and your body are able to deal with. So it’s decrease the carbs or increase the medication. One has a reasonable chance of achieve normal levels and no complications the other will help short term but it just makes the underlying problem of insulin resistance and will likely get worse over time even though at a slower rate than without medication.

What did the dr say about the type 1 possibility? Do you have any means to test ketones? If lowering carbs doesn’t help that would be a red flag, as would higher ketones. Seek immediate help if ketones go up especially if you feel unwell. Be aware very low carb will also cause some lowish ketones under 4 but importantly with low glucose (nutritional ketosis) rather than high glucose and high ketones (DKA) and the two conditions are very different.

Hi HSSS, thanks for the link I’ll be sure to look at this today. On the type 1 possibility the doctor only said I had a 1 in 7 chance of it and that was all. I had been at the doctors for bloods 3 weeks prior to my diagnosis and those bloods were ok so I’m not sure if it coming on in 3 weeks or not is a big thing or if he thought I was gradually going to get worse, I think that may be why he wanted me back 4 weeks after the diagnosis but not sure. On the subject of the ketones at the moment I have no idea what they are, my monitor accepts ketones strips but I’ll need to try and read up on this.
There is quite a lot to try and get your head around, thank you for your reply though.

 

[Daz79]

HI. Just keep an eye on your BS with a meter as Gliclazide can cause low BS if your pancreas still has good beta cells. In general you need to keep the carbs down but if your BS does go low you may need to reduce the Gliclazide dose. Metformin never does that much in reducing BS but it's a safe drug many of us have. Bear in mind that some people diagnosed as T2 are actually late onset T1 so keep an eye on your BS and if it keeps going up and you aren't overweight do discuss the T1 tests with your GP

Thanks I’ll keep an eye on the BS. At the moment the levels just seem to sit the same as noted in my original post. I’m not sure how long both meditations take to effect anything or if my levels have been getting higher and the medications are now masking this.
Thanks

 

[HSSS]

Hi HSSS, thanks for the link I’ll be sure to look at this today. On the type 1 possibility the doctor only said I had a 1 in 7 chance of it and that was all. I had been at the doctors for bloods 3 weeks prior to my diagnosis and those bloods were ok so I’m not sure if it coming on in 3 weeks or not is a big thing or if he thought I was gradually going to get worse, I think that may be why he wanted me back 4 weeks after the diagnosis but not sure. On the subject of the ketones at the moment I have no idea what they are, my monitor accepts ketones strips but I’ll need to try and read up on this.
There is quite a lot to try and get your head around, thank you for your reply though.

Type 2 does not happen in 3 weeks. It builds up for years in the background unseen by glucose tests with rising insulin resistance and levels until it bubbles over to the blood glucose readings and finally gets noticed when hba1c reaches pre-diabetic (42mmol) or diabetic levels (48mmol). Type 1 can happen very quickly

Do you know what exactly was tested and your levels were on both the tests done earlier and the one that got you diagnosed? You have the legal right to this information and can be obtained via the nhs app (you’ll need to ask your surgery for that access probably) or as a printout from reception. Sadly too many drs ignore either rising hba1c or blood glucose until it’s well and truly in the diabetic range and use a subjective “normal” response. Several drs did ignore high glucose levels for me for several years and has happened to quite a number of us in here. Always ask for actual numbers and units and the name of the test done.

 

[Daz79]

Type 2 does not happen in 3 weeks. It builds up for years in the background unseen by glucose tests with rising insulin resistance and levels until it bubbles over to the blood glucose readings and finally gets noticed when hba1c reaches pre-diabetic (42mmol) or diabetic levels (48mmol). Type 1 can happen very quickly

Do you know what exactly was tested and your levels were on both the tests done earlier and the one that got you diagnosed? You have the legal right to this information and can be obtained via the nhs app (you’ll need to ask your surgery for that access probably) or as a printout from reception. Sadly too many drs ignore either rising hba1c or blood glucose until it’s well and truly in the diabetic range and use a subjective “normal” response. Several drs did ignore high glucose levels for me for several years and has happened to quite a number of us in here. Always ask for actual numbers and units and the name of the test done.

Hi I’m not sure what tests were done.

I went to the GP with the following symptoms-
Drinking lots
Urinating more
Burning / itchy down below
Blurred vision
Feeling really sick about an hour after food
Stomach pain
Extreme muscle weakness ( similar to doing a lot of weights at the gym)
Dizziness particularly bad an hour - 2hours after food

I had already been the 3 weeks prior due to extremely high blood pressure that’s how they had a set of readings at that point.
Then they did another blood test due to the above symptoms and said the next day I was diabetic.
They said I was close to it on the first reading 3 weeks earlier but never said anything about pre diabetes or even told me that at that point.
To be honest that’s the first time I’ve probably been to the doctors in maybe a year /year and a half.
I’ll ask to see the results and ask about tests next week

Thanks again

 

[RyJames]

Hi I’m looking for a bit of advice as to what happens or should be happening next. I am a 43 year old male that 4 weeks ago my GP diagnosed me as diabetic only said most likely t2 gave me medication and never told me anything else.
I have some concerns as my father was type 1 so I’m unsure if this effects me or not? I have been giving no guidance to diet etc. The GP put me on metformin and gliclazide, my fasting readings are 8.6mmol in the morning I then rise to between 10.8- 13 mmol 90mins after food and seem to sit between 7.6 - 8.6 at most other times.
I’m not sure what I should be doing as nothing has been explained to me. I am also still experiencing a lot of muscle weakness, dizziness, peeing and drinking a lot and a bit of blurred vision.

Any help or advice on where to go from here would be great.
Thanks
Darren

I hope you don't mind me asking what your Hba1c was at the time of diagnosis if you happen to know. I've had a similiar experience where I've been prescribed metformin alongside another medication whereas many on this forum haven't been initially.

Thanks in advance