Newly diagnosed T2DM and I'm only 26. :(

[sud5nala]

Maybe the doctor intends to use your response to the treatment as one indication of what type of diabetes it is. Although T2 is a plausible guess, you deserve to be tested to identify the type. Unfortunately, doctors tend to miss uncommon types of diabetes, to not even think of them.
You could have a single gene diabetes. If this were the case, the most common are MODY 3 and MODY 1, in that order. Most people with these conditions are originally misdiagnosed as T1 or T2. 90% of MODY 3 is diagnosed by age 40. People with MODY typically can cite a family history of diabetes.
To establish Type 1, they need to test for not only GADA, but also ZnT8A and IA-2A, although some doctors may never have even heard of these.

 

[lovelifex]

I love rice too and I go for basmati rice which is lower in glycemic index. Just so you know one cup of boiled rice equals 45 grams of carbs. So if you take two cups that would bump up your carb intake. I only have a quarter cup of rice per meal with loads of vegetables and some protein like fish or chicken. Try cutting down on rice and you will be okay.


Sent from my iPad using DCUK Forum

Thanks for this Keesha. I cut rice from my diet and so far not that successful because there are times where I'd eat at least half a cup haha. Is it ok though to eat like a lot of protein with vegetables?

 

[lovelifex]

Hi @lovelifex, have you had blood tests for GAD antibodies and a C-Peptide test. There's also the possibility that you are a form of t1 rather than t2 and these would confirm it.


Sent from my iPhone using Tapatalk

Hey! Umm no, I wasn't tested for GAD and C-peptide. I was diagnosed by my hgba1c, urinalysis and random blood sugar. Is it possible that I'd be a type1 despite my body size?

 

[lovelifex]

I would recommend you to take a look at the www.dietdoctor.com website which gives you a lot of clearly presented information about diets for diabetics and weight loss. If you decide to follow a low carb - high fat diet (which many people find successfully helps them to reduce their need for medication and helps with weight loss too ) then do be sure to check with your doctor about possibly reducing the medication to suit the lower carb intake.
I am surprised that you were told to test BG only every 3 days if you are on insulin. i would have thought you needed to test more regularly. If you really want to be in control then you should test before and after meals to see how the food you eat affects your BG levels and keep a food diary along with the readings of several weeks. Then you can see if reducing portions or finding alternatives will help.

Thanks for the website and advice, I'll read on it.
I started noting my food diary but I haven't monitored my BG after meals, would it be immediately post meal or at least a few minutes or hours after eating?

 

[lovelifex]

Have you seen the Low Carb Program? www.diabetes.co.uk/lowcarb - It may be worth signing up, even just to see what others are doing? (it's free)

Thank you for this Admin, I will read on it. I just have difficulty with keeping track on my food because in our place, most of our meals do not have nutritional content measurement. I base it mostly on portions when logging my food diary.

 

[lovelifex]

Lovelifex - For most T2s they find the greatest impacts on their blood numbers come from adjusting what they eat and drink. This was certainly the case for me, and monitoring what I ate and drank, alongside finger prick testing my blood sugars gave me immediate and direct feedback on what foods I got along with or had to put aside - for some time at least.

As you arre taking insulin, I am assuming you have a monitor and test strips to test your bloods. If you do, that's fabulous information you can start to gather. Once you have data, then you will know what seems to make your blood sugars very high and what keeps them relatively level.

One warning I will make in your case is that you really do need to have a good discussion with your Diabetes Team (whether hospital of GP based) before making any significant changes to your diet as it is likely your insulin dosage has been calculated to manage your sugars on the diet you are currently consuming. If you were to make changes to your diet, still taking the same amount of insulin you could find yourself going a bit low. You need to understand what to do should a couple of scenarios occur.

Take it steady. I completely appreciate you want to make positive changes, and that is to be applauded, but your insulin use has to be taken into account.

Good luck with it all.

Thank you for this. I absolutely appreciate everyone's advice. I'm having a hard time because my doctor didn't discuss this with me. We wouldn't be meeting till next week because my doctor is based in my hometown. Yes I was diagnosed and given meds, was told to control my diet assuming I have to avoid high fat, high salt and even sweets which I am trying to comply with. I wasn't told about computing my insulin though based on carbs and I learned about it here when I read it in different threads. For now, I could only record my food diary and the said BG post meal, my medications of fixed insulin: 40 units during my waking hours and 15 units during my rest hours. It is also difficult to measure the food content in our meals because it is given in portions so I base it e.g 1 small bowl of beef brocolli viand = BG. Kinda feeling frustrated.

 

[lovelifex]

They don't tend to routinely offer cpeptide or gad tests on diagnosis unless there is a query over diabetic status - i.e if the story of diagnosis suggests that type 1 is more likely and to consider that the doctors would be looking at BMI, whether there was rapid, untried for dramatic weight loss, whether there was very high blood sugar (30+) ketones or DKA on diagnosis - @lovelifex if any of that sounds familiar it might be worth asking for the further tests.

Thanks for this. Maybe I wasn't tested for this because my BMI is above normal and I wasn't also tested for ketones (does that show in the urine test? I guess my result was negative). I was only tested with hgba1c, urinalysis and RBS.

 

[lovelifex]

Maybe the doctor intends to use your response to the treatment as one indication of what type of diabetes it is. Although T2 is a plausible guess, you deserve to be tested to identify the type. Unfortunately, doctors tend to miss uncommon types of diabetes, to not even think of them.
You could have a single gene diabetes. If this were the case, the most common are MODY 3 and MODY 1, in that order. Most people with these conditions are originally misdiagnosed as T1 or T2. 90% of MODY 3 is diagnosed by age 40. People with MODY typically can cite a family history of diabetes.
To establish Type 1, they need to test for not only GADA, but also ZnT8A and IA-2A, although some doctors may never have even heard of these.

I honestly did not understand any of the information but I will read on it. I'm thinking of what you said that the doctor will base my type on the response of my treatment. I really lack information based on everyone's response, I'm kinda feeling frustrated now.

 

[seadragon]

Thanks for the website and advice, I'll read on it.
I started noting my food diary but I haven't monitored my BG after meals, would it be immediately post meal or at least a few minutes or hours after eating?

Hi
It helps to monitor your BG before you eat and then at one and again at two hours after you started eating. This tends to give you a good idea of the effect the food is having on your body. If you don't test before you eat you have no baseline. So say you tested before your meal an dBG was 5 and then you eat and one hour after it's 7 then that's not too bad but if it was 9 or 10 then maybe you need to think again about that food. Some foods can spike but come down quickly so testing again at two hours tells you if your body is coping with it or not. Trying to keep spikes below 2mm is the aim of many on here but if you are needing insulin then you need someone to help you with working out how much insulin to have.

 

[lovelifex]

Hi
It helps to monitor your BG before you eat and then at one and again at two hours after you started eating. This tends to give you a good idea of the effect the food is having on your body. If you don't test before you eat you have no baseline. So say you tested before your meal an dBG was 5 and then you eat and one hour after it's 7 then that's not too bad but if it was 9 or 10 then maybe you need to think again about that food. Some foods can spike but come down quickly so testing again at two hours tells you if your body is coping with it or not. Trying to keep spikes below 2mm is the aim of many on here but if you are needing insulin then you need someone to help you with working out how much insulin to have.

Ok, this is noted. Thank you for this advice!

 

[sud5nala]

I honestly did not understand any of the information but I will read on it. I'm thinking of what you said that the doctor will base my type on the response of my treatment. I really lack information based on everyone's response, I'm kinda feeling frustrated now.

I beg pardon. Let me try again to explain less technically. In your shoes, I would ask for a copy of the report of how the doctor arrived at the diagnosis.

At least 80% of all diabetes cases are of the insulin resistance type, dubbed Type 2. Some signs of T2 are having poor numbers for HDL, blood pressure, triglycerides, and fasting insulin, and being overweight. The more of these factors that are positive, the likelier one is to have T2.

When a person is diagnosed with diabetes, the proper treatment may depend on diagnosing the type correctly. There are at two other varieties of diabetes that often get mistaken for T2: LADA and any out of some gene mutations collectively called MODY. Both LADA and MODY are much more frequent than the medical profession has thought. Some specialists in LADA think it may make up as many as 1 in 10 cases.

Doctors in multiple countries have a tendency to diagnose T2, prescribe metformin, and then observe for a year or two. Because of the 80% figure, this will usually work. Most people with a diagnosis of LADA or MODY were originally misdiagnosed. Metformin tends to produce some lowering of glucose even in cases of misdiagnosis. This of course makes it even trickier to sort things out.

Testing for the MODY mutations is very expensive, so it would not be surprising to see doctors being reluctant to order the tests. The more of these mutations you test for, the higher the cost.

I wonder if the doctor has indeed ruled out "Type 1", the regular diabetes of autoimmunity, which has a rapid onset and urgent need for insulin. In any case, many diagoses of T1 are actually misdiagnosed MODY, but the precise proportion is unknown.

LADA and regular Type 1 are both diseases of autoimmunity. They are caused by autoantibodies. When doctors don't suspect T1, it seems they don't routinely order autoantibody testing. I also don't know whether they routinely test for autoantibodies even when they do suspect T1. Doctors may order a test for just the autoantibody, GADA, but this is insufficient because there are several of them, and many people with autoantibodies do not have GADA specifically.