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Newly diagnosed Type 2 and confused!!

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Kylie_Baker

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Hi everyone,

I am 30, healthy?, moderately active (11 month old BUSY son) and have recently been diagnosed Type 2.

My Uncle on my fathers side died when he was 17 due to diabetes. My Grandmother (fathers mum) has diet controlled diabetes and is 87.

I was diagnosed with Gestational Diabetes when I was 36 weeks pregnant. I had to self administer insulin based on my BS readings. Once I gave birth, both our BS’s were closely monitored. Things returned to “normal” fairly shortly after.

The Diabetic specialist whose care I was under at the time wrote to my GP regarding my condition stating that I would need to be checked at 8 weeks then every year thereafter, with the onset on Diabetes possible when I was closer to 50 years of age, not 30). My own fault, but I never got around to the 8 week check, motherhood, busy life and a plethora of other things occurring meant that I just got on with it all and put everyone else before me.

In June I had anther unrelated health issue occur and I became very unwell. By September I had started to lose a lot of weight, was thirsty a lot and visiting the loo frequently. Again, I put this done to being the Mum of a busy baby boy and the stress of a very tough year for us.

Two weeks ago I thought a trip to the docs was in order, just to check. Doctor order a full fasting blood-work and urine. My initial fasting BS came back at 16, I also had ketones in my urine. Everything else seemed fine. I immediately cut out added sugar and some carbs (white bread, potato etc). My doctor (who contacted me the same day with the results) ordered a HbA1c test, which came back at 13. At this point I was prescribed 500mg Metmorfin (1 a day, increased to 2 a day after a week) to try to get BS down. Another fasting test was done a week later and my BS reading was 15.5, so no real change. As a result, I am now on also prescribed Gliclazide (1 x 80gm per day). I am trying to change my diet to be more low GI focused. I am due to spend ½ hr with the diabetic nurse this coming Friday.

Now, the tricky thing is that my doctor, from her own admission, is just starting to “learn” more in depth about diabetes. Which I don’t see as a huge problem as she is having her findings/diagnosis confirmed by the local Diabetes Specialist. My real concern is that my BS results I feel are extremely high, and whilst my doctor acknowledges the aggressiveness/speed at which this has developed, along with my high results and severe weight loss (approx. 25kg, I’m weighing 52kg!) my fear is that this isn’t receiving the attention it requires? Do I push for more attention, or just follow the course this is taking?

I don’t know.

I am sorry to babble on, life for my family has been really tough this year without this. I am being extremely positive about everything, but something in my mind is screaming caution to me. That I need to ask more questions and push to see the Specialist.

Any help, advice or such would be greatly appreciated. Again, sorry to babble .

Thankyou!

Kylie
 
Hi Kylie and welcome to the forum :) I'm sorry to hear about your family history, and yours, of diabetes. Now your diagnosis. If you are not happy with the attention you are receiving, then you should try and push for better treatment as your levels are too high at the moment.

Here is some information that could help you to get your levels down a bit and give you better control of your diabetes. The diet information should help you in particular. This information was written for new members and a lot of people find it useful to them. Ask as many questions as you need to on here as there is usually someone who can answer you.

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 well over 30,000 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 ... rains.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 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.
Click to expand...
 
Hi

While it's not for me to diagnose your condition, at your relatively young age, weight loss and not enough impact from the meds there is a possibility you have one of the diabetes variants. Late onset Type 1 or LADA are always a possibility and I think you need to suggest to your GP that at your young age it shouldn't be assumed that you have Type 2 and that further tests might help? Good luck with the nurse.
 
I agree with Daisy1 and Daibell. Your doctor has had the courage to admit she is still learning, so I would push her a bit to send you to the Diabetes Specialist - consultant, not specialist nurse. I think your family history, and the fact that you have had gestational diabetes, indicates that you might need a bit more investigation than a "standard" Type 2 - if there is such a thing, of course! :roll:

Let us know how you get on.

Viv 8)
 
Stress may well have played a major par in all this and may be keeping your levels high.
It is very important to hget he correct treament in the beginning.

I always have far more respect for a Docor who does not pretend to be omniscient or infallible .
She will probably be plesed o help you o see he specialist,
 
Thank you so very much everyone for your replies.
Since my last post, I've been getting some dizzy spells (mid-morning about 3 hr after breakfast) which while the doc doesn't suspect I'd have hypos due to high BS, I can't help but wonder.

I was planning on speaking to the doc tomorrow morning first thing to push for specialist. This fortunately is the same specialist whose care I was under whilst pregnant. I would hope he would want to see me just as much :)

I was close to assuming that the process thus far was the first line of defence; so to speak. However, after reading your comments and more on diabetes.co.uk I have too many questions unanswered. The doc has essentially left these to be asked to the Nurse, however as I understand her/his role is just to inform how to cope with, adjust diet etc. Not the nitty gritty, more tests etc. Thanks again, your comments have given me a bit more confidence to fight my corner a lot more.

You'll hear from me soon,

Best
Kylie x
I'll let you know how I get on.
 
Hello All,

Well, a quick update. I've gotten through to my doctor just now who assures me the initial results of 15/16 for BS and 13 for HbA1c, whilst high, are acceptable. Though I do not feel this is the case. She has had no reply from the Specialist to her letter regarding my condition. I've stressed to her that I am feeling still rather awful, lethargic, dizziness and she again assures me that this is likely to be due to the additional medication. I was not due to see her until Friday for the Diabetic clinic (where I was to give urine sample). Though after this evening conversation she now wants to see me in for fasting BT and urine tomorrow am.
Her opinion is that we need to wait until the meds start working and that the specialist would want to see this implemented before a consultation. However, would I be correct in thinking that this would only mask the problem? Results as high as mine surely warrant more in depth investigating.

I raised concerns regarding my age, family and medical history, weight loss and results, which prompted her to say that she would follow up on her letter. Would I be right in thinking that this is a condition slightly beyond that of the realms of the GP? Should it be up to my GP to diagnose given that I seem to be an unusual case?

What to do? I want to see the Specialist, but at the moment feel that I am being a little blocked?

Thanks in advance to you all for replies.
Best

Kylie x
 
Just for info - NICE guidelines for Type 2 diabetes are target levels of:

4 to 7 mmol/l fasting/before meals;
less than 8.5 mmol/l, 2 hours after meals.

I think they prefer an HbA1c of below 6, though some people can't manage that. I've never looked that one up - sorry!

Anyway! Obviously I'm not qualified to diagnose or anything, but I wouldn't want my levels as high as yours are, so in your place I would continue to push to see the specialist asap. Do you have any ketone testing sticks, so you can keep an eye on those too? If not, ask for some tomorrow.

You do know to get yourself to A&E if you have high BS, high ketones and start feeling nauseous and really unwell? I'm not being alarmist, but those symptoms together could mean ketoacidosis, which is dangerous.

Meanwhile, get a good night's sleep and try not to worry! :D

Viv 8)

Edit: PS - you could ask the doctor to telephone the specialist's secretary? Or even phone the hospital yourself and ask to be put through.
 
Thanks Viv, it's reassuring to read your post.

Yes, I know to get myself off to A&E if it all starts to go wrong. Meeting with the doc this morning and will be getting BS monitor along with ketone sticks too!

Let you know how this morning goes.

Kylie
 
Kylie_Baker said:
What to do? I want to see the Specialist, but at the moment feel that I am being a little blocked?
Click to expand...


Hi Kylie and welcome to the forum, one of the first things you need to do is calm down and try to relax, yes I know it isn't easy when you have just been given such life changing information but you are not going to do any permanent harm if you dont see a specialist immediately. I would imagine that like every other department within the NHS the diabetes units are stretched to breaking point so it doesn't surprise me to hear you have not had a reply from your specialist yet. My wife is a secretary in a cardiology unit and she is currently 7 or 8 weeks behind typing clinic letters and is very stressed but the trust will not pay for any more secretarial staff, in fact there is talk of more cuts to come :crazy:

So sit down feet up and have some you time, your blood glucose (BG) levels are high but not as high as some at diagnosis and the drugs your doctor has prescribed will take time to start to improve them so dont expect to see results overnight. Your diet is going to be as important if not more important than meds at this time, cutting down on the carbs you eat will have a significant effect on your bg. One thing to bear in mind though is that whatever diet you chose is going to be for life, so whatever diet you chose should reflect that, its no good starting a diet that you know you will not be able to sustain.

The single most important thing you can do is start to test your own bg levels and for this you will need a bg monitor and some test strips, ask your doctor to prescribe them for you although fewer and fewer doctors are now prescribing them to T2's as the costs are quite high for the repeat test strips and it is common now for doctors to tell you that T2's dont need to test. But testing is the key to tight control, the way to test for the best results is to test before you eat each meal and again two hours after finishing each meal, aim to see your postprandial (after meal) readings close to your pre meal readings, at first it is likely that you will see a much higher postprandial reading, this is because the carbohydrate content of your meals is too high for your (diabetic) body to cope with.

For example if your pre meal bg is say 8.6 mmol/L and your post meal reading is 14.7 mmol/L then that should tell you that that meal contained too much carbohydrate so the next time you eat that same meal try reducing the carb content and do the tests again and you will see the post meal reading is reduced, keep doing this until you see the post meal readings get close to your pre meal readings this in turn will have the effect of reducing your overall readings to the recommended levels. Its a good idea to keep a food diary to record your findings.

NICE recommended levels for a T2

Before meals: 4 to 7 mmol/l
2 hours after meals: under 8.5 mmol/l

Most members here want to be aiming lower than these but these are a good starting point.

The main carbs to reduce are Flour/Bread, Rice, Potatoes and Pasta but also be aware that carbs are in many other foods too. I would recommend buying a carb counter book like the collins little gem carb counter or the collins little gem GI book both can be bought from good book shops or off amazon/ebay etc for around £5.00. I would also read everything you can lay your hands on about diabetes there are many titles to choose from but for a couple of good ones to get you started I would recommend:

Type 2 Diabetes - The First Year by Gretchen Becker
and
Blood Sugar 101 - What they dont tell you about Diabetes by Jenny Ruhl

Everyone was stressed like you are when first diagnosed, there is a lot to get your head around but it does get easier and the more you read the more you will start to understand, keep reading this forum and look at other forums too and ask questions, lots of them, thats how we all learn :D
 
Hi everyone,

A lot has happened over the past 24 hours.

I've been to the Head Diabetic nurse in our region directly under the Specialist who has confirm Type 1 diabetes. I've been given the 'welcome-pack' and have started on insulin this afternoon.

Sid, thankyou so very much for your support. I didn't want to push too hard as I do understand that the NHS is where it is, but equally I was worried that if I hadn't then I was likely to slip through the cracks and been incorrectly diagnosed. When I was pregnant a similar situation arose as I was scared of something similar happening.

So, I am now Type 1, 2 sets of insulin. Got my meter and am coming up with results in the low 20's. I'm feeling much better about things now. The support that my GP and Specialist Nurse have given me has been terrific. My GP was terrific on Tuesday and secured an appointment for me today. I'm seeing the practice nurse and GP on Friday to get even more information and kit.

I'm pleased that I can now focus on my condition, work with the insulin to even everything out. I've got a long way to go, but am really confident that I can get this under control.

Thank you Sid, Viv, Daisy. Watch this space :D

Kylie x
 
Good for you, Kylie - you sound as if you're feeling much better about things. It's nice to have a diagnosis, isn't it? It sounds as if you've got a really good Health Care team there - for all we knock them, when it works well the NHS just can't be beaten!

Please keep coming back if you've any questions. I'm Type 2, but I follow a lot of the new posts and the Type 1s on here are all really supportive and have a lot of knowledge and experience between them, so you're among friends.

Let us know how you get on.

Viv 8)

PS I have a friend whose gestational diabetes emerged again as Type 1 in her early 40s. She's in her 90s now, and still living an active, stroppy life. A great example to us all!
 
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