Newly diagnosed, type uncertain

Tubbycatsmum_ said:

Hi I was diagnosed with query steroid/chemotherapy/radiotherapy induced diabetes a few months ago. Tried glimepiride, metformin & Empagliflozin but sugars remained high and erratic.

For last couple of weeks my afternoon & evening sugar has been 20-28 mmol/L. Rang the diabetes nurse today and had to go into clinic for review. I’ve now been started on insulin. I’m on 3 units of humalog during the day and 4 units of abasaglar at night.
Feel a bit gutted that having to start insulin as the consultant said that my diagnosis is out of my control because of medication and treatment for childhood cancer. I was against starting insulin as I’d heard it can make you put in weight. So will have to watch out for that.
My tea time sugar after my first insulin was 15.6 mmol/L but guess it’ll take time to get into my system & the dose will have to be adjusted. I’ve got loads of appointments booked with diabetes team over next few weeks. Seeing the dietician on Friday to learn about counting my carbs.
I asked about what my diagnosis is but was told it was an uncertain diagnosis because of my complex medical background. Bit frustrating & not sure what the travel insurance will make of it.

Click to expand...

Hello and welcome. There is a term for diabetes that was caused by this and I can't quite remember it at the moment. It might be Type 3? There are people on this forum who have the same type. If you post in the Type 1 subforum they will help you I am sure.

It can be hard to comes to terms with a diabetes diagnosis, esp Type 1 or a similar type that will require insulin with meals. Your feelings are normal and completely understandable.

I even felt sad about being diagnosed with Type 2, 9 years ago. So I can't imagine what it's like for you. But I can guarantee you there are loads of people on the forum with the knowledge and warmth to help you a great deal.

Yes it does take a bit of time for insulin to get your BG under control but you are already making great progress. It will get easier in time and soon it will be second nature.

I am a big fan of insulin for diabetics of any kind who need it. This info is for Type 2s, which I don't think you have, but it may ease your mind anyway:

http://www.phlaunt.com/diabetes/15478720.php

The whole website is excellent and includes info on your type of diabetes.

Re travel insurance, do you have travel planned soon and how far away is it? I suggest contacting them to say you've been diagnosed with diabetes, unclear type, on insulin and ask them what info they need. You can probably still get travel insurance on the same basis as someone with Type 2, but I don't know for sure. They tend to care more about whether your condition is well managed in the period before you travel.

Hi. It's not insulin itself that causes weight gain as it's merely a hormone that allows the body to metabolise carbs into glucose. If you eat too many carbs, however the excess glucose will be stored as fat by the body just as it would be in a non-diabetic. When you see the dietician ensure that you aren't encouraged to eat more carbs than you want or need. He or she should explain how to adjust your mealtime insulin to match the carbs you plan to eat in the meal. This gives good flexibility for meal plans.

TID: 51 years on insulin. People who have developed diabetes due to their pancreas being removed or damaged in some way have Type 3 diabetes according to the British Diabetes Association. It depends how much pancreas has been damaged as to what treatment is needed. If someone's pancreas is removed, insulin therapy is paramount. I am sure that whatever your diagnosis is will be explained at your upcoming appmts.
My experience is that if my food intake, amount of exercise and insulin regime are in balance I do not gain weight. Too much food/calories, too much insulin, too little exercise or a combo of two or more will put my weight up.
As you say, getting blood sugars down to near normal levels helps people feel better. It is important to know about hypos (low blood sugars) which can occur if one's blood sugar drops too low ( usually less than 3.6 mmol/L), Please read up the hypo section of this site for info on symptoms and management. In brief, I experience tremour, shakes, hunger or nausea, sweating, looking pale, feeling irritable as some of the signs early on. If the blood sugar stays low, I get numbness, un-co-ordination, confusion, Taking glucose tablets, jelly beans, sweet drinks, honey all help to raise the blood sugar level up again. I do not drive a car, ride a bike, go up a ladder etc if my blood sugar is less then 5 mmol/l)
I would imagine you will be shown how to use a blood glucose monitor and finger pricker to test your blood for glucose level.
It is early days for you and feeling overwhelmed is quite usual. Take it step by step, learn about diabetes, stay to a regime with food intake and timing, insulin injections or whatever eventual treatment until you see what works and what does not and then start to explore the edges of the envelope. Keep asking questions of your health team and on here, too. No question is too simple or difficult.
Best Wishes!

Tubbycatsmum_ said:

Thank you everyone for your replies and advice. Like you all say it’ll take time to adjust to this and find the right balance of insulin, carbs and exercise. The exercise is a difficult one as I have severe heart failure from the chemo, cancer the gift that keeps on giving. I’m going to speak with my cardiac rehab team tomorrow to put together an exercise plan that I can manage and maintain.

Click to expand...

I wish you all the best with this endeavour!

A few years ago I found any exercise too painful so I started with aquajogging for a short period of time. It probably wasn't doing a lot for me in terms of fitness, but I gradually increased the duration and intensity over time. Then I found it wasn't doing enough so I started walking, gradually at first also.

In some cities there is a warm pool at a hospital or clinic that is used by physiotherapists with individual rehab patients. Your cardiac rehab team may be able to get you access to a pool if there is one near you. If not, an ordinary pool would still be a good option.

Good luck and do keep us posted.

kitedoc said:

TID: 51 years on insulin. People who have developed diabetes due to their pancreas being removed or damaged in some way have Type 3 diabetes according to the British Diabetes Association. It depends how much pancreas has been damaged as to what treatment is needed. If someone's pancreas is removed, insulin therapy is paramount. I am sure that whatever your diagnosis is will be explained at your upcoming appmts.
My experience is that if my food intake, amount of exercise and insulin regime are in balance I do not gain weight. Too much food/calories, too much insulin, too little exercise or a combo of two or more will put my weight up.
As you say, getting blood sugars down to near normal levels helps people feel better. It is important to know about hypos (low blood sugars) which can occur if one's blood sugar drops too low ( usually less than 3.6 mmol/L), Please read up the hypo section of this site for info on symptoms and management. In brief, I experience tremour, shakes, hunger or nausea, sweating, looking pale, feeling irritable as some of the signs early on. If the blood sugar stays low, I get numbness, un-co-ordination, confusion, Taking glucose tablets, jelly beans, sweet drinks, honey all help to raise the blood sugar level up again. I do not drive a car, ride a bike, go up a ladder etc if my blood sugar is less then 5 mmol/l)
I would imagine you will be shown how to use a blood glucose monitor and finger pricker to test your blood for glucose level.
It is early days for you and feeling overwhelmed is quite usual. Take it step by step, learn about diabetes, stay to a regime with food intake and timing, insulin injections or whatever eventual treatment until you see what works and what does not and then start to explore the edges of the envelope. Keep asking questions of your health team and on here, too. No question is too simple or difficult.
Best Wishes!

Click to expand...

Thank you, this is really helpful information.

I have a trampoline in the garden - some days I just lie on it and watch the apples grow, others I bounce away happily for 20 minutes or more. If it starts to rain it is ten paces to the back door, and it is very kind to the poor old knees whilst at the same time encourages me to roll about and stretch and flex bits which have stiffened up. I think mine is about 8 ft across, so a nice big safe surface and I thoroughly recommend it if you have the space as it is totally adjustable in time and intensity, and being so handy it means I don't feel that it is too much effort to do.