Newly diagnosed with very high numbers - confused by symptoms

jjne said:

To be honest this is the conclusion I came to based on the data I am seeing from my own body.

The implication of this though is that the problem is NOT insulin resistance, it's an incorrect calculation by the brain as to what baseline is appropriate. It's interesting in and of itself, from an academic perspective.

Insulin resistance would consist of the pancreas responding to an excess of blood glucose by producing insulin, but that insulin not being taken up by other organs.

But that isn't what is happening here. If it were, the takeup of insulin would be linear, but it isn't.

Fascinating.

As I have said on here previously, the only explanation is that my system "thinks" that 10mmol/l is correct. Otherwise, the process of coming down quickly from near 13mmol/l, but then not going down further wouldn't be possible. Insulin resistance cannot explain this phenomenon - that would be beatable by throwing more insulin at the problem (because the initial reduction is achieved without issue, this proves that the body can indeed regulate down) and would involve bgl eventually coming down. But mine doesn't do that.

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We are not agreeing. I don't agree with your conclusions but am too tired today to address this. Perhaps someone else will explain.

jjne said:

Hi,

The strips were giving something similar. Something between the 1.5 and 4 shade. I'll keep an eye on it.

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Up to around 3 when on a keto diet would be what you would expect from nutritional ketosis. Maybe a tad higher if deeply into ketosis. @bulkbiker you’ve don’t this measuring ketones thingy a while can you assist with ranges?

jjne said:

To be honest this is the conclusion I came to based on the data I am seeing from my own body.

The implication of this though is that the problem is NOT insulin resistance, it's an incorrect calculation by the brain as to what baseline is appropriate. It's interesting in and of itself, from an academic perspective.

Insulin resistance would consist of the pancreas responding to an excess of blood glucose by producing insulin, but that insulin not being taken up by other organs.

But that isn't what is happening here. If it were, the takeup of insulin would be linear, but it isn't.

Fascinating.

As I have said on here previously, the only explanation is that my system "thinks" that 10mmol/l is correct. Otherwise, the process of coming down quickly from near 13mmol/l, but then not going down further wouldn't be possible. Insulin resistance cannot explain this phenomenon - that would be beatable by throwing more insulin at the problem (because the initial reduction is achieved without issue, this proves that the body can indeed regulate down) and would involve bgl eventually coming down. But mine doesn't do that.

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it can still be insulin resistance. Insulin can only be produced so much. Maybe you’re maxed out as it were and what you have only goes so far when working against the IR. As IR reduces then what you’re making will work better and take you lower. Of simultaneously whilst the insulin is trying to lower levels the liver is panicking and thinking you’re going too fat below your typical baseline and dumping glucose negating the insulin.

jjne said:

Interesting.

I bought a ketone meter to verify if I was in ketosis.

Result was 4.0mmol/L.

Do I need to speak to my doctor urgently?

From what I can make out, if I'm a "vanilla" T2 then this is good, my keto diet is working and I should continue.

If I'm an undiagnosed T1, however, this could be a sign of DKA and I need urgent medical help.

Bit worried now, I wasn't expecting a result of that nature.

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Sorry just seen I was tagged into this..
Your keto diet will be working nicely if at 4 mmol/l ketones DKA is usually a combination of very high blood glucose and very high blood ketone levels so if your bloods are in single figures you should be ok.
I'm very jealous of those ketone figures though I only get there after about 3 days fasting.

jjne said:

But fast initial response followed by brick wall is not something that is consistent with a pattern of resistance.

The "panicking liver" idea is essentially what I am saying - system reacting to a level it considers to be too low. That isn't resistance, which is lack of sensitivity.

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What are you calling fast?

jjne said:

Couple of hours.

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A drop of 2 or 3 mmol over a couple of hours is normal and not unusual for a non medicated type2. What varies is the starting and ending points. Really not sure that your body is doing anything different to most of us. So far your “set point” is higher than you want but I still think it’s too early to assume anything else yet.

Did your scan highlight anything?

I think you’re mixing up various concepts here. Resistance and set point are different things. Your definitions of normal responses (for who type 2 or non diabetics?), resistance and production are also confusing me as well as you.

It’s not so much you are getting rid of a high spike but reducing whichever size spike you are getting - regardless of start and end point as you point out. Because your set point is currently high and the ability of the insulin you produce has a finite capacity to reduce bgl (due to both quantity produced and resistance to it) the level will still be fairly high. Type 2 usually over produce (compared to non diabetics) insulin to try and compensate for resistance. Production, especially for the first decade or two is rarely the problem.

If your set point were lower but resistance the same you’d drop by the same amount but the range would have lower numbers. If your resistance is lower then you’d drop by more for the same amount of insulin produced. Once your liver accepts the current new lower level as normal then it will stop adding glucose into your system and the insulin effect will show up more and you’ll see another drop. Eventually you’ll need less insulin to achieve the desired levels and then as this drops your resistance to it will also drop.

assuming you are a type 2 these will improve on keto. But not overnight. The more resistant you are the longer it takes to get where you’re going. The quick initial response does happen in days as you’ve seen some improvement already.

I’m not sure I’m actually making my point very clearly either. Have you come across Dr Jason Fung yet on YouTube or book and numerous articles many of which are free to access? Or read more widely about insulin resistance in type 2?

Did you have to sanitise hands on entry to docs? I'd hazard a guess it was something on your hands

jjne said:

Funnily enough - no! But I agree that is a distinct possibility generally... I will ensure my hands are washed with soap before they take any readings on Wednesday, as I'm pretty sure my meters are right given how well 3 of them at least bunched together.

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If you're going to have your BG tested on wednesday, bring one of your own meters to test simultaneously.

If you did not test yourself virtually at the same time as the doctor did it, then there can be no comparison. Your stress levels will have been raised by your visit, how you travelled there will have had some impact, hanging about in the waiting room likewise. As @Antje77 says, try to test simultaneously next time.

jjne said:

I am indeed being sent for an urgent referral to get c-peptide and GAD tests.

My meters matched the doctor's one this morning pretty closely.

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Please let us know how it goes if you have chance. x

jjne said:

I am indeed being sent for an urgent referral to get c-peptide and GAD tests.

My meters matched the doctor's one this morning pretty closely.

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Well it will be good to get the bottom of this and know what’s happening keep us informed and keep an eye on those ketones, especially if bgl go up or you feel unwell just in case.

Hi there. I’ve been reading this post with interest as I’ve also been diagnosed Type 2 recently. One thing that sprung to mind was whether the doctor had suggested gliclazide as a way to help bring the numbers down for you?

jjne said:

Hi, it has been mentioned but there is a big question mark currently over whether I am a type 1 or 2, and I am also awaiting the result of a CT scan. I suspect that if/when these confirm a vanilla T2 diagnosis, meds such as these may well be prescribed. I am reluctant about gliclazide though as it forces the pancreas to produce more insulin and that may or may not be harmful long-term. If I were to be put on such meds I'd be looking to try to wean off them ASAP.

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I think you are wise.
In the first weeks of eating low carb I experienced false hypos, when my blood glucose dropped rapidly under the influence of too much insulin being released naturally. Having a warm drink (it was winter) and three grapes stopped me feeling wobbly and over a few days my pancreas calmed down my glucose levels began to look more normal - hammering insulin out of the pancreas is more likely to cause problems than solve them, if everything is normal.

jjne said:

Hi, it has been mentioned but there is a big question mark currently over whether I am a type 1 or 2, and I am also awaiting the result of a CT scan. I suspect that if/when these confirm a vanilla T2 diagnosis, meds such as these may well be prescribed. I am reluctant about gliclazide though as it forces the pancreas to produce more insulin and that may or may not be harmful long-term. If I were to be put on such meds I'd be looking to try to wean off them ASAP.

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I also think you are wise. What is the point in taking meds that encourage extra insulin production when you have no idea if you need the extra insulin. Most T2's produce far too much. In my opinion, people should be given an insulin test before Gliclazide is prescribed.

jjne said:

I am starting to see some evidence that the dawn phenomenon is starting to weaken. Whereas I used to start around 11.5 and slowly reduce down to around 10 or high 9s, this is now starting to settle into more of a pattern of starting around 10.5 (or less) and slowly reduce to low 9s (with the occasional high 8s). The app is showing quite clearly as well through the graphs that the dawn phenomenon seems to be the only thing keeping the blood sugars high - no spikes through the day.

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I have been at this for over 9 years. My morning levels haven't gone under 8. It's the way my body works. Try not to get too hung up about dp.