Not sure

[Redeye313]

Hi.
Sorry for the long post but
I just wanted to ask about my diagnosis and see if anyone can shed any light on my situation.

I was diagnosed in 2016 but I wasn’t diagnosed with type 2 straight away. I didn’t fit into the “typical” type 2 catergory as I have always been very active and eating a good diet. The consultant that saw me on my first review put me on metformin 500mg once a day. That didn’t really affect my bg readings. After my second review the consultant then decided to take me off metformin and put me on gliclazide 80mg once a day. That worked for a little while until my readings started to get higher. I was then put onto 2 80mg which again worked for a little while until they were pretty much having no effect. I was then sent to my practice nurse who has put me on slow release metformin 1000mg a day and gliclazide 40mg twice a day. I had another review about a week ago and the practice nurse is now sending me to the diabetes community nurse, which my practice nurse tells me will more than likely put me on insulin. Has anyone else taken this long to get medication right?
It’s quite frustrating when I am doing everything I can to keep my levels around the range I need them to be but failing.

Thanks for reading

 

[Guzzler]

Hello and welcome to the forum. You may need to speak to your health care professionals about the possibility of LADA or Type 1 Diabetes.

May I ask, in the time since your diagnosis have you addressed your diet at all?
Tagging @daisy1 for the info pack offered to all newcomers.

 

[Redeye313]

Hello and welcome to the forum. You may need to speak to your health care professionals about the possibility of LADA or Type 1 Diabetes.

May I ask, in the time since your diagnosis have you addressed your diet at all?
Tagging @daisy1 for the info pack offered to all newcomers.

Thanks for the welcome.

I have made a lot of changes to my diet. I used to eat a lot of carb heavy food and junk before I was diagnosed so when I had my diagnosis I switched to a healthier diet. I have also been on a DESMOND course to help too.

 

[Guzzler]

Thanks for the welcome.

I have made a lot of changes to my diet. I used to eat a lot of carb heavy food and junk before I was diagnosed so when I had my diagnosis I switched to a healthier diet. I have also been on a DESMOND course to help too.

I have not done the DESMOND course but hear that they advocate the 'Eatwell Plate' and suggest changes such as switching to lower GI foodstuffs or wholemeal versions of foods.
For some people with T2 this is just not enough.
If you could give us a typical day's menu we may be able to help you to tweak it a little in an effort to lower your bg.

 

[Diakat]

@Redeye313
Do you know if you have ever had an antibody test or c-peptide test?
What are your numbers actually like?

 

[Redeye313]

I have not done the DESMOND course but hear that they advocate the 'Eatwell Plate' and suggest changes such as switching to lower GI foodstuffs or wholemeal versions of foods.
For some people with T2 this is just not enough.
If you could give us a typical day's menu we may be able to help you to tweak it a little in an effort to lower your bg.

Yes to be honest it was pushing a lot of wholemeal versions of food like pasta and bread. They didn’t mention “eat well” but I’m guessing that’s the quarter of carbs, quarter of protein, half above ground vegetables. Typical days food would be an omelette or scrambled eggs for breakfast, sandwich for lunch and for tea it varies like today I had tuna salad. I snack during the day mostly nuts like walnuts or cashews and sometimes the odd bag of crisps.

 

[Redeye313]

@Redeye313
Do you know if you have ever had an antibody test or c-peptide test?
What are your numbers actually like?

I had a breath test a while back but that was for a stomach problem I was having.
My numbers for today were 7.1, 13.2, 9.1, 8.2 and 10.2. Not a really bad day today. Other days it can go as high as 14 and as low as 4.

 

[Diakat]

When you see the community nurse ask for those tests as it may be that you are LADA.
Or you could try dropping the sandwich and crisps and seeing what that does to numbers.

 

[Guzzler]

The cashews and the crisps are high carb and quite morish. If the sandwich is made from ordinary bread it will be high carb (there are a few lower carb breads available now such as HiLo).

 

[Redeye313]

I will drop the cashews and crisps and look for some low carb bread. I usually have the malted bread as it was suggested by my practice nurse. Hopefully the numbers will drop. I will ask for those tests as LADA does sound like a possibility.

 

[daisy1]

@Redeye313

Hello Redeye and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you need to and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[Bluetit1802]

Hello @Redeye313

You gave us a list of your BS levels, but when were they taken?

Are you testing immediately before you eat and again 2 hours after first bite (consistently), and are you keeping a detailed food diary including portion sizes, and are you counting the number of grams of carbs (of any description) that you are eating? Keeping a food diary is a good way of keeping on top of matters, especially if you record your levels next to the food and look at the actual rise from before to after. If this rise is more than 2mmol/l and preferably less there were too many carbs in that meal for your body to cope with. These carbs would need tweaking/changing/reducing/eliminating. The food diary will soon show patterns. Your particular danger foods will become obvious.

It is, however, important to test very regularly in addition to the before and 2 hours after tests because of the Gliclazide tablets, and very definitely before you get behind a steering wheel or operate machinery. Gliclazide is one of the strong drugs that can cause you to go hypo, particularly if you reduce carbs. If you see this happening, rather than increase carbs again it is well worth discussing with your nurse about reducing the Gliclazide.

I had a breath test a while back but that was for a stomach problem I was having.
My numbers for today were 7.1, 13.2, 9.1, 8.2 and 10.2. Not a really bad day today. Other days it can go as high as 14 and as low as 4.

 

[Redeye313]

Hello @Redeye313

You gave us a list of your BS levels, but when were they taken?

Are you testing immediately before you eat and again 2 hours after first bite (consistently), and are you keeping a detailed food diary including portion sizes, and are you counting the number of grams of carbs (of any description) that you are eating? Keeping a food diary is a good way of keeping on top of matters, especially if you record your levels next to the food and look at the actual rise from before to after. If this rise is more than 2mmol/l and preferably less there were too many carbs in that meal for your body to cope with. These carbs would need tweaking/changing/reducing/eliminating. The food diary will soon show patterns. Your particular danger foods will become obvious.

It is, however, important to test very regularly in addition to the before and 2 hours after tests because of the Gliclazide tablets, and very definitely before you get behind a steering wheel or operate machinery. Gliclazide is one of the strong drugs that can cause you to go hypo, particularly if you reduce carbs. If you see this happening, rather than increase carbs again it is well worth discussing with your nurse about reducing the Gliclazide.

Hi
The numbers were taken before eating and 2 hours after.
I have started to keep a diary of food, carbs and portion sizes and I’m already starting to see what things I’m eating which are danger foods. I didn’t realise that only a 2 mmol/l was to much so that will help me manage my diet a lot better.
I have only been testing before and after meals so the regular testing should help me keep a better eye on my levels.
Thanks for your advice.