Should C peptide be tested before starting medication?

Swiggy

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324
Type of diabetes
Type 2
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Diet only
I was referred to a hospital diabetes clinic and I have just spoken to a doctor who has suggested doubling Metformin dose to 4 tablets per day and adding a SGLT2 inhibitor because my hba1c has gone up from 59 to 79 since 2021.
In 2021 I had a c peptide test that the GP said showed that I was producing a very large amount of insulin, he didn't give me any figures but said it was three times what the higher end of normal was. I have been testing for the past 6 years and eating a low carb diet but I have lost no weight at all.
My GP suggested Victosza injections before COVID but when I told him that I had had a cyst on my pancreas as a child he said it wouldn't be suitable for me.
The doctor from the clinic was not aware of the cyst and has said that he suspects that my pancreas is not producing much insulin any more and that's why my blood sugar levels are increasing. I asked if I could have a c peptide test before starting to take more medication and he said that I should try the medication for three months and then see if it's needed.
I'm feeling scared and confused and I don't know whether I should pay for a c peptide test privately before taking the medication.
I'm not expecting any medical advice but has anyone else been in a similar situation?
 

Melgar

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871
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Tablets (oral)
I haven’t got much to offer, but I would have thought your GP would wish to confirm his theory that your pancreas is not producing much insulin anymore, with another C-peptide test. It’s a straight forward test. It would at least confirm or dismiss his theory and be in a better position when prescribing you the appropriate meds. I’m not a Dr, but that would be a big drop from producing 3 x the higher end of normal insulin to producing not much insulin.

I’m no expert, but surely if your pancreas was not producing much insulin your blood sugars would be higher .

It’s Always a personal choice whether or not to go private and get tested. If I was in your position and able to go private, I would want to know.
 
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Swiggy

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Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
Thanks Melgar, I appreciate you taking time to reply. I'm going to tell my GP that I don't feel comfortable starting medication without testing to confirm that I'm not still producing too much insulin. Fingers crossed he orders the test.
 
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ert

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2,594
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diabetes
fasting
You need to get your blood sugars down to avoid complications so the best advice is to follow your GP's advice on the medication. The results of a c-peptide test is not affected by Metformin. It could also be that you have become more insulin resistant over time which is causing your blood sugars to run higher.
 

Swiggy

Well-Known Member
Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
You need to get your blood sugars down to avoid complications so the best advice is to follow your GP's advice on the medication. The results of a c-peptide test is not affected by Metformin. It could also be that you have become more insulin resistant over time which is causing your blood sugars to run higher.
Thank you, I have increased my Metformin after what the clinic doctor said yesterday and I'm waiting for my GP to prescribe the additional medication but I would like to speak to him about it. I appreciate you responding to me ert.
 

lovinglife

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4,866
Type of diabetes
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Diet only
If you do not have financial problems, it is better to test your health in all areas before starting treatment
This is a UK forum with the majority of members from the UK, all our health care is free & provided by the NHS, I am a little confused by your comment as you say you are in the UK, are you paying for your medication etc?
 

Swiggy

Well-Known Member
Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
This is a UK forum with the majority of members from the UK, all our health care is free & provided by the NHS, I am a little confused by your comment as you say you are in the UK, are you paying for your medication etc?
I don't pay for my medication but I pay for my test strips and meter etc. I've been testing before and after meals for at least five years and I have a pretty good idea of what to avoid. Anything with more than 5g of carbohydrate per 100g of product didn't make it into my trolley. I managed to get my hba1c down from 143 to 53 but I never quite got it into the normal range.
Over the past nine months or so my blood sugar levels have risen markedly and have not come back down.
Practice nurse told me off for having cream, it's practically 100% sugar according to her. She also told me that my hba1c has increased to 70+ because I am so stressed out by pricking my fingers. She also recommended the "eat well" way of eating.
Anyway I was referred to a hospital clinic and the doctor wants to prescribe SGLT2 medication. I was concerned that he did not know that I had had a cyst on my pancreas as a child and also that I had had a C peptide test in 2021 which showed that my insulin production was very high. This doctor said that my pancreas would no longer be producing much insulin and said he didn't need to test it. I told my GP that I was worried and he has agreed that I should have the C peptide test.
I think that my GP is really good.
 
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lovinglife

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Type of diabetes
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I don't pay for my medication but I pay for my test strips and meter etc. I've been testing before and after meals for at least five years and I have a pretty good idea of what to avoid. Anything with more than 5g of carbohydrate per 100g of product didn't make it into my trolley. I managed to get my hba1c down from 143 to 53 but I never quite got it into the normal range.
Over the past nine months or so my blood sugar levels have risen markedly and have not come back down.
Practice nurse told me off for having cream, it's practically 100% sugar according to her. She also told me that my hba1c has increased to 70+ because I am so stressed out by pricking my fingers. She also recommended the "eat well" way of eating.
Anyway I was referred to a hospital clinic and the doctor wants to prescribe SGLT2 medication. I was concerned that he did not know that I had had a cyst on my pancreas as a child and also that I had had a C peptide test in 2021 which showed that my insulin production was very high. This doctor said that my pancreas would no longer be producing much insulin and said he didn't need to test it. I told my GP that I was worried and he has agreed that I should have the C peptide test.
I think that my GP is really good.
I too fund my own strips etc being a T2 diet only, thanks for sharing your story :) My question was directed to @rubyparkfj really as they seem to think we have to pay for everything in the UK which isn’t the case. I hope you get the answers you need now that your GP has agreed to the tests, there are some good ones out there - mine included :)
 
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Swiggy

Well-Known Member
Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
I too fund my own strips etc being a T2 diet only, thanks for sharing your story :) My question was directed to @rubyparkfj really as they seem to think we have to pay for everything in the UK which isn’t the case. I hope you get the answers you need now that your GP has agreed to the tests, there are some good ones out there - mine included :)
Oh Loving Life, I misunderstood. I don't mind paying for my strips and things because I like feeling more in control of how things are going. I'm glad you have a good GP too, it makes such a difference.
 

lovinglife

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Type of diabetes
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Oh Loving Life, I misunderstood. I don't mind paying for my strips and things because I like feeling more in control of how things are going. I'm glad you have a good GP too, it makes such a difference.
No worries - I enjoyed reading your post anyway :)
 
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HSSS

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For the record if I get to the point medication is being recommended I’d like to know what my insulin is doing before making choices which is most appropriate so I hope if I get there my gp is as helpful as yours
 

Swiggy

Well-Known Member
Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
For the record if I get to the point medication is being recommended I’d like to know what my insulin is doing before making choices which is most appropriate so I hope if I get there my gp is as helpful as yours
Thank you
 

Swiggy

Well-Known Member
Messages
324
Type of diabetes
Type 2
Treatment type
Diet only
I'm having my c peptide test on Saturday. I will let you know the results when I get them.
 
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