Should C peptide be tested before starting medication?

[Swiggy]

You have the right to the numerical results (with units and reference range) of your tests. I’d ask for them from both tests. Great news on the hba1c going in the right direction though.

The accuracy of the app predictions is based upon how often you test and how good a representative sample that is. If you always test at your lowest points and miss highs it will predict a result too low. If you test only at the high points and miss the more stable lower ones it’ll predict too high. With finger prick tests there is a distinct risk GIGO applies (garbage in garbage out) when it comes to estimating hba1c. So based on that I see no obvious reason to buy a new meter.

Do you know how many carbs you eat a day/meal? What sort of difference are you seeing between pre and post meal readings? At an hba1c of 64 it suggests that carbs in V ability to cope with them for whatever reason hasn’t been reached. Fundamentally either you don’t have enough insulin to cope with that level of carbs due to low production or you are too insulin resistant for your adequate/ample insulin to overcome the resistance at that level. It makes a difference which, in order to choose the available paths forward for meal and medication choices. It’s also worth noting that eating very low carb and taking sglt2 medication is contraindicated, due to the risk of euglycemic DKA. If they are recommended again please make the prescriber aware you are already eating low carb /keto (whatever is appropriate).

Thanks HSSS, I eat fewer than 50g of carbs a day and when I test 2 hours after eating it usually goes up by less than 2 units. I have been testing when I wake up then before and 2 hours after every meal so 7 times a day since 2018 and I have only had a handful of tests that are under 7 in all those years but I rarely went above 11 then earlier this year my levels shot up into the high teens and low twenties when I had a new kitchen fitted and was eating ready meals and toast because I didn't have a cooker. I thought it would go back down when I went back to my usual diet but it is coming down really slowly.
I will ask for a print out of all my results.
I really appreciate your reply.

 

[Swiggy]

Hi,
It's been a long time trying to get the results of my C-peptide test and I have had a telephone consultation with a consultant at the Endocrine clinic this morning. I am producing 1800 units of insulin which he said is very high.
The last consultant refused to do a C-peptide test saying that he could tell from my high sugar levels that I was no longer producing much insulin at all and he wanted me to take dapaglifozin even though I told him that I eat a low carb diet. I refused.
New consultant wants me to take the oral version of semaglutide and I am not sure how I feel about that, he said that an injectable version would work better but there are supply difficulties. I think I need to talk things over with my GP before doing anything so keep your fingers crossed for me.