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bulkbiker said:
With blood sugar levels as high as you have I think there may well be something else going on.. I think a nurse is probably not the best person to be speaking to. In your shoes I'd be pushing for a consult with a diabetes specialist before going onto insulin.
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How do I say “your not good enough, get me someone else” ? lol

Is there a certain person/thing to ask for please?
 
Fenn said:
How do I say “your not good enough, get me someone else” ? lol

Is there a certain person/thing to ask for please?
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I would imagine it would have to be a referral from a GP I'm betting a nurse won't be able to that but a move onto insulin could be pretty life changing so I'd want to get a full check out before doing it.
 
Fenn said:
Thankyou, I have been trying to read up on insulin resistance but seems like not the easiest thing to get an answer on, I have decided I must be insulin resistant as my extra weight is only around my belly and everything points towards that being a sign of it, does that make sense? Lol

It being crazy is what worries me, I will try to get them to test me for it before they give me insulin
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This does seem to be a pointer to where your problem may lie.

You also said in your original post

I am a little heavy but most people would not say I’m fat, just big built, I may be a stone too heavy but I’m wide and carry it well, the nurse said “your not fat” when I suggested that to be the problem
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As far as I understand it Insulin Resistance can be very closely tied to the amount of fat you have around your liver and pancreas.
Studies such as the Newcastle Diet have shown remarkable results when the fat around the liver and pancreas have been reduced.
Being wide and carrying it well is really just an excuse to not acknowledge the issue - it isn't how you look but how your organs in your belly are behaving.
Your nurse did you no favours.
The key pointer is to have your true waist measurement (around the belly button) less than half your height.
Please note that this is not your trouser waist measurement because a lot of people have, for example, 34" waist trousers worn low beneath a much larger belly.

A large belly often goes hand in hand with IR and poor BG control. I know that my BG control improved a lot when I got my waist measurement down below 36" for a 6 foot/ 72" male.

You have obviously tried hard and done well with losing weight, but you seem to have reached the point where you need to do something drastic or start on extra medication.

One option would be to have a look at the fasting part of the forum; there is a lot of support there for various fasting regimes and they can sometimes restart weight loss.

I realise that fasting (or even just reducing what you eat) can be hard when you have a very physical job. Especially when you are tempted by sandwiches for lunch. However it may be this or the insulin, which as you correctly note is not the best thing if you are already running high insulin levels.

However, are you? The Insulin Resistance test mentioned here already is not expensive, and will show if you are really putting out lots of insulin but not using it, or if your pancreas is starting to suffer and can no longer put out the high levels of insulin required. To my mind this is something that you should have done before deciding to go on insulin.

Final note; if your pancreas is giving up the unequal fight it can sometimes be revived if you clear the fat from around it.

Oh, and how tall are you, what do you weigh, and what is your current true waist measurement?
 
Please don't assume anything. Always follow it up and check it out for yourself.
I am referring to two things you are assuming - the GAD test results and the insulin resistance.

Do follow up the GAD tests and if they are back, ask for the actual numbers. Don't accept "positive" or "negative".

I think you need a c-peptide test. That will show what your natural insulin levels are likely to be. Have you had one of these? If your own insulin levels are low, then you do need insulin. If they are normal, then you have enough but it isn't working - main reason for this is insulin resistance.

Also, I doubt you will get an insulin resistance test on the NHS. The Medichecks link that @bulkbiker gave you earlier in the thread is a good place to get it done privately. Then you will know. You would just have to persuade a nurse/phlebotomist to draw the blood for you. Apart from that, it is easy.
 
If you are uncomfortable asking your nurse for a referral to the nearest diabetes clinic, then I would make an appt with your doc and explain.
If that doesn’t work, then write them a letter and formally request a referral.
Just keep plugging away til you get one. It is a foundation stone of the NHS that we can ask for, and get, referrals, if we feel our current care is not appropriate. :)

The thing is, you may be insulin resistant, and you may have failing beta cells, and you may be a very slow onset LADA type 1 or a type 2. You don’t have enough info at the moment to know.

However, one thing IS certain - that your blood glucose levels are too high, and living for too long with them this high will increase your risk of diabetic complications. There are actually many different T2 drugs and drug combinations (a heck of a lot more than your nurse seems to be offering!) but if you are a slow onset T1 then getting onto insulin ASAP is in your best interests.

So get thee a referral, and get your situation assessed by an expert. :)
And please come back and tell us how you get on, and what the outcome is? :)
 
You sound like you deserve at least one Olympic medal if not more!
My understanding is that there are a number of medications for T2D diabetes (if that is what you have) in the order of at least
4 or 5 different ones, including an injection (which is not insulin).
The other big thing is whether stress or medication for something else is making the numbers go crazy. Stress certainly wrecks my BSLS as a T1D and I am sure others on this website would agree that it does the same for them whether T1D or T2D.
You make be, for example, under duress or time pressure in your job or have some other worry. Even the worry of the results you are getting, despite all your hard work, will be a stress ! Just something to think about.
Perhaps ask your DSN or doctor about ALL the medication options for T2D whilst waiting for your GAD test result.
Best Wishes !!
 
Totally blown away by you all, Thankyou so much for taking the time, such great great advice!

I will Tuesday be finding out the GAD results, I will also be getting the medichecks kit.

I’ve discovered that I am not in fact fat by my belly button measurement, I’m just 6 inches too short which I am putting down to genetics for sure, I’m 6ft2inches and belly button is 40 inches, I did it with a tape measure and 80 inches was about 6ft8inches.

I’m not accepting my weight, I lost 6 stone originally after diagnosis. I have gained 2 stone of that back and have plateaued there, I know I need to work on being this fat but also have to accept that I also need my diet to be sustainable, I am in the process of cutting out some things and reducing others.

I am feeling very inspired to try harder by you all, maybe this thread, laying out myself in public (sort of) is what I needed.

Instead of regretting my post, I’m very happy I wrote it and very very grateful to you all for your help. Will report my results
 
Fenn said:
Totally blown away by you all, Thankyou so much for taking the time, such great great advice!

I will Tuesday be finding out the GAD results, I will also be getting the medichecks kit.

I’ve discovered that I am not in fact fat by my belly button measurement, I’m just 6 inches too short which I am putting down to genetics for sure, I’m 6ft2inches and belly button is 40 inches, I did it with a tape measure and 80 inches was about 6ft8inches.

I’m not accepting my weight, I lost 6 stone originally after diagnosis. I have gained 2 stone of that back and have plateaued there, I know I need to work on being this fat but also have to accept that I also need my diet to be sustainable, I am in the process of cutting out some things and reducing others.

I am feeling very inspired to try harder by you all, maybe this thread, laying out myself in public (sort of) is what I needed.

Instead of regretting my post, I’m very happy I wrote it and very very grateful to you all for your help. Will report my results
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I’m genetically too short aswell! It’s not fair is it?! ;)
I’m so glad we’ve inspired you.
 
Sorry to ask, I called the doctor for GAD test result, the receptionist said it came back as 5, this means absolutely nothing to me.

Anyone know what this means please? I am assuming that it is fine

Thankyou


Think I found the answer is negative, Thankyou
 
I don't know what it means myself, but I found this on the main website


What will the GAD test results show?
Presence of the GAD antibodies is observed in 75% of people with type 1 diabetes at diagnosis.

If the test shows GAD antibodies are present, this indicates that the patient has type 1 diabetes. If no GAD antibodies are present, however, the test cannot be conclusive in saying that the patient does not have type 1 diabetes.

https://www.diabetes.co.uk/gad-antibody-test.html
 
Fenn said:
Hi, if I am insulin resistant which I assume I am, what would be the point in taking more insulin? So assuming I don’t take insulin, how do I get my numbers down? I have done very low carb and it worked very well, I have found a carb level I can live with long term but the numbers are crazy.

I don’t eat junk food, no sugary drinks or foods etc, I eat very low amounts of the main culprits bread, rice pasta etc etc, never have afters, I might eat a petrol station sandwich if I’m on the road all day but generally eat very well a moderately low carb, I’m back on the yogurt and berries for breakfast, I know all the foods I should and shouldn’t eat, I know all the ways to low carb bake, I’ve been there, done that and the t-shirt is baggy

I do not want to go 30g a day, did that for years, it worked but I’m sick of it so I have found a nice level I can live with, I am very well behaved, I take my pills, I don’t drink or smoke, I eat tons of the good stuff and almost none of the bad.

I get plenty of excercise but not the kind you get from the gym, I work long physical weeks at work, averaging 10-15k steps according to fitbit

So the crazy numbers are telling my dsn that I need insulin, obviously I don’t fancy that, especially as I’m probly insulin resistant and that would not make much sense

I seem to be on this track and want to get off please, the thought of really low carbing for life feels me with depression and can’t see it working anyway as I get bad numbers when fasting

I take x4 metformin, alogliptin and jardinace (I have 3 months before I-day so they are trying the jardinace)

I wake up in the high teens I can fast all day and get to the low teens, eat something like a sandwich and be in the 20s, it generally takes 5 hours to get back to low teens, I’ve gone from a1c’s 116 (5 years ago) to 36 (3 years ago) and now 82, it’s nuts considering what I eat, I am a little heavy but most people would not say I’m fat, just big built, I may be a stone too heavy but I’m wide and carry it well, the nurse said “your not fat” when I suggested that to be the problem

So finally after all that my question.... is insulin a bad idea for me? I’ve been told it’s inevitable but does it have to be?

Thankyou

Sorry, shouldn’t be posting at this late hour, will regret it in the morning
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Hello, regards your question point re "insulin Resistant", i.e. "what would be the point of taking more Insulin"?. that is an excellent valid and warranted question, well done. As I am not a doctor, dont have jurisdiction to comment as such, however, I attach video of Dr Fung, to share with you, which actually refers to the valid question you regards insulin resistance, he explains this situation simply and clearly, which may prove of interest and more so answer your question? Hope this helps.
 
bulkbiker said:
If you are just seeing your GP then it is extremely unlikely that you will get a fasting insulin test. I was recently at the PHC conference where there were more than 50 GP's in the room and none had ever got the test done through the NHS. I had my fasting insulin tested via medichecks who will also do an insulin resistance test.
https://www.medichecks.com/diabetes-tests/insulin-resistance-test
If you are having bloods drawn at the GP then get the test kit beforehand and ask the phlebotomist to fill the medicheck vials too.
Otherwise you can arrange a private blood letting at a private hospital for an extra £25 I think.

At least you will be better informed about what is going on.
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Hi there Bulkbiker

Do you have any knowledge of the lipid test that actually measures (not estimates) LDL and measures LDL particle size? Can’t even remember what it’s called. Hubby has had a relatively minor ‘cardiac’ incident (I hope) and I fear he is going to be put under increasing pressure to go down the Statin route. I’m pretty sure the test is not available on the NHS.

Thanks
 
Fenn said:
Sorry to ask, I called the doctor for GAD test result, the receptionist said it came back as 5, this means absolutely nothing to me.

Anyone know what this means please? I am assuming that it is fine

Thankyou


Think I found the answer is negative, Thankyou
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Southend University Hospital in the UK provide the following information:-
http://www.southend.nhs.uk/pathology-handbook/test-directory/test-directory-g-index/gad-antibodies/

Reference Range
Results shoulf be interpreted as follows

Negative result is 0-5.0 U/ml

Equivocal result is 5.1-25.0 U/ml

Positive result is >25.0 U/ml

​
Generally, it's good idea when asking for results to ask what the units are as well as the number - some tests can be measured in different units in different areas and therefore have different reference ranges. It's also good to ask what the reference ranges are as different laboratories can use slightly different methods for some tests and although the units may be the same,the reference ranges might be slightly different.
 
Thankyou very much, I now have even more reason to suspect insulin resistance.

Sorry Bluetit, I just read your question about the C-peptide test, no I have never had one.

Thankyou
 
AtkinsMo said:
Hi there Bulkbiker

Do you have any knowledge of the lipid test that actually measures (not estimates) LDL and measures LDL particle size? Can’t even remember what it’s called. Hubby has had a relatively minor ‘cardiac’ incident (I hope) and I fear he is going to be put under increasing pressure to go down the Statin route. I’m pretty sure the test is not available on the NHS.

Thanks
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Yes its the NMR lipid profile.. these guys explain it and do it

https://www.invivoclinical.co.uk/products---services/lab-diagnostics/advanced-nmr-lipids-lipoprofile
 
AtkinsMo said:
Thanks, Bulkbiker

Just followed the link, doesn’t seem as though you can just order it as an individual, only as a patient of an approved practitioner, or do you know different?

Cheers
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Hmm looking at the test report it looks like you might need a doctor to order it.. might be worth giving them a call.. this was the cheapest I could find it but have never actually had the test myself. Sorry not very helpful but someone on another forum asked the same question this morning.. there don;t seem to be many places that do it (medichecks doesn't for example) there was one other place that offered it here
http://www.smartnutrition.co.uk/hea...iovascular-risk-assessment/cv-health-profile/
this has the better explanation and looks like you can self refer if you can get a blood sample taken but again I would suggest contacting directly as I have had no contact with either of these two places.
If you do go ahead I'd be very interested to hear how it goes as I might get one for myself.
 
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