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Surprise diebetes diagnosis

Willpower - relax - you won't need as much as you think. It's easier to do than to think about before you start. It's more like won'tpower, as in I won't have "that" food item BUT I can have all this - who needs "that" anyway? Medical challenges from various wild cards of prescribed drugs and/or illnesses need to be allowed for, but we are wholly in support of you and the road isn't anything like as rocky as it looks just now.
 
Outlier said:
Willpower - relax - you won't need as much as you think. It's easier to do than to think about before you start. It's more like won'tpower, as in I won't have "that" food item BUT I can have all this - who needs "that" anyway? Medical challenges from various wild cards of prescribed drugs and/or illnesses need to be allowed for, but we are wholly in support of you and the road isn't anything like as rocky as it looks just now.
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I found that after what I assume to be a quite unpleasant week to ten days of 'sugar withdrawal' that I felt great. I had quite a unhealthy relationship with food - I could easily go a day or two just eating breakfast, but other days I could eat a packet of biscuits. If I can take anything from the last few weeks it is to look after myself better. I put most of it to the back of my mind - I was getting fitter and fitter through exercise and could see that in performance metrics that I really kept on top of and the subsequent increase in stamina. Really I should have put that thought into my diet - and I've committed to that now....

I have felt better since I've started Metformin 2 weeks ago than I have felt in months. As time goes on, I'll probably experiment a bit more with diet (mimicked fasting?), but for now I'm keeping things simple and finding my feet.
 
ChasingRemission said:
Thanks @Chris24Main . I've called the GP surgery every day after the first week since I had my blood test for GAD. I was under the impression I had the C-Peptide (but it turns out I haven't!) - but I will push for that one as well. I'm surprised that the diabetic nurse and the GP seemed to be pretty relaxed about this and are working under the assumption that it is T2. Can the GAD alone not give absolute confirmation as to my diagnosis?

Obviously I'm very anxious to get a proper understanding. 4 years ago my wife was diagnosed with a cancer that we were told would be incurable - but after one year of treatment and a complete change in her diet and lifestyle she has been in a position of 'no evidence of disease' for three years, which is of course incredible and cause for joy itself, but also gives me hope that I can reverse it if it is T2 - and to manage it as best as possible if it turns out to be T1 or something else.

Also @JoKalsbeek - that's a really useful 101 introduction for anyone newly diagnosed to read about diet - thanks.
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Docs see more T2's than T1's, so they might be a bit lax, as they're not expecting a zebra between the horses. But with your ferocious appetite for information, I think you'll have your answers relatively soon, and a plan of action to go with it. If type 1, my whole song and dance becomes a lot less relevant, but carb counting/reduction can help keep blood sugars steady for those who do need to inject as well. All in all, you've seen what taking a condition head-on can do, with your wife's remission as evidence (congratulations!), so... I have a feeling, whatever your type turns out to be, you're in a good place to tackle it. (Some people have a family that just tuts at dietary/medical measures for health conditions, so yeah... Not likely in your case!)

Hang in there and keep on it!
Jo
 
JoKalsbeek said:
Docs see more T2's than T1's, so they might be a bit lax, as they're not expecting a zebra between the horses. But with your ferocious appetite for information, I think you'll have your answers relatively soon, and a plan of action to go with it. If type 1, my whole song and dance becomes a lot less relevant, but carb counting/reduction can help keep blood sugars steady for those who do need to inject as well. All in all, you've seen what taking a condition head-on can do, with your wife's remission as evidence (congratulations!), so... I have a feeling, whatever your type turns out to be, you're in a good place to tackle it. (Some people have a family that just tuts at dietary/medical measures for health conditions, so yeah... Not likely in your case!)

Hang in there and keep on it!
Jo
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Thanks @JoKalsbeek ! I'll push for my GP to give me a C-Peptide test, but if not I'll get it done privately if needs be. I've read a couple of postings of people on here who have had delayed / incorrect diagnosis and I really want to avoid that. Regardless, yes, it is time to embrace a new lifestyle - no point crying about what I can't have anymore - plenty of new things to try and enjoy.

The one thing that I have never really noticed before from a dietary / nutrition perspective - I see items that profess to be 'Sugar Free' on the label, but the details say, for example "Per 100g : Carbohydrates 50g - of which sugars 0g". I presume that I still need to give that item a swerve???
 
It depends on the type of carb -

starches are carbs that are strings of sugars - they turn very quickly back into sugar (which is why a slice of potato on the tip of your tongue can taste sweet - the enzymes in your mouth break down the starch).

fibre on the other hand, is also strings of sugar, but you can't do anything with them, so they will never appear as "sugar" in your system.

So, you need to look at both the ingredient list as well as the nutrition panel, but for me, simply answer is likely yes - anything with high carb will likely be something I want to avoid.
 
I can only mimic what has already been said. I’m surprised they did a test for GAD antibodies without doing a C-Peptide test. One can be GAD positive without developing T1. They can also be transient. Given your quick rise in blood sugars, however, I suspect they will want to do a C-Peptide test to see how much insulin your pancreas is producing. Definitely push for it.
 
Melgar said:
I can only mimic what has already been said. I’m surprised they did a test for GAD antibodies without doing a C-Peptide test. One can be GAD positive without developing T1. They can also be transient. Given your quick rise in blood sugars, however, I suspect they will want to do a C-Peptide test to see how much insulin your pancreas is producing. Definitely push for it.
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I'd pushed for what I thought was C-Peptide! I only discovered yesterday it was GAD - so already I've lost a bit of faith in the clinicians, who don't seem to think that it is anything other than T2. If it is T2 then so be it - but I know I'm going to have to push for that. I work in the health system so appreciate rationing of tests, but waste / harm should be avoided and I believe that treating people incorrectly squarely comes into it harm and waste.

So you would hope that they would 'want to', but they might need a persuasive nudge in that direction ;).

I've already found my purchased blood glucose monitor to be useless and I have sent it back, however, my next door neighbour has the Abbott Freestyle Libre on prescription from when she had wildly uncontrolled gestational diabetes and had given me a few months worth. Anyone recommend a decent fingerprick machine?
 
Yes, strange, I live in Canada so maybe different, but C-Peptide tests are a lot cheaper than autoantibody tests. T1 and T2 are very different disorders from each other, although if it’s late onset T1 / LADA you may have some insulin resistance, but not necessarily so.
 
ChasingRemission said:
I'd pushed for what I thought was C-Peptide! I only discovered yesterday it was GAD - so already I've lost a bit of faith in the clinicians, who don't seem to think that it is anything other than T2. If it is T2 then so be it - but I know I'm going to have to push for that. I work in the health system so appreciate rationing of tests, but waste / harm should be avoided and I believe that treating people incorrectly squarely comes into it harm and waste.

So you would hope that they would 'want to', but they might need a persuasive nudge in that direction ;).

I've already found my purchased blood glucose monitor to be useless and I have sent it back, however, my next door neighbour has the Abbott Freestyle Libre on prescription from when she had wildly uncontrolled gestational diabetes and had given me a few months worth. Anyone recommend a decent fingerprick machine?
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@Rachox keeps an up to date list of what's around: Rachox, can you oblige please?

I got a Gluco RXQ free five years ago and haven't used any other. I've had a look at what's on the market from time to time, but the issue to be aware of is the price of test strips. The ones for my RXQ are inexpensive: the ones for the next model up cost twice as much.

All glucometers are inaccurate: that is, there is an "allowable" inaccuracy of 15%, 95% of the time. In practice that means that a "true" blood glucose value of 6.0mmol/l could generate results of anywhere between 5.1 and 6.9 via glucometer and be "accurate enough". And 1 in 20 results can be even further outside that. So if at 9.30pm after my meal I get a result of 2.1 I can be pretty safe in assuming it's a rogue, and just retest. The thing is not to get hung up on any one reading: what you're looking for is to build up a deeper understanding, over time and with many tests, of how you react to carbs in foods - this may not be the same all the time, and it may not be what you might expect.
 
ChasingRemission said:
Thanks @JoKalsbeek ! I'll push for my GP to give me a C-Peptide test, but if not I'll get it done privately if needs be. I've read a couple of postings of people on here who have had delayed / incorrect diagnosis and I really want to avoid that. Regardless, yes, it is time to embrace a new lifestyle - no point crying about what I can't have anymore - plenty of new things to try and enjoy.

The one thing that I have never really noticed before from a dietary / nutrition perspective - I see items that profess to be 'Sugar Free' on the label, but the details say, for example "Per 100g : Carbohydrates 50g - of which sugars 0g". I presume that I still need to give that item a swerve???
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There's all sorts out there with the "sugar free" label on, but if they used starchy things to make it... Yeah, as a general rule, swerve.

When I was just diagnosed with diabetes, my in-laws went to an expensive, all-natural bio supermarket, and asked for things without sugar. They came home with cake sweetened with dates (which was horrible and got binned after everyone else tried it), a bunch of different sugar free biscuits that were still very carby, because wholemeal... They tried so hard! They could've just asked me, and spent the same money on half a week's worth of groceries, but the gesture was appreciated. ;) (And a packet of pork scratchings would've been a lot cheaper, if they did insist on me partaking)

Have to admit though I still get livid when I see honey chunks, a popular market item here, advertised with very big signs as being good for "especially diabetics!". As a hypo treatment, maybe... But there's no refined sugar in there! (They seem to think if you shout it loud enough, it'll make a difference in blood glucose effect somehow?) It's just a massive lump of hardened honey... *shakes head*

Basically, if it says it has carbs, and they're not made up out of polyols or somesuch, then yeah.. Don't go there. Yay, bacon! ;)
 
Thanks for the tag @KennyA ,

@ChasingRemission , here’s some info with links for UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have diabetes so you can buy VAT free. (for all meters and strips)



If you’d like to try a free 15 day trial of the Freestyle LIBRE 2 plus follow this link:

Sampling | Diabetes Care | Abbott
 
So I have a question, I am taking a empagliflozinum tablet every morning to clear blood sugar from my system, and also taking a 24 hour insulin jab, on top of that there is a fast acting insulin jab before every meal, which when I get the hang of it will be titrated dependant on my carb counting. I am not sure that every type 2 is doing this.
I stopped metaformin 2 years ago, because it was bad for my health, and did tradjenta and repaglind, for a couple of years.
I cannot belive that stopping bread, potatoes and sugar in my tea, will help me get back to normal life.
Is there something I am missing?
Is it only about the numbers or is there something more.
 
@Royjk because with classic Type 2 diabetes caused by Insulin resistance and a pancreas that is unable to produce enough insulin to counter the insulin resistance , reducing carbs in the diet reduces blood sugars thereby reduces the strain on the pancreas. A very simplified explanation. So Greatly reducing carbs for most T2’s reduces blood sugars and reduces weight.
 
Hello @Melgar
Yes I read about that, but what I read said that to get the pancreas working again it may need a transplant or controversial stem cells, to get the system working again. I did not see any accepted ideas on pancreas regeneration through a low carb diet.
Royjk
 
Your pancreas is working.. in fact even for people with advanced T2, the pancreas will be producing much more insulin than someone with a balanced metabolism.

It just cannot keep producing enough, because you need too much, because your metabolism is out of balance. This is the really important bit.. we're not really supposed to need much insulin, because insulin does about 100 different jobs all over your body, in every cell type.
 
Royjk said:
So I have a question, I am taking a empagliflozinum tablet every morning to clear blood sugar from my system, and also taking a 24 hour insulin jab, on top of that there is a fast acting insulin jab before every meal, which when I get the hang of it will be titrated dependant on my carb counting. I am not sure that every type 2 is doing this.
I stopped metaformin 2 years ago, because it was bad for my health, and did tradjenta and repaglind, for a couple of years.
I cannot belive that stopping bread, potatoes and sugar in my tea, will help me get back to normal life.
Is there something I am missing?
Is it only about the numbers or is there something more.
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I have taken zero diabetic-related medication ever. So you're right, not every T2 is taking a flozin and insulin.

Lowering my carb intake (bread, potatoes, sugar, and the rest) did indeed get me back to a normal life - at least, one that does not have the painful diabetes symptoms and does have normal BG levels.

I think what you're missing is that high blood glucose is a real problem regardless of how it is caused. High blood glucose (and what is "high" depends on the individual) over time does damage to capilliaries and nerves. So getting your BG under control is for me a priority even if that doesn't affect your "metabolic syndrome" in any way. If I was to eat the high carb "healthy diet" that the NHS still promotes, I would reacquire the same problems I had between 2010 and 2020. I don't knoe how quickly that might happen and I have no interest in finding out.

As I've said before, you're apparently not a typical T2 and need to keep that in mind.
 
Royjk said:
So I have a question, I am taking a empagliflozinum tablet every morning to clear blood sugar from my system, and also taking a 24 hour insulin jab, on top of that there is a fast acting insulin jab before every meal, which when I get the hang of it will be titrated dependant on my carb counting. I am not sure that every type 2 is doing this.
I stopped metaformin 2 years ago, because it was bad for my health, and did tradjenta and repaglind, for a couple of years.
I cannot belive that stopping bread, potatoes and sugar in my tea, will help me get back to normal life.
Is there something I am missing?
Is it only about the numbers or is there something more.
Click to expand...

There's different ways to tackle T2 diabetes. Oral meds, insulin, diet and medication, or diet only, to name a couple. So, no, not every T2 is doing this. i started on metformin, it didn't agree with me, moved on to gliclazide, which was no joy either, then on to diet, which seemed to be the ticket! Was a bit of searching, but eventually I got there. That is what works for me, but other things work for other T2's: too many variables to say one way to treat is the be all, end all. Your insulin output is likely quite high, due to the steroids upping your blood sugars and your pancreas trying to keep up, and that made you, quite likely, insensitive to your own insulin. Bam, steroid-induced type 2 diabetes. Because there's so much, your body just doesn't use it as it should. Throwing more insulin at it would therefor likely make the insensitivity worse over time, (it'd be a quick fix now, not so much long term...) so you'd need more and more as time goes by. If you reduce your body's insulin levels, your sensitivity to it should come back to some degree: you'd need less of it. You can't do without the steroids that up your blood glucose, but you can have a say in the amount of carbs you eat. Give your pancreas less to contend with.

I don't know how much the steroids affect your blood glucose, so I can't promise you normal numbers. Could well be you'll always be elevated to some degree, but you could, with a low carb diet, get back to better levels and hopefully, more insulin sensitivity. You might not need insulin for much longer if you change your diet, but again, that wholly depends on how much impact the steroids have, and I can't say anything on that. They don't seem particularly optional, so it's a bit of a balancing act. If you can't control one aspect of what raises blood sugars, control the other, see how far that gets you.

Good luck,
Jo
 
Royjk said:
Hello @Melgar
Yes I read about that, but what I read said that to get the pancreas working again it may need a transplant or controversial stem cells, to get the system working again. I did not see any accepted ideas on pancreas regeneration through a low carb diet.
Royjk
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If your pancreas is damaged, no amount of dieting will fix it. T1's and variants thereof have an auto immune condition that'll destroy their pancreas, T3c's 'll have the same issue, but due to pancreatitis or pancreatic cancer: little to no output. A type 2's pancreas does make plenty of insulin, but the body is insensitive to it. So it's usually working (unless after a loooong time of trying to keep up and failing, it's become knackered and reduces output), and then diet could make all the difference. It won't fix the pancreas, because it doesn't need fixing. It fixes your sensitivity/insulin resistance. That's the difference. Different problem, so different fix.
 
Thanks @KennyA and @Rachox for the suggestions on monitoring devices. I set my Freestyle Libre up last last night and very pleased with it. Hopefully I'll be able to continue that for a bit as it has given me piece of mind and until I run-out of my 'goodwill' sensor. My fasting BG level three weeks ago was 13.1 - but it is thankfully remained much, much lower and inside range (in all 14 hours of using it:p!!).

For me, @Royjk I have shifted my diet. I'm afraid that is probably the only thing that will work for me (alongside Metformin, which I've tolerated OK). I've not had a slice of bread in 3 weeks, but perhaps will do in moderation when I've become more familiar with things. I've upped my seeds and nuts consumption, along with yoghurt or scrambled eggs for breakfast. Much more pulses and leafy green veg in the evening. It's probably cutting out absolute junk like chewy sweets (just when loads more are becoming vegan-friendly!), a cheeky can of Red Bull and a Mars Bar that has helped most. I miss pasta and potatoes (I substituted white potatoes with sweet potatoes in moderation) but have largely substituted rice with 'cauliflower rice'. What I have found is that by dropping that amount of carbs has given me so much more energy. I thought that I was pretty fit given the amount of sport and exercise I do and having a athletic body composition, but I feel so much better for eliminating just a few things from my eating habits.

With regards to pancreatic transplant...... Such major surgery for a condition that can be managed medically / therapeutically (which I imagine is the vast majority of cases?) seems unlikely to me unless there is a massive shift in technology.
 
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Hello @Chris24Main

Yes you must be right, if the pancreas fails to produce enough insulin there will be other things that go wrong in addition to blood sugar levels. Things like DKA would also be a problem, and a prerson could have dangerous symptoms.
Royjk
 
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