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T2D, DN says not making enough insulin ! -?

I

ianf0ster

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I am newly diagnosed Type 2 Diabetic 68yrs old. My understanding from 'Low Carb advocates on internet' is that this is caused by Insulin Resistance - not insulin deficiency.

Am I wrong, or is 'Diabetes Nurse' giving me the old Low Fat garbage we have been indoctrinated with for the past 30yrs?
 
Depends.. some people are over producing but their diet is causing their body not to be able to cope with their carbohydrate intake (classic T2).
Some people under produce and will probably need insulin at some time in the future.. T1, LADA, MODY etc
A c-peptide test would probably be able to show which we are and would save a lot of misdiagnoses but hey its the NHS...
If you try low carb and get lower blood sugar levels then you're most likely the former.
 
So far as I know, the blood tests have not gone to that depth - just Fasting Blood Glucose then this time the Hba1c . I was so-called ''pre-diabetic' for a few years. I have been on the NHS advised Low Fat, High Carb diet for healthy heart for over 10 yrs. Isn't 68 rather old for me to suddenly become Type 1 ?
 
Indeed although not necessarily.. but the low fat high carb diet often leads to T2 so in thinking you are keeping healthy you may have made yourself ill with T2. Have you been taking a statin as well?
Also the HCLF diet probably isn't that great for your heart either (IMHO).
 
I would defiantly recommend getting a c-peptide test done as it can show how much insulin you are making.

I was originally diagnosed as T2 (despite having none of the ‘usual symptoms’ which doctors tend to diagnosed I.e. I was thin, only 26, fit).

The c peptide test highlighted that I am not insulin resistant and instead I produce very little insulin - which has opened up a whole new can of testing but hey ho
 
Hi

I would suggest you try low carb high fat eating, if this works then hey presto, if it doesnt then you probly arent producing enough insulin of your own and may need some help, far as I know this does not make you type 1, I believe I am type 2 but need some help, I have never in my 48 years eaten low fat anything lol so it wasnt that that got me.

Hope you find some answers, welcome
 

I was doing HCLF (as advised) to prevent Cardio Vascular problems - my dad died of heart attack aged 45.
Yes I am on statins - I felt I had to cave in on them after my 3X CAB. The statins seem to have reduced my HDL down to 1.2 (at least I blame them). Total Cholesterol at last blood test was 3.2 so they have certainly reduced that , but I am unsure if I am healthier since some statins are known to cause T2D even though the one I am on says it isn't one of them i.e. 'known to have T2D as a side-effect' - LOL!

I have an appointment with one of the 3 'diabetic specialists GPs' at my local Medical Centre next week. I plan to ask him if I can reduce the dose of Statins since my Cholesterol seems so well under control. I won't mention LCHF diet and just hope that the raised Cholesterol it induces during body fat loss stage is done with before my next blood test.
 

I too don't have any symptoms ( just high-ish Blood Glucose and Hba1c ) apart from some tiredness again - which GP fixed first time soon after my bypass op with some Iron tablets.

I think I will give LCHF diet a chance to work before I ask for a blood test for anything, since I would like to get off the Statins.
 
Thanks to all for your replies. They have helped me get the probables and possibles sorted in my mind.
 

First of all, the vast majority of T2s produce too much insulin but it doesn't work properly due to resistance. Only a few have low insulin production, and in these cases blood sugar levels are normally high without injected insulin or some other strong medication that forces the pancreas to produce more. Dietary intervention doesn't work on its own. It would be unlikely you are T1 if your BS are relatively OK and you react well to low carb. Once your blood glucose meter arrives you will be able to see for yourself how well you react to low carb. As your nurse hasn't organised a c-peptide test, and hasn't prescribed medication, it is unlikely she thinks you are T1. By the way, anyone of any age can become T1. It isn't restricted to young folk. Theresa May was diagnosed just before she was 60.

Secondly, statins lower the LDL and triglycerides. They do not affect the HDL at all. The HDL is good cholesterol and the more you have of it, the better. A total of 3.2 is very low. All statins can cause raised blood sugars - which one are you taking? Your HDL should increase nicely if you go low carb. It is carbs that deplete it.
 
ianf0ster said:
I have been on the NHS advised Low Fat, High Carb diet for healthy heart for over 10 yrs.
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Not for everyone. With type II, as explained, you could either not be producing enough insulin, or, you have insulin resistance so that you're not using the insulin you are producing properly.

A c-peptide test will tell you how your pancreas is performing, I had to pay for my test and I think most people do. You could try asking your DN for the test, good luck.
 
I was on Pravostatin and my hba1c increased from 48 to 54 within 6 months of taking them and reduced to 43 within 6 months of stopping them. I will not be taking them again.
 
Hi. My cardio recommended a high dose of statins and low-fat as many cardios around the world still believe that eating high fat results in fat deposits in the arteries. My understanding is that the fat you eat contributes very little (15%?) to blood fat and the rest is produced by the liver. Somewhere the true facts have been lost? Either the cardios are right or those who describe the body's metabolism; I favour the latter. I do have statins but make sure my dose doesn't take my overall cholesterol too low otherwise that would cause damage. I also do have fat and low-carb as I would rather control my diabetes than rely on suspect cardio guidance with regard to fat in the diet.
 
ianf0ster said:
Am I wrong, or is 'Diabetes Nurse'
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I would say that there is more chance that your HCPs will have a better idea and be best at diagnosing you, rather than some people on the Internet.

However, if you are in any doubt asking for some more (different) tests would be advisable.
 
When I was first diagnosed I asked why insulin production wasn't tested.
Initial reading said that with T2 either you are Insulin Resistant or not producing enough insulin (or possibly both).
I was told that they didn't test because regardless of the result the treatment was the same.

As far as I know without a specific test there is no obvious way of knowing if you have IR or you just aren't producing enough insulin.

Even going low carbohydrate doesn't give you a definitive result. If your BG control improves you have either reduced IR or you have reduced your carbohydrate intake to the level where your reduced insulin production can cope (or both).

Which, I think, puts us back where we started. If you subscribe to LCHF then it doesn't matter (at least in the short term) if you have IR or you are under producing. Both conditions can be managed through LCHF.
 
As has been already mentioned many times, it would help to have that c-peptide result. No one can tell you if you are or are not producing enough insulin without it.

That will tell you what the pancreas is producing. Personally, I believe it should be tested post meal, around 45 mins after if possible. This will show how much the pancreas is producing because it will be active and doing what it does in response to food as opposed to a fasting result where the pancreas isn't being asked to do anything much because there is no reason for it to be in full swing.

It would probably put your mind at ease knowing what is going on in regards to insulin production.

I don't produce enough insulin (yes, had a c-peptide test) but I'm not type 1 either, mine is because my pancrease is impaired due to a genetic condition called cystic fibrosis (CF) and this isn't uncommon at all for people with CF. As a result I can beat my BG levels down without insulin, but it requires A LOT of effort.

Good luck getting it done, it can be hard to get a test you want done if your DN or HCP has already made up their mind/s on something, even without data to support it.
 
My triglycerides were raised, and my LD cholesterol a bit too high when I was diagnosed - low carb reduced them into the normal range as well as improving my liver function results. All without stains or metformin as I was diagnosed early and LFHC worked quickly.
 
My practice nurse who deals with diabetes said the same to me. When I said surely most type 2 have too much insulin but can’t use it effectively due to insulin resistance she rapidly backtracked and explained it was just the wording and agreed what she meant was that we don’t have enough to do the job of reducing glucose.

Still not entirely accurate but it makes the point it was a lazy, simplistic way of explaining what was going on. There is reason to suspect I am not producing enough as low carb has work fairly well for me so if I wasn’t informed and questioned it there and then I would have been as confused as your nurse left you. Maybe it was the same one! I would add in other respects she was quite good although a little unsure of the lchf
 
I know I produce a lot of insulin because if I eat something naughty and go high after it, I then drop slowly at first, then like a stone about the 3 hour mark. I drop down to low 4s. Not hypo at all, and my liver then brings me back to about 5. That wouldn't happen if I had too little insulin. It happened when I did a home OGGT as well.
 
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