If he is hungry after his meals he might want to eat more? Especially because he's also losing weight.He is still tired, hungry soon after meals, losing weight
If he is hungry after his meals he might want to eat more? Especially because he's also losing weight.
Not more carbs but more fats and protein.
What alerted me to read your opening posts is the hypo and then in your follow up, the lack of ketones, high BG levels, and getting the tests, maybe eventually.Thank you all for the responses! We saw the diabetes nurse at noon and it transpires that the other diabetes “nurse” who told him to stop finger prick testing his BG and who tried to prescribe him statins was actually a pharmacist! Our usual nurse has written him back up for the testing strips and has told him that - although statins are offered to all DM cases over a certain age now - he is a very low risk, so it’s not something he needs to do at this stage.
Anyhoo, she dipped his urine (no ketones) and took bloods for GAD and c-peptide, but did say that the lab may refuse them from her! If they do, she will get him referred across to the diabetes nurse at the hospital who CAN get the bloods done. She is of the opinion that because his urine dip is ok, he is not likely to be Type 1 or LADA (even though last month she told us about LADA, as she thought he might be!) but that he is not a typical Type 2 either… Does it ever get less confusing?!
I do agree In Response that his low carb diet may well be masking the problem - he has been very disciplined around his carbs recently. Starting to wonder whether the poor chap is best off indulging in some much-missed carbs until they have investigated this fully!!
I agree with the rest of your post but have you got a link for this? You have to have those genetic markers to develop T1? (Not disputing your statement, just had not heard this before.)Also even if you have those genetic markers it doesn't mean you will develop type 1 it just means you are at risk. A person without those genetic markers means that you will not develop autoimmune diabetes.
I have a number of reports, but this one maybe useful :I agree with the rest of your post but have you got a link for this? You have to have those genetic markers to develop T1? (Not disputing your statement, just had not heard this before.)
@LadyPT there are quite a large number of diabetes types other than T1 and T2 . An endocrinologist would be in a much better position to diagnose than a GP . Did he get a hospital referral in the end?
I have a number of reports, but this one maybe useful :
'Latent autoimmune diabetes of adults from oral hypoglycaemic agents to early insulin'
by Resham R. Poudel.
And - 'Genetics of Type 1 Diabetes' by Andrea K. Steck and Marian J. Rewers
I would only add until he is referred and has the diagnostic tests, you could not even guess at what is going onUpdate: he is still losing weight (down another 3.5lbs in about 3 weeks) and has a CT scan today.
We were initially told the lab had refused to test the bloods, then received a separate text message saying he was T2. Having looked on the app, his GAD test came back at < 5.0 kiu/L (vs a normal range of below 10.1) but his the C-peptide just says “not routinely available to primary care” with no further information, so I suspect it was disposed of.
He is crazy tired and feeling rubbish and I have heard from a few people that you can have a normal range GAD but still have something other than T2… can I get the c-peptide test done privately? Can anyone recommend a reputable company for this in the U.K. please?
I am also interested to know if there are other conditions where HbA1C can read high and then respond well to Metformin, but still be unstable during the day/in response to eating/activity. Google searches just keep bringing me back to T2 and recommending weight loss and dietary improvements, neither of which apply to him. I’m not looking for anyone to speculate what might be wrong with him or diagnose over the internet, of course, just to point me in the direction of other conditions where BG can be variable so I can do a little reading and research. Thank you!!!
Thanks for your response In ResponseI believe it is possible to have type 1 without any genetic markers.
There is no history of Type 1 in my family going back at least four generations (and anyone earlier would not have survived). However, that didn’t stop me getting it.
And I have heard of others in a similar sitUstinov.
I find genetics very interestingLatent autoimmune diabetes of adults: From oral... : Indian Journal of Endocrinology and Metabolism
insulin dependency. But often there is delay in insulin therapy, as there are no recommendations for islet antibody testing in adult-onset diabetes currently. LADA clinical risk score can identify adults at high risk who may benefit from antibody testing. The optimal treatment of LADA is not...journals.lww.com
Genetics of Type 1 Diabetes - PMC
Type 1 diabetes, a multifactorial disease with a strong genetic component, is caused by the autoimmune destruction of pancreatic β cells. The major susceptibility locus maps to the HLA class II genes at 6p21, although more than 40 non-HLA ...www.ncbi.nlm.nih.gov
Interesting papers , particularly the LADA risk score in the first paper.
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