I am totally at a loss as to what to do. We obviously need to see what his CT (with contrast - thorax/abdomen/pelvis) shows as this will check out his pancreas, as well as having a general look around for a tumour (strong family history of cancer) to try to explain away the weight loss.
In the meantime, he has no ketones in his urine when they dip and normal range GAD, so his diabetes nurse says “your bloods confirm you have Type 2 diabetes”. No option to get a hospital referral. No mention of there being other conditions that can cause a high HbA1c (that has, admittedly, responded well to taking Metformin and cutting the carbs) and BG that spikes when he eats and drops when he does any kind of activity. Making me feel like I am looking for something that isn’t there… “he isn’t T1, so he’s T2” is the general vibe.
I am starting to wonder if I they are right and I am overthinking this… he was only diagnosed last year, yet he has had many diabetic issues: skin infection, peripheral numbness in fingers and toes, wounds are slow to heal, plus they confirmed background retinopathy in both eyes at his diabetic eye check in December. But - by the diabetic nurse’s own admission - he is not a typical T2 diabetic at all.
This has my interest peaked. I may be repeating myself and I'm not gonna rule anything out, such as has been discussed.
My initial T2 misdiagnosis was because of diabetic numbers. And the symptoms so common with hyperglycaemia. These bloods were taken in the morning and not fasting bloods. I always had carbs (porridge) for breakfast. I was informed to eat a healthy carb filled diet.
The symptoms were a long list.
Most doctors, dsns, dieticians told me I was T2.
However, it came to pass, a later blood test, told a different story it was 3and a half hours after food. I was having a hypo!
I cannot do anything but mild exercise, cos if I need energy when I have used it, glucogenisis occurs (liver dump) this will cause the reactive part of my condition. Walking, doing the chores, a bit of lightweight gardening....
Can't run, do weights, lift and carry too much etc.
So I know that feeling, symptoms.
Again in giving you my experience. And there are many other conditions, that have those symptoms including other hypoglycaemic conditions, pancreatic conditions.
And you may have one or more of these conditions. It is not straightforward.
There is something going on because of the unusual readings, symptoms and effects of having food, drink or just being awake.
You need a referral and if you're not already, testing around meals, pre meal, two hours, three and even four hours after, to see how the food he is eating affects him.
That is to rule out basic hypoglycaemia around food.
But he could be getting high BG levels (hyperglycaemia) because his first phase hormonal response is effected by insulin resistance or insulin of being abnormal at that time.
And because of his high spikes, his hyperglycaemia will only worsen.
And I would suggest to you.
As I do if someone posts about similar conditions to RH. To read our forum and see if something rings a bell.
I do hope you get sorted what ever it is.
My best wishes.