Which T diabetes?

[Geoffno6]

So, I’ve got more results. These all look fairly normal (I think?) so does that mean I’m T2?

Despite doing weeks at a time below 40g carbs/day I’m averaging at best 7.5 BG with peaks of 13 and lows of 6 on 2g Metformin per day. MySugr reclones my Hba1c is 6.7. So what other drugs might I be given to get my BG down or could it carry on getting better if I keep low carbing? Any feedback from people who have been through this or have experience/knowledge is greatly appreciated.

My tingles and aches in my lower legs, feet and hands are getting worse so I’m keen to do whatever it takes to get my BG down quickly.

Fasting C peptide 1.66 Ug/l (or 1.66 ng/ml)
Blood glucose 10.9 mmo/l
Vitamin D 53.8 mmo/L
Active B12 99 pmo1/L

 

[DCUKMod]

So, I’ve got more results. These all look fairly normal (I think?) so does that mean I’m T2?

Despite doing weeks at a time below 40g carbs/day I’m averaging at best 7.5 BG with peaks of 13 and lows of 6 on 2g Metformin per day. MySugr reclones my Hba1c is 6.7. So what other drugs might I be given to get my BG down or could it carry on getting better if I keep low carbing? Any feedback from people who have been through this or have experience/knowledge is greatly appreciated.

My tingles and aches in my lower legs, feet and hands are getting worse so I’m keen to do whatever it takes to get my BG down quickly.

Fasting C peptide 1.66 Ug/l (or 1.66 ng/ml)
Blood glucose 10.9 mmo/l
Vitamin D 53.8 mmo/L
Active B12 99 pmo1/L

Geoffno6 - It would be interesting to see the ranges your lab attributes to be "normal" for each of your tests.

Secondly, when you mention being under 40gr of carb a day for weeks at a time, what does that mean? Do you mean you mixed your approach, so did LC sometimes and other regimes at others?

Edited: Totally neglected to add that your Vit D is low, as is your B12, so those need a bit of attention - especially heading into winter for the Vit D.

Was your blood glucose fasting, or random? If random,when was the blood drawn in relation to your last food or drink?

 

[Geoffno6]

Geoffno6 - It would be interesting to see the ranges your lab attributes to be "normal" for each of your tests.

Secondly, when you mention being under 40gr of carb a day for weeks at a time, what does that mean? Do you mean you mixed your approach, so did LC sometimes and other regimes at others?

Edited: Totally neglected to add that your Vit D is low, as is your B12, so those need a bit of attention - especially heading into winter for the Vit D.

Was your blood glucose fasting, or random? If random,when was the blood drawn in relation to your last food or drink?

Thanks for the reply. My comments were based on me and Dr Google so I wouldn’t put any trust in them.

The tests were at 8.30 am after 12 hours fasting.

Yes I’ve mixed my approach a little but always fairly low carb, I’ve had a few meals with carbs every few weeks but that probably amounts to 3 or 4 days where I might have gone above 100gr carbs. In a typical day my high carb meal is the one accompanied by a couple of tomatoes and a few slices of pepper. My 3 or 4 high carb days have included a plate of pasta and a pint of beer one day a 30g bowl of porridge another, a couple of times when I ate some of the coating on KFC and a small piece of sweetcorn and a coleslaw. So no potatoes, rice, breakfast cereal etc.

 

[Canvaspic]

Hi,
I dont know the answer to your question and mostly its between you and your doc. But at least you are armed with some info. It might be worth checking ketones for a few mornings, just in case.
I have seen a ratio of 11 used as a cutoff in FBG(mmol/L) / C-peptide(nmol/l) . To get nmol/l from ng/ml divide by 3, thats .553 in your case. If I can find the document online where I seen the reference, Ill post the link.
The University of Oxford has a homa II calculator, which does the same thing. Put in your c-peptide, BG and it calculates insulin resistance and beta cell function. Its based on averages from over 650 people, but there are always going to be outliers.
Hope you get some answers.

 

[DCUKMod]

Thanks for the reply. My comments were based on me and Dr Google so I wouldn’t put any trust in them.

The tests were at 8.30 am after 12 hours fasting.

Yes I’ve mixed my approach a little but always fairly low carb, I’ve had a few meals with carbs every few weeks but that probably amounts to 3 or 4 days where I might have gone above 100gr carbs. In a typical day my high carb meal is the one accompanied by a couple of tomatoes and a few slices of pepper. My 3 or 4 high carb days have included a plate of pasta and a pint of beer one day a 30g bowl of porridge another, a couple of times when I ate some of the coating on KFC and a small piece of sweetcorn and a coleslaw. So no potatoes, rice, breakfast cereal etc.

To be honest, Geoff, if your A1c comes back as predicted at 6.7%, it's not that likely you will be given additional meds, because in all likelihood, your team would be happy with that, as it usually signals decent control on the charts.

If you are keen to try to make a further step change, you could try a few weeks of hard core and really just give the pasta, porridge and KFC a wide berth. A few weeks of meat and veg, or if you like meat enough, some have great success on a largely carnivorous diet, could be worth a whirl. Those aren't specific advice, just suggestions you might care to mull.

Your B12 being a bit low and D really quite low need to be addressed, and like all things our bodies will function best where there aren't points of strain, like vitamin deficiencies or inadequacies.

There are loads of threads on here on those vitamins being low. It's really not uncommon. Lower B12 can be a side-effect of Metformin, and low Vitamin D is incredibly common. Heading into winter, it's highly unlikely you'll be able to boost the Vit D naturally, in UK. A loading dose of D3 + K2, then a maintenance dose, at least through the winter should sort that out.

Very often the NHS will prescribe the loading does of D3, with the maintenance dosing down to us to fund. Just to be clear though, for maximum impact, the D3 should be taken with K2, and some say also Magnesium, for optimum uptake and efficacy. There's loads out there on t'interweb on that, and they're not expensive supplements. You will want those tests re-run in a few months time, although probably not the C-peptide. The fasting glucose is a but unreliable if you experience dawn phenomenon.

 

[Geoffno6]

To be honest, Geoff, if your A1c comes back as predicted at 6.7%, it's not that likely you will be given additional meds, because in all likelihood, your team would be happy with that, as it usually signals decent control on the charts.

If you are keen to try to make a further step change, you could try a few weeks of hard core and really just give the pasta, porridge and KFC a wide berth. A few weeks of meat and veg, or if you like meat enough, some have great success on a largely carnivorous diet, could be worth a whirl. Those aren't specific advice, just suggestions you might care to mull.

Your B12 being a bit low and D really quite low need to be addressed, and like all things our bodies will function best where there aren't points of strain, like vitamin deficiencies or inadequacies.

There are loads of threads on here on those vitamins being low. It's really not uncommon. Lower B12 can be a side-effect of Metformin, and low Vitamin D is incredibly common. Heading into winter, it's highly unlikely you'll be able to boost the Vit D naturally, in UK. A loading dose of D3 + K2, then a maintenance dose, at least through the winter should sort that out.

Very often the NHS will prescribe the loading does of D3, with the maintenance dosing down to us to fund. Just to be clear though, for maximum impact, the D3 should be taken with K2, and some say also Magnesium, for optimum uptake and efficacy. There's loads out there on t'interweb on that, and they're not expensive supplements. You will want those tests re-run in a few months time, although probably not the C-peptide. The fasting glucose is a but unreliable if you experience dawn phenomenon.

Thanks so much @DCUKMod
My A1c went from 120 to 67 in 3 months so I’m confident that I can push it down more.

I’m fine with your ‘hard core’ suggestion and I think mulling it will have me going back on the v low carb regime I found it pretty easy to stick to, I suppose it’s just that the NHS DN and the private diabetes Dr that I’ve seen (because I didn’t want to wait until November to see an Endo) have both said I must eat carbs, has made me think I ought to have a few. Although they’ve said it neither could give me a good reason why.

Thanks for your comments re B12 and Vit D. I need to keep an eye on those and will have a good look at that area.

Thanks again for your input

 

[Geoffno6]

Hi,
I dont know the answer to your question and mostly its between you and your doc. But at least you are armed with some info. It might be worth checking ketones for a few mornings, just in case.
I have seen a ratio of 11 used as a cutoff in FBG(mmol/L) / C-peptide(nmol/l) . To get nmol/l from ng/ml divide by 3, thats .553 in your case. If I can find the document online where I seen the reference, Ill post the link.
The University of Oxford has a homa II calculator, which does the same thing. Put in your c-peptide, BG and it calculates insulin resistance and beta cell function. Its based on averages from over 650 people, but there are always going to be outliers.
Hope you get some answers.

Thank you @Canvaspic sorry I missed your feedback earlier