Hi, my diabetes nurse has been treating me as type 1 on insulin since November 18 after my BG was 33! She sent me to get a blood test for c peptide. I fainted at the test (not good with needles although I inject everyday). I was sent back and told to eat and take my insulin as usual. My c peptide was high and so she diagnosed as type 2. I now take humilin m3 and metformin. There has been little change in levels. Should I ask her for a retest and fast before hand?
Worried about wrong diagnosis
- Thread starter Jay86
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Hi @Jay86
Just to be clear, are you saying that the test was not performed on the first visit but you had it done AFTER eating at a later date?
HSSS
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Is there any reason to doubt the c peptide results? As far as I know type 1 would have low to non existent levels. Though not sure how the honeymoon stage would score.
Perhaps the levels of insulin aren’t matching your current needs. If you are in fact type 2 as the test suggests then diet becomes you best tool in the box to help lower your levels rather than increase meds. What sort of levels do you get now? What is a typical days food? Are you over, under or about right in weight terms?
I’ll tag @daisy1 for her welcome information and attach some type 2 links below.
Can I suggest you take a good look at low carb high fat methods of eating (keto is just a version of this). It helps many of us lose significant amounts of weight, if desired, keep our numbers down and for some even eliminate medications and achieve remission and reduce or improve complications. Try clicking these links for more detailed explanations that are well worth readings
https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple
And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation
and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas
also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.
IMPORTANT FOR ANYONE ON MEDS CONSIDERING LOWERING CARBS: if you lower your carbs then any glucose lowering meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc (this is not relevant for metformin on its own) than your new carb intake requires. Keep a close eye on your numbers and ideally do this with your dr. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around.
Perhaps the levels of insulin aren’t matching your current needs. If you are in fact type 2 as the test suggests then diet becomes you best tool in the box to help lower your levels rather than increase meds. What sort of levels do you get now? What is a typical days food? Are you over, under or about right in weight terms?
I’ll tag @daisy1 for her welcome information and attach some type 2 links below.
Can I suggest you take a good look at low carb high fat methods of eating (keto is just a version of this). It helps many of us lose significant amounts of weight, if desired, keep our numbers down and for some even eliminate medications and achieve remission and reduce or improve complications. Try clicking these links for more detailed explanations that are well worth readings
https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple
And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation
and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas
also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.
IMPORTANT FOR ANYONE ON MEDS CONSIDERING LOWERING CARBS: if you lower your carbs then any glucose lowering meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc (this is not relevant for metformin on its own) than your new carb intake requires. Keep a close eye on your numbers and ideally do this with your dr. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around.
daisy1
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@Jay86
Hello and welcome to the Forum
Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.
BASIC INFORMATION FOR NEW MEMBERS
Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.
A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.
On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.
The role of carbohydrate
Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.
If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.
The bad news
Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.
The good news
People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.
Controlling your carbs
The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.
The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.
Choosing better carbohydrates
The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.
Read more on carbohydrates and diabetes.
Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.
Eating what works for you
Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.
To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.
The blood sugar ranges recommended by NICE are as follows:
Blood glucose ranges for type 2 diabetes
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.
You may also be interested to read questions to ask at a diabetic clinic.
Note: This post has been edited from Sue/Ken's post to include up to date information.
Hello and welcome to the Forum
Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.BASIC INFORMATION FOR NEW MEMBERS
Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.
A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.
On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.
The role of carbohydrate
Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.
If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.
The bad news
Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.
The good news
People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.
Controlling your carbs
The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:
- Reduce your carbohydrate intake
- Choose ‘better’ carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.
The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.
Choosing better carbohydrates
The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.
Read more on carbohydrates and diabetes.
Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.
Eating what works for you
Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.
To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.
The blood sugar ranges recommended by NICE are as follows:
Blood glucose ranges for type 2 diabetes
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 8.5 mmol/l
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 9 mmol/l
- Before meals: 4 to 8 mmol/l
- 2 hours after meals: under 10 mmol/l
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
- structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
- self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education
Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.
You may also be interested to read questions to ask at a diabetic clinic.
Note: This post has been edited from Sue/Ken's post to include up to date information.
I am so confused. I just got my a1c back. The result says 40mol- abnormal. 40s good right? I had the c peptide a month after diagnosis. My initial a1c was 90 and my bg was off the scale on the blood meter, fasting was 20.The nurse told me to go to the test after eating and taking my meds as a passed out and started fitting at the previous blood test. Im intrigued to see what they say when I go to my appointment at the end of the month.
Bluetit1802
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HSSS
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Out of interest are you in the UK? Some countries do have differing levels they diagnose at. The USA diagnoses prediabetic at 5.7% or 38.8mmol. So a reduced, following diagnosis and treatmen, reading of 40 would still flag up as abnormal there but vastly improved from 90.
In your original post you say “there’s has been little change in levels”. I’m a bit confused. Which levels? Fingerprick bgl? And do you mean from diagnosis to now or from one treatment regime to the other?
In your original post you say “there’s has been little change in levels”. I’m a bit confused. Which levels? Fingerprick bgl? And do you mean from diagnosis to now or from one treatment regime to the other?
Hi,
I'm in the UK. By little change, I mean from when they introduced metformin to take alongside the humilin m3.
My recent hba1c reads 40mmol ABNORMAL RISK OF HYPO. I've made significant changes to my diet, not going completely low carb but making changes like having low GI bread and changing potatoes to cauliflower in meals. I used to love sweets and chocolate but now I just don't touch it.
I must be doing something right but I wonder if the diagnosis is correct.
I have a chance to speak to someone next week as I have an appointment with the nurse in which I have to send in a week's worth of food and BG recordings.
I'm in the UK. By little change, I mean from when they introduced metformin to take alongside the humilin m3.
My recent hba1c reads 40mmol ABNORMAL RISK OF HYPO. I've made significant changes to my diet, not going completely low carb but making changes like having low GI bread and changing potatoes to cauliflower in meals. I used to love sweets and chocolate but now I just don't touch it.
I must be doing something right but I wonder if the diagnosis is correct.
I have a chance to speak to someone next week as I have an appointment with the nurse in which I have to send in a week's worth of food and BG recordings.
HSSS
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Ah. I think I know what’s happening with your hb1ac. It was taken under the assumption you are type 1. Many drs don’t like type 1 to have too low an hb1ac as they believe the only way that happens if there are lots of hypos. They don’t accept a low carb diet for type one gives a much smoother level with fewer highs therefore needing fewer low readings to give a good average. Hence the full wording of abnormal at risk of hypo makes more sense
HSSS
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So IF you are type 2 having reduced carbs somewhat and simultaneously had even more insulin in your system than you’re already high levels that would explain a much lower hb1ac. Even the worst insulin resistance may be overcome by enough insulin. Whether that’s a good thing overall is debatable though if there are other options (low carb, exercise, more muscle mass, visceral fat loss etc) that have not been fully explored first to reduce the core problem of IR. Metformin, a mild drug, in the face of all that insulin might not have much hope of doing much, depending on dose possibly explaining why you’ve seen little change when it was added.
Regarding diagnosis I can’t comment on the gad and c peptide being fasted or not I’m afraid, but I’m sure someone will know what difference that makes. This site does say c peptide should be done fasted without glucose lowering meds but I don’t know what happens if you’ve eaten and taken meds.
Regarding diagnosis I can’t comment on the gad and c peptide being fasted or not I’m afraid, but I’m sure someone will know what difference that makes. This site does say c peptide should be done fasted without glucose lowering meds but I don’t know what happens if you’ve eaten and taken meds.
HSSS
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881566/ This may be relevant.
On page 5 it talks about post prandial c peptide tests and the results being adjusted for glucose, and then about that reflecting likely maximum insulin output. So long as the lab knew you were not fasted maybe they could interpret accordingly.
On page 5 it talks about post prandial c peptide tests and the results being adjusted for glucose, and then about that reflecting likely maximum insulin output. So long as the lab knew you were not fasted maybe they could interpret accordingly.
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@Jay86
The concern may be that your hba1c is low for an insulin user, and may imply you are having a lot of hypos.
People can have low HbA1cs with a nice steady blood glucose (which is safe) or they can have the same HbA1c with hypers and potentially dangerous hypos.
Do your blood testing records show many hypos?
You can show them to your health team if necessary to discuss you management.
The concern may be that your hba1c is low for an insulin user, and may imply you are having a lot of hypos.
People can have low HbA1cs with a nice steady blood glucose (which is safe) or they can have the same HbA1c with hypers and potentially dangerous hypos.
Do your blood testing records show many hypos?
You can show them to your health team if necessary to discuss you management.
