As usual, data is not meaningful absent context. While the flowchart does indeed divide T2s into three categories, with insulin recommended only for “severe” cases (category 3), the fact is that the majority of T2s do not seek treatment (because they don’t know to) until pronounced symptoms appear. Consequently the bulk of them do present in category 3.
So yes, “every” is an incorrect statement. It should read “most”, which also accords with what Joslin patients tend to report.
You said Joslin starts every newly dx’d T2 on insulin right away. That to me is assembly - line treatment, which I would have refused to follow, & rightly so.
Most would seem to be incorrect also, unless you have statistics that support it. There seems to be many T2’s diagnosed before they reach the higher A1c. I assume those are not treated by Joslin.
I was diagnosed 7 years ago with an A1c of 12.0. My doctor discussed the use of insulin, but suggested that we see how I would react to metformin and diet and exercise changes along with an excellent education program.
At three months my A1c was 7.0 st 6 months it was 6.3 I stopped taking metformin at year two. Currently with diet and exercise only my A1c is 5.6 .
I feel fortunate to have been given the option not to start on insulin.
I am so happy to hear from you @Fraser70. I want to be hopeful and is hasnt looked good thus far. I have been given the option of metformin, I’m actually underweight and still have a test or two left to take but I hope the metformin ER helps. Would love to know your diet routine? I have IBS and thyroid issues, so I get many different answers on what to eat. Then just get overwhelmed and dont eat at all. I’ve really tried this last couple weeks and my fasting BG was stil 110. Hoping the Met ER helps get it lower to stay in a healthy range. Lots of heart disease in my family. So, what do you stay away from and what do you eat!!!
Unfortunately no great secrete. I learned how to eat to my meter.
I tested all the different foods, I elimnated those that spiked me over 120.
We all very, I did not consume much in the way of sugar before dx. So I eliminated, rice pasta. Potatoes breads grains etc. basically LCHF
If I vary from that my numbers soar.
I have retired and increased my exercise dramatically. I have not lost “weight”. But a lot more muscle than fat now,
This works for me, but not necessarily others.
I was fortunate, that by not taking insulin, I really had to analyze what I was eating and how my body was able to utilize it.
My college roommate was diagnosed T2 the same time period I was. His A1c was not as high as mine. He has been able to keep it under 6.0 with metformin only. And only moderate control of his diet.
Thanks for the information. When you say spikes, do you mean post meal? I’m all new to this, so really still learning. My post meal BG has been 150! Scary if thats bad but goes down it seems quickly
Spike is one to two hours after meals (most foods). Depending on what and how much I eat 150 is easy to get to, so it takes a lot of control. 150 for me is a sandwich with real bread. But I does go down relatively fast which is good.
There is not much data on the use of fermentable fibers in IBS individuals. I have seen one study showing that resistant starch improved symptoms of Crohn’s Disease, but have not seen any studies on RS in IBS individuals.
I would suggest you start with small quantities and see if you can tolerate it. If you can, it strongly helps to keep colon tissue healthy as it produces more butyrate than any other fiber tested. Butyrate is the preferred food for healthy colon cells.
I think another member suggested that you get tested for celiac disease. IBS, in my opinion, means “I Be Stumped” and you should not settle for that diagnosis. Your “IBS” Symptoms, thyroid issues, underweight, and now diabetes issues just screams celiac disease. Is your thyroid issue autoimmune? There’s a strong link (same genes) between T1D and autoimmune thyroiditis, and celiac disease.
I have Hashimoto’s thyroiditis, celiac disease and diabetes. I have not been typed for diabetes, but after two years, I think I have T2D. I manage with diet (LCHF – eating to my meter) and exercise and am working with my doctor. I have not tested for GAD antibodies, because my antibodies for celiac disease were barely positive, yet I had severe intestinal damage. My doctor and I decided to take the wait and see approach for now. Anemia was my only symptom at the time of my CD diagnosis.
Please do some research on celiac disease. I can recommend the University of Chicago celiac website which is well-written and maintained (contains testing requirements). PUB MED is also an excellent source of information.
I have been tested for Celiac and always negative. I was talking to my husband this weekend about it and just feel so anxiety ridden about food. Look at cholesterol…because mine is always higher bad for my heart, Look at carbs…because of glucose because of high glucose, or look at not eating tofu or plant based because my throid disease?
Its awful, I’m hungry, becoming depressed and dont feel like anyones helping me
My stomach turns like waves, up and down, all around with areas that ball up, wind up, turn…looks like I have a baby in my belly.
Everything is related to food but what to eat? Dont even know what the underlying problem is thats making everything else so bad. Sure I’ll be on anxiety meds next
What are you currently eating or not eating? You have to eat. I’m sure that not eating is not helping any of the problems that you are experiencing. My experience with thyroid disease (which I’ve only had for a few months) is that stress has a major effect. Since I have Graves’, I can tell the days when the autoimmune attack flares up and my thyroid goes crazy, because I feel almost as bad as I did before I was diagnosed. And I’ve definitely noticed that I feel terrible during periods when my body is stressed (or when I’m stressed emotionally) compared to when I’m not. Your body will be stressed if you don’t eat… Plus, if you don’t eat your body thinks you’re starving and tells your liver to break down glycogen into glucose and then pumps glucose into your bloodstream. This is why many people with Type 2 find that eating some sort of small snack before bed helps their fasting blood glucose. And I know that people have already mentioned that your blood glucose issues may be related to your thyroid, but your cholesterol issues may be related to your thyroid as well, since hypothyroidism can cause high cholesterol (since it’s not broken down as fast, I believe). Having multiple dietary issues can be extremely complex and can make everyday things like eating out, going to social events, or travel very difficult (I have multiple issues that affect diet), but you also don’t want to stress over and limit your diet if it’s not needed. It really sounds to me like everything is pointing back to your thyroid issues, so I would focus on that and see if the other things (blood glucose, cholesterol) improve.
Thank you for writing that. I have definitely been overwhelmed with diet. I have always tried to eat healthy and to see my FBS always being higher is frustrating. I gave in the other night as my daughters ballet class ran really late. I was starving and couldn’t bare another salad. I got McDonald’s (which I never do) my morning FBS was 128.
Yes, trying to celebrate Mother’s Day was horrible. Husband got frozen drinks, and we went out for dinner, the entire weekend I hardly ate, couldn’t drink and felt awful anyway. Maybe it is all my thyroid, causing havoc but doctors can regulate that either, though we try.
I have a bunch of gluten free, dairy free snacks which we bought tonight. Gastro doctor says dont eat Gluten even though I’m negative for celiac. This has been years of the same blood test result. At this point, I really dont know of another test they can do for my thyroid. I too can tell when its out of wack, it is all the time. I’m just exhausted and ready to give up. Would love just one issue to get better but looks as if this nightmare keeps going.
Crazy thyroid, crazy sugar, crazy gastro problems. Oh yeah the gastro called me in xifaxan and donnatal to try and help my stomach. I was sick from it all night. Stopped taking both, not sure which was the issue but it was horrible.
Tons of copays later and a ton of money bloodwork and I’m no better.
Also, I wanted to ask you @Jen what symptoms do you experience with your issues?
When you were diagnosed with type 1, what symptoms did you experience? I think its hard for someone like me to know what disease or problem is causing my many symtoms. For instance the graves, what do you take and what helps you control it?
Mine is so bad one month I’m hypothyroidism and the next Im hyperthyroidism. My stomach remains the same either way. Lots of nausea, swollen areas that come and go , up and down all night. Like waves you can literally see the bulging in the stomach appear and go away but its always moving, like waves. Keeps me up all night. My vision has definitely gotten worse but just things up close. So when people say “blurry vision” with diabetes do they mean constant, when trying to focus or vision declines over time? I’m always fatigued, sometimes night sweats, dizzy. I feel like I’m just dying with no help. Dramatic I know
I was diagnosed with Type 1 at age 9. I only had symptoms for a couple of weeks prir to diagnosis. My symptoms were extreme thirst (like always being thirsty, even after I’d just had a drink), using the washroom constantly, weight loss (other parents apparently asked my mom why I’d become so skinny), fatigue (school staff noticed I’d go out at recess and just sit rather than playing), and in the last few days before I was diagnosed I had “the flu” with feeling nauseated and exhausted (which was likely the beginnings of DKA; my blood glucose and ketones were both dangerously high when diagnosed). I was sent to emergency by my GP and then admitted to hospital for four days. I can’t really comment on the vision thing…my vision does seem to fluctuate from my blood glucose going up and down to extremes, and it seems to be an intermittent thing on days when I’m having wide fluctuations but fine on others. But, it’s hard to tell because I’m legally blind (from birth) and so I have other eye conditions and my vision is severely impaired to begin with, and I also have allergies that make my eyes water non-stop and swollen and irritated, which also seems to make my vision blurry.
I was diagnosed with Graves’ disease in December, shortly after turning 34. Again, I only experienced symptoms for at most a month prior to diagnosis. Symptoms were rapid heart rate, insomnia (not every night, but frequently), feeling overheated, sweating a lot, stomach issues (having to use the washroom a lot, but not in the same way as for diabetes!), irrational irritibility (to the smallest things, like dropping something), hunger (I’d wake up in the middle of the night starving and need a snack to get back to sleep), muscle pain and weakness (arm got tired pouring a drink, could barely climb into a van on my own), and also I noticed that my hands were trembling when I was doing things. I ended up being diagnosed with Graves’ after going to emergency because my heart rate went up to 150-180 and would not slow down. I was put on a beta blocker and a medication that blocks my thyroid from making hormones. I was able to stop the beta blocker about a month later (though also found out from my allergist that I shouldn’t be taking it). I’m still taking the thyroid-blocking medication. I still feel terrible many days, but I’m pretty sure I have something other than thyroid stuff going on; though as I said, there are many days (like most days this past week!) when I’m stressed about whatever and I go back to feeling overheated, heart racing, irritable, sweating, muscle pain/weakness, insomnia, and stomach issues. Then, once the stress is over, the symptoms disappear within a couple of days.
Have you ever seen a gastroenterologist about your stomach issues? I assume you have, if you’ve been evaluated for celiac disease. But it might be something to ask for if it’s preventing you from eating. I currently have health stuff going on that is concerning and affects my daily life, so I can totally relate to feeling terrible and just wanting to feel “normal” again.
but goes down it seems quickly
