New to the World of Diabetes

Type 2
1

Almost two weeks ago I started having a problem keeping food down. I thought it was related to antibiotics I was taking for a dental infection, so I was trying to live through it. For over a day I couldn’t keep any food down and finally, last Tuesday morning, I was throwing up when I knew there wasn’t anything in my stomach to get rid of. There was a weird sweet taste along with it and I swore up and down it was the applesauce I’d had over a day prior.

You can imagine my surprise when, after visiting the ER, I was told that I was diabetic (initially diagnosed with Type 1, later clarified as Type 2). It was the sweet taste I mentioned that really clued the nurse into my condition, verified with a bunch of lab work. From what I was told, had I gone any longer I may have ended up in a coma. As it was, I was already in diabetic ketoacidosis and I ended up spending the next three days in the hospital.

I’m still coming to grips with my diagnosis. There is no family history (if anything, I thought I had cancer) and the whole thing is still surreal to me. With that said, I’m trying to dive in head-first, knowing that the best way forward is to not dwell on what I have, rather on effectively managing the disease. I have a very supportive family, including my mother-in-law who is Type 2. My lovely wife is changing her diet to accommodate mine and even some of my friends at work are trying to change their lifestyle to help support me. I know that their efforts may be temporary, but their willingness to support me is what really fills me with hope.

My biggest challenge thus far has been getting my medications figured out, which was made all the more complicated by the discharging doctor calling in the wrong prescriptions. My new PCP has been great, though, and he’s getting me started on a whole new regimen from what I was discharged on, something that will hopefully be manageable as I get used to the idea of having Type 2 diabetes. Surely things will change as I progress, however it’s good to know that I have a plan and I’m not shooting in the dark.

I’ve been looking through the forums for this site for a few days now and I am so very impressed with the depth of knowledge of everyone here, but also the open-arms with which everyone seems to welcome those new to the diabetic club. I’m very much looking forward to interacting with everyone. I am also chronicling my journey on my website, so I would love for people to read it and provide me with their insights. I know that I will not get through this journey on my own and the more help I get, the better off I will be in the long-run.

Thank you for taking a few moments to learn a bit more about me and I’m looking forward to interacting with you all.

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First of all, welcome to TuDiabetes! Peer support can make a big difference in your quality of life going forward. It can take some time to get used to the idea of having diabetes but you will. Learn as much as you can but do not become overwhelmed. You have the rest of your life to figure this out. Learn some every day and it will add up to a considerable body of knowledge in a short time.

Realize that your diabetes will not match everyone’s experience here but that does not invalidate anyone’s personal perceptions. You’ll often see that sentiment reduced to the acronym, YDMV, or your diabetes may vary.

I think you’ve landed at one of the best support groups online. Good luck!

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Thank you, Terry! I’m very glad to have found this site and I look forward to learning more about how my condition manifests relative to others.

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If you have specific topics of interest, use the search function to access a wealth of information here. Just click on the magnify glass icon at the upper right corner of your screen. Insert a search term and you’ll find lots to read.

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Realize that certain meds like metformin take 1 to 2 months to kick in and that adjustments might have to be made by your physician.

In my case what worked great for a year had to be totally upended with more meds. But when the A1c goes down you will feel better even if now you think you feel alright.

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I was just curious what was the lab work that you had run which caused the diagnosis to switch from T1 to T2?

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Yeah I’m definitely noticing just from my first visit with the doctor that it’s going to be an on-going effort to adjust my treatment. It will be interesting to see how well I feel after the next few months. I can definitely feel my body already adjusting to the changes, but it’s only been less than two weeks.

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The more I’ve been looking into it, I think the ER doctor misspoke or misread the results. According to my PCP, everything in the record points to Type 2 versus Type 1 and he even indicated that my treatment in the hospital would have been completely different had it been Type 1. I guess that would explain why no one ever clarified the diagnosis with me throughout my stay.

When I got to the ER my glucose was at 405, my A1c was at 13.6% with an estimated average glucose of 344. They did find ketones in the first batch of lab work, which may have led to the initial confusion.

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That is really high.

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Yeah, I’m honestly surprised it didn’t turn for the worse sooner. Hindsight being what it is, had I understood some of the signs/symptoms (especially the mass amounts of water I was drinking) I would have sought help before it landed me in the ER.

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As far as I know I have never been that high but after blood work, routine bp issue, the doctor was like my god you are diabetic. It is really serious. Meds exercise class all that.

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Part of my issue was that I never really saw a doctor; I still had the healthcare mentality of a 20 year old. I was going to setup a doctor at 40 because I knew that (given my family history) there was a high risk of prostate cancer. The only time I would even consider seeing a provider was at the local Fast Care when I had an infection.

I was working out recently, too, but with a couple weeks here and there where I stopped due to work commitments, etc. Now definitely going to get back into it, I’ve started to change up my diet, and I have my diabetes management class on Tuesday.

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Go to class. At one point in my class there was a pharmacist running it that could answer any question. I kept going because of that.

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@Tim35 has touched on something important. You entered the ER in what sounds like Diabetic Ketoacidosis. DKA is what most T1s present with when they enter an ER the first time before diagnosis. DKA is fairly rare in a T2. That being said it is possible. I mention this because a large number of Type 1s are initially mis-diagnosed at T2.

Not wishing to alarm you but do wish for you to be aware of the possibility. Getting the correct diagnosis is important.

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Thank you! Yes, I heard while in the hospital that it was quite uncommon for someone with Type 2 to present with DKA. That being said, I will definitely be pressing my provider at my next follow-up to make sure that the diagnosis is correct, and if there is any potential for it not to be to get additional testing to confirm.

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You might want to read this topic by @Melitta, In the third section she discuss the importance of getting a correct diagnosis.

Although @Melitta 's article is aimed at the newly diagnosed Type 1 her top ten tips are things every newly diagnosed should hear.

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A very good read, thank you!!!

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Hi Opining Penguin and Welcome. I would second what Tim and Gary say, if I were in your shoes I would push for autoantibody testing, which if any one autoantibody is positive confirms a Type 1 diabetes diagnosis. IMO, you have classic adult-onset Type 1 diabetes–everything says Type 1. Here is a Diabetes Forecast article on autoantibody testing and here is a companion Diabetes Forecast article on why so many adults are misdiagnosed as Type 2 when they really have Type 1 diabetes. It really is important to get a correct diagnosis and not delay correct treatment.

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+1 to what @Melitta and @Terry4 Terry said. Because cases vary so much on both sides of the T1/T2 fence, there is a rampant tendency in the medical world to make snap diagnoses without doing all the appropriate homework. (Personally I don’t believe in that fence; diabetes is diabetes and every case has its own individual profile. But never mind, that statement usually triggers a lively debate and it’s not really the point here.) But it really is essential to have a correct and accurate diagnosis, for both medical and administrative reasons.

Bottom line, you should have the definitive tests done. If they cause a reappraisal of your current diagnosis, you’ll be really glad you did. If they confirm the existing dx, so much the better.

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That companion Diabetes Forecast article you cite and link to is excellent. The misdiagnosis of adult T1Ds as T1Ds has been going on for a long time. My question to you or anyone who wants to respond is this. What, if anything, are doctors, as a professional group, doing to mitigate this circumstance? Extended periods of hyperglycemia following a misdiagnosis can do a lot of damage. I’ve read of cases where the misdiagnosis can go on for a few years.

The ADA, via Diabetes Forecast, is doing a good job to spread the word. Unfortunately, many doctors do not like receiving pushback from patients who read something online and now are trying to challenge the doctor’s diagnosis. Who do these patients think they are!

Are there any panels at the major professional diabetes meetings that focus on this issue? Or better yet, a meeting of primary care doctors. Are there any studies or publications that doctors read that addresses this pernicious problem? Ten percent of T2Ds (one estimate I’ve read) misdiagnosed is a big number!