Newly Diagnosed type 2. Can't get blood sugar down

Hello, this is my first time posting anything. I was hoping to see what anyone else’s experience has been trying to get their blood sugar down when first diagnosed. I went to the doc for something else and they insisted on testing my bs. It was well over 500. (This was about a week ago.) Since then, I have started taking Metformin, changing what I eat, and I was already drinking 2-3 gallons of water/day. I’ve been checking my sugar regularly, and every time its floating between 400-500. Even when I go 12 hours with nothing but water, my levels are still so high. I don’t understand what I’m doing wrong. Any advice would be greatly appreciated.

I hate to suggest this right now, but I think you may need to go to the ER, because you are probably at risk for DKA (diabetic ketoacidosis) at those levels with those symptoms, which can be very dangerous. At the very least, you want to get some ketone testing strips and check those—if high, go to the ER. My guess is that you may not be a T2, but rather a T1 (which is often missed when people get diagnosed as adults)—at the very least it sounds like you need insulin regardless to get those blood sugars down. You probably aren’t doing anything wrong—you just haven’t yet gotten the treatment you need.

Good luck and please be careful!

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Absolutely agree!

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Read your post. Didn’t notice any mention of the glycemic index. If your unfamiliar with it in a nutshell foods that are 50 and below don’t spike up blood sugar. There are web sites and books with listings of foods and their GI.

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Type 2 rarely go into DKA, however those high sugars can cause a lot of damage.
You might need some insulin.

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Or could be Type 1 misdiagnosed. Wouldn’t be the first time.

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I agree that you should go to the ER. They can both give you intravenous fluids to help you hydrate and if your blood sugar doesn’t go down, can give you insulin to bring your blood sugar closer to normal before you go home. Once the immediate emergency is over, I suggest that you make an appointment with an endo. Even if you’re Type 2, you may need insulin at least until things are under control and after that there are a large number of drugs that can help you maintain decent blood sugars. It can take a specialist to figure out which might be the most helpful.

Good luck,

Maurie

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40% of type 1’s are misdiagnosed a s a type 2 at first. I am one of those. It still happens way to often.

The tests to determine if you are, are first an antibody test. If it’s positive it’s a sign of being a type 1. Some type 1’s test negative and they don’t know why. The next is a c-peptide. This tells you how much insulin you are making. Low or low normal is a sign of type 1, high or high normal is a sign of type 2. Type 1’s are lacking insulin and that takes a little bit of time to completely happen, sometimes years. Type 2’s are insulin resistant and still make insulin but don’t utilize it properly so they actually are usually trying to produce more to make up for it.

Everyone is saying to watch out for DKA. This is because this is how a lot of type 1’s end up being diagnosed because they get sick from DKA. DKA is caused by a lack of insulin. It can be serious and usually happens only to a type 1. It rarely can occur in a type 2.

I’m not saying you are but sometimes when things don’t make sense you could be a type 1.

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Hi, Jungle; did your doctor schedule a follow-up with you? I would call and get an appointment. They don’t know how we’re doing, unless we let them know. You may need something stronger than metformin until you can get your diet and exercise routine up to speed. I also suggest asking for a referral to a Registered Dietitian Nutritionist (RDN).
Meanwhile, if you can tell us what your meals and snacks consist of, we might be able to offer some helpful suggestions…

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Yeah, but are Type 2s often running in the 400-500s when fasting, like OP describes? Anyone who does that, regardless of diagnosis, is clearly insulin deficient I’d think, and insulin deficiency is what puts one at risk for DKA. If your body can’t metabolize your blood glucose, even when you aren’t even eating anything new, it’s going to have to switch over to metabolizing fat instead, which means ketones, and if that’s happening at an extreme level, especially combined with the dehydration from high blood sugars, that is what leads to DKA, which is when your blood chemistry gets off balance. Definitely worth heading off with IV fluids and insulin before it gets severe!

Another rough check for high levels ketones/DKA is to ask someone, if you’ve got someone in your germ pod, to smell your breath. Ketone breath is sort of sweet/fruity. Not nearly as good as an actual test like with urine or blood strips, but if that’s there, time to act.

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Kudos for reaching out! Get back with your Doctor very soon and share your lack of results. Type 2s are at a disadvantage for treatment because most Docs will stick with oral meds far too long when you actually need insulin. The suggestion to get with a CDE very soon is great. A personalized review of your meal plans may help. There is so much to learn about carb counting and your personal response to foods.The main point is be your own advocate. Yes you could be misdiagnosed. But just be pushy on your own behalf to get results you need. One step at a time and realize you’re in it for the long haul.

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Hey @Jungle, I agree with everyone else. Will you write back to us so that we know that you are ok? I know it has only been 24 hours since your post, but we are a bit worried about your safety. Can you please make a couple phone calls to friends and family who live nearby and tell them what is going on and ask them to check in with you everyday?

Today is Thanksgiving.
Today is typically a high ER traffic day, but you can’t be eating a bunch of stuff, so it might be better to just go into the ER.

  • You can eat:
  1. Sugar free jello
  2. Celery with peanut butter on it
  3. Salad
  4. A bit of popcorn (less than 3 cups)
  5. Sugar free fluids - like diet coke, water, crystal light flavored water.

If you must eat something more substantial - eat meat.

  • NO SUGAR SODA, NO JUICE, NO BREAD.

You can buy ketone strips at the drug store.

You might want to call the ER before you go in and let them know the situation.
If it is busy in there, you can always wait outside and tell them to come get you when they are ready. Or, go by ambulance. That’s the way to get in fast (its expensive, but its fast and you won’t be waiting for hours in the waiting room with a bunch of covid people). Its worth the $ because I don’t think that you should get covid now in your current condition.

@cardamom is right about the IV fluids. Your gonna need your blood chemistry checked. Diabetes turns your blood into soup.

@obxdiva, is recommending a CDE - that’s a Certified Diabetes Educator. They need to schedule you with one of those. That will be a nurse who talks to you about all this stuff in an outpatient clinic appointment.

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So far I still don’t feel sick or anything. This picture is from last night. 574. I feel completely normal. I just cant get the parts number to stay lower. Currently in the process of increasing my Metformin dose. Currently in week 2.

This is not OK, @Jungle.

You might feel ok because things have been so bad for so long that your body is adapting to how bad things are.

This is not OK. This is very, very dangerous. You are 1 meal away from hitting 800, which can kill you. Eventually you will collapse. Your blood chemistry will get off and it can stop your heart. I’m nervous because today is Thanksgiving. Thanksgiving is a dangerous day for diabetes.

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DKA is serious. Guidelines say over 300, go to ER.

Seek emergency care if:

  • Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)
  • You have ketones in your urine and can’t reach your doctor for advice
  • You have many signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion
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Can someone double check what I wrote - about how Jungle might be able to eat a little bit of meat? Or, will that make ketones? I would eat meat in this situation, but maybe Jungle should not. Turkey will be prevalent today.

@Jungle, if you feel a little funny about calling an ambulance when you feel perfectly fine, you can always just blame us.

Call 911 and tell them what your blood sugar is. Tell the medics that you are a brand new diabetic and that your blood sugar is very high. Tell them that the diabetics online said that you needed to go to the ER. They will be able to take it from there. If the ER is a mess and they don’t think that you need to go by ambulance, then you should not be charged anything - the ambulance should charge only for transport and care provided during transport (but that’s not always 100% true). They might tell you to drive in (I don’t think they will, but things are strange, now - especially because its a holiday).

Police radios are still quiet in Minneapolis. But, as the day goes on, people will get drunker and have more heart attacks. If your wondering how busy they are, just google your county name + police radio. It should bring up Broadcastify and you can listen to their activity level.

You may not feel that sick because your body has probably been running extremely high blood sugars for a long time, slowly rising to where it is now. But constant thirst is one of the major symptoms you’d expect.

If you aren’t ready to go to an ER right now, and you have means of getting to a pharmacy, I would immediately go get ketone strips (simple urine test). Again, if those are registering as high, you need to go the ER no matter how you feel.

Regardless, it really sounds like you need insulin urgently, and not to just wait on the metformin before getting some kind of immediate medical help that provides better treatment options. If you aren’t in DKA yet, you are likely at risk for it with those numbers that high, that consistently. And DKA can kill you—it almost killed me once, and that was awful. If at all possible, you want to head that off by getting some insulin in your body immediately.

We are all really concerned @Jungle People have gone into DKA with lower numbers than you are showing. You might not feel bad, but that’s because your body is used to the high numbers, but that does not mean you are safe from DKA.

DKA can make you very sick, at the least it can mean days in the hospital, at the most death. It is not something to treat lightly. Those numbers have to come down. If you haven’t started making ketones yet, you can prevent it with insulin that they can give you to lower your blood sugar. At the very least go out and get some ketone strips so you can see more of what is going on. Those numbers show a lack of available insulin, and that is what causes DKA. The thirst is a desperate way of your body trying to flush them out. But it is obvious you need insulin so a trip to the ER is the best solution.

DKA can make you seriously sick within hours. That is why we are so concerned. It is unfortunately a way many find out they have a serious issue.

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The maybe Type 1 instead is what happened w/ me @ age 59. It is called by abbreviation LADA and is not well known. If you are LADA then oral meds will not help.

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When I was first diagnosed (20 years ago) my doctor put me on Actose, a new drug at the time. It did nothing to reduce my BG. It took me 6 weeks to my local diabetic centre to see an endocrinologist. It was a frustrating 6 weeks because it was over Christmas. My BG were always greater than 20 mm/l (I live in Canada). The endo put me on metformin and after a week of no effect he started me on insulin. After 1 day I was in the normal range. I was diagnosed with an A1C of 13. What they should have also checked was c-peptide which would have diagnosed me as Type 1. Because of my age (50) they assumed I was Type 2. Ask your doctor to do a c-peptide, give you a prescription for insulin and a referral to an endocrinologist. I metformin is not working don’t waist anymore time with the drugs.

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