Hi Sean, I don’t have the experience that many here do, I’ve only been aware of my type 2 for 6 months or so. My numbers were a bit higher than yours (12.7 a1c, 381 fasting) but my view and my doctors were the opposite of yours. I wanted a lifestyle change and he kindly explained that lifestyle change is for 6.0 and below. With an a1c above 8 your in the range of uncontrolled full blown diabetes.
I started metformin immediately and it in combination with diet and exercise worked really well, with the exception of some pretty terrible diarrhea.
It took 6 months for my average glucose reading to be 114 and my a1c 5.6. I took a break from metformin and found my blood sugar to jump up by roughly 35%. My personal limit on bs is 130 post meal and I was waking at 125 and seeing 160+ wth low carb meals (less than 8 grams per meals) a week after stopping metformin .
I can’t speak for insulin, but for me metformin is very effective, enough so that despite the gi issues I’m back on it. Hopefully you don’t have the same issues, but if you do there are ways to make it better. Currently I’m working on fiber intake, probiotics, and dosing timing. Thanks to a lot of information from this forum I’m getting a handle on the gi problems. Metformin seems to be very low risk yet offers tremendous help with blood sugar control. I highly recommend trying it.
I know many have issues with sulfa drugs but Met can only help so much. For me adding 25 mg of glipizide along with 2000 mg metformin made a huge difference. 8.5 to low 6 over night.
Hello All,
Hope all are doing well. So to give an update, I was finally diagnosed Type 2 today. I took everyone’s advice and asked for every test under the sun to verify but my GP classified me anyway. One thing I did request was to see an Endo and it seems the request went in one ear and out the other. Any suggestions on how to handle this? or should I take the recommended medications and wait six more weeks before the next a1c?
I did manage to find out that I have a few type 2’s in my family but a lot of type 1’s. Inserting enough she had the “that can’t happen you’ur to old” mentality. However, she finally responded when I said rheumatoid arthritis also runs deep in the family. Interesting
Anyway, and advice is welcome on how to approach this situation. !!!
Thank you all again for being awesome and having so much information.
So, the GP would not do the antibody tests or check your c-pep? Are you taking any meds(what did they recommend you take)? how are your numbers, and even more important, how are you feeling?
At first. she wasn’t interested in the additional tests. I finally said it would bring me the piece of mind to have all the tests done to be sure. This was even after informing her that type 1 runs heavy on one side of my family. So she prescribed me metformin ER 500 once a day. my numbers are up and down. The highest thus far has been 420, the lowest has been 77(no food, I spiked as soon as I ate), my averages have been between 170 and 240. This week alone it was 198. I’m about to go take the c-pep, antibody, and 12 other tests. Do you think I should do the tests and wait to see the doctor in six weeks? or should I push to see an endo sooner?
After seeing so many stories of misdiagnosis I’m so worried that my doctor is simply looking at me as an overweight person and assuming type 2. This way of medical thinking is beyond shocking for a field I have so much respect for.
I’d get the tests done as soon as possible. (you should be fasting). I’d sign up for having the lab send you the results. I’d call the doctor and ask to be put on the cancellation list, so you’ll have a chance to get in there sooner than 6 weeks.
I’m not an expert on type2, but I do know 500 mg of Met once a day is a really low dose.
Make sure you’re drinking plenty of water. Those high bgs can be really dehydrating.
Wow - those are pretty high averages and spikes, and your Dr. won’t refer you to an endo? That’s shocking and borders on negligence in my opinion.
500mg of Metformin ER is not effective, and another sign to me that she has little idea what she’s doing. I believe the maximum effective dose is 2000mg, and there is no risk of going low on just Metformin. I would consider starting with the maximum dose to bring you down to normal levels as quickly as possible and then experiment with dialing it back once you’ve normalized your levels. Metformin can help with weight loss, and if this happens, this will also increase your insulin sensitivity.
Lastly, if you get to see an endo, I would talk to them about the possibility of a temporary basal regimen to shore up your pancreas and give it a bit of a rest until your numbers are back at acceptable levels.
It is a low dose, but some doctors (my GP included) like to start off with smaller doses of metformin because they want to minimize tolerance problems (did not help in my case).
All of this is what I would have said, but more articulate than I would have said it. I was misdiagnosed with type 2 and lived for a year trying to understand why diet/exercise/metformin wasn’t working as well as it should have been. I was basically in my “honeymoon period” which is the window of time where your pancreas is still able to produce enough insulin to reduce insulin needs and help with glucose control.
In the big picture, that year of “wasted” time chasing treatments that wouldn’t work is tiny. But it’s also a really small thing to just go get the Cpeptide test completed with your next blood draw. Now that I’m more engaged and educated in my care, I think that I would fire a doctor that didn’t respect my ability to add perspective/research to the conversation we were having about my care.
Thank you, All, again for the kind replies and much-needed information. To follow up with what I did and have been told. Today I had all the following tests done: ALT, ANA, C-Pep, Cortisol, Creatine, ESR,
GLUTAMIC ACID DECARBOXYLASE-65 ANTIBODY, IGA, INSULIN ANTIBODY HIGHLY SENSITIVE, ISLET CELL ANTIBODY SCREEN WITH REFLEX TO TITER, MICROALBUMIN, URINE, RHEUMATOID FACTOR, SERUM, T4 - FREE, THYROPEROXIDASE ANTIBODY, TISSUE TRANSGLUTAMINASE IGA - QUALITATIVE.
I am hoping this was all the tests I needed.
I will admit that one major issue I’m having is that I again asked the Doctor if I can have a referral to an endo and her answer was " I would like to wait to see the results of the tests, to see if an endo is even necessary." Followed by “Diabetic issues are normally dealt with at the General practitioner level”.
I really feel like my voice is not being heard, or maybe I’m being too proactive in such an early stage? I’m not sure what to do.
If you truly do have Type 1, that statement isn’t even close to true. Not in this country, at any rate. It’s evidence of that same assumption that you must be, or “probably” are, T2. Which is putting the cart before the horse because making that determination is what those tests are for: to render"assuming" unnecessary.*
Piling on to what Mike said up above, I don’t think I would personally keep a doctor with that frozen and rigid a mindset. But that’s just me.
*And we all know the old joke about the word “assume”, don’t we?
You’re doing all the right things, and you’re much more enlightened than your GP. She sounds like she has the right mix of ignorance and arrogance that’s at the expense of you getting the best treatment possible. In my entire life, I cannot recall ever getting denied a request for a referral. I would seriously consider switching Dr.'s. She’s not going to suddenly get more enlightened anytime soon and seems like she’s only going to stand in the way of you getting the compassionate, professional and well-informed treatment you deserve.
I agree with you, good Sir! I actually started looking at some internal med doctors today. I think my first mistake was choosing a family practitioner.
I’m so new to this (and overwhelmed, and scared) that I’m not even sure she ran the right tests. which some have some back but I’m not too sure what I’m looking at.
I think my biggest concern is that my A1C did improve from 8.6 to 7.9 but instead of listening to me the doc just told me how this was going to go. This was even after updating her that one side of the family had a few cases of type 2, while the other had more type 1. To be specific, I have a cousin that was diagnosed first with type 2 and then turned out the types 1.5/1 of which whom had similar symptoms as I have been having.
Just my two cents: the tests you listed above look right, since they include Type 1 auto-antibody tests. However, if you don’t trust your doctor you don’t trust your doctor, even if you do turn out to be Type 2. You’re young, and you’re going to be dealing with whatever type of diabetes you have for a very long time. You want the best medical care you can find, and plenty of Type 2s see an endocrinologist.
In a similar situation last year, I found another doctor and have been much happier since then.
Your statement about being “overwhelmed and scared” really resonated with me. I remember those feelings well around 5 years ago when I was first diagnosed. It was terrifying, but I can assure you it will all be OK. I was initially misdiagnosed as a T2. After the initial shock subsided, I then started to devour information and tackle my situation head on, like you’re doing now. It was only through my self-education and my determination that I was able to get the antibody tests done to prove I was T1.
You’re doing all the right tests. It’s very important that you wring all the ambiguity out of your diagnosis and I hope the T1 results come back negative. But even if they don’t, you really have the right attitude to manage this condition well. The silver lining in mine (and this is the case with many folks here) is that it’s made me the healthiest and most in tune with my body I’ve ever been in my life.
Keep learning, keep questioning and keep advocating for you. We’re all here to help and happy to answer any questions you have. A resource I found very helpful at diagnosis was bloodsurgar101.com. Lot’s of easy to understand information on T2/T1 with many references you can use for even further research.
I’ve gone from “overwhelmed and scared” to “confident and informed.” I have a very cool, open-minded GP who I see for those occasional non-diabetes issues who now asks me about the latest and greatest advances in diabetes treatment. He was the one who initially diagnosed me (suspecting I was T1) and immediately referred me to an endo. And I have the respect of my local endo who knows never to recommend anything unless he can support it with strong data and facts. My primary endo is Dr. Bernstein, and I have no problem challenging him either when something doesn’t seem to make sense.
You’re going to do great, and we’re all here for you. Keep us posted.
How did you do that? I went from “overwhelmed and scared” to well “tenuously confident” (is that possible?), “informed, yet still scared” and even more overwhelmed! And, after a weekend of failure upon failure (D-tech, not me), I’ve added a healthy scoop of “bewildered” to the mix!
I hear you Thas. I saw your frustration over the weekend in the chat room. I probably cycle through all those emotions too, but mine include plenty of time spent in despair and being terrified(probably not healthy, avoid them if you can)
I hit bewildered a lot. I don’t know what it means, but my numbers are all over the place this past couple of weeks while traveling. Which shouldn’t be unusual (given I’ve made some changes to diet and medication on my GP’s suggestion to halt weight loss). But I don’t know why everything has gotten so unpredictable.
In short, I’ve been eating more carbs and cut back on Metformin to try to: a) quit losing weight (since I can’t seemingly eat or digest 3,500 calories a day of fat and protein to maintain weight); and b) see what my response to a moderate amount of carbs is (100g-150g per day). Well, my response is…unpredictable. I’ve been walking 6-10km a day in Belgium, and not eating carbs before noon or so. Then two “moderate” carb meals. All sounds good, right? Problem is…I have no idea what the post-prandials are telling me:
Sometimes I spike to 165 an hour after eating 50g carbs, and am at 145 two hours and then still 145 at three hours after eating.
One time I spiked to 185 an hour after eating and was down to 105 two hours after.
Last night I had the same meal that produced number 1 reponse, and was 92 mg/dL an hour after eating.
Today I’m eating airline food (shudder) during 18 hours of continuous captivity, and so far I haven’t gone over 120 mg/dL.
So…I have no idea what is going on. I figured I’d have a week or so of mid-100s after eating and back to normal, and that has sort of happened. My fastings have been pretty decent (probably all the walking).
Sorry for derailing the thread, just feeling a bit bewildered (sometimes I can almost eat like a normal person, other days I get highs that won’t come down).
