Type 2, two months after diagnosis; need help

I want to say first that I’m aware that the troubles I’m facing are small compared to those I’m asking advice from. I appreciate your experience and I don’t know what else to do or where else to ask.

I’m having several issues…mostly with work, dietary, marriage, fatigue, and mental. They’re all interconnected. Initially after diagnosis I was depressed…but I attacked this as head on as I could. I didn’t understand just how bad my numbers were…but I studied everything…went to the ADA classes…and cut out all the carbs I could. I thought I was doing a LCHF diet, but I don’t believe I was taking in the high fat part as much as I could. Anyways…2 months later…I’m now down to about 173lbs. At diagnosis was 208lbs…which was down from around 240lbs …which was where my unexpected weightloss started…over about a month +. For reference…my diagnosis blood numbers: 276mg fasting. 13.7 A1C.
I know. Truly high A1C.

I’ve got more…much more…to share… and what my actual real time problems are…but I have to take my son to school. Thanks for your attention so far.

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First of all, you’ve come to the right place! and we actually have it written in our values statement that we do not support discussions about “who has it worse”. we are all here to help each other with our struggles with living with a chronic disease.

So, only 2 months in, seems like you’ve already made some headway with losing weight and taking on a new way of eating. Good for you! I’m sure in another month or so, you’ll be getting another a1c, you’ll probably see a reduction from that 13.7 number. What meds are you taking? What have your blood sugar numbers been?

Give yourself some breathing room. It’s so normal to be grieving about this diagnosis, and everyone grieves at their own pace. Come back here often, ask questions, no matter how small and insignificant you think they are, you’ll find someone else who’s probably been there and can relate.

Hugs, and welcome to the community!

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Anyways…I’m a mailman. I have a very physical job, walking, lifting…etc. I burn through a lot of calories in a day. It was my understanding from my endocrinologist (she’s very patient with me)…that if I lost weight I would see-have better ‘control’.

I feel weak and the physical demands of my work are increasing exponentially due to the holidays. I’m just on 1000mg metformin…but I’m realizing that I’ll never be off of diabetes medication. I’ve said this to my wife and she just gets mad at me.
She’s frustrated with my focus on this…but I have to look at the future. I come home so fatigued…and know deep down…I’ll end up on insulin eventually. But the nature of my work is such that I don’t have a traditional job— or predictably steady load of physical effort.

I’m just getting ahead of myself. I’m having mental issues over this. I’ve gone to two different councilors trough a work program…and a separate GP…not my usual one…who all agree I’m clinicaly depressed. I was prescribed Wellbutrin…but haven’t taken any yet…Apparently side effects include insomnia and weight loss. Two things I’m trying to stop at the time.

Also having many troubles having ‘movements’. Right before diagnosis I had constipation. Resulting in a fissure and thrombosed hemeroid.
I’m on a cream that’s healing that…but now I don’t have movement in my gut on this diet. I had most of a yogurt with breakfast yesturday…in desperation. Caused memail to go from 85 fasting (which is outstanding for me)… to about 127mg 2 hrs PP.

My endocrinologist says I need to lighten up on the diet…get more fibre-carbs…and be OK with getting above 140. I know that’ll speed up my road to more meds…

What to do? I’ve got more…but hey…I’m probably pushing my luck as it is.
4 months ago…I was happy…normal…and loving life. Now I’m just broken and D is destroying every aspect of my life.

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Thank you!

I’ve been getting anywhere from 85-100mg fasting. Usually around 122-130 PP.
Eggs and veggies in the AM…salad nuts cheese and some protein for lunch…usually chicken or fish with veggies for dinner.

When I saw a GP about my depression a week or so ago…he went over my numbers and said he was impressed considering I was only on 1000mg of Metformin. Said he if it was him…he would have put me on insulin right then and there. Also said I will NEVER be able to hold this back with diet and exercise alone. Not with my diagnosis numbers.
Yes…that was a real mental breaking point for me. My wife won’t even tolerate me talking about it.

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Being diagnosed can be a really life changing thing. It is easy to get really depressed. I think back to my diagnosis and I really think I had to go through some grieving. I think I had to go through the five stages of grief as outlined by Elisabeth Kübler-Ross: D’Nial, Anger, Bargaining, Depression and Acceptance. I still deal with some of these more than a decade after my diagnosis.

As @MarieB suggested, you won’t just fix this and you need to pace yourself. You can do this, but you can also make the whole process harder by overdoing it. Set reasonable expectations. Look yourself in the mirror and congratulate yourself on achievements. You need to realize how well you have done with your blood sugars. And you also need to cut yourself some slack. It is ok to use medication and you don’t have to overdo the diet. Change takes time and you don’t want to burnout. And you need to remind yourself that a diagnosis of diabetes isn’t the end of your life, it is just a chapter.

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Hi there and welcome!
a few questions and ideas…
how often do you check your BG? from what you are writing, it seems to me that those 1000mg met are already not enough for you… what does your endo think about this? Has your endo checked you for type 1 diabetes? the fatigue and weight loss could very well be associated to uncontrolled BG.
@Melitta has written some stuff about that here
the thought of you about ending up on insulin eventually is very mature, not many newly dxd t2 are able to see that. don’t see yourself as the person who brought this unto you, but as the one working with the dx now and trying everything in his power to learn about it :smiley:
regarding your marriage i am definitely not in a good point to give advice, but mental stress also projects onto your physical health and vice versa…
good luck! hugs

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Take a few deep breaths. You’re going to be ok. It’s to be expected you’re overwhelmed at this point.

Maybe you could try some Metamucil or other fiber supplement. And make sure you’re getting plenty of water.

When I have yogurt, I have the whole milk Stoneyfield plain yogurt with a splash of vanilla extract and a little Equal sweetener. It’s really good!

You’re going to be ok. I understand the frustration.

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Thanks. When I look in the mirror…I look so…not me. I’m unhappy…thin, pale, weak.
I know what you mean Brian. I’m thinking literally.
But I can’t look at my reflection with sorrow welling up…so unlike the indestructible man I thought I was.

My job will not last like this. I also doubt think I have options at this point.

I need to run now…Meeting with a physical trainer. Maybe he’ll give me some ideas…

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Man I can relate. It is absolutely a psychological bombshell. I feel like little attention is paid to how this situation affects people’s careers too-- which has been a never-ending source of stress and concern for me as well. And many of us here can relate that our spouse doesn’t seem to ‘get it’ which can be very frustrating (if they ‘got it’ we’d likely be talking about it to them instead of seeking out strangers on the internet who ‘get it’)

I also know what you mean about looking in the mirror. Up until that day for me I looked in the mirror and saw a robust hardy young man that had the world by the balls. Moments later I became a sickly disease ridden middle aged man with an uncertain future in my own perception— but it’s just that, your own perception. If you had lost this weight in a different context you’d be high fiving your buddies and proudly bragging about it. Your perception will change when you’ve had some time for adjustment.

Just realize you’re still brand new at this and just scratching the surface of how this is going to look for you and how your life is going to adapt to it–as that picture becomes more clear it will get a little easier psychologically, and over time it will become your normal steady-state and not drown out all the good things in life.

PS-- don’t fear being 'put on insulin’
I know that it’s intimidating and not what anyone wants but really it’s what works best. Most people who end up using insulin after any length of time wish they’d started on it a lot sooner. Taking insulin to manage diabetes is not a failure on your part.

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Hi John and welcome. TuD is a great place where you can get support and ask questions, and you have received some good advice and support already. I am going to be bold and say that, in my opinion (I am not a medical doctor), your situation sounds like classic adult-onset Type 1 diabetes. @swisschocolate provided you with a link to a blog I wrote on my Top Ten Tips for the newly diagnosed person with adult-onset Type 1 diabetes. I will also be bold and say, again my opinion, you should get to your doctor now and get on insulin ASAP. Extreme weight loss and extreme fatigue are classic symptoms of uncontrolled Type 1 diabetes, and insulin is the treatment. Getting on insulin should slow/stop the weight loss, reverse the fatigue (it does take time), and help with the depression (high BGs can cause depression). Best of luck to you!

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Welcome @John_R to TuD and the club no one ever asks to join. You’ve certainly found a terrific resource here for support, experience, advice, etc.

You sound like you’re getting pretty good numbers with your low carb approach, along with metformin. The weight loss is fairly significant, though, over a very short time. I don’t know if it is an indication of adult-onset Type 1, as @Melitta suggested or just a function of dramatic changes in your diet and activity. You should ask your doctor to test you for that (C-Peptide and auto-antibodies tests).

I can tell you, though, that when I try LCHF, I always feel a serious lack of energy in the afternoons and evenings – Tried for several weeks, but never seemed to adjust and get my energy back. What helped me (I still eat fairly low carb!) was to add 15-30g of carbs to my dinner. When i do that, my energy the following day is much improved. For you, it might be you needs a few more carbs at lunch. The only way you can find out is by experimenting.

I’s been 4.5 years since my original Type 2 diagnosis (my endo has recently decided to change that to Type 1). I remember going through much of the same things (though I didn’t lose quite that much weight, though I had a sedentary profession). I went through some depression and the head-on “attack mode” you describe. In my case metformin and I did not get along (though it contributed to appetite reduction and some weight loss) – side effects eventually made me go off of it. I started taking insulin four months after diagnosis. You’ll be OK – you’re on the right track already, it seems.

You’re got this!! Give yourself a bit of slack, though. As some say here, diabetes is a marathon, not a sprint. You will find that you have to experiment a lot to find out what works and does not work for you. (And yes, I shoot for numbers similar to those you do - though somewhat less successfully!)

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I’m just going to repeat with emphasis some of what others have said here, because these points are so important that they can’t be overemphasized.

Before we get to the medical specifics, take a deep breath. Then take another, and repeat as needed. You will lick this, as thousands of others have. The Joslin Diabetes Center (pretty much the gold standard in diabetes care) routinely awards medals to people who have survived with diabetes for 25, 50, and 75 years. Recently they awarded their first 80-year medal. We have some of those people here in the community. A century ago, diabetes was the end of life. But that was a century ago. This is now.

Point being, as someone very wise once said, diabetes is a marathon, not a sprint. It’s not going anywhere, and neither are you. So pace yourself. The immediate problems will get solved and the picture will come into focus. It may take a little while, but so what? You’re not going anywhere.

Now to specifics. There’s a ton of good advice above. I’m just going to reinforce two of the most critical things.

First, as Melitta says, you must start with an accurate diagnosis; everything else flows from that. And your symptoms do sound like classic adult-onset Type 1 diabetes. You wouldn’t know it—until this happened you wouldn’t have any reason to—but misdiagnosis of this kind is widespread. The majority of doctors have an automatic pilot that says, “if diagnosed as a child, it must be Type 1; if as an adult, Type 2”. Consequently when an adult presents with diabetic symptoms, too often the doctor will just assume (without testing!!) that it’s Type 2. In thousands of cases, this is tragically wrong.

There are specific tests that will give a definitive answer, and you need to have them done. If your primary doctor won’t do them, or doesn’t understand them, get a referral to an endocrinologist who does. This is just too important to a-s-s-u-m-e about.

Second, insulin isn’t something to be afraid of. Quite the contrary: it’s a lifeline in the most literal meaning of the word. I am a true Type 2. No doctor ever so much as even suggested insulin to me. After some years, I eventually realized that I simply would never get the control I wanted without it. So I marched in and demanded it. It has turned my diabetes (and many other aspects of my life) around and I wish I had done it years earlier.

But whether that’s the answer for you or not, you need to know so you can tame this beast properly and get healthy and happy again. Get those tests.

Just one more thing: our culture tends to be blame-happy, and there are plenty of people in the media and in private life who will try to make you think you are somehow responsible for doing this to yourself. You aren’t. You didn’t do this and it isn’t your fault. Life dropped a bomb on you, but it’s one that can be overcome. “When life hands you lemons—add vodka.” :sunglasses:

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Well. I sat down for an hour with a friend’s personal trainer.
He’s a very good Advocate an excellent listener. He’s also a type 1. He looked me straight in the eye and told me unequivocally that he would not help me with a physical regime until I got my c-peptide and antibodies test. He said the exact same things as the other people here in the forum are saying. I even saw him post to his online friends that he’ll bet a hundred dollars that I’m LADA.

He consulted a Facebook group that he’s part of and every single one of the many responses said I sound like LADA.

I marched back to my general practitioners office and got a 3:30 p.m. appointment to do the test. While they said I should be fasting they did say that I should be okay to take it even though I had two scrambled eggs and two sausages right around 8:30 a.m.

There’s no other way to put it. I’m terrified. But as everybody here and said I need to know.

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You’ll be OK, no matter how those tests come out, really. Knowing as accurate a diagnosis as possible makes things simpler for you: You’ll know if you’re on the right treatment plan or need to change it. After that, sure, you still have things to learn, and there will still be challenges – but life is challenges. As @David_dns said, today people with diabetes can and do live long, healthy, productive lives. We have the tools needed for that, and they are improving every year.

Keep us posted (of course) - and ask any and all questions that you will undoubtedly have. You are never alone!

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Please let us know what happens. It crossed my mind you might have been a misdiagnosed LADA. Our community was founded by @askmanny, also a mis-dx LADA.

I think you are supposed to be fasting for 8-10 hours for the c-pep. but you should go ahead and do it anyway.

we’ll be here for you no matter what happens.

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Well I’m going to take a little bit of a rest before I go in for my test. Feel a little light headed…but not terrible.
Just as a filler information, I have 2 older sisters who are both about 16 and 18 years older than I.
My eldest sister is still alive and a retired nurse. I only recently found out that she is type 2 diabetic for the last 2 years. I just spoke to her and her opinion is that I should definitely get these tests done.
My other sister unfortunately passed away 20 years ago. She was a type 1 diabetic juvenal onset. According to my other sister she really never took care of herself well, although I know that insulin treatment was much different back then and I can understand now why she compensated with her behavior as it was.

Her struggles at the end we’re so terrifying… that I won’t repeat them. But in the end I do have both types in my family apparently.

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Those are not bad numbers At all…Sounds like your wife is not being supportive at all and that is a shame…D alone is difficult not having the support from your mate makes it worse…I know I have been there…maybe you both could see a counselor together? It might help. As for you [quote=“John_R, post:4, topic:56990”]
NEVER be able to hold this back with diet and exercise alone.
[/quote]

I don’t believe that for a minute…D is different for everyone but My uncle was a type 2 diabetic on 7 shots a of humalog a day with Lantus twice a day…Of course he weighed over 300#. He lost the weight, went down to 168# and watched what he ate. went on the LCHF diet, and he doesn’t take any insulin anymore…NADA!!! so don’t let t your Endo scare you like that…it is POSSIBLE to get off medication and use Diet and Exercise to regulate D…Sometimes it may not be Probable, but I personally don’t believe that… I believe ANYTHING is possible.

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So. I just got back from having my blood drawn for the c-peptide tests. Dr. is adamant that it is type 2…just hasn’t been taken care of for years. Says he’s seen numbers as high as mine were in type 2’s.
…Also said he was impressed with me taking the bull by the horns with the diet and my bloodad glucose numbers as of late…but echoed my concern about too much weight loss. Only after I kept pressing.

Anyways…results may be back as soon as Monday. He prescribed me another antidepressant that may make me gain some weight. I’m supposed to revisit him in 2 weeks.

Still…I don’t even know how I’m going to survive 2 weeks. Fatigue plus work being more physically demanding. He didn’t understand that so much…‘You mean stressful?’.

Do you understand the FMLA provisions that allow you to take time off work if you need to for health reasons? (Physical and/or mental)

Unfortunately your c-peptide results, I’d be willing to bet, will be inconclusive unless the lab was drawn when your blood glucose level was sky high (like 250+). The results of that lab are essentially meaningless while your blood glucose levels are in normal ranges, unless they’re zero or very near zero-- which I highly doubt yours is. If it had been tested when you first presented with out of control blood sugars, it’d mean something… now it’s fuzzy at best. I hope they did autoantibody testing as well, which is a less ambiguous result

I’m familiar with fmla…to some degree. I’m worried that using to much to early might be detrimental to how much sick leave it might need in the future. Hard to say so far.