# All Change please....all change



## Superheavy (Mar 31, 2016)

Morning everyone,

Thought I'd start off in the newbies area, as that is exactly what I am. I was diagnosed on Thursday afternoon with Type 2, and ketoacidosis, which the GP was a whole lot more worried about than I was. Nearly admitted to the local hospital, but I talked him down to avoiding that, and just going in if I felt that things got worse over the weekend.

I guess the biggest thing is dealing with all the changes that you have to make. That sadly included giving away a nice bag of chocolate eggs I'd been given by my manager on Thursday morning, but c'est la vie. I have an appointment with the diabetes nurse next Weds, I've already been advised by a friend to ask for something to measure my blood sugar, is there anything else I should be asking for?

In terms of the changes themselves, research over the weekend has been useful, along with the first mistake of assuming the nutrition on a bottle of milkshake was for the whole bottle, not 100ml! Apart from that little blip, I've moved on to a low carb low sugar diet, and just come back from my first session of exercise at the gym.

Apart from that, here's hoping for a smooth ride.


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## Mark Parrott (Mar 31, 2016)

Hi & welcome to the forum.


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## Stitch147 (Mar 31, 2016)

Hi and welcome to the forum. This place is great for help and advice or just a chat.


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## Diabeticliberty (Mar 31, 2016)

A very warm welcome to you. I also hope that you get a very smooth ride. In terms of 'What's in the bottle or box?' Quite a lot of the food processing companies have got themselves into the annoying habit of providing nutritional data for parts of a pack of product and not the entire amount. I think that this makes them feel like they can pull the wool over our eyes. With diabetes, certainly in my own case when newly diagnosed  it was an issue of reading every food box and packet to work out exactly what was what? After a while it kind of becomes second nature and I hope that you find things become a little more natural. Like any condition that demands big lifestyle changes it can feel a little bit (lot) overwhelming at first. If you just edge your way along in small steps you should be fine with stuff. Lots and lots of very clued up members in this here forum. Any questions no matter how insignificant or daft they may feel to you then just shout out and ask.


Pleasure to meet you,
Geoff


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## Annette (Mar 31, 2016)

Diabeticliberty said:


> Quite a lot of the food processing companies have got themselves into the annoying habit of providing nutritional data for parts of a pack of product and not the entire amount.


Yes, Like - here's the data for 100g. The packet is 240g. We're not going to tell you how many are in the packet, you have to wait until you've bought and opened them to find out, then do some maths. Its infuriating!
Oh, and hi, Superheavy, welcome. Ask for an education course - whatever is done in your area - DESMOND is the usual for T2s, but maybe something else round you.


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## Northerner (Mar 31, 2016)

Superheavy said:


> Morning everyone,
> 
> Thought I'd start off in the newbies area, as that is exactly what I am. I was diagnosed on Thursday afternoon with Type 2, and ketoacidosis, which the GP was a whole lot more worried about than I was. Nearly admitted to the local hospital, but I talked him down to avoiding that, and just going in if I felt that things got worse over the weekend.
> 
> ...



Hi Superheavy, welcome to the forum 

Is your GP sure that you have Type 2? Ketoacidosis is very rare in Type 2 and is normally considered a medical emergency - it arises due to a lack of insulin and is therefore more indicative of Type 1. How did he determine ketoacidosis? Do you know what your ketone levels and blood sugar levels were? I think your GP was right to be worried - you could become very ill very quickly. If you are in fact Type 1 then you will need insulin, and it also might be dangerous to exercise if your blood sugar levels are high. I would take him up on his offer to go to the hospital. Adults can be slow-onset Type 1, which means that you can lose insulin production more slowly than a child would, but you still need to get this clarified so that you can be monitored properly and to ensure you get the correct treatment - most Type 2 approaches will be useless if you are not Type 2. Had you had symptoms for long before diagnosis? What prompted you to go to the doctor in the first place?

Sorry to introduce a note of worry, but I really think you need to get a proper assessment from a specialist unit.


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## William 2003 (Mar 31, 2016)

@Superheavy  - Hello and Welcome to the Forum  I too am a Newbie having only just joined yesterday, but have had Type 2 now almost 16 years.


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## Lynn Davies (Mar 31, 2016)

Hi and welcome to the forum - very much a newbie myself so if you have any questions ask away.

I would also be querying the ketoacidosis as well! 

Not a common complaint for type 2's.


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## Copepod (Mar 31, 2016)

Welcome to the forum, Superheavy.
You might have been a bit hasty in giving away your bag of chocolate eggs, as one or two tiny eggs or a creme egg sized egg instead of pudding or other even some carbohydrate from main course of a meal is OK as a treat - there's only one Easter a year, unless you celebrate both western church and Eastern Orthodox dates! Unwrapping foil from a small egg, without tearing, to read the nutritional content is one of the more extreme challenges in reading food labels.


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## Alan.tnh (Mar 31, 2016)

Hi and welcome, one piece of advice I would give for a first appointment is take someone in with you, really as a note taker its amazing how your trying to process one bit of info and then they start on something else. if not at least a notepad for yourself.

Good Luck Al


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## SB2015 (Mar 31, 2016)

Welcome Superheavy.
I would second the idea of take someone with you to the next appointment.
At a recent appointment (not Diabetes related) I made sure that my husband had a note of the questions that I wanted to ask, and he chipped in as I was swamped with info and forgot one of them.  He also took notes so that he could remind me of things that I forgot that they had said.  Very useful


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## Superheavy (Mar 31, 2016)

Hi guys, 

Thanks all for the warm welcome, the notepad suggestion seems to be a good one - sadly I'm a lone wolf so nobody I can really take with me to any medical appointments.  In terms of medication I've just been given Metformin 500mg twice a day, with a view to increasing it to three times a day. I gave another urine test today, and I'm assuming that since I haven't had another panicked phonecall from the surgery that it isn't too bad this time and the ketones are down if not gone.  Will call back for the test results tomorrow. 



Northerner said:


> Hi Superheavy, welcome to the forum
> 
> Is your GP sure that you have Type 2? Ketoacidosis is very rare in Type 2 and is normally considered a medical emergency - it arises due to a lack of insulin and is therefore more indicative of Type 1. How did he determine ketoacidosis? Do you know what your ketone levels and blood sugar levels were? I think your GP was right to be worried - you could become very ill very quickly. If you are in fact Type 1 then you will need insulin, and it also might be dangerous to exercise if your blood sugar levels are high. I would take him up on his offer to go to the hospital. Adults can be slow-onset Type 1, which means that you can lose insulin production more slowly than a child would, but you still need to get this clarified so that you can be monitored properly and to ensure you get the correct treatment - most Type 2 approaches will be useless if you are not Type 2. Had you had symptoms for long before diagnosis? What prompted you to go to the doctor in the first place?
> 
> Sorry to introduce a note of worry, but I really think you need to get a proper assessment from a specialist unit.



Hi Northerner,

Thanks for your response - ketones in the urine sample I provided were the source of the diagnosis, although he didn't give me the actual results, just told me what they meant.  I'm thinking I'll need to pay more attention next time, now that you're questioning it I'm 95% sure he said Type 2.  In terms of reasons for going, I'd lost around 20 lbs in a month or six weeks before going, and I'd been drinking more fluids for a few months (I think...can't remember exactly when it started, at least Christmas, probably earlier.)  I have no family history of diabetes, plus i tick most of the risk categories for type 2.  I had been hoping it was just stress and a few missed lunches at work....no such luck!  Will quiz more when I have my next appt.


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## sugarthat (Mar 31, 2016)

Hi there, I too am a newbie here but have much experience of being a Type 2. I have this advice. Next time you go ask for a blood glucose monitor. Tell the nurse it will help you get your diabetes in control. Ask for an education course. Take a notepad and pen and make notes of what she tells you, especially your BG. Ask her to test your  ketones again as you are worried and write down the number. Google everything or come here for advice regarding your notes. If you're not happy with your treatment or feel they could be doing more make another appointment. GP care for Type 2s tends to be a little laid back. You have to press them to make sure you're getting the right treatment. It's a lot to learn so keep reading. Chin up mate. Keep us updated.


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## Ljc (Apr 1, 2016)

Hi Superheavy.  Metformin and other similar pills are only given to type 2s.
I did well on them for many years. 
I'm now an insulin junky  .
I agree you were a tad hasty giving away all those chocolate eggs, you could have kept some .  
yes we do have to be careful but the occasional treat is ok.  I wouldn't bother buying diabetic sweets , they are high in calories and are often sweetened with Sorbitol and a little to much of that will keep loo roll manufactures in profit lol.

Your GP practice may well have a Diabetic nurse. I would check if your practice does , they are very knowledgable and helpful.  tbh I prefer to see my diabetic nurse for all things related to diabetes rather than a GP as she gives much more info without me having to ask. I see mine every 3-6 months but can contact her at other times easily. 

IMO you do need to keep an eye on your BG (blood glucose) at home so do ask for a meter to test it.

I find its best to make a list of questions so you don't miss any.


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## robert@fm (Apr 1, 2016)

@Superheavy — it sounds to me (from my five years' experience reading these forums) that what you have is actually slow-onset Type 1 (aka LADA or Type 1.5). This is often mistaken for Type 2 at first, and it's only because the T2 meds stop working (or never work) that the penny finally drops. We have a few members who seem to show all the signs of T2, and were thus misdiagnosed at first, but are actually T1.5 or T1.



Ljc said:


> Metformin and other similar pills are only given to type 2s.



Not true; Metformin is used to treat severe and persistent insulin resistance, and some T1s suffer this as well.


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## Ljc (Apr 1, 2016)

robert@fm said:


> @Superheavy — it sounds to me (from my five years' experience reading these forums) that what you have is actually slow-onset Type 1 (aka LADA or Type 1.5). This is often mistaken for Type 2 at first, and it's only because the T2 meds stop working (or never work) that the penny finally drops. We have a few members who seem to show all the signs of T2, and were thus misdiagnosed at first, but are actually T1.5 or T1.
> 
> 
> 
> Not true; Metformin is used to treat severe and persistent insulin resistance, and some T1s suffer this as well.


Thank you. I've learnt something today.


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## Northerner (Apr 1, 2016)

Superheavy said:


> Hi Northerner,
> 
> Thanks for your response - ketones in the urine sample I provided were the source of the diagnosis, although he didn't give me the actual results, just told me what they meant.  I'm thinking I'll need to pay more attention next time, now that you're questioning it I'm 95% sure he said Type 2.  In terms of reasons for going, I'd lost around 20 lbs in a month or six weeks before going, and I'd been drinking more fluids for a few months (I think...can't remember exactly when it started, at least Christmas, probably earlier.)  I have no family history of diabetes, plus i tick most of the risk categories for type 2.  I had been hoping it was just stress and a few missed lunches at work....no such luck!  Will quiz more when I have my next appt.


It's quite likely that the initial diagnosis might be Type 2, given that you have a lot of the risk factors for Type 2. However, losing that amount of weight in such a short period of time (were you actually trying to lose weight?), along with the ketones do suggest (as @robertfm says) a slow-onset Type 1. It's important that you get the necessary specialist advice. Even the fact that you have no family history of Type 2 indicates that slow-onset Type 1 (also known as Type 1.5 or LADA - Latent Autoimmune Diabetes in Adulthood) is more likely. Have any of your family members got any autoimmune conditions, such as thyroid problems, Coeliac's disease, psoriasis? As you can probably guess, it's not necessarily straightforward, and more difficult for a GP when you have indications of more than one type.

Do get things checked out, and let us know what the verdict is!


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## Copepod (Apr 1, 2016)

If you're using a search engine, please note the correct name is coeliac disease - it's not named after anyone. Americans omit the o before e, as they don't retain the Ancient Greek spelling.


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## pat.y (Apr 1, 2016)

HI and welcome Superheavy, type 2 for 10 years here. Do push for a testing meter but depending where you live if you are definitely type 2 you may have buy and fund one yourself. My GP won't fund mine.


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## Superheavy (Apr 3, 2016)

Really useful info guys, will pose the question about types 1 and 1.5...
@Northerner - I wasn't actually trying to lose weight, and if I'm honest I didn't really monitor my weight much, so until someone mentioned my shirt was looking baggy I hadn't even thought of weighing myself. My dad has had a few thyroid problems - how does that link in to diabetes?

Had my first challenge this weekend trying to balance going out with friends with not pushing the boat out too far and keeping on top of my diet. It's not as bad as it could be.


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## Northerner (Apr 4, 2016)

Superheavy said:


> Really useful info guys, will pose the question about types 1 and 1.5...
> @Northerner - I wasn't actually trying to lose weight, and if I'm honest I didn't really monitor my weight much, so until someone mentioned my shirt was looking baggy I hadn't even thought of weighing myself. My dad has had a few thyroid problems - how does that link in to diabetes?
> 
> Had my first challenge this weekend trying to balance going out with friends with not pushing the boat out too far and keeping on top of my diet. It's not as bad as it could be.


Thyroid problems can be autoimmune in origin, and are often found alongside Type 1 diabetes - also autoimmune. Type 2 is not autoimmune in origin.


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## SB2015 (Apr 4, 2016)

Hi Superheavy, you can be diagnosed with T1 even if there is no history of it in the family.
There is no evidence of any autoimmune condition I my family, but I got T1 at the age of 53.
Picked up due to the 4Ts: Toilet, Tired, Thirsty and Thinner (lost 1 1/2 stone in one week) along with ketones.


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## Superheavy (Apr 4, 2016)

Going to be pumping....my diabetes nurse for information tomorrow morning, got a list of questions that I want to discuss. Was really inspired by @Mark Parrott and his thread about getting his diabetes under control enough to maybe consider that it could be 'cured'. Heck, if I can avoid increasing my medication any further I would consider it a good start. 

Been going to the gym on really light sessions (15 minutes gentle bike, 15 minute brisk walk), and it feels like I'm not trying properly if I don't leave a sweaty mess at the end.  Hopefully I'll get the details as to what I have to manage to be able to get to sweaty mess gym sessions! 

Thanks for the info @SB2015 - I assumed for several months that the toilet was simply a side effect of the increased thirst, but didn't really notice being tired, and it was only the weight loss that really forced me to go to the doctor's, although it wasn't anywhere near as dramatic as yours.


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## Copepod (Apr 5, 2016)

Team Blood Glucose offers good advice about exercising with both main types of diabetes - see http://www.teambloodglucose.com/TeamBG/Home.html and click on Type 1 Basics or Type 2 Basics.


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## Superheavy (Apr 5, 2016)

Okay, so after the visit I now have a blood glucose monitor, a sharps bin, about four pounds of paper and am being retested to clarify whether or not it actually is Type 1 or Type 2. Apparently the original doctor didn't do the HbA1c blood test, so that should give more information about whether it is likely to be 1 or 2. The ketones in the urine had dropped from 3 to 1, and blood glucose this morning was at 7.3 around 90 mins after breakfast. Got to do the evening test in about an hour.
This may be a total newbie mistake, but I was told not to over-cut carbs from the diet, and that a small amount of carbs in each meal is required. Whatever the reviewed diagnosis, I'll have to deal with it as it comes.


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## Northerner (Apr 5, 2016)

Good to hear they are on the ball and reviewing your diagnosis - important so you get the appropriate treatment and education


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## Annette (Apr 5, 2016)

Superheavy said:


> This may be a total newbie mistake, but I was told not to over-cut carbs from the diet, and that a small amount of carbs in each meal is required.


Not a newbie mistake but a common thing to be told by dr/nurse/dietician. And really, a loads of cow excrement. It would be almost impossible to remove all the carbs from your diet anyway (most veg have at least a small amount) unless you were trying to survive off water...
I often have 'carb free'meals (probably 2g carbs ish) for lunch (suits me to do so) and it certainly does me no harm. Search on LCHF on here for some thoughts on this...


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## Superheavy (Apr 5, 2016)

Blood glucose came in at 6.3 tonight - i guess its when i start eating foods I maybe shouldn't that the fluctuations in the levels might start to kick in. Lunch is when I usually don't have much carbs - either a chicken or tuna salad, mainly because its being thrown together in around a minute!


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## Superheavy (Apr 7, 2016)

Okay, so test results are back and the picture comes into focus. The Doctor and the Diabetes Nurse are 95% sure it is Type 2, as the ketones have dropped off quite quickly after medication kicked in, which they don't think would have happened if it was type 1. HbA1c came in at 99. Pretty high so plenty of work to do on that front.

In terms of what I can do, I'm cleared for exercise that's a little more strenuous, which is good, as the low intensity stuff was a little boring. Chest muscles are nice and achy after the rowing machine tonight. Also, they've added gliclazide into my medicine cocktail along with the metformin, so we'll see what that does when I start on Saturday. Anyhow, my salmon is nearly done, so off for some food!


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## Alan.tnh (Apr 7, 2016)

Sounds like good news, Did they explain how Gliclazide works and the possible affects regarding low blood sugars? If not you should read up on it.


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## Superheavy (Apr 7, 2016)

Alan.tnh said:


> Sounds like good news, Did they explain how Gliclazide works and the possible affects regarding low blood sugars? If not you should read up on it.



Yup, the full downlow on hypos and how I need to be more careful about them once I'm on the drug. Starting it on Saturday morning, so will report back on how its going. Can't say they sound particularly good side effects, so hopefully its not a permanent prescription that I will be having.


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## trophywench (Apr 7, 2016)

Just going back to @Ljc on Page 1 - Metformin is usually prescribed to young ladies (whether they are diabetic or not!)  too, to treat a condition abbreviated to PCOS !


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## Alan.tnh (Apr 7, 2016)

I've been on them since Feb this year, by keeping carb intake low 50 to 60 a day, my bloods are very good and consistently 4.5 to 7 range, however if I exercise i.e. more than 2 mile walk at 20 min per mile pace I do drop into the 3's so I need to up carbs prior to walks.


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## Superheavy (Apr 7, 2016)

trophywench said:


> Just going back to @Ljc on Page 1 - Metformin is usually prescribed to young ladies (whether they are diabetic or not!)  too, to treat a condition abbreviated to PCOS !



Indeed, we have a rather open office when it comes to discussing just about everything, and I got the full discussion about what Metformin was going to do to my stomach and bowels from a friend who has exactly that. However, until now I've never googled it to find out what it is! It doesn't look to be a nice condition, although hopefully the treatment doesn't affect my ability to grow facial hair....I have little enough as it is!


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## trophywench (Apr 7, 2016)

I don't fink you look like a pre-menopausal lady, or were born with the parts affected by the condition - so I shouldn't stress if I were you!


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## Northerner (Apr 8, 2016)

Superheavy said:


> Okay, so test results are back and the picture comes into focus. The Doctor and the Diabetes Nurse are 95% sure it is Type 2, as the ketones have dropped off quite quickly after medication kicked in, which they don't think would have happened if it was type 1. HbA1c came in at 99. Pretty high so plenty of work to do on that front.
> 
> In terms of what I can do, I'm cleared for exercise that's a little more strenuous, which is good, as the low intensity stuff was a little boring. Chest muscles are nice and achy after the rowing machine tonight. Also, they've added gliclazide into my medicine cocktail along with the metformin, so we'll see what that does when I start on Saturday. Anyhow, my salmon is nearly done, so off for some food!


I'm still not convinced with the Type 2 - but that your pancreas is still producing erratic amounts of insulin. There are tests that can be done, which they are no doubt reluctant to do at this stage, which can determine whether the cause of diabetes is an autoimmune attack and also to quantify how much insulin your pancreas is producing - if you are producing lots of insulin then Type 2 is likely, but if it is less than normal then autoimmune/Type 1.5.

Something to bear in mind if the gliclizide appears to stop working in the coming months.


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## Superheavy (Apr 9, 2016)

I'm pretty sure I'm going to hold off on the Gliclazide for now, at least so that I can do my testing before and after my gym sessions this week, and take them to the nurse on Friday to get some more information about what I'm worried about - namely that the medicine will push my sugar levels too low and threaten hypos after the gym. I don't really want to be adding food into my diet just to get the levels up before the gym, as weight loss is the aim, which rarely happens by eating more.


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