# New diagnosis type2 but meds just dont work.



## Hellybell80 (Mar 9, 2021)

OK i apologise for a long post. But I could do with a little help.
So about 4 weeks ago I tested my urine, as I used to get alot of kidney infections. I test weekly at home so I don't bug the Dr each time. They have glucose on them as well. I was glucose intolerant many years ago. But it really was a low amount. 

I've never had any glucose in my urine at all in all the time I had tested. Until I started to feel unwell about 4 weeks ago. Weeing loads started to loose weight. Felt awful.
It was a high amount in my urine. Had tested a week before nothing. 
So because I have family members who are type 2 diabetic. (None over weight) I tested on a blood glucose monitor. It was 17. A little shocked to say the least.
Did a fasting blood sugar and it was 14. 12 hrs after eating. 
Since I first measure its never been below 13 and thats on a fasting. Going up to 29. 

I was diagnosed within the first week with a hba1c of 77. My average sugar is 18.1 over the last 4 weeks. 
They put me on gliclazide 80mg a day it did nothing. Then 160mg then 320mg. Didnt move my sugar levels. Nurse was surprised. 
So yesterday they put me on lantus just 10 units to start off. First day not much improvement but I'm aware it will take time.
I've lost 8lb in a week. I'm overweight by about 10lbs. So not a massive deal. 
Anybody else type 2 thats had it develop so fast. And the meds not work. And yes I lowered my carbs.


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## Robin (Mar 9, 2021)

Has your GP considered Type 1? A lot of people, including doctors, think you can only develop this as a child, but in fact more adults are diagnosed with it than children. I would ask the question, ask for tests to confirm (gAD antibody and c-peptide are the names of the common ones) and if your GP looks blank, ask for a referral to a hospital consultant.
Oh, and welcome to the forum, and don’t apologise for the long post, it always helps if there’s a full story for us to go on.


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## grovesy (Mar 9, 2021)

A


Robin said:


> Has your GP considered Type 1? A lot of people, including doctors, think you can only develop this as a child, but in fact more adults are diagnosed with it than children. I would ask the question, ask for tests to confirm (gAD antibody and c-peptide are the names of the common ones) and if your GP looks blank, ask for a referral to a hospital consultant.
> Oh, and welcome to the forum, and don’t apologise for the long post, it always helps if there’s a full story for us to go on.


I was thinking this too, but you posted before I could.


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## Hellybell80 (Mar 9, 2021)

Thank you so much for a reply.
I mentioned  the GAD and c-peptide test, but the nurse said I have to be in hospital to do it. And the hospital consultant refuses in most cases.
All my life I've had experience with type 2. Mother grandad, 12 great uncles! Brother also. All had it. I've never seen it respond in this way over such a short time.


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## Inka (Mar 9, 2021)

I agree with @Robin that Type 1 needs ruling out. Contrary to popular belief (including some healthcare professionals) you can get Type 1 at any age and it’s just as common in adults as in children.

The fact you have family members with Type 2 doesn’t rule out the fact you could be Type 1.


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## Ljc (Mar 9, 2021)

I agree T1 needs ruling out.  

T2 ordinarily does not come on quickly. I know in the past you were dx as glucose intolerant, now called pre diabetes , but their is T1.5  LADA (latent auto immune diabetes in adults) it’s like a slow onset T1 , in the beginning it often responds to meds for T2 which can eventually stop working.  
Instead of speaking to your nurse about testing for T1 , have a chat with your dr .


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## Hellybell80 (Mar 9, 2021)

I haven't even seen a GP so far. My result came by text message and was told to contact a nurse. I've been dealing with her by phone. She's actually all right. Yesterday was the first time I actually had a face to face due to teaching me about injecting insulin. (It was a Different nurse) She took my weight, didn't want to see my logged blood sugars. Told her my average was 18. Gave me a booklet and that was that.


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## Inka (Mar 9, 2021)

They’re assuming you’re Type 2. Too many adult-onset Type 1s are misdiagnosed as Type 2. I’d be pushing for an explanation of why they’re assuming you’re Type 2.

While GP diabetes nurses might be lovely, I found mine lacking in knowledge compared to a proper DSN, particularly about Type 1.


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## Ljc (Mar 9, 2021)

The thing with Gp diabetes nurses is, most have only had a little more training in T2 diabetes, they are not the real experts, and to be honest an awful lot of GPs aren’t either .

Nor do we have all the answers either.  It’s just that sometimes we notice something that , how can I put it, that rings a few bells and mine is ringing with you. But I may well be wrong. 

Whatever type of diabetes we have, once we are on the right medication if needed and have the right info , diabetes is mostly managed by ourselves . With occasional health checks and reviews but we also need to have contact details for when we need help between theses times.


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## rebrascora (Mar 9, 2021)

Another vote here to push harder for Type 1 testing or a referral to a consultant/specialist clinic. 
Have they given you a means of testing for ketones? If not ask for this as you should be testing when your levels are consistently mid teens and above. Even if it is just Ketostix to test your urine. If you can't get them from the nurse, they can be bought over the counter at a pharmacy for about £5. If you start to have abdominal pain or respiratory problems or your breath starts to smell funny or you get significant ketone readings, get yourself to A&E pronto.


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## trophywench (Mar 9, 2021)

Sounds like Type 1 to me too.


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## everydayupsanddowns (Mar 12, 2021)

I think a cPeptide result would be very helpful - possibly even moreso than GAD antibodies (though both would be best of all).

Checks to confirm T1 in adults are shrouded in a cloud of slight uncertainty, so they aren’t routinely used. But weight loss, very high Bgs in the absence of carbs, and the complete ineffectiveness of meds that are supposed to get you to release more insulin are pretty solid indicators that your insulin production may be impaired in my (completely unqualified and un-medically-trained) opinion.

Hope you can get a referral to the hospital and get some definitive answers. If you are LADA or T1 you’ll be needing mealtime rapid insulin alongside the Lantus pretty sharpish I would think.


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## Hellybell80 (Mar 12, 2021)

I had a phone call yesterday again with the nurse. She has upped my lantus to 14 units. Which I have took this morning. It was really high yesterday. Well to me 27 is high. She said my sugar levels will get high untill they get the lantus right and I have to make small adjustments at a time. I've another call on Monday morning. She said I won't need insulin to adjust my mealtime sugars.. that the lantus on its own will fix it.
My fasting will not go below 13. 12 hours between eating. Even though my sugar levels came down to around 16 before bed. (I had 16g of carbs for my dinner) it was 14 when I woke up at 6am. I'm feeling so ill through the day where I'm feeling so bad. I'm struggling to do much while my sugars are so high through the day. 

Did mention the tests again she said it wasn't necessary. I can't get a GP appointment for 4 weeks.


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## Inka (Mar 12, 2021)

27 is very, very high! You’re quite right to be anxious about this. Lantus is a slow-acting background insulin which is made to keep your blood sugar down _in the absence of food! _It’s not made to deal with meals. Even if the nurse is right and you are Type 2, the Type 2s on insulin I know from my local surgery are on both slow and fast (meal-time) insulin or insulin that’s a mix of the two types.

I wouldn’t be happy with this personally. Could you ask to speak to the Practice Manager? Not to complain but to state your concerns and ask if you can speak to a GP sooner.


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## Ditto (Mar 12, 2021)

I'd go to A&E, I wouldn't put up with it, diabolical.


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## everydayupsanddowns (Mar 12, 2021)

Hellybell80 said:


> I had a phone call yesterday again with the nurse. She has upped my lantus to 14 units. Which I have took this morning. It was really high yesterday. Well to me 27 is high. She said my sugar levels will get high untill they get the lantus right and I have to make small adjustments at a time. I've another call on Monday morning. She said I won't need insulin to adjust my mealtime sugars.. that the lantus on its own will fix it.
> My fasting will not go below 13. 12 hours between eating. Even though my sugar levels came down to around 16 before bed. (I had 16g of carbs for my dinner) it was 14 when I woke up at 6am. I'm feeling so ill through the day where I'm feeling so bad. I'm struggling to do much while my sugars are so high through the day.
> 
> Did mention the tests again she said it wasn't necessary. I can't get a GP appointment for 4 weeks.



Your nurse is quire correct IF you are T2, and if your pancreas is still producing lots of insulin... but several things you have said seem to question that. I wonder why the Gliclazide was so ineffective, even at very high doses?

Perhaps would be wise to contact NHS111? Or visit A&E? You might also consider nipping to a chemist and getting some Ketone urine strips (£5 for a pot of 50) which will show if your body is producing ketones, which could be worrying if you are producing insufficient insulin.


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## Hellybell80 (Mar 12, 2021)

I was in A&E at the start. I was being quite sick with upper abdominal pain. Still am. They suspected gall bladder stones. As it was tied to eating. This was one day after testing my sugar levels and realising they were high, I was in.  They measured my sugars off of an IV as they tested for a few things. My levels was 19. I asked the Dr about it and he said that it wasn't high enough to treat at the hospital. And if the sugar levels bothered me to see my GP if I was that concerned about it.
My gall bladder scans came back normal. But tests did reveal I had issues as my white cell count wasn't normal. It suggested an issue with either pancreas or gall bladder. But no other investigation is needed. 

I do have keytone sticks only had low amounts a couple of times.


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## Deleted member 25429 (Mar 12, 2021)

Why do we have to fight to get the correct tests . Shouldn’t these be done as a routine to rule out type 1 when sugars are this high . Makes me so angry .


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## everydayupsanddowns (Mar 12, 2021)

Hellybell80 said:


> I was in A&E at the start. I was being quite sick with upper abdominal pain. Still am. They suspected gall bladder stones...
> 
> I do have keytone sticks only had low amounts a couple of times.



Glad you have been able to check for ketones, and that you are only seeing trace ketones - otherwise those abdominal pains might have been an indication of DKA, which can be very serious!


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## EllsBells (Mar 13, 2021)

When I spoke to my gp about controlling my diabetes without meds, he told me that if my levels got to 20 or above, to go straight to A&E. 27 is scary high. I hope you get sorted soon.


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## Hellybell80 (Mar 16, 2021)

Another phone call from the Dr today. 
I asked for a GAD and cpeptide test. But he told me he won't refer me for 3 months of trying to get get my blood sugars down. I have to be in hospital  for the tests.
The nurse has upped me to 18 units of lantus. I've actually had one morning of 12.8. Lowest its been. I had not eaten in 15 hrs. But the problem is as soon as I eat anything it just goes up by the time it starts to trend down im having another meal.

Does anyone just take lantus and be able to control sugar levels? 
How long did it take to get the right level?
My Dr just told me it could take 3 months to lower them.  To loose weight and my diabetes will disappear. 
  My carb intake was around 50gs a day. For the last few days. To be honest more because I'm not feeling too well to eat. Still sugars around 15-21 and fasting around 13-17.


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## Inka (Mar 16, 2021)

@Hellybell80 What you’re describing screams “I need a bolus (meal-time) insulin”. Whether you’re Type 1 or Type 2, your scenario screams the same.

I don’t know what to suggest other than asking for a fast/meal-time insulin else you’ll make a complaint. How could Lantus, a background/basal insulin, control your blood sugar when you eat? If it was at a high enough level to do that, it would probably be giving you hypos. Why can’t they prescribe a meal-time insulin too?

How overweight are you if you don’t mind me asking - ie what’s your BMI?


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## Hellybell80 (Mar 16, 2021)

Inka said:


> @Hellybell80 What you’re describing screams “I need a bolus (meal-time) insulin”. Whether you’re Type 1 or Type 2, your scenario screams the same.
> 
> I don’t know what to suggest other than asking for a fast/meal-time insulin else you’ll make a complaint. How could Lantus, a background/basal insulin, control your blood sugar when you eat? If it was at a high enough level to do that, it would probably be giving you hypos. Why can’t they prescribe a meal-time insulin too?
> 
> How overweight are you if you don’t mind me asking - ie what’s your BMI?


I'm 11.5 stone. And 5ft 3in So am a stone over weight. I should be below 10 or so.  So not massively overweight but maybe thats the reason.


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## Inka (Mar 16, 2021)

Hellybell80 said:


> I'm 11.5 stone. And 5ft 3in So am a stone over weight. I should be below 10 or so.  So not massively overweight but maybe thats the reason.



Ok, so just a little overweight - BMI of around 28. Losing weight might indeed help you but you shouldn’t have to put up with high sugars like this in the meantime. Did you tell the Dr how little you’re eating and how rough you feel?


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## Hellybell80 (Mar 16, 2021)

Lockdown weight 
Yea that was the reason for the call. He just said they won't do much apart from upping my lantus until I get blood tests redone in 3 months time.
 The weight is coming off on its own but ill give it a little shove anyway.


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## Ljc (Mar 16, 2021)

Hellybell80 said:


> I'm 11.5 stone. And 5ft 3in So am a stone over weight. I should be below 10 or so.  So not massively overweight but maybe thats the reason.


Being so slightly overweight is no reason to deny you the obvious treatment that you need and it’s obvious to you and us that just a background insulin is not enough, you  need a rapid insulin such as Novorapid for meals as well .

As you know many of us are concerned that you have been misdiagnosed as T2. That’s why you may be losing weight , it’s one of the typical signs of T1 . But even if it turns out you are T2 their is notheung wrong about being on a rapid insulin 

If you are not doing so already.
Keep a food diary with notes on carb content and pre and 2 hrs post meal BGs @nd present this to your nurse /Gp at regular intervals . 
If you should suddenly start to feel unwell, then get to hospital fast .

Phone our helpline 03451232399 to see what else they advise. 

In an earlier post you mentioned feeling too ill to eat, what symptoms are you having


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## grovesy (Mar 16, 2021)

Hellybell80 said:


> Lockdown weight
> Yea that was the reason for the call. He just said they won't do much apart from upping my lantus until I get blood tests redone in 3 months time.
> The weight is coming off on its own but ill give it a little shove anyway.


Even if you are Type 2 , which as @Ljc rightly says a number of us are doubting, losing weight does not necessarily make it go away for everyone.
Hope you manage to get sorted.


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## Inka (Mar 16, 2021)

Hellybell80 said:


> Lockdown weight
> Yea that was the reason for the call. He just said they won't do much apart from upping my lantus until I get blood tests redone in 3 months time.
> The weight is coming off on its own but ill give it a little shove anyway.



Do look at the treatment guidelines online. I’d be surprised if they say to just leave people on Lantus if it’s clearly not enough and your blood sugar is high. This is madness - and potentially damaging.


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## Inka (Mar 16, 2021)

These are the NICE guidelines:

https://www.nice.org.uk/guidance/ng28/chapter/Recommendations

1.6.32 onwards is about insulin.


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## Inka (Mar 16, 2021)

Note - those are the Type *2* guidelines just to show that you shouldn’t just be left with high sugars because you’re Type 2.


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## Hellybell80 (Mar 23, 2021)

Just want to say thank you for all the support you guys have given me. Much love to all. 
 Still not massively eating but keeping my carbs around 60g or below a day. My lantus was upped to 20 units. Has brought my average down to 14. Which is better. But won't drop below 10. Still rising to between 15 and 20 after meals.
My lantus has been upped to 24 units from today. But was told that if it didn't work by Thursday I'll need to go on a mixed insulin. That should help with my base levels and meals. Hopefully.


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## Inka (Mar 23, 2021)

@Hellybell80 Better but still not right. I hope you’re not feeling too rough. Yes, a mixed insulin should help but consider pushing for a separate meal time insulin in addition to the Lantus. Mixed insulin is very inflexible because it contains fixed proportions of each insulin, so if you want to reduce/increase one element you’re stuffed basically.

You’re eating very few carbs - which might be masking your problems. I’d still be pushing for the C Peptide and GAD tests, perhaps by showing how high my sugars went after a normal amount of carbs.


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## rebrascora (Mar 23, 2021)

It would have been more sensible to start you on mixed insulin in the first place if they weren't going to give you a quick acting insulin along with the Lantus. It really is ridiculous expecting Lantus to cope with the carbs from meals. 
I really feel like you are being short changed by your HCP but I hope the mixed insulin helps you to feel a bit better and I hope the increased Lantus doesn't cause you to hypo in the mean time. Please make sure to keep hypo treatments near to hand at all times and that includes by the bed, in the bathroom etc If you come tumbling down from those high levels it will feel very unpleasant indeed. Jelly babies work fine or orange juice or full sugar coke if you don't have glucose tablets. Please keep yourself safe and test regularly.


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## Hellybell80 (Mar 23, 2021)

Inka said:


> @Hellybell80 Better but still not right. I hope you’re not feeling too rough. Yes, a mixed insulin should help but consider pushing for a separate meal time insulin in addition to the Lantus. Mixed insulin is very inflexible because it contains fixed proportions of each insulin, so if you want to reduce/increase one element you’re stuffed basically.
> 
> You’re eating very few carbs - which might be masking your problems. I’d still be pushing for the C Peptide and GAD tests, perhaps by showing how high my sugars went after a normal amount of carbs.


I'm following a 1200 calorie diet of here. But obviously this isn't a long term thing. So I agree when I start to eat normal again (which isn't that bad food wise) my levels will go up. So all this adjustment now in insulin won't mean anything in the near future. Thinking  about it if the low carb amounts are masking my sugar levels then maybe the lantus isn't being as effective. Its basically having very little carbs in the first place. 
Whats a healthy amount of carbs?  
As for the inflexibility of the mixed I agree. But apparently I have to try it first before they will try something  else.


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## Hellybell80 (Mar 23, 2021)

rebrascora said:


> It would have been more sensible to start you on mixed insulin in the first place if they weren't going to give you a quick acting insulin along with the Lantus. It really is ridiculous expecting Lantus to cope with the carbs from meals.
> I really feel like you are being short changed by your HCP but I hope the mixed insulin helps you to feel a bit better and I hope the increased Lantus doesn't cause you to hypo in the mean time. Please make sure to keep hypo treatments near to hand at all times and that includes by the bed, in the bathroom etc If you come tumbling down from those high levels it will feel very unpleasant indeed. Jelly babies work fine or orange juice or full sugar coke if you don't have glucose tablets. Please keep yourself safe and test regularly.


I completely  agree with the insulin type i was given. I repeatedly said to the nurse how she expects it to control the peaks . I've been upped by 4 units every 4 days. It's still to drop below 10 on fasting. But yes I have jelly babies in my bedroom, coat pocket and kitchen.


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## Inka (Mar 23, 2021)

I can only say what I’d do @Hellybell80 I’d eat a reasonable amount of healthy carbs in order to show them what my blood sugar actually does eg I’d have, say, two Weetabix plus milk, a sandwich plus fruit, etc, and a normal tea with normal carb amounts eg meat, veg, potatoes, or pasta plus fruit for dessert or whatever. Maybe 150-200g carbs. I’d do one day of that because I’m presuming my levels would go very high. I’d also be putting my concerns in writing to them.

You’re being messed around, and they’re not using their brains. They’re doggedly following some schedule even though it appears not to be appropriate to you as an individual. High sugars cause damage. I know I sound forceful and I’m not really but I’ve had enough experience of cr*p treatment to show me that sometimes you have to push firmly.


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## Hellybell80 (Mar 26, 2021)

So the last couple of days I've had a bit more carbs. Still under 100g. But my sugar levels are just getting higher again staying around 17 from lunchtime and over 20 in the evening. 
Since my fasting sugars have not gone below 10. My nurse has now suggested I take nova rapid with my evening meals. Only 4 units to see if it makes a difference. But she's come to the conclusion that lantus on its own will not work. She kept mentioning type 1 on the call and I would need to control my sugars after meals. I think she was surprised that the lantus didn't control my levels enough. I think she just wants to see what or how it effects my evening sugars. I did say it rises with every meal but she just wants me to take it with either my lunch or dinner depending on what has more carbs. So for now its just the one shot of nova rapid and to continue with the 24units of lantus. 
See if I can get below 10.


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## rebrascora (Mar 26, 2021)

Pleased to hear you have NR even if you are just to use it for one meal at the moment. I would be inclined to use it at lunchtime I think. Purely because if the combination of that and the Lantus drops you low, it is better for it to happen in the afternoon/ evening than overnight. 
When do you take the Lantus? I am just thinking that the Lantus has been increased to perhaps a higher level than you actually need because it has been trying to cope with the glucose from meals too, so that if it suddenly gets some help from the NR (and you are eating quite low carb) you could drop quite fast.


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## Hellybell80 (Mar 26, 2021)

I take it in the morning. So I won't be asleep in general if I get a hypo. I seem to have a glucose dump between 3am and 6am. I used a libre for a bit to see the swings I was getting.


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## rebrascora (Mar 26, 2021)

Good to hear that. Some HCPs start people off taking Lantus at night which just seems dodgy to me when it has a known spike of activity between 5-8 hours post injection.


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## Inka (Mar 26, 2021)

Hellybell80 said:


> So the last couple of days I've had a bit more carbs. Still under 100g. But my sugar levels are just getting higher again staying around 17 from lunchtime and over 20 in the evening.
> Since my fasting sugars have not gone below 10. My nurse has now suggested I take nova rapid with my evening meals. Only 4 units to see if it makes a difference. But she's come to the conclusion that lantus on its own will not work. She kept mentioning type 1 on the call and I would need to control my sugars after meals. I think she was surprised that the lantus didn't control my levels enough. I think she just wants to see what or how it effects my evening sugars. I did say it rises with every meal but she just wants me to take it with either my lunch or dinner depending on what has more carbs. So for now its just the one shot of nova rapid and to continue with the 24units of lantus.
> See if I can get below 10.



Thank god she’s finally got Type 1 in her head! It must be so frustrating for you to be so high. I agree with @rebrascora It’s possible that with the addition of Novorapid - which was what you needed all along - your Lantus might be too high. Be aware of that and test lots.

Perhaps you’ll have more luck with pushing for the C Peptide and antibodies tests now your nurse is considering Type 1.

If you’re going high after every meal, there’s no sense in only having Novorapid before your evening meal. As also said, you could go low during the night. It seems a strange place to start it.


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## trophywench (Mar 26, 2021)

Well why don't you ring the nurse up and say to her, you know you kept mentioning Type 1?  Why don't you do the blood test for that then?  All it involves is extracting some blood out of your arm and sending it off to whatever path lab can do it - eg if you lived near Coventry that's UHCW at Walsgrave in Coventry - not sure whether they do those at Rugby or not.  Or were you near Exeter - Exeter Uni hospital definitely do - in fact for several years it was the only place that did them.  Yeah the tests themselves take time so you have to wait for the results, but as far as the GP is concerned it shouldn't be in the slightest bit complicated.


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## rebrascora (Mar 26, 2021)

I had to go to my main hospital to have my Type 1 tests done because they didn't have the facilities to keep the blood stored at the appropriate temp at my surgery or community hospital or in transit from there to the appropriate facility for testing so it may be a little more complex logistically than a normal HbA1c test. I think one of them needs to be frozen immediately and then sent off.


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## rebrascora (Mar 26, 2021)

It is of course also a lot more expensive than an HbA1c but that is no reason to deny you an accurate diagnosis and appropriate treatment.


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## Hellybell80 (Mar 26, 2021)

Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital  to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment. 
To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.


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## everydayupsanddowns (Mar 28, 2021)

Hellybell80 said:


> Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital  to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment.
> To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.



Glad you have access to NR now. Frustrated for you that they have set an arbitrary time period of 3 MONTHS before they will request a blood test to establish whether the treatment regimen they are suggesting is actually appropriate or not


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## Inka (Mar 28, 2021)

Hellybell80 said:


> Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital  to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment.
> To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.



In that case, ask why they can’t treat you as a Type 1 until blood tests prove otherwise. No reason why they can’t, is there?


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## Hellybell80 (Mar 28, 2021)

I think they are testing whether the nova rapid will make a difference. At 4 units it hasn't done much, but not going to lie I've had several naughty days on the food front. But unless its at each meal as needed its always going to go high. Unless I match my carbs to that 4 units. My sugars have been around 17-21 in the afternoon right up to me going to bed. By eating around 120g a day. I Will correct that today. 

 But I am a little confused. If I was type 2 would I need such an intensive regime of NR at each meal? I'm aware later on in type 2 insulin is needed. My family all ended up on insulin. Not as quick as me though. I know ppl think it may be type 1 but can this happen with type 2?
 I'm also aware that insulin needs to be adjusted by small amounts at the start so as to avoid hypos. But I am getting  a little frustrated I seem to obsessed with what I'm eating. I'm testing my blood sugars around 5-8 times a day. So I can keep good records of my sugar levels. 
 I take my lantus in the morning as when I started it it was towards mid day onwards I wanted my sugars to level. In the late afternoon I've actually had BS of 7.9 once.Didnt eat much crbs at lunch was before my evening meal. So obviously the lantus has kicked in. But as soon as I eat its high again. In fasting its never below 10. 

I'm sorry I'm just trying to get my head around things. As I can't get any definite answers from my health care providers. I know its only been a couple of months since being diagnosed but I don't seem to be getting anywhere and I'm fed up with feeling like cr#p for most of the day.


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## Inka (Mar 28, 2021)

@Hellybell80 Yes, Type 2s can use Lantus and Novorapid - that’s why your doctor waiting for 3 months to see if it works won’t give you a definite answer as to what type you are.

Your Lantus should control your blood sugar in the absence of food. Your Novorapid should deal with your meals. I can only say what I’d do, but I’d use the NR at every meal if needed. It would be daft not to IMO.


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## Inka (Mar 28, 2021)

120g carbs isn’t excessive. It counts as low carb.

The problem seems to be you’re not having enough/appropriate insulin.

*“I think they are testing whether the nova rapid will make a difference. At 4 units it hasn't done much, but not going to lie I've had several naughty days on the food front. But unless its at each meal as needed its always going to go high. Unless I match my carbs to that 4 units.”*

I’ve edited my post to respond to your above statement @Hellybell80 because I was thinking about it on our dog walk. Novorapid is a _short-acting insulin. _It works and then pretty much ‘goes away’. Having 4 units with your evening meal will only affect that meal. That’s the whole point of NR and other fast/short insulins. They have a number of names, and are usually called “fast” but their other names are “short” and “mealtime” and “bolus”. All describe their action - a short, fast action.

So your evening NR won’t deal with your breakfast or lunch, and the only matching you need to do is to match your evening carbs to the 4 units because that’s the only carbs the evening NR will be working on - or, far better, match your NR dose to your carbs ie have enough NR to deal with the carbs you’re about to eat.


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## Ljc (Mar 28, 2021)

I am glad that at last your nurse is starting to consider you may have T1 , bout time imo.

When it was believed I was T2 I was put on Insulatard, a long acting insulin then soon after Novorapid. So it isn’t unusual for T2s to be in MDI (multiple daily injections) , it’s more of a case of if you need it you need it, in whatever amounts you need. 

When we first go on insulin, though their is a formula they go by, they don’t really know how much we really need as it’s very individual, so they start us on a low dose and gradually build up.  Also it’s not good to lower our levels too quickly as it causes unpleasant symptoms and can affect our eyes.

I really don’t understand why they are not referring you to the specialists  .
If you have T1 as we suspect then you need the knowledgeable help of the real professionals a DSN 
I also don’t understand why you have been told to inject Novorapid for that one meal a day, as has already been said it sticks around for around 4ish hours , deals with your mealtime carbs then disappears . 

You are doing all you can to get the right help , I just wish those that should be looking after your health , start doing so properly soon.


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## Hellybell80 (May 18, 2021)

Afternoon all.
Just wanted to say thanks for all the support that you guys gave me in the beginning. 
 I'm now taking insulin (nova rapid) with meals. Around 10 units. I don't take it with breakfast as I don't really eat any carbs and my sugar levels are between 6-8 so alot better then before. I take about 44 units a day split between  my lantus and nova. And it's worked. Looking at the guidelines this is the amount needed for my weight?  
My nurse told me about a month ago to adjust it myself to the needs of what I'm eating. It seems to be working. I've got my hba1c this week so I'll see how that goes. It will probably be higher since my sugar levels were up to 30. Since my first one. 
I have to see how these results are before they refer me to the hospital. 

But a question I have... my insulin amounts I'm taking are what they would normally advise for type1 . I think.. I dont seem insulin resistant as I'm not taking excess amounts. 
 44 units seems to about right for my weight, so does this push more towards type 1 ? I know how ppl feel about me and think I'm more of a type 1 but I need more of an argument to push for more tests etc with my GP and nurse. 
Can you have an idea of which type by how much it takes to bring it under control? 
I've had no hypos which is a bonus so far. Lowest I've been is 5.


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## Inka (May 18, 2021)

I don’t think Type can definitely be determined by insulin usage @Hellybell80 You’ll find that Type 1s take varying amounts of insulin - yes, even Type 1s of similar weights. The weight formula thing just gives a rough starting point. You then need to find the amounts of insulins that work for *you* as an individual. Carb counting is crucial - that is, counting the carbs you’re about to eat and adjusting your Novorapid as appropriate.Do you know your meal time ratios? 

How long it takes to control it isn’t an indicator of Type either. The C Peptide and antibodies tests are far more useful.


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## Hellybell80 (May 18, 2021)

I take about 10 units of nova with my meals. Sometimes a little more if its higher carb. It seems to suit me so far. Around the 100 give or take carbs per meal.


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## Ljc (May 18, 2021)

Just to make life interesting , we all need different amounts of insulin. It literally depends on how insulin resistant we are .  Their are a few  folks with T1 who are on Metformin as well as insulin as their insulin resistance is high , Metformin  helps reduce this. 

It really is only the C-peptide  and antibody tests  that can determine 
Which type we really are . Many Gps and practice nurses unless they are really on the ball don’t know that T1 can occur at any age not just in childhood.


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## Hellybell80 (May 18, 2021)

Unfortunately  my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so.  I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.


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## rebrascora (May 18, 2021)

How about our ex Prime Minister Teresa May being diagnosed Type 1 in middle age.... if your Dr wants evidence that age is not relevant to diagnosis. 









						Theresa May is a British politician for the Conservative Party and the current UK Home Secretary. She was appointed in May 2010 when David Cameron became Prime Minister.
					

Name: Theresa Mary May Date of birth: October 1, 1956 Hometown: Eastbourne, Sussex Diabetes Type: Type 1 Theresa May is the Prime Minister of the United Kingdom, and the first world leader to have type 1 diabetes. Mrs May was appointed as Prime Minister on 13 July 2016. Two days previously, she...




					www.diabetes.co.uk


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## Bruce Stephens (May 18, 2021)

Hellybell80 said:


> Unfortunately  my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so.  I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.


NICE has recommendations on diagnosis and treatment of adult Type 1 diabetes. This is the diagnosis bit:






						Recommendations | Type 1 diabetes in adults: diagnosis and management  | Guidance | NICE
					






					www.nice.org.uk
				




Must admit I find it odd that someone nowadays would dismiss the possibility given that we've recently had a Prime Minister and currently have a Speaker both diagnosed as adults. (It's possible I watch too much political news coverage.)


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## Inka (May 18, 2021)

Hellybell80 said:


> I take about 10 units of nova with my meals. Sometimes a little more if its higher carb. It seems to suit me so far. Around the 100 give or take carbs per meal.



You have 100g carbs per meal for which you take 10 units of Novorapid? Did I understand that correctly? If so, your ratio is 1:10 ie 1 unit per 10g carbs. That, on the face of it, would be more like a Type 1 ratio, but there is a big overlap. Just to add more difficulty, some Type 1s can also have insulin resistance and some can have what’s referred to as ‘double diabetes’.


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## Hellybell80 (May 18, 2021)

Inka said:


> You have 100g carbs per meal for which you take 10 units of Novorapid? Did I understand that correctly? If so, your ratio is 1:10 ie 1 unit per 10g carbs. That, on the face of it, would be more like a Type 1 ratio, but there is a big overlap. Just to add more difficulty, some Type 1s can also have insulin resistance and some can have what’s referred to as ‘double diabetes’.


Yea give or take. Its working out to 1:10 ratio.


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## Deleted member 25429 (May 18, 2021)

When I was first diagnosed with type 1 I was advised to take 20 units of lantus , 8 of novarapid per meal based on my weight. I only use between 15 and 20 in total per day now . We are all so different


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## Inka (May 18, 2021)

Hellybell80 said:


> Unfortunately  my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so.  I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.



Oh, I so wish I could find the actual chart that shows age of diagnosis for Type 1! More adults than children are diagnosed with it and you can get it at any age. Point out ex-PM, Theresa May to him!


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## Inka (May 18, 2021)

Here’s one link anyway:

https://www.sciencedaily.com/releases/2017/11/171130214925.htm

.


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## Ljc (May 18, 2021)

In the not too distant past I am pretty sure I remember someone coming here for advise on T1 as they had just been diagnosed at 70+ years.
And quite a few T1s on here were 40 + yrs at dx


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## Deleted member 25429 (May 18, 2021)

I was 52 and came up against the same attitude got to be type 2 cos of age . I’d been in hospital with DKA . What’s the harm in doctors just doing the tests to be on the safe side??


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## Drummer (May 18, 2021)

All your symptoms and responses seem to be diametrically opposite to what I experienced.
There was a long slow deterioration as I struggled with a 'healthy' high carb diet to reduce cholesterol (It didn't).
Weight increased bit by bit month by month as I gritted my teeth until they broke and stuck to the diet (I was being interrogated every few months to ensure compliance).
When finally diagnosed I went low carb and blood glucose dropped from over 17 at a mid afternoon test to 8 in under a month. After that it went down again. I felt wobbly - I had loads of insulin sloshing around, I assume, so when it started to work, my levels went down like a hawk. 
I am a very ordinary type two, and low carb at 50 gm a day dropped me to under diabetic levels in 80 days - your lack of response even with medication really should have rung alarm bells with someone.
I do hope that you will be able to get the proper treatment and see normal blood glucose levels very soon.


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## everydayupsanddowns (May 21, 2021)

Hellybell80 said:


> Unfortunately  my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so.  I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.



Oh no! That’s terrible.

We have many, many members here who were diagnosed in later life - see:


			https://forum.diabetes.org.uk/boards/threads/type-1-year-of-diagnosis-age.93228/
		


I think the most popular(!) age for diagnosis is something like 10-15, but there is no upper age limit, and 50% of cases are diagnosed in adulthood.

I hope you can find a way to get the checks done, or a referral to a hospital clinic to get checked out. Getting a tick in the right ‘diabetes’ box can be so important to get access to the right technology, education courses, and treatment options.

Those aren’t things that your Dr should be denying you access to IMO.


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