New to the forum...and diabetes

[MMoran]

Hi everybody.

I was just diagnosed with diabetes in April of 2012. My doctor is leaning towards type 1, but doesn't seem to be sure. Right now I'm just trying to wrap my head around all the info I've been given, and I thought that this may be be a good place for some info & tips.

[Bountyman]

EDIT: Nevermind...just read your other posts.

[MMoran]

Thanks for the welcome!

To answer your questions:
1. I'm 37, normal weight, my bg at diagnosis was 437 and a1c was 13.9. I think they were leaning towards t2 because of my age, but t1 because of my numbers.

2. I went into see the doc because I lost about 20lbs in about 5 weeks, was thirsty constantly, going to the bathroom every half hour and vision was getting blurry. She immediately checked my sugar.

3. I'm on 1000mg metformin 2x/ day, 75 units Lantus and bedtime, and she added in 5 units humalog at meals last week. I've had islet cell ab (negative), c peptide (1.63 ng/ml), gad65 (<1) and insulin serum (<2 micro iu/ml).

4. I'm seeing a dietitian to try to improve my diet.

[Cormac_Doyle]

Hi MM

T1 vs T2 is not defined by taking insulin. There are a number of tests available to verify if you are T1 or T2

1. Is your body producing insulin? (a T1 cannot produce insulin at all; if the production capacity is slowly destroyed, rather than it occuring over a longer period of time, you may be referred to as T1.5)
- the "c-peptide" is part of the insulin produced by your body; it is not present in injected insulin; measuring your c-peptide levels when fasting, and during a glucose challenge will show if your body is producing insulin

2. Does your body show antibodies to the insulin or pancreatic cells? (most T1 and T1.5 individuals show an auto-immune response against either the insulin itself, or the pancreatic cells that produce the insulin)
- most common test here is the "GAD65", but there are others ...

If your c-peptides come back unmeasurably low when both fasting and under challenge, then you are T1 (continuously high levels even when fasting implies that you are T2 - your body is constantly creating insulin, but the insulin produced is not having an appropriate effect; often, high fasting c-peptide levels are coupled with a non-existant "phase 1 response"; so any carb snack or meal will spike you massively for several hours before your body slowly catches up ...)

If you have antibodies, this implies that without adequate support you will burn out whatever remaining capacity to produce insulin you may already have ...

The tests you list:
islet cell ab (negative) = a sample of your blood was put in contact with a collection of pancreatic islet cells. your blood did not trigger damage to the cells. (indirect measurement of antibody levels)
GAD65 <1 = low or unmeasurable levels of a specific antibody (direct measurement of antibody levels)
insulin serum (<2 micro-iu/ml) = this is about 10 times higher than a "normal" person

So - you are taking additional insulin to overcome some degree of insulin resistance; similarly, the metformin is to address insulin resistance. This puts you squarely as a T2.

Setting aside all concerns of T1 vs T2, diet is going to be the single most important aspect for your control. most dieticians need to be taken out and shot. they are incapable of telling you what you need to know, at least partially because their hands are tied by various regulatory bodies.

What you will be told is to focus on "healthy grains", "low fat", "no saturated fat", "limit red meat", "avoid eggs", "lots of fruit and veg", "no sugar"

That is all wrong.

the problem is not "sugar" - at least not dietary sugar. ALL carbohydrates get turned into sugar. Your body can no longer process that sugar. therefore you need to limit ALL forms of carbohydrate. Simple carbs (sugars) are a really bad idea, but things like bread (and other baked items), breakfast cereals, potatoes, pasta, rice, corn or potato snacks ... that all needs to be limited. Think of a serving of mashed potato or rice as JUST AS BAD as the same weight of skittles. Sure, you can have a small amount as a TREAT - but not a regular part of your diet!

Instead, lots of veggies; any meat you want; cheese; milk (FULL fat ... the low fat options have more sugar); yoghurt (see milk); eggs (at least one a DAY).

Be careful of fruit - it is naturally high in sugars.

Most of all - TEST.

What do we mean by that?

TEST your blood when you wake up
AND before you eat
AND 2 hours after you ate.

- This will show you whether you can eat that meal, or need to reconsider some of the choices ...

If you want to do extra testing ...

Test before you eat, and then every 30 minutes for 3 hours. (yes - that is 7 tests ... you do that when testing new foods, you do not have to do that every time).

Especially if you are injecting insulin, you must test both before you eat and 2 hours afterwards!!!

Why? Before you eat - tells you where you are. if you are between 4 mmol (72 mg) and 7 mmol (126 mg), you probably should not correct that level. Then ... calculate the amount of carbs in your meal, and use the insulin:carb ratio your cde/doctor gives you to work out the correct dose of insulin to cover the carbs. obviously, the more carbs, the more insulin. the goal is to take enough insulin so that your numbers do not raise by more than 2.5 mmol (45 mg) points, and then return to the fasting levels within 3 hours. If they don't you did not take enough insulin; if they drop dramatically lower ... you took too much!

[Gladtobehere]

Welcome to the forum.

Already been said by Cormac, but here's the Readers Digest version.

Carbohydrates (carbs), in your diet, are the key to how well you control your diabetes.

Learn all you can about carbohydrates AND the foods they are found in.

Try to limit or reduce the highly processed carbs. Things like sugar in coffee, juices and soft drinks, followed closely by many breads and packaged cereals.

To avoid the starvation sensation replace small reductions in carbs with small increases in protiens, fats and green vegetables. Nuts are a good way to snack.

Ahhh. But easier said than done. Good luck with the dietician.

[Cormac_Doyle]

hehe ... I write technical documents, not readers digest

Cormac

[Gladtobehere]

hehe ... I write technical documents, not readers digest

Cormac

I know what you mean. I used to work for ATI(PC graphics hardware) . The engineer said, after reading a help screen for his wonderful new feature, "I don't understand what this is saying........And I wrote it!". Tech Pubs had adjusted the techy geek speak. It gets even better after translation to an Asian language and back to English. Just chalk it up to occupational hazard.

[Bountyman]

It gets even better after translation to an Asian language and back to English.

I worked at a computer store as a tech for awhile. This was in the '90s when a lot of mom & pop stores built their own computers. I used to look forward to reading the installation instructions for new add-ons to the motherboards that were translated from Asian to English. I used to literally break out laughing at the syntax. Whenever I'd read one of those inserts I used to think that maybe George Lucas read one at one time and designed the way Yoda spoke after it.

"After instructions you read. In the PCI slot goes first this board you must put."

[TeddySue]

CORMAC_Doyle! WoW! Thank you so much for this well versed reply! It made so much sense. My ancestors are from Ireland and settled here in the U.S. in the 1800s around Highland County Ohio.
Good luck on your diabetes journey as I see you are very committed to the walk.
TS

[TeddySue]

To avoid the starvation sensation replace small reductions in carbs with small increases in protiens, fats and green vegetables. Nuts are a good way to snack.

The "starvation sensation" is one of the scariest experiences I've ever known. It's like being zapped with a cattle-prod for several minutes. I think it was important for me to experience the "starvation sensation" in order for me to take diabetes more seriously. Now, it is a 24/7 journey.

[TeddySue]

"After instructions you read. In the PCI slot goes first this board you must put."

I have 7 adopted children from Asia and traveled there several times. I had a good laugh reading the "instructions" you posted because this IS how they speak English. LOL! Thanks for the chuckle!
TS

[Moonpie]

welcome to the forums., & Cormac gave great advice.

[Gladtobehere]

I worked at a computer store as a tech for awhile. This was in the '90s when a lot of mom & pop stores built their own computers. I used to look forward to reading the installation instructions for new add-ons to the motherboards that were translated from Asian to English. I used to literally break out laughing at the syntax. Whenever I'd read one of those inserts I used to think that maybe George Lucas read one at one time and designed the way Yoda spoke after it.

"After instructions you read. In the PCI slot goes first this board you must put."

! Backwards talking is Yoda Me too, on reading the user manual for a chuckle.