Log in
Diabetes Research & Wellness Foundation
4,439 members875 posts

Type2 Diabetes

I saw a consultant diabetes Doctor last Friday.

I wanted to try and identify the cause of my type2 diabetes. I was suprised to learn about the lack of tests available which can tell me. There's nothing that can show how healthy my insulin is. There's no tests that can identify Pancreas issues. I know my liver is working fine,so I can rule insulin resistance, so it must be either the medication I'm having to take or something else. All the consultant would say is, "just accept it".

So much for diabetes research. Very frustrating.

17 Replies
oldestnewest

What did you have for your A1c test?

Reply

My HBA1C reading as of the 15/10/18 was 48 and my EGFR was 62 (down from 73 15/05/18)

Reply

What do you think down your eGFR?

Reply

C. Peptide test will tell you

1 like
Reply

I don't think I've ever had one of these tests.

Reply

You would not normally be given a c-peptide test unless it was thought that you might be a late onset type 1 diabetic. It is often used to distinguish between type 1 and type 2 diabetes.

1 like
Reply

If you didn't have does not mean you should not now

Reply

Your liver tests being fine does not rule out insulin resistance.

1 like
Reply

Liver is fine thanks, got a new one 2016.

1 like
Reply

You misunderstand. You said that you could not have insulin resistance as your liver is fine. That is not true. I have had Type 2 diabetes for 20 years with insulin resistance but no liver problems.

Reply

Medics. should be doing simple blind trials, with groups eating less, more fat, meat, etc.. It’s not difficult.

1 like
Reply

There are two sets of investigations. They are:

1) To assess severity of diabetes and pancreas status.

Fbs

Fasting serum insulin assay from the same blood sample as fbs

And hba1c

2) To assess organ damage caused by Diabetes.

Lipid profile

Microalbumin in urine - fasting

Lft

S tsh assay

Sonoscan of abdomen for fatty liver and amount of fats around organs.

These are basic investigations at the first visit and ideally before starting medication treatment or any other modality of treatment.

2 likes
Reply

Richard64

I do understand your anxiety and reaction. As you may be aware, in majority of the cases T2D can be caused by one or more of the following :

1. Genetics

2. Loss of beta cells resulting in reduced production of insulin by pancreas

3.Insulin resistance. Enough insulin but not able to transport glucose from blood to the cells efficiently.

There are medical tests which can confirm all of the above. These tests are not done by NHS because they are not of much value as far as treatments are concerned. Whatever is the cause, they have to prescribe the same medicine. There is no cure for diabetes so far, treatment is to keep blood sugar in control.

For example, HOMA - IR can be estimated from the measurements of fasting insulin and fasting blood glucose. Fasting insulin alone can give indication of insulin resistance. In fact, these are very useful test results if some one wants to control blood sugar with diets and exercise.

You may discuss with your Doctor about fasting insulin test along with FBG, though I doubt very much if he will agree for the test. It is currently not in standard practice.

With HbA1c of 48, it should be easy to reverse your condition to non-diabetic number (HbA1C< 42) with dietary management alone. Consider following Low Carb High Fat (LCHF) diet and some physical activity.

Reply

Thank you so much for your detailed response.

I should have pointed out that I became diabetic 3-years ago at the ripe old age of 62. Up till that time, I've never had a problem with my sugars. My liver back then was in a very poor state and was beginning to fail, this is why I suspected it had become insulin resistant.

I had a liver transplant in 2016 and have gone on to complete two university courses on the Liver. This has given me a greater insight into understanding not only the workings of the liver, but that of sugar control as well. I became particularly fascinated of the workings of the CRTC2 (switch) gene. Sadly, in a post transplant patient the medications used to prevent rejection can alter the way hepatocytes handle sugars and drive overproduction and release of glucose into the blood. Also patients with diabetic risks before transplant are more likely to experience it after transplant. So, in my case it maybe due to the anti-rejection medication. This is also having an impact on my cholesterol, as I have never had a problem with this prior to transplant, and I'm not over weight. The other danger of the anti-rejection medication is possible kidney damage. The kidneys as you'll appreciate are also part of the bodies sugar control.

What I was trying to establish, was to try and understand the cause of my diabetes. I am now taking Metformin, Linagliptin and now on empagliflozin (Jardiance) all these medications are going to have an impact on the kidneys and liver. I'm of the opinion that throwing these medications at my diabetes is just an attempt to control the symptoms without knowing the cause. If in my case the cause is now due to anti-rejection medication. then I'll see if I can have the dosage cut down. If this is the case, then this may well solve my cholesterol issues and possibly prevent kidney damage.

I'm a great believer in understanding the cause before trying to treat just the symptom. I hope now you can understand my frustration a little better.

Best Wishes

Richard

2 likes
Reply

Hi Richard 64 - you have a very complicated medical background having had the liver transplant. All I can say is that I was diagnosed as type 2 diabetic in 1997 but had symptoms long before it was diagnosed. My Blood sugar using an ordinary meter

was about 20. I managed to keep it down for a number of years but then it was static at 9 which was still too high. It went up again. I was put on drugs but as the drugs did not work, the dose was raised, and I still had high blood sugar. What was I doing wrong? What could I do to stop going on insulin? I tried metformin but my doctor ignored me when I said I had side effects and prescribed it - after one tablet I had a bowels bleed and terrible pain in the side. I refused to go back for checks until I could help myself. This year I had a food intolerance test through a pharmacy chain Alphega

which was a smart test. After taking a small sample of blood, and feeding it into a smart meter, the blood tests came back with multi food intolerances including grains

rice barley, wheat, maize, rye, egg, and dairy. The test itself was about five minutes but the pharmacist was ace with an in depth history taken before the test.

Since removing all these grains and cereals and other food intolerances my blood sugar has gone down. I have lost two and half stone.

As I was eating too much cheese, before the test my cholesterol was too high. I also found out that some no added sugar drinks squashes, and tonics, are labelled as calorie free but can have sweeteners such as sucralose which can convert in the liver to glucose. I cut down my carbs by eating green vegetables, curly kale, spinach, and broccoli. I eat potato crisps, and eat oats in muesli with fruit - chopped apple - but I found the oats might make my weight static but lower both cholesterol and sugar. My sugar level is normal. The nurse was puzzled. How did I manage to get my blood sugars down by myself? Recommendations in the states, are that metformin does not suit everyone and they are stopping prescriptions. Hope you can test yourself with a glucose meter as it helps you keep on the straight and narrow. I had one given to me over twenty years ago so do not have to pay for testing strips and needles. Hope you are not asleep by now!

Reply

Eat less or lower carbs will help. If you are 20 odd stone your pancreas gets surrounded with tissue. T2 your pancreas can work 80% or 20 %. If you go for a walk every day will also help. Good luck.

Reply

I am a mere 11 stone my BMP is good. I go out every day and take the dog for a brief walk 4 times a day. My pancreas may well be damaged, but l told to just accept it. Which of course l won't.

1 like
Reply

You may also like...