[sedeinco]

I posted this thread which got very heated and is now closed.

http://www.diabetesforum.com/diabet...-dropping-5-within-hour-help-appreciated.html

I was basically told not to post back until I did know what worked for me. While some people here were downright passive aggressive, others were genuinely trying to help. I think I have part of the answer for me.

What I have resolved

I've worked out what to eat to keep my numbers in the "good" range, though it runs counter to a lot of the advice I've received, and I do not know it's effect long term.

I have found that if I severely limit but not eliminate carbs, I feel awful all day every day and feel like I need a nap around 2pm. By the end of the day I'm so exhausted I'm practically a zombie. I can only guess this is something akin to perpetual "Atkins Flu". I'm talking beyond the joke unliveable. Not working for me at all.

This last week I have been sleep deprived (early shift, worked part of the weekend with early start then too) and I have a cold. Despite this my readings - every single one - even the one time I had a slice of mud cake - have all been below 6.0 which is my target. Previously I was struggling to stay under 7.0. I have just cut over to different box of test strips, and the readings have stayed under 6, so I don't think it's bad strips (though I have yet to confirm with a second meter)

What I have changed is that I'm eating white rice (indian and thai microwave meals) in the morning. It started with what some might call a binge (I hate that term) or others might call eating off plan. Basically being up at 5am with no other prospect of food pushed me to use what I had even though I thought it was bad. I don't quite understand how this works for me. It seems to work best with rice, but I'm yet to experiment with other carbs. I know that breakfast cereals push me way up. It also seems to help if I eat something with a little bit of carb just before bed. I know about the dawn effect and Somogyi phenomenon. I doubt any of the doctors I see are enlightened enough to test me with a continuous monitor but I'll bring it up at my next visit. As I have a cold I'm putting that and my first HbA1c until I'm over it. I had a chest infection when first diagnosed with diabetes and I'd like a baseline while I"m well.

Things that don't seem to spike me at all - a couple of slices of the lowest carb Burgen bread, and rice. Things that do - white bread, other seed breads. Pizza takes me just above 7 two hours after but quickly falls back.

As I said right now I don't understand what's going on, I just know it keeps my numbers low. I hope this continues after the cold subsides. A week is long enough to see a trend but not long enough to declare I have a permanent solution. I also don't know what my current eating will do in terms of other blood test results (protein etc).

What I have not resolved
Still no idea what to do about the inaccuracy of the meters. I do not think this should be ignored, nor do I think the meters should never be used. I'm still testing at least twice daily. But I think the way most people use them by doctors (only use rough trend) and how I've been told to use them here (blood sugar 101) is neither very scientific and could lead to false conclusions.

I also have no idea what to do about the horrible bloating and gas. I had IBS (medical speak for can't find what's wrong with your gut!) long before being diagnosed with diabetes and I don't know how much of the extreme discomfort is that, how much is my huge intake of salad, and how much is the metaformin. It's very unpleasant to say the least.

I'm walking for excercise but still not doing any significant cardio...still have to work my way around long work hours, bad ankle, ear infections if I go to the pool.

Still I think I've made progress.

 

[optimist]

Hello!
I think we all are different and we all have to find our way to do thing, including living with diabetes.
I`m type 1, just in the end of the honeymoon I think.
I also has IBM, and my cholesterol was earlier too high. It`s now perfect.
I struggled a bit to find my way, but when I realized that I can choose if I want my body to use carbs or fat to energy, it all became very simple.
Now I eat 40-50 carbs each day and I don`t eat wheat since it always give me stomach trouble, I have a good life.
I eat fatty fish, oils, nuts and fat milk products so my body can use the fat as energy.
If I lower the carbs, I have to increase the fat otherwise I will feel fatigue and I will also get a headache and feel hungry all the time.
Same if I lower the fat, I have to increase my carbs (which leads to need for more insulin) if I don`t want to feel fatigue, hungry and nearly feeling sick.
Before I got the diabetes I could choose freely which source of energy I wanted to give my body, today I have found the balance me and my diabetes like.
When it`s about proteine, the body usses that for building muscles and replacing cells. I am not active because I have different illnesses which make it hard and painful to exercise, so I choose to eat 1 g proteine pr kg bodymass.
My son who is a long distance runner needs to eat 2,5 g proteine pr kg bodymass.
None of us are gaining musclemass or losing it, so I think for us this is the right amount.
But everyone has their own way. I have a friend who has had diabetes 1 for over 40 years. She thinks I`m crazy eating like I do. She eats high carbs, takes a lot of insuline, has ended up in several hospitals, had two heartattacks, really much trouble with her vision and painful feets.
I hope to avoid that, and thats my reason for living like I do.

 

[diabetes86]

This is going to drive you nuts then. What about your cars speedometer and odometer. Ive had several that where more than %20 off Yeat you drive to it. I take my meter and use it as truth and It works great. stop worrying about the meter and spend your energy on things you can control.

 

[Shalynne]

Glad you found something that's starting to work!

All I can do is continue to use my meter in the way that works for me ... and continue to search for new developments on the 'Net.

As for IBS (plus GERD), I used to blame my own woes on proteins and fat. The fact that my worst symptoms often came after eating plain crackers somehow escaped me ... likely because that's Not Supposed to Happen.

I used to live on Prilosec and Tums. Now, it's been months since I've taken any digestive meds, except for occasional probiotics. Turns out the chorizo was innocent. It was my system trying to deal with carb+protein+fat, all at the same time.

Like you, I find that rice doesn't cause digestive problems. It does spike me -- a lot -- but I can bolus for small amounts, on rare occasion. Potatoes and corn, same thing. But anything with wheat brings the Bad Old Days roaring back, with all the spiky/achy/moody trimmings.

Your IBS trigger(s) may be different. The only way I know how to figure it out is to eliminate suspect foods for a time, one at a time. That, or (my unintentional favorite) to stumble on the answer by accident.

Best of luck!

 

[naynay]

I am attempting to find what works and doesn't work for me. What I do know is that my system is very messed up and needs time to decide what it likes carb-wise. I have been religiously staying away from potatoes (all), white anything, pasta, rice, carrots, corn, and some other stuff. It is very difficult for me to stay away from the pasta as I am Italian, and well, I love pasta! I am finding alternatives to be satisfying (such as eggplant or spaghetti squash). As long as I can have my meatballs and homemade sauce, I don't really care what it is on! I am not eating high protein, but I am eating protein. I have had to give up some stuff that I was accustomed to eating all the time (such as peanut butter), but hope that some day I can have a little here and there without damaging my progress. And I do use my meter quite a bit everyday. I have to know what food is doing what to my bg's. Whether it is 20% +/- doesn't matter to me; I use it as gospel.

 

[sedeinco]

Appreciate the response. I'm type 2 and appreciate that type 1 is much harder to manage.

I do not know what eating some carbs like rice in the morning will do to me long term. I do not imagine that just because my numbers are good now that this will be sustainable since diabetes is progressive. I've heard type 2 has no honeymoon??? But I've heard a lot of contradictory things, and plenty that just don't work for me.

...and of course I spoke too soon. What I found this morning doing exactly the same thing - rice in the morning - was at the 2 hour mark I got readings of 7.9, 7.5, 7.7...but then 20 minutes later 6.0 and 5.8. So eating the rice is probably just spiking me for a shorter period of time. I think the only way to work this out would be a contant monitoring device. I don't know if I can get this easily at this stage of my diabetes.

For me I've found eating protein and fat does not give me an energy boost. Have tried nuts, ham, tuna, cheese, egg and others. I have to eat copious amounts to feel full (and then end up with an ill full feeling - queazy). Without some carbs I also feel like I'm twice my age - constant fatigue - unable to function - need naps in the middle of the day. Lots of hunger. And then there's the gas - it's like a mild-moderate IBS attack 24/7 but I don't know if it's diabetes, IBS or metaformin that's doing it.

I'm hungry all the time. Most days it takes a huge salad or a very large meal to make me feel full for more than half an hour. That isn't normal. If I bring it up with a doctor I'm usually told it has to be psychological. I do not believe it is - it doesn't vary with moods or stress, and I've been this way as long as I can remember. I believe something is very broken with my sense of hunger, but I don't know what. It's not just that I crave the wrong foods. It's rare that I feel satisfied let alone full.

There are odd days that I do feel full, but I don't see a pattern. Sometimes it I don't have to have eaten much but most of the time feeling full is the result of over-eating. Today I celebrated my 4th wedding anniversary and we went to an all you can eat buffet. I had a few bites of things I shouldn't - honey chicken, a couple of scollops, a couple of 4cm square dim sims - but tried to stick with salads and protein - praws, beef, ham, chicken...after 2 1/2 small-medium plates (20cm square plates) I am full to the point of discomfort and have been for about 3 hours now. My reading at the 2 hour mark was 6.3 - certainly above my target but not by much. That is a lower than typical reading for days when I've limited but not eliminated carbs (eg. had a couple of crackers all day).

Also tricks like drinking lots of water, while it does help keep the numbers under control (and I'll be doing more of that!), don't make me feel full. Lots of water just makes me feel ill and bloated yet somehow still hungry. And if I eat slowly I find I'm eating through the whole day. I doubt I'll ever have enough time to put down the knife and fork between bites.

Even if it were sustainable, is it better to sit at 6.8 all day long or spike to 7.9 for < 20 minutes and come back under 5.4? I don't honestly know. I wouldn't be surprised if there's differing opinion in the medical community too.

My diabetic educator said I should be eating carbs at every meal for instance. But when I try to eat wholemeal bread or oats it spikes me big time. She also belittled my smaller meals throughout the day referring to it as "3 meals with snacks". A lot of successful diabetics here swear by the low carb approach but would you swear by it if it meant constant "Atkins Flu" 24/7 for the rest of your life?

Clearly I shouldn't have written the first post of this new thread. I thought after a week I had a partial solution and obviously what I have is new questions.

Edit: I also did one really bad thing today. I skipped lunch. In fact I ate nothing between about 8am and 8pm. Long story involving unexpected family trip to the circus (actually 2 trips. I had to buy tickets in person in the morning).

 

[sedeinco]

naynay. Thanks for your response. I also love Italian food. Lasagne and Cannelonni were my favourites for special occassions.

Regarding the meters, I hope that a better technology comes along soon, and no I do not feel grateful that I don't have to rely on even less accurate pee stick tests. I work in IT and there is a saying "Garbage in, garbage out". Or to paraphrase bad data, bad decisions.

Some days I get an unexpected reading and repeat a few times only to see values fluctuate by 2 or 3 a few seconds apart. Other days I'll take 3 readings in a row that only differ by 0.1. I'm left wondering how much is inconsistency in my blood and how much is inconsistency in my meter. As a consequence I trust none of my readings. Even trends like my week long lower readings (ruined today) can be misleading. I've tried hypothesising various causes or combinations of causes for highs and lows - stress, lack of sleep, illness, particular foods, particular times of day. All seem to end up being completely violated/falsified to the point that I wonder if my "control" is anything but an illusion.

But I'll just shut up about the meters now. People here have gotten quite upset at me for bringing these things up as you can see on the other thread.

 

[Shalynne]

Like everything else (and doesn't that get old?), low-carb is different for everybody. Some here can get away with about 150 carbs a day. Others -- like me -- can't approach that level, even with insulin.

Similarly, while rice and fruits spike most of us, there are a few Forum members who eat both on a daily basis. They report good numbers, too. Sometimes, they question why we can't do the same. (My brilliant answer? 'Cause I can't!)

My pet hypothesis -- 'cause it seems researchers aren't looking into these differences very deeply, if at all -- is that a combination of genetics, overall condition, and childhood-to-early-adult eating habits determine, not only how many carbs one can tolerate, but which types of carby foods can be tolerated, or not.

Anyway ...

You should not be forced to settle for lifelong, 24-7 Atkins flu. While some say it lasts 3-4 days, my own bout lingered for about 10, and lifted gradually. If it lasts much longer, it may not be Atkins flu. Something else, like an oncoming illness, or (hope not!) an additional condition may be at play.

Also, most formal low-carb diets start with a period of fairly extreme low-carb. Atkins calls it "induction." For normal folk and most diets, I think it's about a 2- or 3-week period, during which the body adjusts to low-carb. Being abnormal, I'm not into this primarily for the weight loss, but I understand folks can pop in and out of induction and, basically, they get to restart on Square One if they decide to get back on the wagon. Don't know if diabetics are affected the same way. Might be worth considering, and perhaps wiser folks will join in.

Yes, it's frustrating how many factors, known and unknown, affect glucose control. I'll add temperature changes, pain and illness (including pre-symptomatic illness) to your list. Once again, everybody's triggers vary, and our own can change over time.

 

[sedeinco]

This is going to drive you nuts then. What about your cars speedometer and odometer. Ive had several that where more than %20 off Yeat you drive to it. I take my meter and use it as truth and It works great. stop worrying about the meter and spend your energy on things you can control.

Speedos are easy. They are usually consistently off by an amount or percentage or amount plus percentage. And unless you modify the car, they usually overstate your speed which so you won't get caught speeding (but people will get mad if you're doing 10 under the limit consistently and that is a risk too). In any case these days its very easy to work out by taking your car out on a drive on a flat highway with a GPS. I do this in the first couple of days anytime I buy a car. Where I live there are speed cameras scattered like sand grains. Drive an hour in any direction on major roads and you're bound to encounter 3 or 4 at least. So not knowing your speedo is out will probably mean you lose your license pretty quickly.

If the glucose meters were so easy to calibrate, I'd never have complained.

 

[Patdart]

I don't know if this will help, but I use the same meter all the time and just accept what it reads unless it goes really wild. It's my best friend these days. It's the best dietician these days and doesn't 'do me wrong'. My A1Cs come as no surprise.

 

[diabetes86]

Speedos are easy. They are usually consistently off by an amount or percentage or amount plus percentage. And unless you modify the car, they usually overstate your speed which so you won't get caught speeding (but people will get mad if you're doing 10 under the limit consistently and that is a risk too). In any case these days its very easy to work out by taking your car out on a drive on a flat highway with a GPS. I do this in the first couple of days anytime I buy a car. Where I live there are speed cameras scattered like sand grains. Drive an hour in any direction on major roads and you're bound to encounter 3 or 4 at least. So not knowing your speedo is out will probably mean you lose your license pretty quickly.

If the glucose meters were so easy to calibrate, I'd never have complained.

Your missing the point. just take the meter (BG and speed) at face value and move on with your life.

 

[optimist]

naynay. Thanks for your response. I also love Italian food. Lasagne and Cannelonni were my favourites for special occassions.

Regarding the meters, I hope that a better technology comes along soon, and no I do not feel grateful that I don't have to rely on even less accurate pee stick tests. I work in IT and there is a saying "Garbage in, garbage out". Or to paraphrase bad data, bad decisions.

Some days I get an unexpected reading and repeat a few times only to see values fluctuate by 2 or 3 a few seconds apart. Other days I'll take 3 readings in a row that only differ by 0.1. I'm left wondering how much is inconsistency in my blood and how much is inconsistency in my meter. As a consequence I trust none of my readings. Even trends like my week long lower readings (ruined today) can be misleading. I've tried hypothesising various causes or combinations of causes for highs and lows - stress, lack of sleep, illness, particular foods, particular times of day. All seem to end up being completely violated/falsified to the point that I wonder if my "control" is anything but an illusion.

But I'll just shut up about the meters now. People here have gotten quite upset at me for bringing these things up as you can see on the other thread.

When I got my diabetes last year, I tried really hard to do everything correct, but my readings were not logical at all.
I became frustrated and believed I did something wrong because as you says, my reading danced up and down without I had drunk or eaten anything at all.
For several months I wrote down everything; when and what I ate or drunk, how I was feeling (I have several others autoimmune diseases), when I went to the bathroom and I read my bloodsugar once an hour.
I learned a lot about my own body and how my bloodsugar react. For example I found that pain raises my BG, all kind of fysical activity lowes it dramatically, anxiety first raises it and then it falls like a rock minutes later, etc.
When I knew what to expext, it didn`t scare me anymore and I slowly started learning how to deal with it (I still makes lot of mistakes, I`m afraid).
Next step was to test how different food works for me. I really love food and to just eat salad and a few other thing is no options to me. I started out with few "safe" ingridients which I weighed and I read my blood many times for the next 12 hours. Then I tested what happened when I added another food (which I also weighed).
I t was a long testing, and I had always with me a book and a pen so I could write it down.
I didn`t stop eating carbo one day, I cut it down over weeks and I reduced my insuline during this time so my body could adjust.
I found that some food is totally wrong for me, some I can eat if I really, really want to, but then I must accept a peak even if I takes more insulin. What really pleased me since I`m really loving food is that many types of food can be in my diet if I just eat a little, tiny bit of it.
I`ve made plenty of mistakes in this process, and I guess I`m going to make many more, but that`s how it is.
By the way, I have two glucose meters, one which I always bring with me when I`m out, and one thats always ready to use at home.The Freestyle shows 5% less than the OneTouch. The one at the hospital is right between them. I doesn`t really care about the difference. If I`m hypo I don`t have to read it exactly, I really feel it. And when I have a high blood sugar, I can`t regulate my insulin so precise anyway, so the margin of error doesn`t effect me.

 

[naynay]

Sedeinco, no one person (diabetic that is) is the same. We all have our own uniqueness with our diabetes. I agree with Shalynne that some here can eat carbs and fruits on a daily basis, or more carbs per meal or day than others. I ate carbs at dinner tonight and ended up with an 85 before a 2 hour reading. I felt rather hypo at 85 because I've been high for so long my body took it as a low. I had to counter it with some dark chocolate (was all that was available at the time. I was out shopping). I don't like having to do that because it is counter productive to trying to attain good control, but I had to do what I had to do at that moment. Now what really surprised me was that I had a low after eating some carbs (honey wheat bread on half a sandwich and some asiago cheese croutons in soup). I've had meals where I'm eating less than 10g carb in the meal and end up with higher than expected numbers. Sometimes our bodies even deceive us, or go against us. Sometimes it is all just a guessing game. But with all that said all we have at this point is our meter to go by, so go by it we must. Your body obviously can still recoup from a spike quite quickly. There may come a time when it does not. Hopefully that will not happen for you, but it might. Without the meter to give you indication of wild fluctuations, or even more even keel, you would have no idea what your system of body was doing. I know it is very confusing and frustrating, but you have to just stick with it and find what works to keep your numbers even. I was shocked at the low I had after eating carbs. Perhaps because I did alot of walking today it did this, or perhaps it was just a good combination of food for my body. Whatever it was I am glad that my numbers were lower rather than the 300's I've had for the past year. And I think you are perhaps reading more into others who you feel have gotten upset about talk against meters. This forum has alot of really great people on it, and I have found them to be more caring and helpful than other forums I have visited. I'm sure nobody was upset; more or a debate than anything else. Many can also give useful information for you to ponder on. People here are very accepting of pros and cons. Stick around. I love to have indepth conversations and love to read others thoughts and ideas. It helps me understand this confusing thing called Diabetes.

 

[sedeinco]

I don't know if this will help, but I use the same meter all the time and just accept what it reads unless it goes really wild. It's my best friend these days. It's the best dietician these days and doesn't 'do me wrong'. My A1Cs come as no surprise.

Telling me what works for you is fantastic and I'll take and appreciate it as an attempt to help.

My doc didn't do A1C at diagnosis. I'm about to do my first one. I'm just waiting to get over this cold so I have a baseline of bloodwork that is me at my healthiest. I don't think my first one will tell me much other than how deep in the hole I am. I've simply had to try too many different things to attribute good or bad to any one attempt. If I can establish myself on something that works I hope to see my A1Cs improve over time as well (as I'm assuming they're not glowing). I'll also be waiting with baited breath to learn if I'm still spilling protein in my urine (I was just over the threshold indicating the start of a kidney issue last time).

I am quite concerned that there is some underlying condition or conditions causing the more unusual symptoms but haven't found anything too consistent. Pancreatic cancer would be my biggest fear. However with both parents type 2, and previous poor eating habits I think diabetes was going to happen for me and at worst I brought this on a decade or so early. Figures I've read are 75% chance if both parents are type 2 and it is rife on at least one side of my family. I also would like to know if I'm insulin resitant or not producing it - I know current practice is to treat the symptom of high blood sugar regardless but I honestly don't think both conditions are the same thing.

However to be blunt I've given up on finding a doctor that I can have an intelligent discussion with. They all just want to cycle you through their office as quickly as they can regardless of public bulk billed, public with gap or private system in Australia. If I say I'm hungry all the time they just want me to see a shrink. Not helpful. A couple have mentioned "Syndrome X" as a possibility but I've looked that up and it's not a diganosis they do anything with other than counselling to make good food choices and do excercise. It's a BS diganosis just like IBS which means "It ain't cancer but we don't know why your gut is in knots". I don't need a lifestyle coach to berate or push me, a priest confessor ("Forgive me father for I have eaten white bread"), or a pretend friend I can pay every couple of weeks to have a whinge to. I need a medical professional who'll actually take me seriously, talk to me like an intelligent adult, and actually look into what's going on.

 

[sedeinco]

Thanks Optimist.

This week I've had a cold, been sleep deprived and had plenty of stress. My readings are lower than before. For me it really appears to be food that makes the most difference though I have had a few unexplained highs. I THINK what's happening there is it's taking longer to digest/process the food sometimes (perhaps related to the IBS) but that's just a theory and I don't know what the trigger is yet.

I've been told to stick to 1 meter so the readings are comparable, but I did buy others to check it against. All my current meters are Accuchek. A Performa (got it free at diagnosis in exchange for a data dump one month later), a Performa Nano ($10 after rebate) and several Actives ($10 each). I bought the first Active while waiting for my free meter, then I bought more because $10 for the meter or $22.95 for the softclix lancet device alone.

I refuse to use the multiclix that comes with the Performa and Nano. It is way too complicated for what it should be. I've had a defective one where the needle would not retract unless rearmed (replaced for free) and it's WAY too easy to waste lancets by accidentally rotating or because the darn thing comes out.

 

[Shanny]

I also would like to know if I'm insulin resitant or not producing it - I know current practice is to treat the symptom of high blood sugar regardless but I honestly don't think both conditions are the same thing.

You're right, they aren't the same thing, and it's actually common knowledge. Current practice is to treat insulin deficiency with exogenous insulin, and to treat insulin resistance with metformin preferably, or other drugs like the sulfonylureas, as well as weight loss. Some patients are both insulin deficient and insulin resistant, whereupon they may use exogenous insulin and metformin both. Being both deficient and resistant is called double diabetes . . . we have a few on this very forum.

 

[sedeinco]

You're right, they aren't the same thing, and it's actually common knowledge. Current practice is to treat insulin deficiency with exogenous insulin, and to treat insulin resistance with metformin preferably, or other drugs like the sulfonylureas, as well as weight loss. Some patients are both insulin deficient and insulin resistant, whereupon they may use exogenous insulin and metformin both. Being both deficient and resistant is called double diabetes . . . we have a few on this very forum.

Are you talking about type 1 vs LADA/type 1.5/whatever it's called today vs type 2 (which I know about) or are you talking about different forms within type 2, in which case that's actually news to me? I have never had my insulin levels tested and my diganosing doctor seems to think it's unnecessary (though probably will let me have the test if pushed).

The diabetic educator I was sent to see simply said "It doesn't matter which. We treat both the same way. Change of diet and excercise and medication". Same diabetic educator that said to eat carbs at every meal (which does appear to be what I need to do after all) and dismissed my aim of 6 small meals I was having "3 meals with snacks". She was also the one that picked up that my multiclix was defective and had me call on the spot to have it replaced. A mix of good and awful advice. I haven't been back since.

 

[sedeinco]

naynay, thanks for your encouragement. Last time I was explicitly told to go away until I did work out what was working for me. Mostly because I was expressing frustration and angst at accepting things that did not add up or make sense.

Since this all started for me I've been told "I"m not a scientist" by a nurse and others have said if I keep trying to be scientific about it I'm just going to end up frustrated. Personally I believe that I need to work on a firm scientific/rational/logical basis if I hope to succeed.

Some people I've found get too wrapped up in what has worked for them and insist that you must do it or it must work for you if you want to manage the disease - for those people reporting that it doesn't work or doesn't make sense to me does indeed seem to upset them - that I find can be counter-productive.

I don't doubt there are some fantastic people here, nor do I want to judge others. I have no interest in aggrevating other people. Life's too short for playing high judge or immature trolling games - I am young but not THAT young. I would just like to find something that works for me.

 

[sedeinco]

Your missing the point. just take the meter (BG and speed) at face value and move on with your life.

Not missing the point at all. Just disagree with it strongly. Using readings at face value without at least checking unexpected readings isn't much better in my opinion than using a pair of dice and assigning that number to my blood sugar. Bad data = bad decision (unless you fluke it).

 

[Shanny]

Are you talking about type 1 vs LADA/type 1.5/whatever it's called today vs type 2 (which I know about) or are you talking about different forms within type 2, in which case that's actually news to me? I have never had my insulin levels tested and my diganosing doctor seems to think it's unnecessary (though probably will let me have the test if pushed).

No, I am not talking about any specific type of diabetes. I'll define it again and hopefully more clearly:

Being insulin deficient means you're not making enough insulin to cover your body's needs and you need to provide additional insulin by injection.

Being insulin resistant means you're making plenty of insulin, but it can't get into your cells where it's needed. In this case you use oral drugs which help the cells open up & accept the insulin that's available. This is where weight loss often helps too - it can reduce insulin resistance.

It's possible for both of these to be present in any type of diabetes. A type 1 or 1.5 patient who begins as insulin DEFICIENT may gain weight from drug side effects etc., and develop insulin resistance, thus requiring additional oral meds. A type 2 patient may burn out their beta cells using sulfonylurea drugs etc., and develop insulin deficiency, thus requiring injections.

Diabetes is not black & white; it isn't predictable. There will always be things you don't know and/or don't understand. But if you're open to learning new things, there's enough here to keep you busy for a lifetime.