In at the deep end

Following 6 months of unexplained (but not unwelcome!) weight loss, my family started becoming concerned that there was something wrong with my health. Losing weight usually requires some effort for me, such as sticking to a fairly strict low carb diet, but since November 2024, my weight had steadily ticked down at a rate of about 2 kg per month. Every time I hopped on the scales, the number was lower. I felt pretty well otherwise, so I wasn't worried, and was happy to lose the extra 12 kg that I didn't need.

My son, with his medical knowledge as an Emergency Medical Technician (EMT), was more concerned, however. He was aware that sustained, unplanned weight loss could be a sign of a serious health condition, such as cancer. He persisted in encouraging me to make an appointment with my GP.

I have a history of leaving health problems too long, such as the trip to ED in an ambulance for tachycardia caused by anaemia, so this time I listened to my son. Despite feeling ok, I was going to see the doctor before I became really unwell ... or so I thought!

I called my local health centre to make the appointment.  To my surprise,  I was able to get an appointment with my preferred GP in just a week's time. It had been a while since needing to see a doctor (pre-Covid) and I had heard many stories of long wait times and difficulties in seeing the doctor I wanted to see. During this week, I started to do a bit of research online, so I had a few more ideas to discuss with my doctor when I saw her. My son's main concern was the possibility of cancer, but with my family history of thyroid issues and Type 2 diabetes, I thought those to be more likely causes for the ongoing weight loss.  When I looked up the list of symptoms for both thyroid and diabetes, I was able to tick a few of the boxes, in addition to weight loss.

On Monday 19 May 2025 I visited my doctor to discuss my current symptoms and family history of medical conditions. She felt my thyroid and ordered a comprehensive list of blood tests, covering all the obvious possibilities. The blood samples were taken at around 9.00 am the following Thursday, and an appointment made for the next Monday to discuss the results.

Before returning to the doctor on Monday 26 May 2025, I was able to access some of my results through the 'Manage My Health' patient portal online. The most glaring result, by far, was the blood glucose level of 18.5 mmol/L, well outside the normal range. I generally start the day with just a cup of coffee with a splash of cream in it (a very low carb breakfast!) so this was pretty much a fasting blood glucose level, as I hadn't consumed food since the evening before. With this result, my top option of hyperthyroidism was replaced by my second consideration of Type 1 diabetes.

Then, with the benefit of hindsight, I started to think through the other changes that had been happening to me over the past six months that supported the T1D theory.

- The 'keto rash' in a crease on my abdomen (something I was familiar with from when I'd chosen to lose weight for surgery in 2019).

- Increased thirst in the evening after eating.

- Getting up in the night to pee when previously I'd wait till morning.

- Running out of energy earlier in the day, so needing to take it easier by the evening.

- Increased sugar cravings, eating more carbs and sweet foods when normally I'd happily avoid them.

- Finding it harder to read things.

Although my symptoms were mild, I was ticking many of the boxes.

When I saw my GP, I also found out that my HbA1c was 128 mmol/mol. That's right, 128! This came as a bit of a shock to someone who generally follows the Low Carb Healthy Fat (LCHF) way of eating. For comparison, the last time my HbA1c was tested about 5 years ago, it was 38 mmol/mol. While before it had been at a normal non-diabetic level, it was now heading off the charts at the high end, confirming that my body had been failing to control blood glucose levels for months.

So what did my doctor do? She went and found the never-used-before ketone meter and measured my ketones. Twice. The reading was up around 4 mmol/L. She also tested a urine sample for further confirmation before calling the specialist at Whanganui hospital to discuss my case. "Never a dull moment here in Taihape" was her comment. 

Following her call to the specialist doctor, I was instructed to head straight down to the Emergency Department (ED) at Whanganui Hospital so I could be treated for diabetic ketoacidosis (DKA). I called my husband and broke the bad news. He'd have to cancel playing bridge that evening and drive me to the hospital instead.

I arrived at the ED still feeling quite well, with none of the gastrointestinal symtoms of DKA, but obviously the numbers on the blood tests weren't looking too flash. After a couple of hours in the corridor,  I was given a bed in ED for the night so they could start giving me IV fluids and insulin to bring the ketones down.

Although I barely slept with all the bright lights and loud noises of an Emergency Department, I had a lovely nurse who came to check on me every hour throughout the night - a job better done in ED than in the ward. By morning, my ketone and blood glucose levels were looking much better, so off to the medical ward I went as a newly diagnosed insulin-dependent diabetic.