Diabetics, please help!

[themarquis]

Okay, I am hoping anyone out there who is diabetic/pre-diabetic or is close to somebody who is can help me.

Very long story, but basically for about two years, I have been struggling with weight gain and some strange symptoms after meals, esp. high carb meals. (shakiness, anxiety, sweating). I have seen several doctors and have had a ton of tests. Everything seems to always come out borderline normal. Long story short, an endocrinologist diagnosed me with PCOS/Insulin resistance. But the dr. said I am not diabetic, and in fact I think she didn't even put me in the "pre-diabetic" category. My fasting blood sugar has consistently been in the normal range (though my fasting insulin is always on the high side).

I was put on a medication (Metformin) to help regulate my blood sugar. I took it for a couple of weeks and did okay, but was having trouble with persistent nausea. Spoke to my regular dr. and she mentioned I might be having slightly low blood sugar due to the medication that might make me feel weird b/c my body isn't used to it. So on a whim, I picked up a blood sugar monitor and decided to see how low I was.

Well ... surprise, surprise. I wasn't low -- I was HIGH! I've only been testing for two days, but it looks like I am at about 120 before meals, 160 after a light meal, and 225 after a big meal (!!!!) The 160 and 225 were obtained 1 hour post-meal and then I went down to about 140-155 at the 2 hour mark.

Looking up stuff, it looks like this is NOT normal ... in fact, it kind of looks like once you pass 200, you are officially in the diabetic range.

So ... what is going on? Any insights? Could I be diabetic and not know it and somehow it was missed after all those blood tests? How could my fasting insulin numbers be normal but after meals, I am shooting up into the 200s?

WTH?!

 

[Eeyores Butterfly]

You are pre-diabetic and your doctor is out of date.

Prediabetes is diagnosed as:

-Two or more fasting readings over 100

OR

-Two or more post prandial (2 hour post meal readings) over 140.

The threshold for diabetes is over 125 fasting and over 200 at any random stick. (Again, 2 separate readings)

Here's the kicker: the fasting readings are the last to rise. Recent research has shown that anything over 140 does damage, and spikes are actually more harmful than consistent high blood sugars (to an extent). Also, the feeling you are getting is what is known as a reactive low. Your blood sugar spikes before your pancreas can produce enough insulin or your body can respond, so your body overreacts and you end up with more insulin than you need. This causes you to go low.

I am "officially" a prediabetic because in the last lab test my two hour post prandial was 180. I consider myself diabetic though because I often have readings well over 200. But then, my body does weird things and I don't neatly fit into any category.

Request to have an Oral Glucose Tolerance Test done and request for sticks at 1 and 2 hours after consuming the beverage. This will help catch any abnormal spikes.

You need to watch your carb intake. Aim for no more than 45 per meal (and even that is too many. Stick closer to 15-30 grams). Avoid refined carbs. Be careful with fruit.

The best thing to do is test. Test your fasting readings to keep an eye on them. Test two hours after each meal. If you are over 140, you are consuming something you shouldn't be. We call this eating to the meter. Let your meter guide what is good for you because every body is different in how it reacts. For instance, some people can eat bananas with no problems, others it will send them skyrocketing.

I also highly recommend diabetes forums. That is what has been helping me to get things figured out. The address: www.diabetesforums.com/forum

 

[bumbershoot]

The first thing you should do is check with what your doctor was actually testing for. I assume the numbers you're mentioning are the ones NOT done by the doc, but what you're seeing while taking a drug for something your doctor says you don't even have (good gravy I don't understand why docs push that stuff so much without a proper diagnosis*).

I don't believe that that drug is benign, so if you're seeing numbers completely different from what your doc was seeing, I'd let the drug leave your system and then monitor more.

But start with finding out what the doc was actually testing; I must assume doc was checking blood sugar, and so you need to find out what they were seeing. Then go from there.


*actually I do. At his endocrinologist appt, hubby was reading a magazine about diabetes made for the *doctors*, and it talked about how metformin is prescribed, and even was MADE, because doctors don't believe their patients can change their diets...that prejudice explains the HUGELY surprised reaction the endo has had to hubby's amazing blood sugar changes without taking metformin after the first week of it being prescribed. they don't *believe* dietary changes can be made by patients, therefore they prescribe a drug, therefore patients don't feel the need to make changes, therefore the doctors don't see any changes...self-fulfilling prophecy! (I'm not saying that everyone can change their diet and see as amazing changes as hubby has seen, but they aren't even *trying* to get their patients to make changes, since they've got the drug right there)

 

[themarquis]

You are pre-diabetic and your doctor is out of date.

Here's the kicker: the fasting readings are the last to rise. Recent research has shown that anything over 140 does damage, and spikes are actually more harmful than consistent high blood sugars (to an extent). Also, the feeling you are getting is what is known as a reactive low. Your blood sugar spikes before your pancreas can produce enough insulin or your body can respond, so your body overreacts and you end up with more insulin than you need. This causes you to go low.

I am "officially" a prediabetic because in the last lab test my two hour post prandial was 180. I consider myself diabetic though because I often have readings well over 200. But then, my body does weird things and I don't neatly fit into any category.

Request to have an Oral Glucose Tolerance Test done and request for sticks at 1 and 2 hours after consuming the beverage. This will help catch any abnormal spikes.

You need to watch your carb intake. Aim for no more than 45 per meal (and even that is too many. Stick closer to 15-30 grams). Avoid refined carbs. Be careful with fruit.

The best thing to do is test. Test your fasting readings to keep an eye on them. Test two hours after each meal. If you are over 140, you are consuming something you shouldn't be. We call this eating to the meter. Let your meter guide what is good for you because every body is different in how it reacts. For instance, some people can eat bananas with no problems, others it will send them skyrocketing.

I also highly recommend diabetes forums. That is what has been helping me to get things figured out. The address: www.diabetesforums.com/forum

Thank you, EB! I was hoping you might respond to my thread, because I know you've recently been through a lot in getting a diagnosis.

I think what you said really clarified a lot of things for me, and after reading your response, I went and googled a bit and you are totally right and my doctor is WRONG!!! It seems that some people can have normal fasting blood sugar for a very long time, all while having massive swings in blood sugar during the day in response to food. From what I can see, it kind of doesn't matter if your fasting is OK, because any blood sugar elevation is bad and causes progression toward diabetes and organ damage ...

So ... it looks like I will be calling my endo and regular doctor on monday. I'm very curious to see what the endo says, because she really did think, esp. in light of my normal (ish) A1c that I was NOT having massive blood sugar swings. I wonder what she will have to say when I tell her I was at 225 She and I talked about a glucose tolerance test in the past but she said in light of my labs that I wouldn't need one -- now I know I will have to demand one.

This all kind of makes me furious because I've been telling various doctors for three years that I've been shaky after higher carb meals and nobody has thought that might be significant enough to do a darned thing about it

 

[Muushka]

At his endocrinologist appt, hubby was reading a magazine about diabetes made for the *doctors*, and it talked about how metformin is prescribed, and even was MADE, because doctors don't believe their patients can change their diets...that prejudice explains the HUGELY surprised reaction the endo has had to hubby's amazing blood sugar changes without taking metformin after the first week of it being prescribed. they don't *believe* dietary changes can be made by patients, therefore they prescribe a drug, therefore patients don't feel the need to make changes, therefore the doctors don't see any changes...self-fulfilling prophecy! (I'm not saying that everyone can change their diet and see as amazing changes as hubby has seen, but they aren't even *trying* to get their patients to make changes, since they've got the drug right there)

I agree with this statement 100%. Diabetes runs in my family. Parents, sisters, even my cat is diabetic! I am the youngest of the 3 sisters. The oldest was diagnosed as diabetic when she was in her early 40's. Her doc put her on drugs without even trying diet. She is now on insulin.

My next older sister was diagnosed when she was in her mid 40's. She (by choice) started on the drugs but eliminated them by dieting.

I was very close to the disease in 1998. I started watching my diet and I have yet to get the diagnosis (close, but not yet). I bought an el cheapo glucometer at Walmart (the strips are very inexpensive) and check my sugars periodically. I want to go as long as possible without that diagnosis.

 

[themarquis]

The first thing you should do is check with what your doctor was actually testing for. I assume the numbers you're mentioning are the ones NOT done by the doc, but what you're seeing while taking a drug for something your doctor says you don't even have (good gravy I don't understand why docs push that stuff so much without a proper diagnosis*).

I don't believe that that drug is benign, so if you're seeing numbers completely different from what your doc was seeing, I'd let the drug leave your system and then monitor more.

But start with finding out what the doc was actually testing; I must assume doc was checking blood sugar, and so you need to find out what they were seeing. Then go from there.

It is an interesting question that you bring up re: why the doctor wanted me to take Metformin. This med has been on the table for quite a while (my regular nurse practitioners have been discussing it with me for about a year) as a way of reducing my documented insulin resistance (although my fasting bs is fine, my fasting insulin has been consistently high, indicating that my body is releasing too much of it in order to try to maintain a semi-stable blood sugar).

I have resisted starting Met for a long while, and during that time I have made substantial dietary changes ... moderately low carb, high protein, tons of fruits and veggies, whole grains, etc. I have lost about 15 pounds overall and it seems to have triggered my body to have periods again (initially, I was having about 2 or 3 a year) and pushed me into a healthier state. BUT ... the test results are still not great re: fasting insulin. So that is really the main reason to start Met -- not as a substitute for dietary and lifestyle changes, but as an adjunct b/c the dietary isn't enough.

But ... now that I know that my blood sugar is spiking and fluctuating so much more than we thought (A1c was good at 5.7, but possibly indicates just that I am having highs and lows all day and they're averaging out at an okay level??) this seems to make the Met make MORE sense in that it will lower blood sugar.

That being said, I am off of it for now . I stopped taking it the day before yesterday in light of the tiredness and nausea and all that. And you are right -- I do want to see what my BS is doing OFF the Met. Though I think if anything it will now probably be higher (met wouldn't normally worsen blood sugar, as you imply it might -- rather the opposite).

Anyway, sorry -- rambly. I am obviously going to be seeing my drs soon, so we can reconsider the Met issue. I think you're totally right that diet/exercise is going to be really critical at this point. I want to be trackign blood sugar every day and figuring out how to get it down to a healthy range and maybe the mere fact that I can be tracking at home with a meter might make Met unnecessary because I'll have more control over stuff and won't just be flying blind all the time like before!

 

[DebIreland]

Have you had your thyroid checked? Some of your symptoms (weight gain, shaking, anxiety) could be attributed to a thyroid issue. I'm glad you've increased your protein intake cause those refined carbs are tough on the body. Good luck. I hope you get answers soon.

P.S. Do you, by any chance, suffer from migraine?

 

[themarquis]

Have you had your thyroid checked? Some of your symptoms (weight gain, shaking, anxiety) could be attributed to a thyroid issue. I'm glad you've increased your protein intake cause those refined carbs are tough on the body. Good luck. I hope you get answers soon.

P.S. Do you, by any chance, suffer from migraine?

Lol, yes, I've had every test under the sun. Several thyroid tests, metabolic panels, blood glucose/insulin, igh-1, cortisol (24 hour urine), blah blah.

There were some initial concerns about thyroid stuff, esp. since my mom has a thyroid disorder (not sure which one -- hashimotos?) but everything always looks okay with that.

I do have migraines. Usually right before my period each month. During the height of my symptoms and before I changed my diet and lost some weight, my migraines were a lot worse, I think because of the fluctuating hormone levels caused by irregular ovulation/PCOS.

Is there something else I should be thinking about with the migraines?

 

[Eeyores Butterfly]

Thank you, EB! I was hoping you might respond to my thread, because I know you've recently been through a lot in getting a diagnosis.

I think what you said really clarified a lot of things for me, and after reading your response, I went and googled a bit and you are totally right and my doctor is WRONG!!! It seems that some people can have normal fasting blood sugar for a very long time, all while having massive swings in blood sugar during the day in response to food. From what I can see, it kind of doesn't matter if your fasting is OK, because any blood sugar elevation is bad and causes progression toward diabetes and organ damage ...

So ... it looks like I will be calling my endo and regular doctor on monday. I'm very curious to see what the endo says, because she really did think, esp. in light of my normal (ish) A1c that I was NOT having massive blood sugar swings. I wonder what she will have to say when I tell her I was at 225 She and I talked about a glucose tolerance test in the past but she said in light of my labs that I wouldn't need one -- now I know I will have to demand one.

This all kind of makes me furious because I've been telling various doctors for three years that I've been shaky after higher carb meals and nobody has thought that might be significant enough to do a darned thing about it

Glad I could help.

As for Metformin, in studies of prediabetics, Metformin actually slowed or even prevented the progression to Type 2. It is one of the only drugs that does not cause lows and is the only drug approved to treat prediabetes. That being said, I have declined to go on it because I do not wish to add the side effects to my already significant GI issues.

Definitely see an endo. You want to be testing a minimum of four times a day (fasting and after each meal, some people do bedtime as well.) Make sure he gets you an appropriate script and be prepared to maybe have to fight your insurance company to get enough strips a month. Also ask for him to do a week trial of a Continuous Glucose Monitoring System (CGMS). You will log what you eat and the sensor will record your readings. It takes readings every minute and will show you exactly what your blood sugar is doing.

If you have not had a chance to check out diabetes forums, I highly recommend it. Without them I would only be testing my fastings and would therefore think I am doing fine and would be completely clueless. They gave me the tools I need to begin to get this under control.

 

[torinsmom]

I have a similar question, so I hope it is okay if I post here.

My fasting blood sugar was 98 in March, but two weeks ago, it was 125. My doctor said it was still fine, probably just an anomaly. I was not convinced and got cheap glucose meter. For 4 days straight it was 125-130 before eating or drinking anything. Then I was feeling weird one day about 2 hours after eating and it was 26, ate something and it went up to 57 after that. Knowing nothing about diabetes, I am not sure what to make of this. I went to the dr. because I have been feeling fatigued, foggy and anxious. She said vitamin D was low, to take a supplement.

So, do I need to go to an endocrinologist to get answers? There is Type 2 Diabetes on both sides of my family. I am on a low carb diet right now--will that help or not? TIA

Marsha

 

[themarquis]

I have a similar question, so I hope it is okay if I post here.

My fasting blood sugar was 98 in March, but two weeks ago, it was 125. My doctor said it was still fine, probably just an anomaly. I was not convinced and got cheap glucose meter. For 4 days straight it was 125-130 before eating or drinking anything. Then I was feeling weird one day about 2 hours after eating and it was 26, ate something and it went up to 57 after that. Knowing nothing about diabetes, I am not sure what to make of this. I went to the dr. because I have been feeling fatigued, foggy and anxious. She said vitamin D was low, to take a supplement.

So, do I need to go to an endocrinologist to get answers? There is Type 2 Diabetes on both sides of my family. I am on a low carb diet right now--will that help or not? TIA

Marsha

I don't know that much (obviously, since I started this thread by asking a bunch of questions ) but I do know that 26 is nowhere near normal!!! Even 57 is somewhat low, I think.

Did your doctor have an idea aobut why your blood sugar was 26 or did they just brush you off??

If I were you, I might buy another meter and test again to make sure there isn't something wrong with the meter. I'd also be switching doctors and going to an endo ASAP.

There is something that can happen called reactive hypoglycemia. Normally, a person's blood sugar gets higher after a meal. For some people it gets really high really fast and then your body is trying to compensate and so it dumps out a bunch of insulin to lower your blood sugar. Then ... oops ... it lowers it too far and your blood sugar is low. Sometimes this is connected to diabetes and sometimes not. You really need a better doctor, though, to help you figure out what's happening.

Best of luck!

 

[torinsmom]

I don't know; the fasting glucose level seemed to be in the same range every day. The time I got 26, I was feeling really weird, which is why I took it then. I am definitely going to get an appt. with an endocrinologist. Will my being on a low carb diet affect the results they get there or not?

Marsha

 

[pumba]

I too am A diabetic but not on meds trying so hard to maintain good bs readings with diet and exercise....
I think you should also get into a diabetic educator for assistance. I had 8 meetings with her alone and also with a large group of people in the same boat. I was not overweight either..as alot of diabetics are....not all are overweight...Insurance paid for all of these meetings which was great.
I test in the morning and write it down....I do not test after a meal but will test two hours after a meal if I am in doubt. I also test if I start to get the shakes or feel weird.
After a problem in Disney two years ago, I have started to wear a med id bracelet...Low sugar because I forgot to eat lunch and a snack and we were on our way to Epcot for supper.......
Always remember to eat breakfast and a snack later, lunch and a snack later, and dinner and a snack before bed......somehow that snack before bed stabilizes some peoples morning blood sugars.
Good luck and definitly talk to your doctors....

 

[shortbun]

My internist told me there is no such thing as 'borderline' or 'pre-diabetic' anymore. If you are in those old term ranges, you are a diabetic. Metformin is a great drug but should be prescribed in the extended release type instead of the original form. This helps with nausea and other intestinal problems caused by the original. Chances are if your doc is still using the old terms and old numbers they are still prescribing the old med. Ask for diabetes education - a four class series run by the ADA; they will give you the real scoop and can recommend doctors who know their stuff. I had to change docs because mine was using such ancient information and refused to change his opinion.

 

[themarquis]

I don't know; the fasting glucose level seemed to be in the same range every day. The time I got 26, I was feeling really weird, which is why I took it then. I am definitely going to get an appt. with an endocrinologist. Will my being on a low carb diet affect the results they get there or not?

Marsha

I'm reading more and more stuff about how fasting glucose might not "tell the whole story" for some folks. For me, it seems fasting is fine, but the second I eat anything and the whole rest of the day my sugar is sky-high. For you it seems that fasting is okay but meals are making you have lows (possibly precipitated by a high bs?).

In either case, if several times a day you and I are having these massive swings, it is bad for our bodies. Our bodies are trying to regulate and they are able to up to a point (i.e., they can handle fasting), but then sometimes bs gets shoved over the edge somehow and that self-regulation is breaking down.

I think from what I've seen, a normal person's glucose should stay somewhere between 80 - 120 pretty much all day long, with maybe brief blips after a high carb meal. But very quickly they return to their normal rate, say 90, and stay right around there much of the day.

Low carbing can cause low blood sugar, I think. Eating more carbs = higher blood sugar and vice versa. But yours was so low that it seems frankly abnormal. I just googled and I'm seeing that anything under 30 (and maybe under 40 actually) can lead to fainting or even a stroke!! So not good

 

[Muushka]

I have a similar question, so I hope it is okay if I post here.

My fasting blood sugar was 98 in March, but two weeks ago, it was 125. My doctor said it was still fine, probably just an anomaly. I was not convinced and got cheap glucose meter. For 4 days straight it was 125-130 before eating or drinking anything. Then I was feeling weird one day about 2 hours after eating and it was 26, ate something and it went up to 57 after that. Knowing nothing about diabetes, I am not sure what to make of this. I went to the dr. because I have been feeling fatigued, foggy and anxious. She said vitamin D was low, to take a supplement.

So, do I need to go to an endocrinologist to get answers? There is Type 2 Diabetes on both sides of my family. I am on a low carb diet right now--will that help or not? TIA

Marsha

A blood sugar of 26 is extremely low . In the lab, it was beyond panic value. If you got that result and were able to test it yourself, I would question the actual result. If you get a very unusual result, try to repeat it in case there is something wrong with the way it was tested. I would also compare your glucometer to someone else's (run the same blood on 2 different machines to compare results). And when you get it tested at the doc, try to run yours at the same time, just to check your instrument.

As a lab person, I know that what a machine says is not always accurate.

Your low carb diet will affect your sugars for your office visit. They will be better than if you were not on the diet.

 

[themarquis]

My internist told me there is no such thing as 'borderline' or 'pre-diabetic' anymore. If you are in those old term ranges, you are a diabetic. Metformin is a great drug but should be prescribed in the extended release type instead of the original form. This helps with nausea and other intestinal problems caused by the original. Chances are if your doc is still using the old terms and old numbers they are still prescribing the old med. Ask for diabetes education - a four class series run by the ADA; they will give you the real scoop and can recommend doctors who know their stuff. I had to change docs because mine was using such ancient information and refused to change his opinion.

The more I read, the more I'm starting to get concerned about this doctor. Weird because I've seen a number of different docs and got the "oh, you're just fat and neurotic but there's nothing wrong with you" response .

This doc is the most invested and (seemingly) knowledgeable and willing to get involved of all the folks I've seen. And she's young and seems more, um, updated on this stuff. Definitely updated with PCOS stuff, which is great.

But now I'm like ... WTH?? She even said I do'nt need a glucose tolerance test because all my other numbers are great. Hmm ...

Talked to my friend who is a nurse last night (just got her degree so knows a ton about recent changes in diabetes stuff) -- she said something interesting, which is that my doctors are looking at me and thinking that I'm too young and not fat enough to "really" be diabetic. I'm 33 and definitely fat ... lol ... but it seems like becoming diabetic when not grossly obese and/or over 50 or whatever is pretty unusal. So my doctors are just not seeing it when they look at me. Grrr....

 

[torinsmom]

A blood sugar of 26 is extremely low . In the lab, it was beyond panic value. If you got that result and were able to test it yourself, I would question the actual result. If you get a very unusual result, try to repeat it in case there is something wrong with the way it was tested. I would also compare your glucometer to someone else's (run the same blood on 2 different machines to compare results). And when you get it tested at the doc, try to run yours at the same time, just to check your instrument.

As a lab person, I know that what a machine says is not always accurate.

Your low carb diet will affect your sugars for your office visit. They will be better than if you were not on the diet.

So, maybe the 26 was a bad test? I know once I tested and it said HI, which from the book said over 600 and to test again. I did and got 78. So I know they can give wrong readings.

Anyway, I think I will go off the low carb when it is time for my visit, so they can get the true values. I have been trying to limit carbs, but maybe it is not the best time until I find out what is really going on.

Marsha

 

[pumba]

Remember when I said I was not overweight....I went to the diabetic clinic meetings and two of us were on the right weight and body mass index track....The other eight that were there were obese....
A diabetic can be from genetics also....My grandmother was a diabetic and my dad was too ..
The diabetic instructor that I went to also said.....that there is no borderline.....Either you are or you arent a diabetic..its like either you are pg or not pregnant.....If you are not quite the level of A1C's or fasting blood sugars then you are not a diabetic but take care of yourself at this stage so you WONT become a diabetic..
Hope you get this straightened out..you will feel better if you know what the heck is going on....

 

[PatsMom]

I have to agree with those who said to find a good certified diabetes educator if in fact you are diagnosed by a doctor as being diabetic. My educator, Judy, has been great and a wonderful resource in managing my disease.

My doctor followed the updated belief that there is no pre-diabetes or borderline - either you are or you aren't. The only long glucose tolerance test I've ever had was when I was pregnant. I will never do that test again! My gestational diabetes never went away. So I became a fairly young (31) type 2 diabetic. For a while I was able to manage with diet and exercise but time has taken its toll. I am now on insulin and Byetta in addition to metformin. The metformin used to give me some stomach issues but once I switched to the extended release form it got much better.

Given a choice between living with more gastro-intestinal issues or controlling my blood sugar, I'll go for controlling my blood sugar!

Good luck to you in reaching a diagnosis. And I hope you have a prescription drug plan that covers test strips. They are obscenely expensive. Even with a drug plan, they are expensive. I don't test four times a day - more like one or two usually. Or if I am feeling 'off'.