Question:I think it is important to give a little background before asking my question.
I am 6'1", 175 lbs, 41 years old.
A little over five years ago, I weighed 250 lbs. I had gotten there over several years of overeating and not excersizing enough. I had been there before and lost weight while in law school with simple diet and exercise. I was feeling no symptoms of Diabetes and the thought of it had never even crossed my mind. I decided to lose weight and went on a low carb, low cal diet. By a little more than two years ago, I was down to my target of below 200 lbs and started eating "normal" again.
I soon begain to notice that no matter how much I ate, I continued to lose weight. I began to experience excessive thirst and urination, leg cramps, etc. I did some research online and became aware that I might have diabetes. Having no insurance, I purchased a blood glucose monitor. My first test was that night and was 357. I did a fasting test the next morning and was 301. I immediately contacted a good friend of mine who is an Internist. He agreed with me that it sounded like I had type 2 diabetes. He instructed me on diet and exercise and told me to check my BS regularly, but I did not go in to get a formal diagnoses. I did a home A1C test that was 11.3.
I did much more research and learned how to eat low carb and began exercise. Within a couple of weeks, I was in pretty good control with fasting
normally under 100 and ppl rarely over 140. If I ever did cheat on my diet, I could semi fast for a couple of days and be right back down again.
I didn't worry too much about it after that and tested infrequently, staying on my diet and exercise. However, I began to notice that my BGs were steadily rising. I was consistently around 250 fasting. I decided to fast for a couple of days to get back down. When I hit 118, I ate a chicken breast and immediately spiked back up to over 250.
At this point, I decided to get serious again and went to see my Internist friend. He gave me a full physical and found no problems other than my BS, which was 275 at the time. He started me on metformin and I am up to 1000 mg X2 per day now. He ordered tests which just came back. The met has seemed to have no effect.
Test results:
Total cholesterol - 169
LDL - 104
HDL - 53
Triglycerides (fasting) - 79
BS - 271
A1C - 9.4
C-Peptide - 1.0
I have absolutely no history of diabetes that I am aware of on either side of my family.
I have been reading this forum and others and it appears to me that I fit the profile of some type of 1.5. Is this correct? Also, with the C-Peptide test results, I'm thinking I should start on insulin immediately so as to preserve what beta-cell function I have and to get my BS under control.
Am I missing something? Is there some other course of treatment I should try before insulin?
Thanks to everyone in advance for any help you can give me.
Answers:
my goodness! what a journey! also i think many here will be shocked that you have been ignoring the serious fact that you have high blood sugars.
as you are probably aware by now it can take a few years to see the complications in your eyes/kidneys etc. by that time the damage is already done.
you should remember that glucose acts like glass in your blood steam! so when your glucose levels are elevated the damage is already being done.
im sorry if this reply is coming on a bit strong but i cant tell you how important it is to get yourself on insulin and get those blood sugars down.
besides anything else i'll bet you are exhausted and probably cant perform in the bedroom department (thats enough to get most guys straight to the doctors for a prescription!)
you really do need proper medical attention! we can help you with the rest but you really do need the correct treatment as well.
(((HUGS)))
oh and welcome to our nutty band!
Answers:
just for the record (i nearly forgot!) going onto insulin therapy really isnt so bad. i couldnt believe how much energy i had within just a few days of starting it!!!!
Answers:
Thank you Shabby! Just for the record, its not that I have really been ignoring it as much as not knowing what to do. As I said, I don't have insurance. I was hoping to stay under control long enough to get insurance before diagnosis, but it hasn't happened. I've made the decision that my health is more important than money, so I'm going to do whatever it takes to get under control and to heck with insurance!
Thanks again for your post!
Answers:
Steve,
You should assume you have
, because people with Type 2 typically will get down to normal blood sugars with low carb and metformin.
If money is a problem, you can use R insulin as your fast acting insulin and NPH as your basal insulin. They are available at Wal-mart for about $22 a vial and if you are insulin sensitive, which you probably are, a vial will last you at least a month, maybe several.
Get yourself a copy of the book
Dr. Bernstein's Diabetes solution. Most libraries carry it. He teaches you how to dose the insulin. You'll need a prescription for the needles but the R insulins are, weirdly enough nonprescription.
Don't delay, though. Your blood sugars are far too high and there is some evidence that injecting insulin can shut down the autoimmune attack and prevent further beta cell destruction.
Also, I know another lady with
who is doing extremely well with R. I think it might be the ideal insulin for early
especially if you are eating low carb. I used it very happily for years until I developed antibodies to it.
Answers:
Hi Steve.
Many of us who were older than 20 upon diagnosis (and especially older than 30) were assumed by the medicos to be type 2 when we were 1.5,
,
, (whichever) and had high blood sugars longer than needful because they tried the metformin first. But as Sharon said, one feels SOOO much better once beginning insulin and stabilizing things.
I have not read completely through the Bernstein book recommended above, but do know he has lots of advice if you want to go really low in carb consumption (like under 35 grams/day). A book I'd recommend is
Using Insulin by John Walsh. Maybe Bernstein goes more into the dosing for the NPH and regular insulin regimin versus the Lantus/Levimir plus quicker acting regimin, but I like the way Walsh explains things. Since my insurance covers the insulin with only a small copay I've never compared prices.
Anyway, if its not apparent, I agree with what the others said - get your doc to really look at your test results, etc. and prescribe you with insulin.
Best wishes.
June
Answers:
I really liked June's way of phrasing this:
If you aren't OBVIOUSLY a
, and you aren't conclusively and OBVIOUSLY a
, your case bears more looking into. There's a whole lot of difference of opinion here, including (I think until recently) even among ENDOs whether there even WAS such a thing.)
Here in DD land, we have a group which we label T 1.5, which means pretty much everyone not a
or a
, until proven otherwise, except for gestational diabetes. There always is at least one exception. Seems pretty sound to me.
T 1.5 seems to include
(Latent Autoimmune Diabetes of Adults) sometimes called late onset
, or slow onset mature autoimmune, or probably other names not repeatable in polite company, which seems for most of to eventually progress, although sometimes quite slowly, to complete and obvious
; AND
(Maturity Onset Diabetes of Youth) for which there is a LOT of argument about who and what is and isn't, but which is a different critter, altogether.
One (but only one) of the problems here is that in "early days" it's pretty hard to tell the difference, without genetic testing for which many insurance companies will not pay. When I was
'd and even when the issue came up, I remember being told it wouldn't make much difference. That would have been about three years after
, when, although "following the program, doing everything right" I had to start insulin. Classic T2s (which I was first
'd) don't generally have to do that.
's do.
Even after 7 years (I was
'd in late 2001) it isn't 100 percent obvious where I fall, although with each passing day of what appears to be a "honeymoon" I am more and more inclined to include me with the Modys.
You need to get your BS and your HBA1C under control pronto. IF the metformin isn't doing the trick, it might be time to try insulin. The fact that you were losing weight before diagnosis seems to point in the
/eventual
direction, in which case all the pills in the world won't do the trick for long.
Answers:
Thanks to everyone. I'm making an appointment with my doc for next week and tell him I want to go on insulin. If he won't help, I'll find someone who will or do it myself. I do have Bernstein's book and used it to teach me how to eat when I thought I was a type 2. I'll read the insulin dosing chapters now. I'll also check out Walsh's book.
It's great to have a place to go to get advice from people who have been there / done that.
Thanks again,
Steve
Answers:
Steve,
Bernstein most definitely teaches you how to dose with the cheaper insulins and he prefers them.
Many people don't realize--including doctors--that the older R insulins are as effective as the analogs for blood sugar control, and R is identical, molecularly, to what your body produces, which is NOT true of analogs. So it may be safer.
R is much less likely to cause hypos, because of the slower speed and if you keep it in the fridge it can last a couple months per vial if you use small doses.
But the analog companies have marketed their insulins so heavily to doctors that many have been told that R is "old fashioned" and given the impression it is inferior, which it isn't.
Answers:
Update
Answers:
Well, I had an interesting night last night. I was out of town at a convention and my wife and I went out to eat. After supper, as usual, I felt horrible and was extremely irritable. 2 hours after the meal, I had spiked to 405. I had been telling my wife that I was going to go see my doctor next week to get on insulin, but when I was so irritable and mean, she decided enough is enough! She called my doctor (again he is a good friend) and told him what was going on. He immediately told her to find a Walgreens and called in a prescription for Lantus and syringes.
I took 8 units last night at around 9:30. I tested all night and won't give the details, but I will say that I just tested before lunch and was at 193. This is the first time I have been below 200 in weeks. I am also negative for ketones for the first time in weeks. I can't even begin to explain how much better I feel already. I actually have some energy!
Again, I want to thank everyone for the help. I'm sure I'll have more questions as I try to figure all this out. I'm going to explore the R insulins for the future.
Steve
Diabetes With People