lab results back from endo

[didi1]

Hi everyone from a newbie here. I got my results from a second ogtt test to confirm diagnosis. My results were 82 fasting, 166 at one hour and 142 at 2 hours. The endo said I am between abnormal and normal or How did he say "have not crossed the bridge onto the other side but did from the normal side" ????
My Ac1 is 5.3 but that was rom last month from GP but did not get one today because the ogtt is a best indicator for the disease. I do Bernstein's low carbing, exercise, lost 22 pounds as of May to date, and currently on no medications. He thinks I'm doing excellent at whatever I'm doing and to keep it up. However, I did notice that the 1 1/2 hour of reading 0f 142 was the same as the 2 hour reading of 142 too. Is this because of lack of insulin or insulin resistance? Should he have prescribed medication to improve this? My 1st ogtt did show a c-pepetide 2hour reading of 12.1 but none was performed today. I should have asked but was freaked out mostly. Can anyone shed some light on how I should respond to this. Am I officially pre-diabetic or what?
Thanks for listening:confused:

[xMenace]

Whatever you are, you're a hellava lot better than me:eek: The 142 isn't bad and any A1C under 6 is awesome. I think if the fastings hold, they'll do nothing. I think only time will tell.

[BrendaK]

In order to be diagnosed w/diabetes in a OGTT, the 2 hour number is over 200. Prediabetes is between 140-199 at the 2 hour mark. You're BARELY over the prediabetes mark. I think you're doing great.

[didi1]

thanks for the encouragement. I hope this will not be so hard to keep in control as long as I keep on trying. The nurse practioner was in the room before the endo got there and did not say anything positive about the future. I did ask if there will be further deterioation even with strict diet, exercise, etc and her reply was it is a progressive disease and eventually will be on insulin about 9-10 years from now (no matter what, just a matter of time) I thought that was very disheartning to hear since keeping it in control is a hard Job in itself. Well, I am very glad to be able to see Dr. Bernstien's teleconference tommorrow. Hope you all will view it too. Thanks again.

[grace girl]

I did ask if there will be further deterioation even with strict diet, exercise, etc and her reply was it is a progressive disease and eventually will be on insulin about 9-10 years from now (no matter what, just a matter of time)

If I had a dollar for every ignorant medical professional I'd be a rich woman. I've seen people get a hold on pre-diabetes and never even need meds, let alone insulin. And I've seen people on insulin get their act together and get off of all insulin and meds and be totally diet controled.
Fear not. Keep doing it right, and ignore all of the negative garbage they seem to want to feed us by the spoonful. If you start expecting to be on insulin within 10 years no matter what, guess what you're going to get???


Sounds to me like you're doing great, keep it up!

[didi1]

Thanks for the words of encouragement. I do appreciate it after all the negative words from the practioner's mouth. Take care too

[Dan Gato]

Didi,

That nurse isn't right, there have been people that have been on medications for over 20 years, before starting insuline.
But also there have been some people on denial & that don't take care of their condition, those people get complications early on.

Get a glucose meter & test several times a day, BG's over 140 cause damage to the nerves.

To stay within the normal BG's you may need supplements, meds, or a good diet & exercise.

See you,

[HelenM]

The figures for the various diagnoses, diabetes, impaired glucose tolerance and impaired fasting glucose are in the latest WHO recommendations. Theres a lot of discussion about the usefulness of the various figures.
'http://www.idf.org/webdata/docs/WHO_IDF_definition_diagnosis_of_diabetes.pdf

They don't like the use of the term pre-diabetes for various reasons including because it doesn't inevitably lead to diabetes :
The Group recommends using the term Intermediate Hyperglycaemia to describe glycaemic levels between ‘normal’ glucose tolerance and diabetes.Use of ‘pre-diabetes’ is discouraged to avoid any stigma associated with the word diabetes and the fact that many people do not progress to
diabetes as the term implies. In addition this focus on diabetes may divert attention from the important and significantly increased cardiovascular risk.
I'm not sure I like the mention of stigma :(

[Ronin]

Hi Dora!

Take a deep breath and relax. The first thing you need to understand is that our status of "Pre-Diabetic" is a very new diagnosis. When you read through the medical literature the intended purpose is literally to scare the **** out of us before we "cross-the-line." The fact is that nobody really knows the mechanism that causes a "normal" person to become a Type-2. It could be lack of exercise and poor diet, it could be genetics, perhaps a combination of both -- we just don't know.

That being said, the reality is that living a life that has a more sensible diet with fewer concentrated sugars and more physical exercise is a good thing in and of it self. If it makes you feel better, gives you more energy, and all those side benefits, keep doing it.

I got the same five-to-ten-years-from-now warning. I'm not letting that bother me. I do regular daily monitoring of my BG levels (I still cannot find a solid 1:1 relationship between what I eat and following BG levels and I've been searching for over two years!). I found a good home test HbA1c kit that I calibated with a lab test and I do this once a month as the actual average is skewed to the last four to six week period within the 90 day average. Like it was said in this forum -- anything under a 6.0 is excellent.

Take the diagnosis for what it is -- a warning that you may have been on the path and by chaging the way you live you may avoid Type-2 onset or delay it to the point where it just doesn't matter (hey, if I become Type-2 at 90 I don't think I'll care.)

[didi1]

Hi Ronin!
Thanks for all the information. I have been doing quite a bit of research on my own too but it sure does not coerlate with what is said at doctor's office. (Meaning low carb Bernstein's way). I do still have questions as to why don't these doctors "tailor" treatment as an individual as Dr. Bernstein. It makes a lot of sense, but yet, it is considered "not traditional" and not recommended. I do have questions about why there is fluctuations in BG levels if one does follow the "WOE." However, the reasons can be limitless and one does need to ask and research what is happening to our own bodies. I do question about c-peptide levels and what does that mean to your own body ( Metabolic syn, ins res., no insulin or severe ins resistance) etc.. Maybe in a sense of collaborative methods we (or I ) can try to make sense of what is really happening and try to not offend a doctor by asking questions and being aware or informed about it. Any suggestions will help here. By the ways, been having some lower back pain ,minor, but it has me not exercising as I am used too. 1 week and already I see a difference. About 5 -10 mg at every meal. It is dishEARTNING! Thanks for listening

[didi1]

sorry for the typos. OOps. A little late for me and goodnight.

[Larry H.]

In my book, Dr. Bernstein is a bit radical.. Granted he has kept his problem at bay, but he is a type I from what I recall.

I was suggested to be type II about 9 months ago tipping the fasting test just over and just under the limit. I too did some research, joined this group and was adamant that I didn't want medications, I take enough already with no insurance.. If you do the research you will see that people that use diet and exercise to bring down their levels do two thirds better at keeping side effects away.. So unless you absolutely need it, your diet and exercise is the way to go. I think its partly due to what so many of us see, those that take med's often then eat anything and wonder why they still get long term problems.

I guess there is some truth in the slowly advancing disease senerio, but I am doing all I can to keep it at bay. Well maybe I could eat no low sugar items, but I feel if I am getting my overall improvements and staying within suggested levels then my system is able to handle the carbs it is getting.. Actually I read a report that mentioned that when caught really early, the cells in the body that are rejecting the sugar, or whatever they do, sometimes begin to act more normally when the sugar load is reduced.. My system appears to be handleing similar levels that would have come in higher, now coming in lower. I don't know if thats a result of that theroy or not? All we can do is do the best we can and not give in to thinking we are cured, but maintaining our situation though careful work.

[Ronin]

Hi Dora, et al.,

Since we have started to discuss books, allow me to reccomend one that calmed me down: Know Your Numbers, Outlive Your Diabetes by Richard Jackson, MD and Amy Tenderlich (The Marlowe Diabetes Laboratory).

Dr. Jackson is an advocate of what is being called "The Metabolic Disorder" and focuses on more than just BG levels as a diagnostic tool. Reccomended numbers to track are : HbA1c, Blood Pressure, LDL & HDL Cholesterol, Triglycerides, Microalbumin and the results of an annual eye exam. By his calculus, I'm in the low/no danger zone.

The problem that we Pre-Diabetics have is that everyone focuses on the "D-Word" and never hears the "Pre" that comes before it. Therefore we are assumed to be diabetic when the jury is still out.

I had a consult with a physician that I respect and she has been to a number of conferences on the topic as she is a primary care and the first one to diagnose in many cases. What she noted is that since it's inception a few years ago, the Pre-D Diagnosis tends to predominate the over-50 population (instead of the anticipated younger generation who are being diagnosed as Type-2 in their teens). Also, a lot of Pre-D's either never develop Type-2 or, due to pancreatic slowdown become Type-1.5's. (Hence the C-Peptide testing to determine how well the pancreas is working.)

As I stated previously, the regimine of reducing carbohydrate intake, increase in exercise, and other measures like regular self-testing are beneficial in and of themselves. However, the jury is still out on the Pre-D's.

I have to agree with Larry H. on the subject of Dr. Bernstein. If you can maintain his regimine and it works for you -- great! On the other hand you must read Bernstein's personal history closely -- he went through **** and did a lot of self study as his research. His experimentation with small dose insulin regimes has helped a lot of Type-1's gain better control with fewer complications. His dietary recommendations have likewise assisted a lot of Type-1 and Type-2 people avoid serious complications. Unfortunately, little of his work is backed up by solid scientific research.

On a personal note I have found that, on occasion, I can eat like a "normal" person and not have any negative consequences. And sometimes when I apply myself to really lower BG levels the result is the exact opposite of what I anticipate.

I've found that modified "grazing" (small snack sized meals) work best for me. I have also found that my hard-core exercise actually raises my BG levels in the short term but brings them down overall. And Using Dr. Jackson's criteria I'm not in an "at-risk" condition but with the Pre-D diagnosis I am being a lot more careful.

[Larry H.]

I will second that thought that sometimes exercise gives the opposite result you expect.. Particulary when you first start. Sometimes after I did extra walking or pushing my mower about, I would find that my numbers weren't as low as I thought they might be. Actually a bit higher than usual.. But after my body has readjusted to the extra work load, then I seem to get benifits that show up nicely on the Glucose readings. Now I think I am seeing a bit of a carry over in that with this extreme heat were having, and I without air, my activity is way down. Yet my numbers are holding pretty good, at least so far. So for us prediabetics at least it may help to hold the numbers down more than just at the moment of the exercise.