Not looking good.

[Larry H.]

HI all,

Been a bit since I chatted here. All summer things had been doing quite well and I was able to keep things well in control it seemed. About the past month or so I have noticed slowly creeping fasting numbers. I may have changed my eating habits a bit but not significantly usually. Had the occasional splurge but normally they would come out pretty good on checking.

Mom, bless her, has been pretty good at making things that are easy on the diet. But since I was normally ok with many things I knew others couldn't eat much of I may have pushed my self into a problem that is worsening. Not too happy about it. Yesterday I was out of town all day and the evening meal was aboard Amtrak, I wanted to try the new menu and although I mostly had steak and vegies' I did eat some instant mashed pottos, but not all of them, and had a piece of cheese cake for desert. That was on top of a regular large chocolate chip cookies in chicago with a pastrami sandwich.
This morning I had a 116. I had my eggs and turkey bacon with a slice of toast and small amount of cereal. I walked and thihgs came in at 94 two hours from the first bite. But tonight I had a chop suey with some crunchy noodles, and then a narrow piece of fruit cake mom had been having. I walked about 25 minutes. At two hours I had a 178. Nearly a record high for me. I have been doing some projects around the house tonight and feel rather odd. I checked my numbers at five hours and it came in at 150. That seemed over the top for me. Not sure how to go about getting it down. Not on med's and have so far attempted to avoid them. My crazy doctor wouldn't even give me a script for medicare for testing strips because he said I didn't have anything to worry about. I am starting to think I do!

[volleyball]

I would not worry. Your number will come down.

[Ronin]

Hi Larry!

Dealing with this condition is vexing, particularly in the world of Pre-D's. A lot of medical professionals as well as those in the diabetic community don't buy into the diagnosis in the first place. Yet, we are concerned.

I'm less strict than others I know and my HbA1c's have been holding steady at 5.2 and that says that I'm okay. Have you had an HbA1c test done? If so, what were the results? If not I recommend the Biosafe home test kit (available at Amazon.com for around $20) I have checked this kit against my lab results and they have been bang-on with the lab results. I am also an advocate of getting a fasting C-Peptide reading to see how much insulin your pancreas is producing. I found that mine is quite low which indicates that I am not insulin resistant, but at the same time says that my pancreas is producing less than normal amounts of insulin.

Finally, while the FBG is the most common test the reality is that test done after meals because it says just how well your body handles the processing of carbohydrates.

[morrisma]

I read somewhere that some endos are writing scripts for insulin for pre-Ds in an effort to prevent full blown D. Can't quite come up with the details since I'm type 1 and it meant little to me at the time. You need to find an endo that will take these 'excursions' more seriously and maybe provide a low dose med for as-needed use. Test strips scripts are a must.
Good luck!

[Larry H.]

An update here. Things are still coming in almost unexplainable off. Or maybe they are explainable? Granted I was lucky most of the past year in that I seemed to be able to eat some of the things that others said they couldn't. To be honest I did usually keep the amount of carbs down to a reasonable amount. But I am somewhat unclear on what is going on now. I know I had a rash of food days recently that were above the usual. But normally that wouldn't have caused a long term problem. However now I am still getting for me at least higher numbers than anything in the past year.
Again last night I had turnips, carrots and some salmon paddies that had a bit of whole wheat crackers in them. I had about a quarter cup of left over baked beans and a low carb ice cream for dessert. At two hours I had a 168. I have cut my snack of a small bowl of cereal at night to a smaller yet with higher fiber and less carbs. Still got a morning reading of 120. One of my highest so far, although a couple recently breached the 125 point on the first test.
I talked to a lady last night that was a dietitian and she wondered if my even low total carb meals weren't pushing my levels over the point where they weren't reacting as I had hoped. Its very frustrating seeing these levels after doing what I had thought for the most part were positive steps.

[xMenace]

You are doing great, but eventually great isn't enough. Your body is going to need help. Consult with your doctor and don't hesitate to do what he says. It's not you that's failing, it's your bod. This slide will probably continue for many years, so get used to it.

[Larry H.]

Another night, another high for me reading.

A few turnips and maybe a small cooked carrot. A salmon patty with a few whole wheat crackers for filling. 16 carb piece of bread and a few chips. A scoop of four carb ice cream.. Came in at 177. I would say the total carbs above is considerably under the possible 70 for dinner an yet I am getting these numbers. I am starting to see why so many say they can't eat anything.

[matingara]

A few turnips and maybe a small cooked carrot. A salmon patty with a few whole wheat crackers for filling. 16 carb piece of bread and a few chips. A scoop of four carb ice cream.. Came in at 177. I would say the total carbs above is considerably under the possible 70 for dinner an yet I am getting these numbers. I am starting to see why so many say they can't eat anything.

i would leave out the wheat crackers, the chips and the bread.

i would add in a leafy green salad with peppers, onions, broccoli (etc). i would also add in a glass of wine or two (if you like wine that is).

i am enjoying the low carb diet because i get to eat alot of stuff i love again! (like eggs).

i eat the low carb (4g) ice cream and real ice cream without a major spike.

my fasting readings are between 72 and 110 usually. and my worst spikes are between 144 and 153.

i just think of myself as "pre agricultural"!!!

-- joel.

[CaptainMike]

The condition is universally considered 'progressive'. Sorry for the bad news.
You may be able to slow the progression, but probably not while eating ice-cream, cookies, pastrami sandwiches, carrots, and cereal.
My advice; try cutting out dessert and after dessert high-carb snacks. If you want to eat like you are eating then it is probably time to start meds.

Mike

[Real4]

Again last night I had turnips, carrots and some salmon paddies that had a bit of whole wheat crackers in them. I had about a quarter cup of left over baked beans and a low carb ice cream for dessert. At two hours I had a 168.
I would suggest counting the carbs in a meal like this. I mean by the book and with a scale. I suspect your count is a lot higher than you think.

[Larry H.]

Your probably right about the hidden carbs here. I tried adding up about what I ate, including something I forgot. It was about at the limit for carbs that ADM would recommend for an evening meal. I know that many here will not even come close to eating those carbs. Unfortunately for me, I guess, is that for quite some time I had no real problems with those limits. But probably as I started this thread, I had overdone it. I guess I wanted to believe that my old doctor knew what he was talking about in having nothing to worry about. That probably encouraged me to over do a bit compared to what I had been doing. But it is sort of a shock to now see much higher numbers when eating the same items in a similar amount. For lunch today I ate some red beans, 1/4 cup and a half sandwich with low carb bread, meat and cheese and my scoop of low carb ice cream. I kept up the walking and exercise machine after for about 20 minutes. I got a 136 at two hours. So that meal is looking better. But the evening is where It usually gets up there. Will watch it closer tonight and see if I can bring it down from those 160-70 ranges.

[Larry H.]

Well now I wish I had read the tread about the way diabetes develops much sooner. I am taking advice and cutting back, but gee even that is giving poor results at the moment. Maybe it will eventually come down?
Tonight we tried to have a nearly carb free meal.. Sauerkraut and some sausage, 1/2 cup applesauce, sugar free jello and egg white cookies.
Two hours later 155. I would not expected that to do much of anything. Very hard to figure out for sure. All I can do is keep trying to keep the carbs down and see what gives.

[Larry H.]

Thought this deserved and update since I have worked hard at changing the numbers I was seeing. I don't know what it means exactly as it most likely means I had been overdoing on the carb end without realizing the net result. Being one of those prone to depressive type of diabetics I of course had the world ending with the type of numbers I was getting for a while. For now at least I am somewhat happy with the reversal I have been able to accomplish though increased movement and watching more closely my carbs. I have not given up absolutely every hint of anything worth eating. But I have reduced greatly my intake I guess. I started using one slice of bread, (low carb) which only amounts to about 9 carbs for my lunch sandwich. Instead of chips I am eating about a 1/4 cup of canned beans, red or white which have some carbs but provide a bit of balance with the fiber content. Then I am restricting my self to very low carb ice cream and at times no sugar jello or other low carb items.

At first the numbers seemed stuck leading me to think I had entered that "no return" point I read about here in the article of how Diabetes progresses in the type II discussion. A good article I found.

So After days of 178, 168, 150 and now 139 after dinner with lower numbers between. My fasting has gone from 120 to 97 or less. This morning I had a 77 after my two slices of turkey bacon, egg beaters and about a 1/4 cup bran flakes with half a banana. I walked my usual half hour interspersed with reps on the Health Rider. I figure that extra activity would help to parallel what I was getting in summer with the push mechanical mowers. Now the catch is to keep it with in reason. My no insurance had led me to testing more faithfully in the morning, and didn't exactly realize that those numbers are the last to go south.. Hopefully I can keep them at the levels I am now seeing.

Happy holidays to all.
thanks for being there.

[volleyball]

Glad to see your numbers are where you want, an early xmas gift to yourself.

[Tropo]

My no insurance had led me to testing more faithfully in the morning, and didn't exactly realize that those numbers are the last to go south.. .

This is not in fact true. Some Pre-D people post good fasting numbers yet their post prandial readings are high. Others post high fasting numbers yet their post prandials are ok.

I'm of the latter type.

[Ronin]

Larry H., et al.,

I am concerned that Larry is only using the results of his meter checks. We all know these to be useful but not definitive tests.

Larry, I cannot state it strongly enough -- you really need an HbA1c test done to determine what all those daily tests are actually showing. I also insisted on a fasting C-Peptide to determine if I was becoming Insulin Resistant.

Managing this condition requires knowledge at many levels. Reliance on a home test will only send you on a fast trip on the emotional roller-coaster. FWIW: your MD is all wrong pronouncing that you don't have a problem without follow-up testin (HbA1c, et cetera). Right now neither you, nor your MD really knows where you are because you don't have reliable test results.

As I noted in an earlier post, if your MD will not prescribe and HbA1c, you can get a home test kit and do one yourself for $20 or less.

[Dan Gato]

Hi Larry,

I agree with Ronin, please get those tests, the A1C & C-peptide.

Talk to your doc about some meds, as a preventive measure.

I've read that damage to the nerves happen at bg's over 140, for pre- or diabetics.

A normal bg is under 100 ( some say is 85) & the A1C, 4.2 - 4.6 Hope you achieve these.

Happy Holidays !

[Larry H.]

Thanks for the replies. I agree about the testing. That was one reason I went to the Doctor a couple months ago to have testing done. Somehow the test he prescribed were not the usual ones and showed almost no issues related to diabetes. Of course he also said that numbers up to 200 were fine after eating. So my faith in his opinion was eroded significantly. I think unfortunately he is of a past generation of doctors and what he is saying is probably 30 years ago treatment. Biggest problem is to find a decent doctor in these small town rural areas. He is overall fairly decent, but way off on this one.

The local health departments have recently begun offering a AC1 test weekly. I will call and get one done soon.

As to where I am now. It still proves that watching what your eating and becoming more active is a plus for sure. At least for some of us. I have now managed to get two evening meals down to 110 and my fasting this morning dropped to 85. I admit that the time and effort to do that is not for everyone, and also it has sort of taxed this old body a bit to increase the work out a lot. I am sure its a crutch and shouldn't do it, but I find when the numbers are down and I am active I can eat a few things more than I might otherwise.
I can see that winters will be a challenge where activity can become typing these keys. Lucky I have access to a large basement in moms home next door, so I can listen to music and walk and exercise.

One thing about those AC1 test, they would of course now show the higher levels that occured when I was not as aggressive about bringing things down. But I guess its more of a real picture of where I would easily be and worse.

[morrisma]

Larry,
Not sure if anyone mentioned it but a diabetic honeymoon could explain how easy it seemed to keep things in control and now that they are getting tougher, you may be over that honeymoon. If I remember my honeymoon, it began about 6 months after diagnosis and lasted about 8 months. Your mileage may vary. Good luck, keep testing and get an a1c!
Mike

[Larry H.]

Yes I have heard of that. And it may be a part of the picture. When I lost the 35 pounds and watched my carb intake things dropped nicely. I think that was why I was surprised that my numbers started to creep upward, and in retrospect may have been coming in way higher in those after evening meals and I had not caught on because due to cost and the previous readings, I had been avoiding constant testing. I changed to a Walmart Reli On meter last week. Although I must say I went back and bought yet another container of ONe Touch test strips to get some idea of how the two were comparing. So far the few times I have done double test they are quite near each other. I just don't like the awkward wide testing port on the Reli On, but otherwise its ok for the money.
Back to your point though. I am not real clear on how that works but I guess after a while the body goes back to doing things like it had before you lost the weight. I still know though that while I was very active pushing my reel mower and gardening and such all spring and summer my numbers were quite good in comparison. So its still about what your do to some degree as to what your going to see on your readings.

[morrisma]

Absolutely. The more activity you can manage, the better everything is. Keep as active as possible and do SOMETHING as regularly as you can. I'm type 1 and when I am at the gym 4 or more time a week (or the outdoor equivalent), my readings are better and my insulin use is a little lower.
Helps keep the weight down too and that isn't a bad thing either!
Mike

[Larry H.]

With the amount of food I have restricted my self too most of the time I don't have to worry about gaining weight anymore which I used to have issues with. I know that more sophisticated test show a long term level. But if your indeed keeping to your routine that works, then the levels will be showing even with your meter I would guess. I mean, after all the test is only a reflection of the readings the meter is showing. Had I not cut back on testing I would have seen the results that ended up causing the over all problem.. An AC1 is only going to tell me in hind site what I may have already been seeing with more frequent testing.. The AC1 is a convenient way to see the overall pattern in one test. But daily readings will still give a sense of what is going on also.

[xMenace]

With the amount of food I have restricted my self too most of the time I don't have to worry about gaining weight anymore which I used to have issues with. I know that more sophisticated test show a long term level. But if your indeed keeping to your routine that works, then the levels will be showing even with your meter I would guess. I mean, after all the test is only a reflection of the readings the meter is showing. Had I not cut back on testing I would have seen the results that ended up causing the over all problem.. An AC1 is only going to tell me in hind site what I may have already been seeing with more frequent testing.. The AC1 is a convenient way to see the overall pattern in one test. But daily readings will still give a sense of what is going on also.

There are 24 hours in a day. Much of it is hidden from those of us that test a lot. Good self monitoring and bad A1C's are not uncommon. They indicate undetected problems with control: middle of the night, post prandial spikes, and whatever. I insist on quarterly A1C's to validadte my own results.

[Larry H.]

Would that be true as much of type II as of type I where the levels are more dependent on medication?

[jvetter18]

Larry, get the test, get the results THEN decide if the test is good or not. Until you get an A1c, you really can't comment on it's validity. For someone who has been on this forum for this amount of time, you seem to be blind to what everyone is saying. if you doc won't give you the test, get a new doctor.

It's the standard of care for any diabetic. Get an A1C. This should be done w/ active BG testing on your meter, and an A1C every 3 months. c-peptide? maybe.

sorry if this sounded harsh, but you seem like you're talking around the issues.

[Larry H.]

I had made the appointment for the test this morning. Due to the holiday the first day they will be doing it is a week from next tuesday.. I will let you know what it comes out.. I think your right, I don't still understand all the details of this disease.

[Ronin]

Hi Larry!

I'm glad, as I am sure most of us are, happy to know that you will be getting the HbA1c test done. If you can talk them into a fasting C-Peptide that would be great. Note: I am a big fan of the C-Peptide test because there is an assumption that all adult onset diabetic problems are due to Insulin Resistance. However there are more than a few folks who show what looks like Type-2 diabetes when, in fact, their pancreas is shutting down. The MD's get confused, you take all kinds of medications and nothing seems to work until somebody suggests the C-Peptide test which reveals the underlying problem with the pancreas itself. (This happended to a close friend who spent about three years trying to get his "Insulin Resistance" under control when his pancreas was failing -- they found out his C-Peptide was 0.3 and further testing showed him to be a Type-1.5)

[drsanjaynayak]

hey folks
my fasting levels all the while are showing in the range of 84 to 90 .... and till yesterday my post meals in the afternoon was around 124 to 140 .... today it showed 164 after two hours of a moderately heavy meal .... i am concerned .i am due for A1c this month end ... what do i do>> help me guys
regards

[Larry H.]

Obviously not being an expert, I would suggest that perhaps your moderately heavy meals wouldn't help. For my self I had to start moving more, which worked for a while and still is, but I did start to wear down on how much I could continue to walk and exercise. Not that I am old exactly, but at 65 it does become tiring if you overdo it and I perhaps was. But it did get the numbers down, between that and eating less carbs.

Tomorrow is the AC1 test and from what I hear you get the results the following day. So I will know more for sure at that point. The worst part is that I know my numbers had been coming in higher than expected so I may not be too pleased with the results.

I did buy a second Reli On meter and use it most of the time now. It isn't much variation from the One touch so I feel pretty comfortable going by what it says. I have been able to get lower results these past couple weeks with what I am doing. I still have a feeling that summer will help with the activity level I usually have then.