Wonder if the honeymoon is over?

[Larry H.]

Hi all,

Seems I get on here mostly when things look bleak, and for some reason of late they are bleaker than usual for me. Compared to what I see others are seeing sometimes maybe not, but its the progressive numbers increase that bothers me the most. And if that loosing weight study was correct I would be in perfect shape.. I am way to skinny now at about 156 down from 193, 6' tall. And yet this winter has seen readings that are higher than I have ever had. Especially recently, or better yet probably over the past few months. I have blamed it on winter but I think something else is going on. I know I have resisted med's and may yet do so, but things just are looking overly good to me.
Besides a raise in morning readings from the 90's up to the low 120's or a bit worse a few days, to readings in the evening with meals that used to not bother me much now coming in at 160's to tonight 197 and a 190 a couple days ago. I tried to count those carbs and really if I had 60 for supper that would have been about it. Then I walked for the second time that day a half hour and did over 225 reps on a exercise machine.. Still got he 190. I am almost positive the relationship between the food intake and the numbers has changed dramatically.
In the morning I can still get a 95 after my egg beaters and then my small bowl of fruit and cereal, but for some reason the later the day goes the worse things become, with no exact cause I can pin down. Yes I am eating carbs but not in excess that I can tell. I have had the slightest sinus infection the past few days but this tendency to higher evening numbers has gone on for some time, it may just be adding too it now. My first and only AC1 was 5.8 a month or so ago but at this rate it is bound to change. I just hate to give up every thing I eat, as well as the idea of meds. So now what? I am exercised out at my age, its rather depressing..

[matingara]

you should really read the Bernstein book IMHO. you can read parts of it for free at Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site (http://www.diabetes-book.com/)

Bernstein recommends a max of 30g of carbs per day!!!

i know from my record keeping that starting to exercise and starting to take Diamicron MR (a sulfonylurea) did lower my BGL somewhat.

What really DRAMATICALLY lowered it and got my A1C down from 16% to 5.9% was lowering my carb intake.

i think that having 60g of carb with supper may be way too much for you.

i know that 60g of carbs would raise my BGL somewhere between 100 and 200 mg/dl.

-- Joel.

[TomB]

Hummm, 6' tall and down to 156lbs from a 193. Larry, it is good to take pre-diabetes seriously, but perhaps you might be taking it a bit too serviously. When the body needs energy and there isn't any fat cells around, it starts using muscle tissue and that kicks up the blood glucose. I know that for myself, my numbers will go up and stay up when I get stressed. A glass of wine is a good cure for both.
Tom

[Larry H.]

Yes that weight loss has been an issue but how to maintain it and keep the numbers down so far has been something I haven't had much luck with. I ask a dietician the other day and they suggested more meat and nuts, and Princess Linda suggested some Ensure drinks. I wonder if that business of the muscles might be involved? I have been using a Health Rider that is supposed to use all your muscles to try and build up, maybe it is having the opposite result.
That business of Bernstein diet seems way too severe to me. I can't keep any weight up with what I am eating. I don't understand why those amounts of carbs are supposed to not send your numbers up that much but somehow still do. My morning at 5am was 120 which is high for me, I had no snack last night like I usually do so that reading is still from the meal I had last night, which normally would have fallen back, especially not eating anything since 5pm last night.
This is a most frustrating problem, you exercise, you cut your food way back and you still see things changing out of your control. I recall seeing that when I first read some of the web sites the diabetes groups have up. Just don't like it when it is happening to me.

[Larry H.]

This is what is so confusing about the way it works. I had the 120 at 5am. Now after exactly two hours, no exercise and having a breakfast of three mugs of coffee, egg beaters, and a small bowl of cereal with half a banana, it just came in at 91 which is the lowest reading I have seen in months?

[princesslinda]

Larry, I don't know that Ensure would be good...as it probably contains sugar. I think you'd do better with some of the EAS Carb AdvantEDGE protein shakes, available at Walmart...4 carbs/shake, which might help you gain weight if you added these as a snack...and they wouldn't cause your blood sugar to rise. I know you are very diligent about exercise.

[Larry H.]

Oh, Oh, I just thought, this morning I did something I haven't done in some time.. I had a package of Salacia Oblonga that I had stopped taking due to the digestive upset it causes and I thought I wasn't doing anything anyway.. Maybe it was? I took two capsules before eating? Many studies say it drops blood glucose by up to 20 percent, maybe it does and maybe it doesn't, but why such a low reading all of a sudden?

[Larry H.]

One other possible thought here.. I have really cold hands and feet in winter and normally have some trouble getting blood out to test. This morning after breakfast I sort of shook my hands and rubbed them briskly together for a bit trying to be sure I could get a decent drop of blood, could that be an issue?

[Larry H.]

This is how erratic this is. I reluctantly had two pieces of french toast for lunch with sugarless syrup, and two scoops of low carb ice cream with sugarless chocolate syrup, a few nuts and a dash of cool whip.. At two hours, no exercise I had 119. I will have to see what the evening brings as that is usually the worst reading for some reason, but even the lunches have been considerably higher than this one? I am going to keep taking the Salacia and see if I continue to see a lower number of if it is just a coincidence.

[loris]

The reason your BS was high in the morning wasn't due to anything you ate. In fact it has to do with what you didn't eat. Your liver is dumping sugar into your system because your body thinks it needs it. This is a natural and normal thing for your liver to do, and it's what keeps us from starving to death when we don't or can't eat (for instance like when we sleep :) ).

The reason that it's important to take your fasting BG is to see if your body is handling the sugar that your liver is dumping into your system. Normal non diabetic (or non prediabetics) don't have a problem putting out enough insulin to manage the balancing act that the liver is trying to perform. But one of the surest signs that someone is having problems is having high fasting BG. It's called 'dawn phenomenon' and for me, it's the hardest number to control.

I think it's also what's going on when you exercise so much and your sugars actually go up. I've been assured that exercise induced dumping does even it's self out after a few weeks and your body gets used to how much sugar you actually need for the level of exercise you're doing. If you've increased your activity level in the past few weeks, things should even out for you soon.

It also explains why after you eat, your blood sugars go down some. Because your body is actually managing the carbs you're eating, just not the dumping that your liver is doing.

All isn't lost though. I think you're a long way from being out of control, with a few adjustments you should be back on track. My suggestion for managing the 'dawn phenomenon' you're experiencing is to go back to eating a snack before bed. Preferably a high protein snack with substantial fats to keep your body from getting too hungry in the middle of the night and dumping sugar to compensate.

Some people also have good success with drinking their daily glass of wine before going to bed. A little wine and cheese snack before bed seems to be a good combination. I haven't tried it so I can't speak from personal experience.

I wouldn't push yourself so hard if you're losing weight and don't want to be. You do sound rather underweight. Dealing with this disease is a balancing act, and losing too much weight means something is out of balance for you. Learning how your body works, what it needs, and what happens to it when it doesn't get those things, are the best ways to help you succeed in balancing things well.

:) hopefully your BS will calm down for you soon and you can settle into a comfortable routine to keep you healthy and away from needing meds.

[Ronin]

Hi Larry!

You are in a very common phase of dealing with the Pre-D diagnosis -- confusion, guilt, and anxiety. All of us who share your diagnosis have been there, and some of us are still there.

Like you, I have periods where my FBG measurements are above 100, and then they fall back into the below 100 range.

Most of what you have experienced in the FBG testing is probably due to the Dawn Phenomenon/Effect where your liver dumps a bunch of glucose when you wake up and a test shows you as high while your post breakfast numbers go back to below 100.

Have you done a fasting C-Peptide test yet? I am a strong advocate of that test for all my fellow Pre-D's, with particular attention to those of us over 60. You may simply be the victim of a slowed/diminshed pancreas. Normal fasting C-Peptide readings are between 1 and 5. Obviously "normal" would be somewhere around 2.5. The higher the number the closer you are to demonstating classic Type-2 (Insulin Resistance) the lower you are the closer you are to adult onset Type-1 or Type 1.5 diabetes.

I agree that Dr. Bernstein (considered by some to be a diety and by others to be a devil) is, in my opinion, over the top for those of us diagnosed as Pre-D in our older years.

You may also want to look into the timing of your carb intake. I try (not always successfully) to eat carbs immediately before or immediately following exercise so that my muscles get the maximum uptake and benfit of my diminishing insulin supply.

Final note: If you haven't gotten the C-Peptide test get it done. If you go on Type-2 meds and you are not IR they won't work properly. People who are not IR and have low insulin production do not need increased insulin sensitivity, they need more insulin to compensate for the reduced production of their pancreas!

[HelenM]

Final note: If you haven't gotten the C-Peptide test get it done. If you go on Type-2 meds and you are not IR they won't work properly. People who are not IR and have low insulin production do not need increased insulin sensitivity, they need more insulin to compensate for the reduced production of their pancreas!

I thoroughly agree, if you are losing weight whilst eating sufficient calories it may because you are gradually losing your insulin production. I don't know if it is possible to ask for an anti GAD test as well as the C peptide . Whatever the results of the tests you would have more information on which to make treatment decisions.
see Action LADA - (http://www.actionlada.org/why/why.html)

[Larry H.]

Thanks for the thoughtful follow up notes. I have continued to take the Salacia Oblonga, which may have nothing to do with it. But studies by Abbot Labs show a reduced glucose of up to 20% in even now diabetics according to the last study on it. My numbers after a fairly high carb lunch.. Sandwich on two slices of low carb whole wheat and some chips along with my low carb ice cream came in a 119 yesterday and my evening meals have dipped into the 140 range instead of the 190 I was getting last week. Morning is dropping slowing, this morning was 108. It may also be something else, I have no clue, I just know as one of you mentioned its very frustrating and sometimes quite depressing when you try so hard only to see things that at least for you, aren't where you want to be.
I also seem to have cleared up the little bit of obvious sinus problem I had too, which could also have played a role here.

[Ronin]

Hi Larry!

I know the frustration well. I went through the emotional roller-coaster a while back and it took some time to get things in perspective.

What I have focused on is the post-breakfast changes. The reason being that I have a very strong Dawn Phenomenon/Effect. At the same time my post breakfast numbers are always in the low to mid 90's despite what the FBG number may have been.

I have also noted a direct coorelation between exercise levels the previous day and the FBG the next morning. In winter, when I get less aerobic exercise, my FBG's tend to run high. In Spring, Summer, and Fall they tend to run lower.

Regarding the "Salacia Oblonga" -- while I doubt that it will hurt you, it seems from what I have read, that this herb increases insulin sensitivity. That is fine for Type-2's who produce a lot of insulin but Type-2's are generally Insulin Resistance. Your unanswered question is: are you Insulin Resistant? Neither you nor your MD can answer that question without the C-Peptide test.

When I was first diagnosed everybody was telling me that I was Insulin Resistant, including my Primary Care. You should have seen the look on her face when she saw my 1.3 C-Peptide reading.

Diabetes is a multi-faceted condition, not just a simple disease. You need to do the right treatment and take the right action for what is causing your body to not properly manage BG levels. Knowledge is power Larry, and right now you are lacking a key data point.

[missusg]

Hi Everyone,
I was pre-diabetic, awaiting my "diagnosis" of diabetes...I know I am or gonna be over soon ...I started getting really sick, blurry vision, really tired and do have a normal c peptide so far...but, my a1c was 6.3, and gonna do a fasting test tomorrow morning, been getting tons of lows all the time and then swinging high...a few mornings I have had 17, even 24! yikes...my doctor doesn't know what to think ....any thoughts?
ps...in manitoba the doctors actually encourage tons of carbs, but that doesn't seem to be the consensus here? (the dietician I seen here didn't even know that type 2 diabetics could swing high and low.. (she only thought they could be high) and she told me to limit meat severely, (one tablespoon of peanut butter on bread with a bannana and apple for breakfast was her recommendation)
Any thoughts?

[Tropo]

Here's an idea Larry. Why don't you try taking your focus off your readings and redirect them towards a sport.

That's what I've done. I put in 2 hour intense gym workouts every other day with intense cardio routines in between these. I feed my muscles with plenty of carbs and concentrate on growing muscle and getting fitter and stronger.

My BG levels are now an afterthought, and on the odd occasion that I test them they are surprisingly good and improving.

I was curious, why do you use egg-beaters for breakfast? You need the calories, so why not have a good old scrambled eggs for breakfast (and plenty of them). You need plenty of calories to help you gain weight, so plenty of fat can only help. You can keep your lipids in balance by consuming plenty of flaxseed oil or fish oil.

[Real4]

Hi Everyone,
(the dietician I seen here didn't even know that type 2 diabetics could swing high and low.. (she only thought they could be high) and she told me to limit meat severely, (one tablespoon of peanut butter on bread with a bannana and apple for breakfast was her recommendation)
Any thoughts?
Yeah, your dietician is nuts. It's better to eats nuts than consult them.

[matingara]

ps...in manitoba the doctors actually encourage tons of carbs, but that doesn't seem to be the consensus here? (the dietician I seen here didn't even know that type 2 diabetics could swing high and low.. (she only thought they could be high) and she told me to limit meat severely, (one tablespoon of peanut butter on bread with a bannana and apple for breakfast was her recommendation)
Any thoughts?

this is madness IMHO. if i ate that set of foods for breakfast i would probably raise my BGL by 10 mmol/l (180 mg/dl)!!!

try scrambled eggs and bacon with no toast.

what is the rationale for "severely limiting meats"???

man!

:)

-- Joel.

[Larry H.]

As to the additional fats, unfortunately I had a quadruple by pass about 5 years ago now. So with so many clogged arteries I have pretty much tried to keep the fat intake lowered. But recently with some of the research that fats seem to reduce you intake of glucose a bit I have been eating more fats than I used to. I just got used to substituting the egg beaters for regular ones and have mostly maintained that.
I know its comes as a different view or maybe reaction than some, but I have recently discovered that the addition of a whole grain, high fiber muffin with my meals has seemingly added nothing to the numbers and actually seem to have shown a reduction by quite a bit. I didn't get much response on that thread, but I wish some would give it a try and see if its me or actually helps some way.. My observations had been that originally I had tied harder to balance my fiber intake to my meals and of late we had gotten away from that. When my numbers started showing unexpectedly high I started looking at what had changed and the help of the fiber to slow the ingestion of the glucose was one I thought I could pin down. So far after two weeks its still showing considerably lower numbers. It may be something else completely but I am enjoying the new ability to have something else with my meals for now.