New Around Here. My Story

[Daniel23]

So i've been sifting through board messages for about 5 months now, but this is my first post.

My story goes as follows:

In July of 2007 I decided to take advantage of my employer's insurance benefits and get a full blood panel done to see if i was in tip top shape. I had been losing weight over the past several months, nothing drastic, but nothing expected as I was eating well and exercising at a minimum (for me, about twice a week, lifting weights for 60 minutes).

I received a phone call from the doctor's office, it was the nurse, she said everything looked great except my sugars were really high ( fasting at 275 ). I freaked the f out because i didnt know what that meant. Why were my sugars high? I dont eat sugar often, I dont eat carb heavy white breads and pastas. I ate better than everyone i knew, i exercised, and i appear to be in great shape. (5' 7" 147 lbs and lean, at the time). So this was an obvious shock to me.

When i arrived for a followup visit, the doctor basically said you're diabetic, here are some pills(metformin and glimperide?) and a book to show you how to eat, go get you sugars under control and come back in a week. This was ridiculous, because i was eating a lot better than what this crazy book was telling me. No f'ing way was i going to have 3-5 servings of pasta or starches a day, that was nonsense to me. So i did some research on how to bring sugars down and went on an extreme low-carb no sugar diet. About 4 weeks after my 275 reading and a1c of 12.9, my fasting was still at 139.
So the Doctor said I was doing well and i should just continue what i was doing, take my pills and go on with things. I left that doctor because he basically led me to believe there was nothing to worry about and didnt want to give me a glucose monitor.

Since I had become learned on the matter of diabetes, i knew that 139 was still fairly high for a fasting glucose. I demanded a glucose monitor about 2 months after dx and started doing my own readings. With my strict diet and exercise routine, along with a ton of supplements and meds (januvia, amaryl, and metformin - all of which were on and off), i was getting readings anywhere between 54 - 299. If i'd get a reading in the 200's, id pop pills and wait eagerly for my blood sugar to go down. Sometimes it wouldnt go down for hours or until the next day.

I got a new doctor and an endo. So this continued for about 4 months until my next a1c readings. They came in at 7.3 in November of 2007. I continued the diet and exercise and pill popping. Still, I saw erratic readings, no real control, no way to effectively get my bs down when i needed to. A1C in February was 7.2. I felt like ****, every day, day in, day out. Couldnt concentrate, couldnt think clear, blurred vision. I started experimenting with which pills were helping and which were hurting.
Metformin - Did not help. BS were not affected when i took this.
Amaryl / Glimperide - Worked, but in an erratic fashion.
Januvia - Made me feel like sh*t. Did not work, made me gassy and cause a hypoactive thyroid until i was off it.

I changed my endo last month. The current one is still an assh*le, but at least he is more knowledgeable than the rest of them. He gave me GAD , Islet, and Insulin antibody tests. I came back positive on the GAD and Islet.

So now, here i am. Type 1. Honeymooning perhaps. I have heard this phase lasts from a month to several years. I'm not sure what to do.

Over the past week(7 days), ive quit all the pills that i was rx and started a raw food diet. Everything Raw, no processed, no grains, no meats, no diary, etc. This is extremely hard, but i have seen incredible results. I haven't seen my numbers so stable or in this normal range ever. Each day my fasting number keep coming down btw.
Fasting range - 78-103
Post Postprandial - 98-139

Pretty amazing, even if i am in the honeymoon phase. My thoughts are that im prolonging this period because my body can sustain normal bs levels(with no huge swings) without meds.

Whats everyone's idea on taking a low amount of insulin right now? Should i demand that my doctor give me insulin or a pump just in case? Should i wait out the honeymoon period or just go straight to insulin?


I'd like to hear from anyone that had a similar experience or wants more info on what exactly my diet and routine entails.

Thanks and I look forward to talking with everyone.


Daniel
Age: 24
Athletic, 5'7" 152 lbs

Dx Type 2
7/2007- A1C 12.9
10/2007 - A1C 7.3
2/2007 - A1C 7.2

Dx Type 1 - Honeymooning ?
4/4/2008
No Meds, No Insulin.
Raw Diet and Normal Exercise.

[DCaplinger]

Daniel:

Glad to see you've gotten good control with just diet and exercise. From the sounds of things, you are doing what you need to do, so please keep up the good work.

You may be honeymooning, but remember... you are diabetic, even if your numbers are normal now, you'll always have to watch what you eat and to get the proper exercise. But hey, that's good for you anyway... right?

I have heard of people that are Type 1 that are able to control with diet and exercise for a few years, while their bodies continue to destroy the islet cells. The process may have just started in you.

Welcome to the forums, and please don't be a stranger.

Regards,

[xMenace]

I don't understand 1. why you won't eat carbs and 2. why you won't take insulin. You need carbs for energy. Very few if any last long on extreme low carb diets. I don't mean to imply you need all that pasta and rice those stupid books want you to eat, but fresh fruit and whole grains are what we are designed to eat along with veggies.

You are actually overworking your beta cells. Supposedly they will last longer if you take some insulin. I'd try a basal and if needed, a fast acting with meals. You also need to test regularly which I assume you do now. Change is inevitable for all of us.

[Daniel23]

DCaplinger - Thanks for the support! Greatly appreciated.

xMenace-
I agree with you, i do need carbs for energy, thats what i noticed when i was doing the extreme low carb diet.
My current diet (Raw Diet) does have a substantial amount of carbs, all of which that come from either fruits, veggies, seeds or nuts. I'd say daily i get like 50g of carbs, mostly fiber.

I test about 8-10 times a day. I dont know what constitutes as overworking the cells....since the numbers haven't been out of range. since i've been eating Raw, the post prandial numbers are typically less than 130 one hour after, and less than 120 two hours after. What do you think... should i take some bolus to make it less or let my cells do what they're doing? My before-meal numbers are seem to be fine, 85-110 range, so i dont know if basal is needed.

your thoughts....ideas...comments....thanks!

[xMenace]

Good stuff!

This is where the endo comes in. A good one will work with you, explain his recommendations, and try to fit it into your lifestyle.

I think (don't trust my thinking!) that a mild basal would be best. It seems to me your cells are running flat out to keep your basal sugars in check and don't have enough left for your meals. If you give them some help in the slack times, they'll be able to work better on your meals. I'd much rather have natural insulin covering meals. It works much better. A basal insulin shouldn't stack on top of your own. Your beta cells just won't release as much.

That's generally the pattern we see with progressing type 2's.

[xMenace]

I started experimenting with which pills were helping and which were hurting.
Metformin - Did not help. BS were not affected when i took this.
Amaryl / Glimperide - Worked, but in an erratic fashion.
Januvia - Made me feel like sh*t. Did not work, made me gassy and cause a hypoactive thyroid until i was off it.


BTW these drugs, particularly metformin, are difficult to assess this way. Met builds up in your system and can take weeks to become effective. You won't see immediate results stopping and starting it.

I suspect your conclusions are right, but this test is not valid. This type of testing is great for insulin and is the foundation of basal testing.

[Jan B]

Welcome Daniel,

Sadly, your story isn't terribly uncommon. I'm really glad you found this place to get some help. Advice from a doctor is great, but it's not safe to let that stand alone as you have learned.

I can't advise any better than xMenace (John) has about dying beta cells, etc. I just know that you want to eventually get your post prandial numbers down to a very good range . . . like 100. Some aim for under 140, but to me, that's too high. I'm impressed with how often you are testing and your amazing action to take care of yourself.

I was very obviously type 1 when diagnosed at 18. I guess if I'd been 19 or 20, I'd have been diagnosed as type 2 and given a bunch of pills. Thankfully, there is a bit more understanding of the fact that type 1 can happen after age 18!

[Eddy]

I think (don't trust my thinking!) that a mild basal would be best. It seems to me your cells are running flat out to keep your basal sugars in check and don't have enough left for your meals. If you give them some help in the slack times, they'll be able to work better on your meals. I'd much rather have natural insulin covering meals. It works much better. A basal insulin shouldn't stack on top of your own. Your beta cells just won't release as much.


/me chimes in in agreement.

Also: I can't remember whom, but someone in some other thread on here mentioned being on a low Lantus dose... with no (very little?) bolus. He (IIRC) and Daniel23 might do well to swap information.

[BlueSky]

The more assistance you provide your remaining eta cells, the longer they will last. If prolonging your honeymoon is something you want to do, you need to supplement the insulin your beta cells are producing. Most doctors will put you on a basal (Lantus or Levemir) because it involves only one injection a day. But mealtimes is when the beta cells are the most stressed and where supplemental insulin is needed the most. You might as well go all the way and get started on full MDI now rather than later. The nice thing about it is that achieving really good control will be easy as your pancreas is still producing insulin. If you don't inject any insulin it will stop doing this sooner rather than later. ;)

[Eddy]

The more assistance you provide your remaining eta cells, the longer they will last. If prolonging your honeymoon is something you want to do, you need to supplement the insulin your beta cells are producing. Most doctors will put you on a basal (Lantus or Levemir) because it involves only one injection a day.


Nitpicking: "only one or two". I know you know this, of course; I'm just adding. (I'm finding that Levemir fades quickly enough that I have ~35 mg/dL rise during the hour after Levemir injection... even when they are 12 hr apart.)


But mealtimes is when the beta cells are the most stressed and where supplemental insulin is needed the most. You might as well go all the way and get started on full MDI now rather than later. The nice thing about it is that achieving really good control will be easy as your pancreas is still producing insulin. If you don't inject any insulin it will stop doing this sooner rather than later. ;)


Ehhh... good point. However, if one's pancreas is producing usable quantities of insulin, would it not make sense to bolus "a little too small" to cover all CHO, thus relying some on natural insulin? i.e., no point in experiencing hypos if it's not necessary. What the balance between hypo-avoidance and beta stress, Daniel23 would have to determine.

[Emm]

As a type 1 (LADA by the sounds of it, otherwise nicknamed T1.5), you WILL be on insulin - and if you'd like to prolong that honeymoon then get started on insulin asap.

The honeymoon can actually be a pain in the butt, so be aware of yourself for a while - it can be really tricky if your pancreas goes quiet and then kicks in for sunday lunch leaving you low... then goes quiet for another few days til it finds some energy again! It's not really that simple - for me it was just vague ups & downs for a while and easy to stay on top of (so long as I was testing regularly) but I've heard others say it can be a bit of a mission. I missed most of my honeymoon, I was misdiagnosed as a type 2 at the time, so don't take my experience as gospel!

I would definitely recommend getting on insulin as soon as you can manage it. At least that way you can chose your carbs with each meal, and feel like you have some control.

Welcome to the forums Daniel :) Glad you're with us!