A few questions

[frombc]

I posted in the Pre-D forum, but would like to know if it's possible that I might be heading towards LADA. I don't want to re-type everything so here are the links to my posts.

http://www.diabetesforums.com/forum/pre-diabetes/40600-a-little-confused.html

http://www.diabetesforums.com/forum/pre-diabetes/40606-dawn-phenomenon.html

I know I have some type of problem with Glucose, but if it were Lada I was heading towards, would my numbers not have deteriorated in the last 3+ years?

I ask about LADA, because as you'll see by reading my posts I'm 5'6", 130 lbs low cholesterol and BP.

Thanks if anyone has any opinions.

[Kazz]

Hey there ... my first post! I've been lurking on this forum for a year or so, but am only now finding the courage to say something .........

frombc, I don't have any advice for you, being pretty new to (and mystified by) this whole diabetes thing, but your posts made me want to exclaim "me TOO!" so I wanted to let you know you're not alone out there. I'm a 41 year old woman, slim, fit (a bit of a gym junkie, in fact), with a good diet (home cooked from fresh, healthy ingredients) ... and in excellent health ... apart from the fact that my last four annual medical checkups have shown me to be on the borderline between "high normal" and "pre-diabetic". The first time it happened my doctor assumed it was a one-off error, and told me to go home and keep up the good work (exercise and diet). The next time it happened he did some more digging and found that diabetes (Type 2 - as far as I know) was in my family history, so said it was probably inevitable that I'd develop it eventually, but to go home and keep up the exercise, etc. The third time it happened I bought a blood glucose meter, and I've been recording my FBGL each morning since then. I'm still slim, fit and healthy, and if it wasn't for the family history (which is why I have the annual blood work) would probably be blissfully unaware that anything was amiss. No matter what I do, my FBGL is always at the upper end of "normal", or the lower end of "pre-diabetic". My doctor has never sent me for any additional testing (e.g. OGTT, A1C) and I've been reluctant to ask for this, as I don't want to look like (or indeed, be) a hypochondriac. But the vibe I get from the people on this Forum is that the fasting numbers I'm getting (usually between 5.0 and 5.5 mmol, which is about 90 to 100 using the other scale) are NOT normal and should have me worried.

If anyone with more experience has suggestions I'd be happy to hear them. I'm posting this under "Type 1.5" as I don't fit under the type 1 or type 2 definitions, and suspect that if/when I do develop diabetes, it will be one of those weird types that are hard to diagnose ~ just my luck!

Thanks everyone, and best wishes.

[frombc]

Hi there, Your situation does sound almost exactly like mine--except I'm not a gym junkie, he he. I get most of my excercise by parking far away at the mall, using stairs instead of elevator etc.,

I did read somewhere that they tested the beta cells of slim people from families with type 2 and found that they did have some beta cell damage, even though they remained slim. Some type 2's are indeed slim and don't fit the profile. I also don't believe that everyone that's on the high end of normal goes on to get full blown diabetes (unless it's not type 2).

I don't know my family history, but thought perhaps this is what's happening to me. Maybe my pancreas doens't function at 100%, so I get the slightly elevated fasting nos.

Do you ever take a reading after your meals? You should give that a try. Apparently those are usually the first to go. Mine are pretty good, running at about 95-110 after most meals. They arent' super high carb meals, but they always include carbs. ie: last night I had whole wheat spaghetti with broccoli and 2 hours later my reading was 112.

I sent an email to the person that runs the "What they Don't Tell You About Diabetes" because she has some information about 1.5 on there. She emailed me back with some information.

I don't want to post it here without her permission, but she basically told me that if I were headed towards 1.5 my fasting and especially my after meal numbers would have gone up by now.

I'm not sure why no one has answered my question in this post, but maybe someone will come along with some more information for us. The usual answer is that everyone is different, and I understand that, but there must be some type of pattern before reaching 1.5.

If you'd like to keep in touch, since our situations are very similar, you can contact me through my profile.

Take care, and we'll both try not to worry:)

[mortis505]

Hello and welcome to you both. First off I'd recommend some additional testing from your Drs. Specifically C-peptide and Gad tests. The C-peptide will show the level of insulin production and GAD will search for antibodies.

Here is a link or 2.

What Type Of Diabetes Do I Have? (http://www.diabetesnet.com/diabetes_types/whatype.php)

Latent autoimmune diabetes - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Latent_autoimmune_diabetes)

[frombc]

Thanks for the links and information mortis505.

Unfortuetley not all drs. are willing to send you for these tests, especially when you're not even considered pre-diabetic. In Canada, my fasting and OGT numbers are considered perfectly normal.

I took it upon myself to buy a meter and see if there was any deterioration in my numbers over the last 3+ years.

There hasn't beeen any, and that's why I'm asking the question about what could someone expect to see in the progress of fasting and PP BG nos. if one were actually a type 1.5 instead of a type 2.

I honestly don't think my Dr. will send me for those tests, since I'm not even on the radar for D. as far as he's concerned.

[Subby]

From one of your threads:

I test for a week or so every few months to see what's going on...checking for changes. For months now my fasting has been steady at 84. Two hours after meals is usually 95-110.

Your fasting is completely "normal". With typical meter variance, your pp is most commonly likely close to just over 100.

My opinion: with these figures, although there is variation as to what exactly "non diabetic" is, I'd say you are not far off it at all. With that in mind I have a lot of difficulty considering what type you "might" be headed for.

[mortis505]

Type 1.5 - LADA is just a slow onset of Type 1. Without treatment, meds, or insulin you would progress quickly into a stage of pancreatic(Beta-cell) failure and would have likely ended up with MUCH higher numbers.

The numbers both of you state are well within normal IMHO. And most here would kill for numbers like that.

That 158 could be attributed to the extremely high carb value of the McD's food.

Otherwise I'd recommend OGTT tests and discussing issues with your primary care physician.

[frombc]

Thanks mortis and subby,

I actually did have a OGTT back in 2006. It came back at 119 after 2 hours. My fasting that same day was 103.

I'm going for a physical soon and will bring up these issues with my Dr. But like I said, he doesn't even consider me to be pre-D, let alone heading toward LADA or anything else.

I appreciate your input.

[Subby]

I take it you've found various sources, have you seen this data of non-diabetic reaction to a meal? What is a Normal Blood Sugar? (http://www.phlaunt.com/diabetes/16422495.php)

The vertical line at the bottom is the meal. The blue line is the average, the brown lines above and below are the range. The range is big. I guess there can be no guarantee that some of those in the higher range may not be headed for prediabetes. But it is some data to consider, and shows how perhaps spikes really are a part of non diabetic life.

The page is well worth a read for more input on the question. A lot on that site is good info, though I haven't read through all of it so it's not an unreserved comment from me.

[frombc]

In my internet travels the other day, I found something interesting about some testing they did with university students about how stress affects BG levels.

There weren't many participants, but I did notice that all their numbers went pretty high after the 60g glucose load.

According to the websites that say truly 'normal' people NEver go above 120 and go back to about 85 after 1 or two hours, these people would all have glucose problems.

Here's the link to the study.
psychosomaticmedicine.org/cgi/reprint/47/6/558.pdf

Every single one of them went above 120 at the 60 minute mark. Many, quite a bit above 120.

What would be the chances that they happened to pick these people and all of them had glucose problems. One of the criteria of them participating is that they didn't have any relatives with diabetes.

This sort of thing really makes me wonder about some of the stuff I read out there about what 'normal' is.

[Kazz]

Thanks everyone. I'm going to keep monitoring my fasting figures (they are "abnormal", according to the "what is a normal blood sugar" article - alas) and explore it more with my doctor next time my annual checkup rolls around. I don't want to let this take over my life though, so that's enough navel-gazing for today - I'm off for a run! :)

[Subby]

In my internet travels the other day, I found something interesting about some testing they did with university students about how stress affects BG levels.

There weren't many participants, but I did notice that all their numbers went pretty high after the 60g glucose load.

According to the websites that say truly 'normal' people NEver go above 120 and go back to about 85 after 1 or two hours, these people would all have glucose problems.

Here's the link to the study.
psychosomaticmedicine.org/cgi/reprint/47/6/558.pdf

Every single one of them went above 120 at the 60 minute mark. Many, quite a bit above 120.

What would be the chances that they happened to pick these people and all of them had glucose problems. One of the criteria of them participating is that they didn't have any relatives with diabetes.

This sort of thing really makes me wonder about some of the stuff I read out there about what 'normal' is.

What all this suggests is that with your current trends, concentrate on improving your life and dealing with stress better. Improve your diet. Remove big sugar and carb hits hits. Take up tai chi or swimming. Walk a lot. Interact with people more in an enjoyable social sense. Get regularly de-stressed from work or study. Walk your dog more. Go hiking. Whatever it is that makes you more relaxed and healthier, and that includes relaxed and happy with life mentally, do it.

By all means keep one eye to your BGs, and I'd try and get some kind of regular or semi regular A1c to further fill in the picture for yourself. I'm really not sure that overly worrying about this or taking test after test for months when you show essentially non diabetic levels, is going to be beneficial in that aim of avoiding body and mental stress! This is just a suggestion, the thought that comes up for me when you discuss your case.

[Subby]

What you also have to ask yourself, is, just say a doctor diagnosed you with type 2 diabetes - what would it change? What actions would you take? What are you actually looking for with a diagnosis, considering your situation?

Anything that you'd be doing in that scenario... you can and should be doing right now if worried, such as moderating diet, maintaining healthy activity and de-stressing. This in no way guarantees avoiding the condition. It's just what you would be doing anyway, or should be and may well be preventative.

[Subby]

Frombc, I thought of you again today, coming across this article. I don't know what your age is, but I didn't think you sounded particularly old. Anyway, it's a study over 20 years (long term studies can be valuable) that supports the notion that you can really maximise your chances of preventing or avoiding problems down the track with staying in better shape physically.

Aerobically Unfit Young Adults On Road To Diabetes In Middle Age (http://www.sciencedaily.com/releases/2009/06/090618124944.htm)

Just kind of parallel to what I was saying: get on with being healthy now, it may be where your work really lies right now.

[frombc]

What all this suggests is that with your current trends, concentrate on improving your life and dealing with stress better. Improve your diet. Remove big sugar and carb hits hits. Take up tai chi or swimming. Walk a lot. Interact with people more in an enjoyable social sense. Get regularly de-stressed from work or study. Walk your dog more. Go hiking. Whatever it is that makes you more relaxed and healthier, and that includes relaxed and happy with life mentally, do it.

How do you know I don't do all or some of those things already? Your post is very condescending. It sounds like my questions annoy you.

I'm just trying to get a clearer picture of what BG is all about, and what better place to come than a message board with people that know about it.

There is so much conflicting information out there that I find the best way to get a clearer picture is to gather as much information as you can and then come to your own conclusions from what you've learned.

I admit, I over analyze things, but it's amazing what you can sort out by doing so. My Ulcerative Colitis wouldn't be in remission right now if it wasn't for my own research. My Dr. wasn't much help at all.

I'm really not sure that overly worrying about this or taking test after test for months when you show essentially non diabetic levels, is going to be beneficial in that aim of avoiding body and mental stress! This is just a suggestion, the thought that comes up for me when you discuss your case.

I agree, overly worrying is no good, but researching is good. As far as essentially normal levels, I guess it all depends on who you listen to. According to the ADA I'm Pre-D. According to the CDA I'm just fine. If I listened to my Dr., I wouldn't even know I may have a glucose problem.

From the reading I've done on diabetic message boards and websites they say to test, test, test. Yet you make it sound like the fact that I'm testing myself is unusual or crazy.

Frombc, I thought of you again today, coming across this article. I don't know what your age is, but I didn't think you sounded particularly old.

Thank you for thinking of me :) I'm not sure if your remark on my age is a passive aggressive insult or not, but I'm a 50 year old female.

[Subby]

I don't know you or what you get up to, so it has to be taken for granted that you may already be doing, or already know, advice to improve the odds against developing insulin resistance. I always take that for granted. How is someone offering you their own advice insulting, just because you agree with it/already do it?

Testing: yes, test test test for diabetics, depending partly on the stability of their BGs. Even for diabetics it can take a toll and they can overdo it and it's a stress. I wasn't trying to make you "feel" anything with that like "unusual or crazy". You read way to much into that.

As for your age, it was simply an impression based on the fact you "sounded" younger to me, as far as inquisitive, not stuck in your ways, etc. I'm more than happy to apologise for getting it wrong - maybe a part of it was that as I read that report, I thought of you, and thought "hey this is big news that potential prediabetic should know" and I made the decision that instead of post it in it's own thread, it might have more meaning to share it with you on your thread about potentially being prediabetic. Talk about major backfire - so be it.

For seeming condescending and all the other things you feel I've done here - my apologies.