New.... and very confused! [Archive]

diaconfused

03-08-2006, 08:14 PM

Hello everyone!

I came upon this site by accident today and I must say I found it to be great!

I recently (about 3 weeks ago) went for a routine physical that, for my family, includes blood tests. My mom's a vet and she makes us all do all kinds of crazy stuff!

The test results came back - all perfectly normal, except some biggies:

Fasting Blood Glucose: 119 (lab range 10-115)
2h PP Blood Glucose: 201 (lab range 70-140)
Total Cholesterol: 106 (lab range 130-220)
HDL Cholesterol: 21 (lab range 35-55)
LDL Cholesterol: 58 (lab range 110-140)

Turned out I was diabetic. I made an appointment with a doctor, who basically told me to chill, pop a couple of pills (2x daily Metformin 500 and 1 x daily Pioglitazone 15), exercise, avoid pure sugar, bananas and rice, and get tested again in 6 weeks.

I didn't like that doctor, so I'm shopping for a new one.

In the meantime, I am completely confused. And wondering if any of you folks can help.

1) I know my test results aren't good. But what do they really mean? Are they really bad? That extremely low cholesterol, is it something to worry about?

2) I have accepted that I am diabetic - though that first doctor sais "not yet". However, am I not supposed to feel unwell? I haven't had a single symptom that one is supposed to. In fact, I've never felt better - physically or mentally - in my life than I do today. I'm 29, 5'10" and weighed in at 148 lbs this morning.

3) When I go back to get re-tested, will the hospital do the tests without a doctor's orders if I haven't found a new doctor by then?

4) I have cut out everything with high or added sugar in it: fruit juice, candy, chocolate, sweet cereal, gatorade, dessert (sob!), etc etc etc. Stopped eating meat, rice and eggs completely. And I've been sticking to at most 2 drinks a week (usually Friday night after work). Is this enough? Or do I need to do more? I also work out for an hour, 5 times a week.

5) Back to food: I haven't been able to find a cereal that has no sugar in it at all. Is it okay to eat something by, for example, Kashi, that has "evaporated sugarcane juice" for a total of 8g sugar per serving?
What about yoghurt? Are the naturally sweetened, no sugar added ones okay? What about fructose or corn syrup?

Sorry for the bombardment. I am just completely shiny and new (still in the original packaging, I guess!) and haven't been able to get answers I need from the useless doctor.

Thanks guys! Any input will be really appreciated.

greendavid

03-08-2006, 10:33 PM

Your numbers are not that bad. You have plenty of time to figure things out. Don't freak! This is not an emergency!

Don't make radical changes to your diet or behavior without more information.

Go to a bookstore or a library and browse the diabetes shelf. Look for books specific to type 2 diabetes.

There's a lot of good information flying around and a lot of crappy misinformation, too. It is going to take you days or weeks to get the basic picture and weeks to months to get a complete view of your personal situation.

You will be fine!

SemperFiMac

03-08-2006, 11:17 PM

SemperFiMac

03-08-2006, 11:19 PM

cerals? Oatmeal, and total bran are my favorites

Yoplait light, actually recommended by the nutionists I got to go see four times. She said to make sure you get the "light"....

greendavid

03-08-2006, 11:27 PM

Here are some online resources. (The problem with many online resources -- and books too -- is that they mush together information about type 1 and type 2. Then, they mush together information about type 2 controlled with a) diet and exercise, b) diet, exercise, and oral medication, and c) diet, exercise, and insulin. So you have to read more than you would think to sort out what's relevant to you.)

Joslin Diabetes Center (http://www.joslin.org/LearnAboutDiabetes_Index_home.asp) at Harvard
American Diabetes Association (http://www.diabetes.org)
National Diabetes Education Program (http://www.ndep.nih.gov/)
Centers for Disease Control (http://www.cdc.gov/diabetes/)

seacomp

03-08-2006, 11:32 PM

In fact, I've never felt better - physically or mentally - in my life than I do today. I'm 29, 5'10" and weighed in at 148 lbs this morning.
Welcome to the forum, I hope we can help.
It's not at all unusual to have no symptoms, especially since your diabetes is at a very mild stage. When you get reading around 300 or so is when you start to experience the classic excess urination and excessive thirst.
Given you height, weight, age and that you are physically active, I wonder if you are really a Type 2. You sound more like what is referred to here as a T1.5, but there are others here who know more than I on that.

MarkMunday

03-09-2006, 01:14 AM

Welcome to the forum, I hope we can help.
It's not at all unusual to have no symptoms, especially since your diabetes is at a very mild stage. When you get reading around 300 or so is when you start to experience the classic excess urination and excessive thirst.
Given you height, weight, age and that you are physically active, I wonder if you are really a Type 2. You sound more like what is referred to here as a T1.5, but there are others here who know more than I on that.
Following on from seacomp's comments, it sounds like the doctor thinks you are a Type 2. But because of the circumstances (age, weight) it would be a good idea to get that diagnosis confirmed. Ask the hospital to do the anitobody and/or insulin level tests. You could be a so-called Type 1.5, or even in the very early stages of Type 1. The different types of diabetes require very different forms of traetment.

Those cholesterol numbers seem very low. Low cholesterol suggests that your body is struggling with something. So, even if you are feeling well, it is probably a good idea to have a thorough medical checkup. Low cholesterol is associated impaired cognitive function and psycholgical problems. But if you are feeling well, it sounds like that isn't an issue. But you should probably be eating lots of good fats and maybe supplementing with cod liver oil.

There isn't much info around on dealing with low cholesterol. But here are some comments I found :

So what should you do if you find that, without obvious underlying illness such as cancer, AIDS or a chronic auto-immune or “infectious” condition, you turn up with a cholesterol below 150? The first and most important thing is to try to take an unbiased assessment of how you are feeling. Try to find a source of some imbalance that perhaps you have been overlooking. For instance, do you feel run down, fatigued, achy most of the time? Does something hurt that you are trying to ignore? In other words, a low serum cholesterol often means your body is struggling with something and you are using up your reserves. As you are on the lookout for the source of the struggle, you should as soon as possible adopt a traditional diet, including the liberal use of good fats (butter, egg yolks, cod liver oil, etc.), lacto-fermented foods, bone broth and all the other healing elements of this regime.

If a source of the trouble is discovered (in one patient we discovered an underlying hepatitis, in another chronic Lyme’s disease), it should be
addressed appropriately. If no reason for the low cholesterol is found, adopting a traditional high-fat diet will often resolve the low-cholesterol issue, but only after about two to three years. In this case, there is often a situation of high stress or a chronic low level “infection” which is the source of the trouble. Thus, any lifestyle changes to lower your stress can also be helpful; remember, the stress hormones are all made from cholesterol. In most cases, we either find the source of the trouble or it resolves on its own given time, patience, and a diligent approach to improving our lifestyle.

About the Author
Tom Cowan, MD is a physician in private practice in San Francisco, California. Visit his website at http://www.fourfoldhealing.com

Hope this helps,

Mark

greendavid

03-09-2006, 08:33 AM

Here's a link to an explanation of what "Type 1.5" means:

http://www.diabetesnet.com/diabetes_types/whatype.php

The main distinction (as best I understand it) is that a person with type 2 produces insulin (in the pancreas) but has "insulin resistance" which causes elevated blood glucose.

A person with type 1.5 produces insulin, but less than the body needs, and the production of insulin goes down over time. There is no insulin resistance.

In type 1, the pancreas produces no insulin at all, and there is no insulin resistance.

I agree with the other folks here who say that you should be tested to determine what type you have. (The test is called a "c-peptide" test, and it looks for anti-bodies that signal the autoimmune process that characterizes type 1.) Find a doctor who has a clue and can help you.

Ritehsedad

03-09-2006, 08:47 AM

(The test is called a "c-peptide" test, and it looks for anti-bodies that signal the autoimmune process that characterizes type 1.)

Actually, what the c-peptide test does is to test for c-peptide molecules. The amount of c-peptide in the body directly corresponds to the amount of insulin the pancreas produces because the pancreas produces insulin as a larger molecule called propeptide (I've also seen it called proinsulin). This molecule is then split in two by the body into insulin and c-peptide.

greendavid

03-09-2006, 08:51 AM

Right! I was wrong! C-peptide is not the test for antibodies! My bad! :ahhhhh:

There's a different test, the name of which I don't know, at present.

Simon

03-09-2006, 09:08 AM

My type 1.5 diagnosis was confirmed with a GAD antibody test which is different to the c-peptide test but either will probably do. You won't be on insulin for a while yet (if ever) with figures like that so there's plenty of time to get sorted.
It's worth getting into the habbit of counting the carb content of your food. Up to 40g per meal is a good start. No need to cut back on protien like meat/eggs etc unless you've been told otherwise. Sugar is allowed in small amounts, just count the carbs. It's worth learning about GI values as well though and trying to eat more low GI foods.

sydneya

03-09-2006, 09:50 AM

:thumbsup: Welcome to the site. Most of us have been in the same confused state. I was diagnosed almost twenty years ago when I was pregnant. I was sent immediately to the hospital and given three days of training. So it's handled very differently now. It would be nice for you to be given more info. I would talk to the doc about a diabetic educator and nutritionist. They don't put you in the hospital anymore for training but they have wonderful courses with lots of info. Plan on being confused for awhile though. It just takes time to learn and adjust. And you do have time!!
Many people don't recognized any symptoms when they are diagnosed. More find out from lab tests with normal physicals than because they felt symptoms.
I don't imagine that the hospital will do any tests without a doctors order. I would stick to your doctor until you find another. The thing with diabetes is that noone is the same. Maybe you can eat Kiosi cereal and it will be fine. I can't. I can eat yogart, but only the yoplain light. You'll need to look for the one with the least carbs. You need to hold the carbs down (I eat 45 at each meal and 15 at 2 snacks a day) but you can't eat absolutely none. That's why you need a dietician appt. The diet is different for each of us.
I imagine that when the doc said you were "not yet" he meant you were pre-diabetic. Getting close, but not 100% yet. He was asking you to be careful. Not to overeat, hold down the sugars, eat protein, drink lots of water and exercise.
It sounds like you are doing what you can for now. In fact, I believe you are doing more than you need to. (Keep in mind that I am not a doctor.) You need some protein. I wouldn't cut out all meat or all eggs. I would be reasonable, though.
We are pleased to have you on the forum. Post often. Ask any questions and give any opinions. There is a lot of knowledge here. I've been given much help and hope you will to.
Good luck. I also agree with others that have said, try to keep the stress down. :vollkomme As strange as it seems, adrenalin turns to sugar. It's as damaging as food. Find things you enjoy doing and enjoy life!!! :five:

Harold

03-09-2006, 12:22 PM

Interesting. A dx for type 2 usually requires one to fail 2 of the 3 types of glucose test on different dates, usually 4 to 6 weeks apart. The slightly elevated Fasting Blood Glucose (FBG) shows you to be developing Insulin Resistance. Since it is not above 140 it is considered "not yet" for diabetes. The 2hr PP Glucose Test is not usually part of a routine blood work up done for a routine physical. The 2hr PP Glucose Test usually comes from a Glucose Tolerance Test or GTT where a standard amount of glucose is given and your response monitored over several hours. Anything greater than a 200 reading at the 2hr hour mark is considered a failure.

Your height/weight does not fit the usual mold for type 2 and I can think of two reasons for this. One your resistance has been caught very very early. I say this because some of us are not overweigt or obese to start with, but start putting on weight several to few years before dx, seemingly regardles of what we eat untill we are overweight and some almost obese. The gained weight is usually blamed by us for the symptoms felt untill dx and then blamed as the cause by doctors. The second reason would be that your starting to experience Secondary Diabetes. This would be diabetes symptoms caused by some other condition. The Low Cholesterol may be symptoms of a primary cause of your high 2hr PP bg and needs to be evaluated by a professional.

Then as the others have said you may really be an early 1.5 and failing your next test along with repeated low cholesterol levels you should ask your doctor for a referal to see an Endo.

Notes:

C-peptide test given done at fasting will only show if it's normal for a fasting level and not your response levels.

Gad-anti bodies show up in various reduced levels in 20% of type 2's, but not at levels to be positive for total destruction of beta cells.

Secondary Diabetes while not type 2 may cause or lead to type 2 if the primary cause is chronic.

Ritehsedad

03-10-2006, 08:53 AM

Right! I was wrong! C-peptide is not the test for antibodies! My bad! :ahhhhh:

Pobody's nerfect! :flute:

Isn't that other test called the "test for anti-bodies that signal the autoimmune process that characterizes type 1"?

OK, I'll shut up now.

diaconfused

03-11-2006, 09:38 PM

Thanks for your replies and inputs everyone!

Clearly, I have a LOT to learn. :eek:

Whatever I've been doing so far, hasn't seemed to be all that difficult. Obviously, that means I ain't doin' it right!

The most difficult part actually seems to be having to think before I eat anything - unlike before, when I would shove whatever and whenever in my mouth.

And here I was thinking I basically need to avoid sugars and exercise (to oversimplify). Turns out, no, watch the carbs! I looked at the carb content of everything - and, ****, almost everything's got carbs in it! The only thing I found with no or very little carbs was Diet Coke, butter and cheese! The 'safe' cereal I had found has 0 sugar but 38 g carbs!

This was my diet yesterday:

Breakfast: Cereal w/ milk & Splenda, 1 whole grain toast w/ butter, coffee
Elevenses: Coffee
Lunch: 2 oranges
Afternoon: Diet Coke
Dinner: Salad without dressing, penne in marinara sauce, 2 beers (Bass)

Is that acceptable? Or am I on the way to a BG reading of 5000?!

Also, what's the deal with skipping meals or eating at odd times? Is it okay, or does that cause more complications? It's not always possible to eat at the same time every day - for example, I refuse to wake up before 10 on Saturdays, so that's breakfast or lunch out the wndow.

I also started looking up and reading the information on many of the websites out there. I found that it was quite like reading Scripture - you have to muddle through multiple versions of the 'truth' before arriving at an inaccurate conclusion! Makes me think it's better to stick with the opinion of 1 doctor you trust and you guys, of course.

Nothing beats personal experience, in my mind.

I have an appointment with the GP on Tuesday and with the endo on Mar 28. Let's see what they tell me.

In the meanwhile, I'm going to continue doing what I'm doing, take the great input from you guys and prepare to get my butt kicked by the gym instructor again!

And, as I process all the information, I'm going to have plenty more questions!

Thanks all - you'll are great!

seacomp

03-12-2006, 02:21 AM

And here I was thinking I basically need to avoid sugars and exercise (to oversimplify). Turns out, no, watch the carbs! I looked at the carb content of everything - and, ****, almost everything's got carbs in it! The only thing I found with no or very little carbs was Diet Coke, butter and cheese! The 'safe' cereal I had found has 0 sugar but 38 g carbs!

Well, the sooner you learn that carbs=sugar, just a difference in speed of absorbtion, the better. Things aren't that bad: a bacon cheeseburger - hold the bun - is 0 carbs. And a glass of dry wine is zero or near zero.
Do you have a meter to test BG yet? How your body reacts to various foods and to various types of exercise is different for everyone. The only way to find out what works for you, or doesn't work is to test.
It's good that you were DXed early, if you control things well you can prevent complications and perhaps any progression of the disease.
Good Luck!:thumbsup:

diaconfused

03-12-2006, 09:41 AM

Well, the sooner you learn that carbs=sugar, just a difference in speed of absorbtion, the better. Things aren't that bad: a bacon cheeseburger - hold the bun - is 0 carbs. And a glass of dry wine is zero or near zero.
D'you also find it weird how that works?

I mean I could, in theory, drown some asparagus and mushrooms in salt and butter, crumble some yummy blue cheese on it and wash it all down with a nice glass of the Margaux. And that would still be better for me than a bowl of all-natural, super-healthy whole grain cereal with skimmed milk! :ahhhhh:

My BP's normal and cholesterol almost non-existent, so that theory could work, right? :wink:

seacomp

03-12-2006, 10:23 AM

D'you also find it weird how that works?

I mean I could, in theory, drown some asparagus and mushrooms in salt and butter, crumble some yummy blue cheese on it and wash it all down with a nice glass of the Margaux. And that would still be better for me than a bowl of all-natural, super-healthy whole grain cereal with skimmed milk! :ahhhhh:

My BP's normal and cholesterol almost non-existent, so that theory could work, right? :wink:
In so far as you are a diabetic that is certainly true.
There are those who believe that a high carb, low fat, low protein diet is the way to go no matter what. If people can control their BG on that, more power to them. But I believe most diabetics can't, and if your BGs aren't controlled then the complications set in soon, not in the 20 or 30 years down the road that the low fat diet aims at,
My own personal opinion is most of what you have been taught about what is healthy food is a load of dog poo intended to discourage the eating of meat. After all in a gobalized world how can you compete aginst the rice eating asians if you eat meat?

diaconfused

03-12-2006, 10:48 AM

If you are in gwinnett county, you can go to my doctor.
But he also told me to take a few pills, exercise, and learn to eat better.
He also sent me to four nutrionists consults to teach me about the diease.
He also told me to chill...
Thanks. I'm over at Lenox and I've got myself an appointment with a doctor by Piedmont. Let's see how that goes.

Given you height, weight, age and that you are physically active, I wonder if you are really a Type 2. You sound more like what is referred to here as a T1.5, but there are others here who know more than I on that.
To be honest, I wasn't actually told I was a Type anything. I was just told I'm not yet diabetic - whatever that means. According to my brother - who's great, if a little tactless - it's like being HIV+ but not yet having AIDS.

I just automatically assumed that, since I wasn't shooting up insulin, I was a Type 2.

You know, if it weren't for the test results, I wouldn't have thought I had form of diabetes at all. I honestly have never felt better in my life than I do now. Life's going well, work is good, all the people I care about are happy, I'm generally happy, physically and mentally I've never been better. And then the evil lab tests showed up. That's what baffles me.

Those cholesterol numbers seem very low. Low cholesterol suggests that your body is struggling with something. So, even if you are feeling well, it is probably a good idea to have a thorough medical checkup. Low cholesterol is associated impaired cognitive function and psycholgical problems. But if you are feeling well, it sounds like that isn't an issue. Mark
Thanks Mark. I agree and I did have a thorough medical checkup about a month ago. Of course, I didn't go have the checkup because of the test results, but because I hadn't been near a doctor in years and my mother the vet made me when I went to visit her in England last month.

I spent almost all day getting everything imaginable tested: physical, blood and urine (fasting and PP), stool, stress, heart, lungs, eyes, nose, ears, chest xray, etc.

The only things that were outside the lab range were the sugars (119 and 201) and the cholesterol (all very low).

It seems the cholesterol numbers are as worrisome as the BG and something I completely overlooked. I will have those examined next time.

Your height/weight does not fit the usual mold for type 2 and I can think of two reasons for this. One your resistance has been caught very very early. I say this because some of us are not overweigt or obese to start with, but start putting on weight several to few years before dx, seemingly regardles of what we eat untill we are overweight and some almost obese. The gained weight is usually blamed by us for the symptoms felt untill dx and then blamed as the cause by doctors.
Again, my situation seems to differ in the weight matter too. I was overweight until not too long ago. I used to be about 190-200 lbs and started working on it a couple of years ago. Through diet and exercise, I brought my weight down to 145 by October last year. That's when I seriously cut down on the exercise and started eating 'normal' again. The result was that I gained 5 lbs in the next 4 months. So, I was 150 lbs when my sugars came back high. Then I got put on the Metformin and Pioglitazone, which, supposedly, are supposed to make you gain weight. I decided that wasn't going to happen and have managed to lose 2 lbs in the 3-4 weeks since I started popping the pills. My new target isn't to just to lose much weight, as it is to gain muscle (which I don't really have) and to get rid of the little tummy and love handles. A waist of 29" (from 31" right now) will be nice!

I can dream, can't I? At least that won't send the BG flying!

Harold

03-12-2006, 12:18 PM

My new target isn't to just to lose much weight, as it is to gain muscle (which I don't really have) and to get rid of the little tummy and love handles.You may have hit the nail on the head here. Lack of muscle mass or muscle tone will influence how efficiently your body uses insulin. Work on your muscle tone first both resistance and aerobic. Then work on the mass, you may find you don't need that much mass after achieving good muscle tone.

Ashtur

03-12-2006, 01:12 PM

If your doc said, "not yet diabetic", then that means you are potentially type 2. The proper term would be "pre-diabetic" or that you have "impaired glucose tolerence", which is a precursor to Type 2.

As for high carb vs low carb, it's a loverly eternal compramise. If you go meat heavy, you risk your heart and brain (stroke). If you go carb heavy, you risk the entire range of complications.

Ultimately, the first goal will be to keep your BG's under control. If you can do so with a relatively high carb regimen, that's probably the best. If that doesn't work, make the necessary adjustments.

diaconfused

03-19-2006, 10:32 AM

You may have hit the nail on the head here. Lack of muscle mass or muscle tone will influence how efficiently your body uses insulin. Work on your muscle tone first both resistance and aerobic. Then work on the mass, you may find you don't need that much mass after achieving good muscle tone.
Agreed. I gave up any fantasies I had of looking like Brad Pitt or whoever a long time ago. I'll be able to walk on water before I can achieve that!

The trainer in this new gym I joined has been kicking my butt twice every week. And I told her that my goal now is to exercise to stay healthy and try to get rid of my spare tyre in the process. Anything else will be an added bonus.

It would be nice to get down to 140 lb (from 148 now) and have a 29-inch waist (31 in now) but I'm not holding my breath.

diaconfused

03-19-2006, 10:39 AM

As for high carb vs low carb, it's a loverly eternal compramise. If you go meat heavy, you risk your heart and brain (stroke). If you go carb heavy, you risk the entire range of complications.

Ultimately, the first goal will be to keep your BG's under control. If you can do so with a relatively high carb regimen, that's probably the best. If that doesn't work, make the necessary adjustments.

I've never been the greatest meat lover - even before, the most I usually ate was a steak about once a month. And giving up meat completely was my own decision, and it's not been at all difficult for me to pass on it completely for the last 6 weeks.

Carbs, on the other hand, were something I never thought about before. Now that I've been looking at the food labels, I'm amazed to find that almost everything is full of carbs! This one's going to take some major adjustment.

diaconfused

03-19-2006, 10:56 AM

So, I found a new GP and went to see him a couple of days ago.

This doctor I liked. He seemed well-informed, was patient, spent 45 minutes discussing things with me and he responded to all of my questions with acceptable answers.

He checked the vitals:

Height: 5'8"
Weight: 148
BP: 110/74
Everything else: Just fine

So he asked me what the fuss was all about. I told him I was kinda sorta diabetic. He looked the test results over and noticed I hadn't got an A1C done, so he ordered that. He also did a random BG test right there. This was around 11.30 am and I had over-indulged in a nice little carb fest earlier that morning: big bowl of cereal with 2% milk, 2 slices of white toast and a yoghurt. And then the random BG was 62!

Funny disease, this diabetes!

I don't have the A1C results yet, but he did recommend a bunch of things:

1. Continue to exercise at least 5 days / week
2. Make an appointment with the dietician
3. Stop taking the Piogliatazone (but continue the Metformin)
4. See what the A1C says and then we can take any further action needed
5. Give cinnamon / chromium pills a shot - might not work, but certainly won't do any harm

He also said that my shockingly low cholesterol numbers weren't that big of a deal. If my LDL were high or even normal and HDL low, then it would be an issue. But since the LDL, HDL, VLDL, Triglycerides and total cholesterol were all very low, there's nothing to worry about. I should just make sure that LDL and triglycerides stay low.

seacomp

03-19-2006, 11:07 AM

It doesn't look too bad at all. I happy for you. And it's good that you found a doctor that you like; that's very important.
Do let us know when your A1C comes back.

diaconfused

03-19-2006, 11:36 AM

It doesn't look too bad at all. I happy for you. And it's good that you found a doctor that you like; that's very important.
Do let us know when your A1C comes back.
Thanks! I'm waiting for the A1C as well and I'll definitely post the results once I know them.

And I was definitely very satisfied with the new doctor - that was a great relief.

diaconfused

03-22-2006, 12:39 PM

Finally got the A1C results today. Doesn't look good at all.

It was 8.1.

However, the PA said that this didn't just show that I was diabetic (duh), but it indicated my glucose levels over a period of time. And, since I've only been diagnosed recently and have been 'managing' my diabetes for only a few weeks, it will take time for the A1C levels to change. Also, the random BG taken from the same sample was 62 (!!!).

Basically, I should get re-tested in 3 months or so and then we'll have a better picture.

Is this correct? And what am I supposed to do until then? Sit around and wait?

greendavid

03-22-2006, 05:06 PM

If you have not been using a blood glucose meter at home, you should start. This will give you real-time feedback as to what's going on with your blood sugar during the day. You can probably get the meter for free (because the strips are where the companies make their money, about 75 cents per strip). Ask your doctor or pharmacist.

It's a little strange that your A1c was 8.1 and your BG at that time was 62. These readings indicate that your blood glucose level is fluctuating wildly during the day. An A1c of 8.1 means that your average BG over the past 2-3 months was about 205 mg/dl. BG 62 mg/dl is actually hypoglycemia (low blood sugar; the threshold is 70 mg/dl).

What could be happening (I am not a doctor!) is that you are having high post-prandial (i.e. after-meal) BG levels. If your BG is spiking in the 1 or 2 hours after you eat, it could be raising your average blood glucose level and thus your A1c.

The best way to discover what's going on is to use a meter during the day. Take a reading when you wake up ("fasting blood glucose"). Take a reading just before you eat, then 2 hours after. You can measure around a different meal each day, to save strips.

The recommended target BG levels for being "in control" are as follows:

Before meals: 90-130 mg/dl.
2 hours after meals: < 140 mg/dl. (or < 180 from the ADA).

Whatever your numbers are, you will be able to use them with your doctor to get a handle on what is happening. (You may also want to write down the foods you eat so you can correlate them with the BG readings.)

diaconfused

03-24-2006, 11:51 AM

If you have not been using a blood glucose meter at home, you should start. This will give you real-time feedback as to what's going on with your blood sugar during the day. You can probably get the meter for free (because the strips are where the companies make their money, about 75 cents per strip). Ask your doctor or pharmacist.
Thanks David. I am going to do that. I suppose I need to call in and get a prescription, right?

Also, here's what my insurance policy says about meters and test strips:

Covered medications include:
** Diabetic medications and supplies (Rx; OTC is limited to diabetic test strips, disposable and reusable syringes, needles and lancets)
Medications not included in the plan are:
** Diabetic monitors

So, I guess I can get the test strips for 'free' but I have to pay for the monitor itself. Is that correct?

It's a little strange that your A1c was 8.1 and your BG at that time was 62. These readings indicate that your blood glucose level is fluctuating wildly during the day. An A1c of 8.1 means that your average BG over the past 2-3 months was about 205 mg/dl. BG 62 mg/dl is actually hypoglycemia (low blood sugar; the threshold is 70 mg/dl).
I concur completely - I concur completely. However, the doc said that this could be because I've only started 'managing' my diabetes for a few weeks now, while the A1C goes back much longer than that. If I'm managing it right, then, theoretically, the A1Cs should be better the next time we test them, in a couple of months.

As for the 62 reading and hypoglycemia - what am I supposed to feel? I mean, when ones goes hypo, how does one feel, physically. I'm asking because - for some reason - no matter what happens, I feel the same. I've never felt better, physically, and that does not change if I eat or not, if I exercise, if I drink or OD on the carbs or anything. No matter what I do or don't do, I feel the same. Which also makes it that much harder to identify if something's going wrong, I suppose.

Tatermom

03-24-2006, 12:12 PM

Is it okay to eat something by, for example, Kashi, that has "evaporated sugarcane juice" for a total of 8g sugar per serving?

From what the nurse educator told me, Kashi is one of the best cereals you can eat b/c its LOADED with fiber which doesn't have such an awful effect on blood sugars.

On the other hand, have you ever actually eaten Kashi? Absolutely reminds me of chewing twigs. I love Grape Nuts and "good for you" cereals, but that Kashi stuff is gross. I have two boxes in my pantry that you are more than welcome to have.

seacomp

03-24-2006, 01:12 PM

I suppose I need to call in and get a prescription, right?
Also, here's what my insurance policy says about meters and test strips:

Covered medications include:
** Diabetic medications and supplies (Rx; OTC is limited to diabetic test strips, disposable and reusable syringes, needles and lancets)
Medications not included in the plan are:
** Diabetic monitors
You don't need a script to get a monitor, but it's a good idea to have one, and especially a script for the number of test strips you are to use per day. The more the better.
Monitors can be gotten free or very cheap. There a thread here on doing that. All the $money$ is in the test strips.

greendavid

03-24-2006, 07:54 PM

You may be able to get a free meter by calling the company (whichever one you choose) directly. (My HMO gets meters free and gives them to us for free because they spend $5 million per year on test strips. I don't know if it works for individuals.)

About hypoglycemia: Some people feel it severely and others don't, and the feeling can change over time in an individual. Shaking, sweating, and rapid heartbeat are common symptoms (caused, I recently learned, by the stress hormones andrenaline and coritisol being released into the bloodstream). You can also just feel generally shi**y for no apparent reason.

If you're only taking Metformin, you are at low risk for hypoglycemia, according to my CDE (Certified Diabetes Educator). But, I would suggest being ready to treat hypo anyway, since your meter recently showed 62 mg/dl. You should carry rapid-acting carbohydrate (i.e. sugar) with you, like the "glucose tabs" you can buy at a pharmacy, or even some packets of table sugar.

Here's the whole regimen, even though you sound like you are at low risk:

If your meter reads less than 70 mg/dl, take 15 grams of rapid-acting carb, wait 15 minutes, and test again. If your BG is still below 70, take another 15 grams and test again in 15 minutes. (15 grams = 4 glucose tabs = 2 teaspoons sugar or honey = 1/2 can of regular non-diet soda = 4 ounces fruit juice). This is called the 15-15 rule.

Don't eat fat with the sugar, because it slows down the absorption in your bloodstream. This means that you should not use a candy bar or chocolate or nuts for hypoglycemia. After your BG is above 70 mg/dl, you may want to eat a snack that includes protein if your next meal is more than 1 hour away.

You should be on the lookout for hypoglycemia after you exercise, and if you skip a meal or a planned snack. Be especially careful before you drive.

(As I said, none of this may apply to you if you are only taking Metformin for the moment, but it doesn't hurt to be aware and prepared.)

Sounds like you are in good shape and learning a lot. Keep up the good work!

diaconfused

03-25-2006, 06:41 PM

Thanks David and seacomp!

When I go see an endo (for the first time) on Tuesday, I'm goping to ask for a prescription.

I'll have to look into getting a free monitor, but supposedly the test strips are covered by my insurance, so that's a good thing.

And I suppose I will have to start depending on the test readings to tell me if I'm going low, because, honestly, I never feel anything.

Yesterday, for example, was a crazy day at work. I had a bowl of cereal for breakfast and a couple of coffees (black, no sugar or Splenda) through the day. That's all. Then I had my butt kicked for an hour and a half by the trainer in the gym, followed by 80 laps of the swimming pool. I actually felt the same, if not better, after the workout as I did through the ay, or any day before.

It is really odd.