[jilliebean42]

Diagnosed as pre-diabetic about 6 weeks ago. I started making adjustments to diet (decrease carbs to about 90-120 per day), eliminated sugar, and so forth. I think I went overboard and started having almost daily episodes of hypoglycemia. PCP started me on Metformin, 500 mg per day extended release and I bought myself a meter and started checking my levels. They would drop as low as 46!!

Anyways, I seem to have the lows back under control now by eating more often (and the metformin I imagine) but have had 3-4 times when my levels have reached 250-275. I can usually tell when it happens because I get a terrible headache, and get really tired. This is not an effect of sweets or "bad" foods.

The ONLY blood work I have had is a fasting morning glucose (112) and my insurance will only pay for supplies if I get a prescription.

My questions are-

Should I insist on more blood work? No idea what my Ac1 or whatever that test is.

Should I be concerned about the spikes of 250 and more? It has happened after a really healthy meal of chicken and veggies for dinner.

Should I ask for a referral to an endocronologist?

I know diet and exercise are the key, and I am doing both of those. The problem is, I feel like there is more going on with my body. I am in a near constant state of dizziness even when my levels are good.

[UltiMica06]

Dunno...LoL

Are u Pre Type 1 or 2???

I like to help....I dunno any of the answers to u questions!

[foxl]

Spikes over 250 would indicate you are not Pre-D, you are D.

I would be asking for more, yes. Are you scheduled to go back anytime soon?

[jilliebean42]

No scheduled visits for now. I forgot to mention they did do a "insulin level" check with was 23. She indicated it should be under 16 to be considered "normal".

[foxl]

Originally Posted by jilliebean42

No scheduled visits for now. I forgot to mention they did do a "insulin level" check with was 23. She indicated it should be under 16 to be considered "normal".

Would that be serum insulin? So you are a type 2?

[DCaplinger]

You need to see your doctor and DEMAND the following:

A referral to an Endocrinologist.
An A1c test
An anti-body test
A C-Peptide test
A prescription for the stuff you need (metformin, test strips, meter, etc)

I completely agree with foxl. A post-prandial reading of 250 would not suggest pre-diabetes, but rather diabetes. You need to get further testing done to insure you are getting the appropriate treatment.

Ask any questions you have. You need this information now while it's early. The sooner you get this under control, the better your health will be in the future.

Regards,

D

[jilliebean42]

Yes, serum insulin and I imagine it would be type II

[jilliebean42]

That was my feeling as well. I really like this doctor as far as other health issues go, but this is potentially some pretty serious stuff here and I don't feel a "wait and see if diet and exercise" approach makes sense.

Thanks for the feedback, at least I don't feel like I am overreacting or crazy!!

[DCaplinger]

You aren't crazy. You wouldn't see your family physician to treat ongoing heart problems, would you? Of course not... you'd see a cardiologist for that. Diabetes is no different. You need to see an Endo so you know that the care you are receiving comes from an expert in the field. That's exactly what you tell your doctor if s/he gives you any issues when you ask for your referral to an Endocrinologist.

EDIT: Oops, I almost forgot... you also need to demand diabetes education classes for you and your significant other, if there is one!

Regards,

D

[jilliebean42]

One more question if I may-would a "pre-diabetic" have ketones in their urine?

[DCaplinger]

Originally Posted by http://www.medterms.com/script/main/art.asp?articlekey=12478

Ketonuria: A condition in which abnormally high amounts of ketone bodies (a byproduct of the breakdown of cells) are present in the urine.

Ketonuria is a sign seen in diabetes mellitus that is out of control. Diabetics prone to ketonuria need to monitor their urine for signs of ketone buildup that could lead to life-threatening symptoms unless promptly treated. Ketonuria can also develop as a result of fasting, dieting, starvation and eating disorders.

Alternate names for ketonuria include ketoaciduria and acetonuria.

Originally Posted by http://www.deo.ucsf.edu/type2/understanding-diabetes/how-the-body-processes-sugar/ketones.html

Understanding ketoacidosis is very important for someone with Type 1 diabetes, because they have the highest risk of developing dangerous levels of ketones. However, ketoacidosis also can occur in someone with Type 2 diabetes if there is a major increase in insulin resistance (such as infection or treatment with steroids) or reduction in insulin release from the pancreas.

In short... not likely. As we said, post-prandial (2 hours after a meal) readings of 250 suggest diabetes, not pre-diabetes. Also, if you are spilling ketones, you need to report that to your physician immediately. Ketonuria is nothing to play around with. It can be deadly. Report it to your doctor, and let them decide what you should do from there.

EDIT: Oops. Also, please ask as many questions as you need to. Just because we've answered one doesn't mean your time is up. LOL. Ask, ask, ask. That's the only way to gain knowledge. Let's face it, there is already enough to learn when it comes to this disease, and when you are first starting out, it can be absolutely overwhelming.

Regards,

D