what do you think?

homeschoolmom · #1 (**permalink**) 07-06-2008, 12:03 PM

I am curious what you think of my situation. I am 37 years old with no history of diabetes in my family and weigh 108 pounds (down from about 122 a few months ago). I lost the weight after last winter, when a fasting blood sugar test came back with a 102, and I went through a premature menopause for no apparent reason. My physician did an hba1c which came back 5.3. He told me I was fine and to forget about it. The only problem is, whenever I eat a lot of carbs, my bs level goes very high ( one time 188 one hour after spaghetti). Also, when I was eating a lot of carbs, I had this tingling/numbness in my feet. Sometimes after a meal with dessert, I would get real thirsty, have a horrible headache and have to urinate a lot. So, my dr. sent me to an endo who checked my c peptide which came back at .8. He also did a glucose tolerance test that was normal (111) at 2 hours. The test for gad antibodies came back negative. Endo told me I was perfectly normal. The problem is I don't believe him. Why is my c peptide so low if I have such high readings after carbs? My fasting levels have all been normal at home (usually somewhere in the 80s range). The tingling in my feet has stopped since I cut way back on the carbs. Am I making much ado about nothing? I have a feeling that if i went back to my old diet that was full of carbs, my fasting numbers would creep right back up to prediabetic range. Am I on the road to diabetes? Am I normal? What do you think? Could I be a type 2 since I tested negative for antibodies? Could I be a type 1 with such a low c peptide?

xMenace · #2 (**permalink**) 07-06-2008, 12:06 PM

Cut back on teh refined carbs. Otherwise you are perfectly normal. 180's 1hr pp for a normal person are not that far from the norm. Your meter may also have been off for one of many reasons.

Go enjoy your summer and forget about it!

lilituc · #3 (**permalink**) 07-06-2008, 12:22 PM

I had very similar things going on, and it turned out I was diabetic. All the nondiabetic people I've tested have been below 100 after a carb-heavy meal, so I tend to agree with you more. There is no negative antibody test - there's just "not positive." It doesn't necessarily mean you're not a Type 1 or LADA. Have you looked at MODY, though?

Unfortunately, if you don't fit the diagnostic criteria, you can't get a diagnosis. If you can't get a diagnosis, you can't get your insurance to pay for supplies or treatment. So right now you have a couple of options - use your own meter to test and keep an eye on it. You could also pre-emptively treat it by cutting back on carbs, but keep in mind that if you do that, you will have an even more difficult time getting a diagnosis if you need one further down the line. Basically, at this point the best thing to do is watch and wait. You could keep insisting on GTT every so often (six months to a year) until you "fail" one. That's what I did.

parrotletzoo · #4 (**permalink**) 07-06-2008, 12:48 PM

If you are very insulin sensitive .8 cpeptide isn't all that abnormal and 188 after a high carb meal like pasta isn't abnormal either especially considering the inaccuracy of most meters. If your fasting blood sugars are normal I wouldn't worry about the occasional 180 after a large high carb meal. Everyone gets thirsty when they eat a lot of salt and carbs. thats normal also.

You could have some imparied glucose tolerance but that doesn't mean diabetes. If you feel better eating lower carb the by all means go for it. Most people eat way too many refined carbohydrates anyway and its possible you just feel better on your current diet because it is healthier.

Lizkep · #5 (**permalink**) 07-06-2008, 07:40 PM

Hi homeschoolmom, I'm a homeschool mom too! I have similar problems, but I actually have a diagnosis as a prediabetic. My understanding is 180 is high 1 hr after meal. What are you looking at at 2 hrs and 3 hrs. I posted a similar story on the intro's . I'm waiting to hear if the antibody tests come back normal. My c-peptide is normal. However, I know from 2 yrs of watching sugars that I have gone up from where I was over time. My advice if you have a meter is to monitor what you eat over a week, chart your 1,2 and 3 hrs sugars and take the info to your Doc.. Even with a hyperglycemia diagnosis some insurances will pick up strips. There is a discussion somewhere about MODY (absent antibodies, yet poor postprandial control). Good luck!

lottadata · #6 (**permalink**) 07-07-2008, 06:28 AM

Sounds like prediabetes to me, and if your doctor thinks 180 is normal, well, he's a bit out of date on his training.

There is strong evidence that nerve pain starts when blood sugars are elevated above 140 for 2 hours or more.

The best thing you can do though does not require a doctor's help. Cut back on your carbs! If doing that does not give you truly normal blood sugars, find a new doctor who is willing to work with you more aggressively.

The fasting blood sugar is pre-diabetic but many of us have been fully diabetic after meals with that kind of fasting blood sugar. By the time the fasting blood sugar is fully diabetic (especially in women) you have lost a significant amount of beta cells to glucose toxicity--poisoning from high post-meal blood sugars.

BrianSCohen · #7 (**permalink**) 07-07-2008, 08:23 AM

homeschoolmom,

You may very well have emerging diabetes, but your tests all came out within normal ranges. There is a great deal of variability in people, and going high after a high carb meal is not necessarily out of the ordinary. It is unlikely that tingling after a meal is the onset of neuropathy. Usually the damage is accumulated over time. As others have said, it would only be beneficial for you to cut back on carbs. If you do have emerging diabetes, you will eventually see it in the GTT or fasting tests, but by getting your diet in order and exercising regularly you may be able to put off your risk of diabetes.

mazea · #8 (**permalink**) 07-12-2008, 07:59 PM

I had tingling in my feet and arms and hypos's 5 years before I got diagnosed with type 1 dibetes. My BG levels came back normal too. It is possible you may be a prediabetic.

grace girl · #9 (**permalink**) 07-12-2008, 08:16 PM

I would add that your age may be playing a part in things if it really is type 1. Adult onset is generally very slow...when I was dx'ed type 1 my doctor was able to trace back symptoms for several years...you just may have caught it early.
Follow your instincts. That's my best advice.

howdysf · #10 (**permalink**) 07-12-2008, 08:54 PM

I think it's strange that you test your blood sugar and don't have diabetes. What made you even think to test your blood sugar or do an A1c?.. Obviously I don't know you, but I was just curious what would prompt someone w/o diabetes to think about testing their blood sugar...
I hope everything works out for you.

Noturningback · #11 (**permalink**) 07-12-2008, 09:23 PM

Quote:

Originally Posted by lottadata

....

The fasting blood sugar is pre-diabetic but many of us have been fully diabetic after meals with that kind of fasting blood sugar. By the time the fasting blood sugar is fully diabetic (especially in women) you have lost a significant amount of beta cells to glucose toxicity--poisoning from high post-meal blood sugars.

This, I believe, confirms what I have always thought. I was referred to my GP by an eye doctor who thought I was diabetic after an exam. He ran a fasting blood sugar test on me and came up with 75 and for the next several years, when I took my anual blood test I always came out with a fasting blood sugar of 75 (or very close to it). This year, I went for a blood test to check my white blood cell count because it's been elevated for two years. He asked me if I wanted anything else checked. I asked to check my iron (anemia/hemochromatosis) and check for diabetes. They all run in my family and I have some history. This is the first time he ever did an A1c on me and it cam back 6.5 - diabetes. So, was the fasting blood sugar test not really the right test to use to diagnose diabetes? Could I have been diabetic for several years longer than I know of?

~Danielle

kristyn28 · #12 (**permalink**) 07-12-2008, 09:34 PM

Do you get sleepy soon after eating? 9 years ago i was preggy with Daughter, and i noticed that soon after i ate sugar, i would want to sleep. My son is 13 months younger than her, When i went to do thier sugar test, i told them about me being tired, but it didnt seem like they were listening. They only cared about before and 1hr after. I dont know what the numbers were (or cant remember) but they said i was fine. I didnt believe them, i knew something was wrong, but i didnt pursue it. And i thought the symptoms were from meds, i didnt notice them, or i thought they went away, Last year i lost a bunch of weight, and i maintained my high weight with sugar. Just recently i seemed to be REALLY tired, and i was tired of being tired and i wanted to know what was going on.
Another thing you can do is take your results to another doctor if possible.

lottadata · #13 (**permalink**) 07-14-2008, 06:11 AM

Here is a page I put together that summarizes what peer reviewed research has found about the various patterns in which diabetes develops from normal glucose tolerance.

The Patterns in Which Diabetes Develops

As you will see there are several very different patterns, but one dominates, especially in women. And with that dominant pattern the fasting blood sugar is the VERY LAST measurement to show abnormalities. By the time those abnormalities show up in the FBG, people are 3 or fewer years away from dramatic deterioration in their blood sugar control.

The Glucose Tolerance Test or failing that the 1 and 2 hour post-meal challenge test are the only tests that will reliably diagnose pre-diabetes and full fledged diabetes (Random blood sugar over 200 mg/dl according to the ADA).

A blood sugar of 180 mg/dl at any time is almost 100% certain to reflect pre-diabetes and two hours after a meal it may well point to blood sugars that have been over 200 mg/dl--and hence fully diagnostic for diabetes.

Noturningback · #14 (**permalink**) 07-14-2008, 10:13 AM

Quote:

Originally Posted by lottadata

Here is a page I put together that summarizes what peer reviewed research has found about the various patterns in which diabetes develops from normal glucose tolerance.

The Patterns in Which Diabetes Develops

As you will see there are several very different patterns, but one dominates, especially in women. And with that dominant pattern the fasting blood sugar is the VERY LAST measurement to show abnormalities. By the time those abnormalities show up in the FBG, people are 3 or fewer years away from dramatic deterioration in their blood sugar control.

The Glucose Tolerance Test or failing that the 1 and 2 hour post-meal challenge test are the only tests that will reliably diagnose pre-diabetes and full fledged diabetes (Random blood sugar over 200 mg/dl according to the ADA).

A blood sugar of 180 mg/dl at any time is almost 100% certain to reflect pre-diabetes and two hours after a meal it may well point to blood sugars that have been over 200 mg/dl--and hence fully diagnostic for diabetes.

Thank you so much for this information. I can't change my past so, I'll work hard on my future. I will pass this on to anyone who will listen. I wish I had known this earlier.

~Danielle

homeschoolmom · #15 (**permalink**) 07-14-2008, 01:03 PM

Quote:

Originally Posted by howdysf

I think it's strange that you test your blood sugar and don't have diabetes. What made you even think to test your blood sugar or do an A1c?.. Obviously I don't know you, but I was just curious what would prompt someone w/o diabetes to think about testing their blood sugar...
I hope everything works out for you.

I bought a glucose monitor to prove to myself that the tingling in my feet was NOT due to high blood sugar. (My dr. thought it was stress or a vitamin deficiency). Then, when I started testing myself, I saw how high my numbers were after a lot of carbs. That's when the dr. did the a1c and c-peptide tests.
Everyone I know thinks I am too skinny to have type 2 diabetes- especially when it doesn't run in my family. So, if I am prediabetic, would that mean type 1.5 since my c-peptide is so low? Anyone else with a .8 c - peptide level? I can always tell when my bs gets too high bc of a very dry mouth and headache- also the tingling feeling comes back a little. Now, the tingling comes and goes, but when I was eating a lot of carbs, it was constant and turned into a numbness.