I've been tracking my blood sugar for the past 4-5 months. I finally realized that the headaches, shakiness, mind-fog etc. might be low blood sugar related, and sure enough once I started testing, I could see a pattern. My PCP ordered a GTT, and below are the results.
fasting - 95
1 hour - 172
2 hour - 57
3 hour - 74
I can't remember what my a1c was, but it was under 6 (5.6?)
Since then, I've been to a nutritionist, and have made changes to my diet. Smaller meals throughout the day. More whole grains, fiber, vegetables, proteins, and less bad carbs (white rice, bread, pasta) along with reducing sugar anywhere I can. I think it has helped, since I can definitely see that my numbers are more even, and the swings are less drastic.
But. There are still times when I am low (55-60) regardless of the small meals/snacks. I'm also finding weird highs. 145, 167 even when I've forgotten to eat. The same salad on two different days can put me at 140, or at 89.
At the same time as the GTT, I also tested positive for one of the markers for lupus, although I don't seem to have any symptoms. I was gestational diabetic during my pregnancy (13 years ago), and had to go on insulin almost immediately after dx. My father was type 2. He was also obese, smoked for a number of years, and had a long history of cardiac problems and poor diet. Even after he was diagnosed, he never seemed to get control his blood sugar.
I could stand to lose 10lbs, but am fairly active, and in general didn't have a bad diet to begin with. No, I wasn't eating small "appropriate" meals, but I never really ate fast food, drank soda, or gorged myself on massive amounts of chips/cookies/candy.
Should I be doing anything different other than my dietary changes and keeping active? I realize my #'s are nowhere near alarming, but I'd like to get better control over the roller coaster.
Thanks for any input.
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Permalink Reply by angela.m on June 6, 2012 at 8:12am Gerri, you were hypo before you were diagnosed as T1? Are you saying that had you been tested earlier, they would have determined then that you were T1?
Bear with me, because my diabetes knowledge isn't very deep. I know that you can be diagnosed with T1 at any point in your life, but I also thought it meant that your pancreas was no longer able to produce insulin at all. How is that determined, and would your treatment plan have been different if you knew earlier?

Permalink Reply by Gerri on June 6, 2012 at 9:14am Hi Angela,
I was hypogylcemic for a very long time before finally crashing with DKA & ending up in ICU. I knew I was hypo because I'd get ravenous, feel strange, cranky & eating immediately made me feel better. My fasting glucose from annual blood tests was low. If doctors over the years had taken any interest in my hypo symptoms & explained hypoglycemia could be a precursor to diabetes & to monitor BG, I could have preserved some beta cell function. I ate a very high carb vegetarian grain-based diet, which was stressing my pancreas. But, I didn't know anything about diabetes & there's no history of diabetes in my family.
So, the treatment should have been monitoring, testing & changing my diet to have prevented almost dying from DKA when my pancreas finally gave out. I'm not saying this could have stopped T1, but I'd be healthier now. I was diagnosed at 53 & may have been able to avoid T1 for longer.
People with T1 can produce some insulin. The tests are a GAD antibody panel to determine autoimmune attack & C-peptide. C-peptide is produced in direct relationship to insulin. High C-peptide is indicative of T2. Low C-peptide indicates T1. Had I been tested periodically (or even had a OGTT), the path to T1 would have been clear as GAD went up & C-peptide went down. I would have started on insulin earlier.
Permalink Reply by angela.m on June 6, 2012 at 9:51am Thank you for the explanation Gerri. It helps to know that diet can have such an influence in the development & progression of diabetes. I guess I should say that it helps to know, but then the key is actually making those changes; that will be my challenge.
I also recently tested positive for one of the markers for lupus, which is also an autoimmune disease. I don't know if they are related. It is something that I will bring up with my PCP when I go back next month.
Thanks again.

Permalink Reply by Gerri on June 6, 2012 at 10:19am I've not heard of a link between diabetes & lupus. However, it's not uncommon for people to have more than one autoimmune disease. Perhaps one marker is insignificant.
There are T2s who control just through diet & exercise. Judith is a shining example.
I thought I was eating well following a vegetarian diet. I never had a weight problem & never ate junk food, processed food, sugar, white flour, soda, etc. Ate whole grains we're sadly told are healthy--ha! My diet, even without the usual suspects, was extremely high carb.
Permalink Reply by Emmy on June 5, 2012 at 10:43pm Diabetes can often start out as reactive hypoglycemia. It looks like your body put out too much insulin in reaction to the sugar, triggering a low, then you had a slow recovery. I had similar results with an early GTT many many years ago, and was diagnosed hypoglycemic for many years. I eventually developed diabetes, probably in part because my beta cells were being burnt out. Same thing happened to my mother.
This looks like a similar pattern. The gestational diabetes usually leads to type 2 eventually, so I'd say your pancreas is putting out a last ditch effort, over-reacting, and will eventually be unable to keep up. If you can further reduce your carb intake, it might help keep the insulin down, so your blood sugar doesn't drop so much or so often. I would avoid all white grain products and all sugar. Stick with whole grains, in small quantities only. Fruits with low carb counts, like strawberries, blueberries, raspberries, blackberries, are all ok in small quantities. Focus on lean meats, and lots of salad greens, nuts, seeds, healthy fats like those found in nuts.
Skip the sugary drinks too, they can cause a drop when you have reactive hypoglycemia.
Metformin would probably not be a good idea at this point, as it can cause lows, and you already have a problem with them.
What you're doing can help, at least for a while, but you should probably continue to test at home to keep track of what's going on. Get your A1c and GTT once a year. One of these days it will likely show that you've gone over the line, into diabetes.
Permalink Reply by angela.m on June 6, 2012 at 10:18am Thanks for the diet pointers Emmy - I love raspberries/strawberries and any kind of berries, so I've got that working in my favor.
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