Replies to This Discussion

Permalink Reply by Gerri on April 25, 2009 at 10:59pm

Hi Mark,

Inhaled steroids aren't supposed to cause high BG like oral steroids, but they can. Do you have a choice of using a non-steroidal inhaler instead? Viruses effect my BG, any type of illness does.

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Permalink Reply by Anthony Holko on April 26, 2009 at 1:44am

Ditch the flonase and get some safeway non steroid nose spray in the 30 ml spray bottle more efective than the smaller one. No efect on BG.

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Permalink Reply by Mark Holmes on April 26, 2009 at 6:09am

I should add that if I restrict my carbs severely - in other words, letting no grains pass my lips and eating large salads,chicken,fish,eggs,nuts etc, that my blood sugar will go back down to around 100-105 (I'm not on any meds). I had a spike from 112 up to 165 after 2 hours (I can imagine it was probably 200 after an hour) after eating a small 250 calorie Lean cuisine meal of chicken and noodles - net carbs about 25. I knew the noodles were bad, but I wouldn't have expected that big of a jump from that few carbs. A few days ago, I had a small 15-20 net carb bowl of oatmeal with pecans - my bs was 134 before eating that and 250 two hours later! I double checked that reading with another meter.

Is my pancreas finally just giving up? (I've had diabetes about 12 years). Or could it be virus or flonase related? If it were related to those, I wouldn't think it would return to the 100 level eating only salads,meat,nuts,etc. Seems like it would remain elevated. (my last hba1c was 7.3 - which prompted me to start being very strict with my diet again, which normally if I do, I can bring it back down to the low 6's and maybe even into the 5's - the question is - how long will my discipline hold out eating this stuff over and over? Of course, it is highly preferred to have limbs removed).

This morning's fasting BS - 107.

Any thoughts?

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Permalink Reply by Gerri on April 26, 2009 at 9:39am

If you can maintain postprandial readings at 100-105 by avoiding grains, why even look at a noodle:) Foods like oatmeal turn to instant sugar for me, like any grains. I'm Type 1.

Wonderful that you can keep your A1c in the low 6's & 5's with diet after 12 years!

Hate to say this, but it could be your pancreas especially because you've had some high A1cs. The better control, the less burnout of beta cells, of course. I eat low carb & it doesn't bother me. Like you said, better than having complications.

Only way to know where things stand is to have a C-peptide & GAD antibody test & compare these to your previous test results.

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Permalink Reply by Mark Holmes on April 26, 2009 at 10:16am

Yes, not sure why last time he didn't order C-Peptide and GAD antibody tests. Probably because I hadn't had my labs done yet (he draws those after the office visit) and my last hba1c was 6.3. Now it's 7.3, so maybe time for a retest. Back in September of '06, my c-peptide was 1.4(nl 1.1-5.0) and anti GAD titer was mildly positive at 1.9 (nl <1.0)

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Permalink Reply by Gerri on April 26, 2009 at 10:39am

I'd have the tests done.

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Permalink Reply by Anthony Holko on April 26, 2009 at 1:08pm

Dear Mark.

My thoughts would be to get on some insulin ASAP a few units of lantus or levemir and then a few units of fast insulin before meals. While it is not known why pancreases fail quickly in some people and very slowly in others but there is some belief that high BG will kill it.

Once your pancreas dies the disease becomes your worst nightmare, in this case an ounce of prevention is worth a 1000 tonnnes of cure. Get a doctor that is sympathetic to early use of insulin don't let them kill your pancreas I know from personal experience. I did not need any insulin for 5 years and now I need more than 100 units per day and gaining weight like mad.

Of course low carb diet and much exercise with insulin are good things. Weight gain will not be a problem with a small total daily dose. Pancreas may even recorver.

Absolutely refuse the oral crap that will kill it for sure.

Best of luck

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Permalink Reply by Mark Holmes on April 26, 2009 at 4:36pm

He has mentioned insulin and has also talked about Januvia. I think his first choice was going to be Januvia. Although he was thinking that my beta cells were slowly dying, perhaps modestly so since I'm taking methotrexate for my rheumatoid arthritis which he said could also be helping to protect my pancreas to some degree. But he did say, I recall, that a person could go along slowly for some time and then suddenly it just goes crazy and sometimes very quickly. I guess I'm being stupid thinking that is just will power that should be able to control this and if I just eat nothing bad and exercise a lot, I can stay away from the pills. Taking methotrexate is bad enough - adding other drugs is not my desired wish, but then I don't want to burn the pancreas out completely as you've made that out to be one sorry scenario. He did talk about inhaled insulin, but apparently it isn't here yet. When does one chose insulin shots over an insulin pump? Is the pump required for very serious cases or is it more a matter of cost and what the insurance company will allow?

Thanks for your input,
Mark

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Permalink Reply by Mark Holmes on April 26, 2009 at 4:39pm

I also might ask how one knows if the pancreas is producing enough insulin or whether the issue is one of insulin resistance? He mentioned something called a "clamping" test that would determine that, but that it was expensive and they didn't have access to it. Are you familiar with this?

I guess on the other hand he can tell from my c-peptide and GAD antibody titer that it's slowly (or maybe quickly now) waning. That would indicate that the pancreas wasn't making enough insulin, I believe.

Mark

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Permalink Reply by Anthony Holko on April 26, 2009 at 3:21pm

Tried my son's flonase last night did not appear to have any effect on BG. Viruses bad for pancreas at times the more so if the micmic it.

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Permalink Reply by Mark Holmes on April 26, 2009 at 4:40pm

micmic it? did you mean attack perhaps?

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Permalink Reply by Anthony Holko on April 26, 2009 at 5:50pm

If the virus mimics the cells in an organ then your immune system will attack the virus and your organ too. My father had kidney damage from strepthroat bacteria that mimics kidney tissue.

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