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I was diagnosed 13 years ago as type 2 by my internal med dr. I have actually never seen an endo for diabetes but my dr. then was pretty up on things. At the time I was diagnosed I was on the high end of normal for weight, very active, and very muscular. I was also only 34. Anyway, she gave me some of the standard diet stuff the ADA hands out and I followed it. A month later, my levels were still high by ADA standard.
The only reason the dr. tested me was that I was gestational with both of my pregnancies and I insisted. I have family history of type 2 on both sides. I had been tested every years since my first pregnancy at 21.
I was put on 1000 mg of metformin which helped get my bs down. As I remember, it was about 105 fasting and about 145 2 hr pp. The met combined with diet kept me in pretty good control for about 10 years.
Around year 10, my bs started to creep up and my met dose went up to 1500 mg. Since I was sticking pretty well to the ADA diet and the increased met kept me in ADA range I continued on.
About a year ago my body seems to have gone haywire. For a while, I had no insurance and ran out of synthroid for my hypo active thyroid. I finally found a clinic to go to and they drew to test my TSH. It was normal after about 3 month of no drugs. The GP kept me off my pills. But, I didn't feel very good and eventually got a referral to an endo around the time I got medicaid. As you know, it is impossible to get private health insurance when you have chronic health issues.
Endo still has not figured out what is going on with my thyroid. I'm still off meds. My numbers are what he calls odd and so is my history. He's watching me waiting to see if my tests ever stabilize since they wander a bit.
Meanwhile, we're still trying to figure out why I still feel so bad. Ultimately, a bunch of problems are pinned to female issues that results in a hysterectomy in December, 2011. Here I am, nearly 3 months later and have recovered enough from that to have normal BS readings.
If anything, they are worse (I kept my ovaries so my hormones should still be the same but they aren't). Obviously, I have to take it easy exercising and was bed ridden the last 2 months before surgery. So I figured I should watch my diet. I ended up dropping my carbs down to 20 a day for a few days but just couldn't handle that. I'm a full time student and it was making me dingy. Now I'm at about 60 which makes my brain function better but still hasn't gotten my blood sugar consistently to the point of meeting ADA standards much less anything lower.
I have always had random spikes and drops even when pretty well controlled. I can eat 5 carbs and shoot up 50 points, I can eat 60 carbs in a single sitting and go up 15 points. I can feel hypo even when I haven't done anything different. I have always had DP which is somewhat helped by eating something fatty right before bed.
My A1Cs used to run in the 5s. In the last couple years it's been low 6s. BS runs the gamut from just over 100 to as high as 250. I have never caught it going below 100 in probably 5 years except when I feel hypo (which is really not because then it is about 75). I am still the same weight I was when diagnosed but not as toned so I'm trying to take off about 20 lbs. That will put me at a body fat on the low end of normal, right now I'm at the high end.
Sorry for the novel, my history is long and my health is complicated. It seems I have all sorts of endocrine issues. I am trying to get a dr. appt. for next week. It will be with my GP since I will need a referral to see the endo. So what should I ask him? Are there any tests besides A1C I should have done? He is a great guy but since he's a GP he mostly deals with colds and such. He is always exploring new ideas and is fascinated whenever I bring him new info from my endo. Also, drug recommendations? If there is something we should look at trying he'll be more than happy to look at it but he may not know a lot about it. Sally has already told me that she thinks I should look at insulin and I'm inclined to agree. It seems that orals besides met won't give me enough control over lows since I seem to be making some insulin sometimes.
Thanks for any suggestions. I'm really excited I found this forum. Some of the forums are full of people who insist that 20 grams a day is the only way to control diabetes and if you don't do that then it's your fault you have bad BS.
welcome to the site. sorry for all your troubles but you will figure a way thru this mess. my .02 if you don't already track what you eat, exercise, meds and blood sugar readings so you can show the doc and you can figure what trouble spots you can work on. might ask to talk w/ a dietician too maybe to see if they can help
Intresting post. My read is that your T2 is bearing its teeth as your body ages and the organ complex of liver, pancreas, skeletal muscle cells get nastier as predicted in T2 diabetes.
Inearly stages, control is more straighforward with diet/carbs control and hearty exercise doing the work as long as one follows well.
Then the disease/problem turns nasty and liver excess glucose release goes up - or gradually gets worse and now prior control stratagies are insufficient. As a 30 year+ fighting this mess, I had to with my Doctor's help take more agressive stratagies to reign in mess.
I would check out liver excess glucose release issues to see if they are hammering your numbers.
Good luck and best wishes.
Hi My story is very similar. I posted a couple of things relating, after 10 years my blood sugars starting climbing. I gave in after years of stating ill do anything not to take insulin I actually changed it to I will do anything to keep in control. Over the past 3 months I have been taking long acting insulin and now can wake up in the 70's which I have not seen almost ever. 3 months ago my A1C was 10.5 and today it was 6.3 and honestly I know I can use some fast acting insulin also which I am asking for on my next visit for my meals which will make it even better. Everyone is different and you have to experiment for yourself but for me I'm off the pills and happy to see numbers that the insulin now gives me.
I'm really thinking I need insulin. My FSB has always been worse than PP. Now that I'm testing a lot I'm seeing that PPs can be all over the place even when I eat the same thing for 2 meals. I think the reason my A1Cs have been reasonable is because I often will drop under 130 during the day. I'm afraid of other orals because I have no control over them and with such fluctuating levels I'm afraid I'll be eating to catch up to the meds.
Actually I am still taking the Metformin, 1000mg twice a day but I did drop Januvia and amaryl. Doctors who told me years ago, one day I would need insulin. Yesterday my blood was 72 when I woke up.. I went to the hospital got my blood work done, did not eat or drink anything and a few hours later I was 109? Over the past 3 months I check my BS close to 8 times per day. I take Levemir at night and now every FSB is great..next move is to work on my PP and really just general throughout the day.
A1c was 6.4. GP feels that is a good A1C and that I must be in good control to get it. I told him that I was bouncing around quite a bit and maybe that was working out to look good on the A1C.
So the first thing we are doing is to increase my met at night. Instead of taking 3/500mg doses I'm going to try 1000 before bed and 1000 in the morning. Hopefully if we can get my morning numbers down then the rest of the day will be better. He said if that didn't seem to work to try other configurations and see if there is a way that works better.
He also wants my meter tested, he's wondering if it isn't reading right.
He has ordered a bunch of blood tests to be run before I go back in in 3 months including a cpeptide. Since I have never been a classic T2 he said it's possible I'm some kind of 1.5.
At this point, he isn't worried because he feels that I am sort of worrying about nothing since I am his best controlled T2. He also feels that my blood tests may still be out of whack because of my female problems and surgery. He said it is possible that my A1C is wrong because I was anemic a few months ago and that my BS may still be running high from the surgery stress. Given that I'm still feeling it that may be true although my BS was creeping up before surgery. But then again, I was really sick before surgery. In fact, looking back on it I was having a lot of health problems for about a year or so (which is the time when my BS started getting worse).
He also doesn't want to put me on anything else because he's afraid I'll hypo too much since I already swing so much, although my lows are more like 80.
Hopefully he's right and I'll be able to eat a few more carbs with higher met.
it's a process figuring out what works and what doesn't at least your doc is working with you and paying attention to you and your questions. keep it up!
My GP is a good guy. I know that he is going by ADA standards so I think I'll find info on the Endo Dr standards.
Changing my med dose seems to be helping. Fasting this morning was 106.
that's great. keep it up