Replies to This Discussion

Permalink Reply by She Ra on May 20, 2011 at 10:10am

Your A1C is great. So, how high are your numbers? you need to see the doc and maybe discuss adding one more dose of metformin? I take 2000 mg a day, probably for nothing but it makes me feel better. If that doesn't help then maybe you need some insulin, or another oral added into your protocol?

Maybe try the 6-small-meals a day? Take your current intake and split it up into smaller meals, your spikes might be a lot lower?

Seriously though I think a doc appt is the way to go. T2 is progressive for some, like me.

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Permalink Reply by Frances on May 20, 2011 at 10:16am

How high are we talking about numberwise? It's hard to imagine they can be that high with an A1C of 5.8.

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Permalink Reply by Melitta on May 20, 2011 at 10:38am

Hi Spirit7: Just a possibility, but have you ever considered that you might have slow-onset Type 1 diabetes (aka LADA)? Have you ever had antibody testing (glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and insulinoma-associated (IA-2) autoantibodies) and/or c-peptide test? Your situation sounds like so many people here on TuD, who were initially misdiagnosed as having Type 2 diabetes but later were found to be antibody positive and have Type 1 autoimmune diabetes (another possibility is MODY, but that is a bit rarer than T1a). Have you considered that you might need exogenous insulin to control your blood glucose levels? Check out the LADA group and my blogs on misdiagnosis--unfortunately, misdiagnosis of people with adult-onset Type 1 autoimmune diabetes as Type 2, strictly because of age not etiology, sadly remains really common. Just my two cents.

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Permalink Reply by spirit7 on June 14, 2011 at 7:40pm

Curious that you should mention LADA! I just dumped my endo from Joslin. He wouldn't answer my questions, I found him to be very patronizing and he said his way and wasn't willing to discuss anything. I went to them when first diagnosed but never impressed by their service. I found Dr. Berstein to be much more informative and insightful! Well, I have questions I want answered and in that I am not only curious and I interested in keeping healthy. So, I found a new endo. One who answers my questions fully and completely and he believes strongly that I have been misdiagnosed. I had mentioned this to Joslin about further testing to which he replied, "it wasn't necessary." My new endo did a much more complete history on me to find out several facts, diabetes does not run in my family, no one has ever had it. Auto-immune does! Everyone in my mothers family has a thyroid issue including both of my sisters, I do not. Guess I got the diabetes instead... Anyway, its good to be with a doctor who is most helpful and I'll find out in a week or two if I truly have been misdiagnosed. Thanks for your 2 cents!

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Permalink Reply by Melitta on June 14, 2011 at 8:37pm

Check out my blog Bill of Rights, you may see yourself there. Good for you for being your own best advocate, and "firing" a doctor who wouldn't do appropriate tests for you. Your new endo sounds excellent.

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Permalink Reply by spirit7 on May 21, 2011 at 3:06pm

Thanks so much for all your advice everyone. The A1C was a month ago and since that time my numbers have gone up; I know that my endo will not think they are bad because they are still within the ADA guidelines, however, I believe after researching for some time and believe that the ADA guidelines are too high. My am readings used to be under 100 most of the time, now I have been getting readings of 110 and higher in the morning. My after meal readings go anywhere from 124-136 or a bit higher. Previously the after meal numbers were under 100 most of the time with occasional readings higher so I am trying to figure out what is going on. I am eating the same meals and my lunch numbers seem the highest no matter what I eat.Even if its very low carb. I have done the smaller meals previously and should probably try that again. I did have the testing for LADA (c-peptide) which proved negative. My doctor seems to believe I developed Type 2 from low birth weight. There have been studies done that show babies with low birth weight (I was 5 pounds) are prone to type 2. It doesn't run in my family and I was overweight but worked out regularly. I think stress played a big role. I am kind of anal about my numbers and strive to keep them down so I can be here for my family in years to come. Again, thanks for the suggestions and advice, I always find this site very helpful and I really don't have a support system other than the net. Thank goodness for that.. Best to all.

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Permalink Reply by Brian (bsc) on May 22, 2011 at 1:54pm

Well, I went through several years of ineffective medication. I went on and off maximum metformin. I tried double and triple therapy adding Actos, Byetta and Victoza in various combinations. And I never saw much improvement from the medications. I basically had an A1c 6-6.5% no matter what (and I also followed a low carb diet). And while my fasting numbers were out of range, my levels were never "bad enough" for my doctors to prescribe insulin. And I asked repeatedly. Eventually, I made the choice on my own.

In your case, you have only used a partial dose of metformin, some might argue it is barely an effective dose, and you blood sugar levels are not particularly bad. I am just saying that while insulin would work and I think it is good to keep an eye on things and you could try a maximum metformin dose and other medications before insulin.

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Permalink Reply by Jeannie Wagner on May 23, 2011 at 3:23pm

I understand how you feel, I am obsessive about my bgs, too. I finally got them below 100 and if they go much above it drives me nuts. Sometimes with diabetes our bgs just go wonky for a few weeks. Last summer I had a lot of inflamtion which drove my bgs to 200. Even though I ate lower carb and exercised the inflammation and stress hormones trumped my lower carb eating. Finally I found the cause of the inflammation - statins and stopped them and bgs gradually fell. So sometimes something else may be going on in your body. Another thought after this happened to me I switched to a more organic diet using tons of Coconut Oil. I do think the CO really helped my bgs.

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Permalink Reply by xring on June 14, 2011 at 9:46pm

You got it right when you said "I am kind of anal about my numbers." I don't use any meds, I wake up around 120-140, my A1c is 6.0% & my doctor says I'm doing fine.

Since you say you got results from it, you could revisit a raw/vegan type diet for better overall health & add more plant-based fats (nuts, seeds, avocado) & snack more often to prevent weight loss. In my opinion, you're stressing out for nothing.

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Permalink Reply by Natalie ._c- on May 21, 2011 at 3:44pm

I have one important word: insulin. If you are losing weight, it doesn't matter if you are Type 1 or Type 2 -- you're not making enough insulin to keep your weight up. Insulin is the fat-storage hormone. So it follows that if you want to keep your weight up, you need more insulin.

Second, as many as 10% of Type 1's don't present with antibodies. So it doesn't matter if you're "proven" to be a Type 1 or not -- if you need insulin you need it, and that's that.

If you're stubborn and crazy like I was, you will go off your carefully constructed diet and let your BGs REALLY go up in order to prove to your doc that you need insulin. I did that because I didn't have the patience to wait for the doc to discover that the oral meds weren't working, and that if I ate the way everyone else eats, my BGs were definitely uncontrollable.

Going on insulin was one of the most relieving days of my life. FBG immediately went down from ~180 to 116. However, since he only gave me NPH at night, my PP's were as bad as ever. But the door had been opened, and I eventually ended up on the pump, and my life has become MUCH easier.

So think about it!

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Permalink Reply by Trudy on May 21, 2011 at 3:59pm

Hi spirit7. I will repeat Natalie's word: insulin. Whatever type you may be, when you need insulin, you need it.

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Permalink Reply by Melitta on May 21, 2011 at 8:17pm

I will second what Natalie and Trudy have said, which are wise words indeed. Also, Spirit7 had the c-peptide test, not antibody testing.

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