Hi! I apologize in advance for the length of this post, but you guys seem like a gold mine of information and experience. I've already learned a lot reading through the forum and researching. I feel compelled to lay it all out here in the hope that you all will be kind enough to answer some of my questions, even if they seem silly :-)
I'm a 33 year old woman dx'ed 2 weeks ago. I'd been in a bad state for months. I was exhausted, achy, loopy, cranky, with loads of fluid in/out, ravenous hunger, boils, abscesses, colds/flus, blurry vision, headaches, high body heat, super dry skin, and recently, yeast that won't stay gone. I'd also lost about 20lbs while eating massive amounts of food. I thought that part was a miracle, ha!
Q- Are all these symptoms common? Will they all go away when my bs is more normal? Any tricks on dealing with these issues?
I finally saw my GP, but he wasn't really concerned and didn't get any tests done. Luckily, I had an obgyn appt soon after, and she agreed to do blood work. I was surprised to get a call from her early the next am. She told me I had severe diabetes and that she'd made an urgent appt with an endo for me that day. She's awesome! My blood sugar was about 500, and my A1c was 11.8.
Q- How dangerous was it to go around like this? What would've happened if I hadn't gone to that dr? Do you think it's likely my body was damaged from having my bs so high for possibly months?
At my appt with the endo, I was given a novolog pen, 70/30 mix, and a glucose monitoring kit. My instructions were to test and inject 10 units 3x/day before meals with 60-85 carbs each. My bs stayed in the 400's.
My next appt a few days later covered more information and answered some questions, and I was put on a schedule to slowly increase my dosage to bring my bs down. Blood was taken for a lipid panel, metabolic panel, and antibodies.
Over the next 10 days, my bs was between 250-400 while I ratcheted up my insulin to 20 units 3x/day. My thirst is less, but I still feel like a mummy... dried up! My infections are gone, but I must take diflucan every 4 days to keep yeast away. I swelled about 10lbs so far and have a constant headache. I still get loopy, hungry, and super tired. Exercise (even heavy housework) makes me feel AWFUL.
Q- Is it normal to still have these symptoms? Will this all stop once my bs are under a certain #? If so, at about what #? What's causing the headache? Will anything make it go away?
My last (3rd) appt was yesterday. My endo dx'ed me as having type 1 due to the presence of GAD antibodies (8.1 U/mL) and the way I presented. I'm still surprised that it's not type 2, I didn't even know that adults can just suddenly have type1 D before all this! I was negative for the other antibodies. I switched to 4 meals/day (and 20 units novolog mix before ea meal) with a goal of 50 carbs/meal. Told to only test before each meal.
Q- Is there any way it's not type 1? Are there any other tests that could give more insight, or a possible change in dx? Is there anything I should ask my dr to change his instructions on? Is there anything else I can do right now to improve my progress?
I'm concerned about my other test results. Dr. says it's likely all from the high bs, but I can't find much info on internet searches.
My microalbumin was high (28 ug/mL, normal 0-17), and the microalb/creatine ratio followed suit (69.5 mg/g). I was told to use less nsaids (so hard w a bad back!) and go light on meat consumption.
Q- How bad is that? Is it likely that my kidneys will go back to 100% with better bs? How do you know when there's permanent damage? Is high protein from veg, soy, dairy, and grains ok? How much will eating meat affect me? Is there anything else I can do to be kind to my kidneys?
My triglycerides are crazy high at 959 (0-149 normal), cholesterol is 357 (100-199 norm), hdl is low at 30 (39+ norm). I was instructed to eat low fat, retest later.
Q- Anyone else ever have numbers like that? Did they go to normal quickly once your bs was ok? Am I at risk for any extra problems right now, assuming those levels haven't been a long term thing? What do I eat??? Does having four meals consisting of 400-500 calories, 50g of carbs, low in fat, and no/low meat seem ideal for me? Any suggestions?
Lastly, I want to lose weight. I've been overweight for over a year now, and really want to get back in shape. I spent the 5 months after the 'big gain' eating clean (veggies, lean meats, good fats, high fiber carbs, some fruit, etc), lowish calories (1400-1800/day), and doing 4 hrs weight training, 5+ hrs cardio per week. I've been heavy before, but was always able to get back to normal this way. After 5 mo, I did look a little better, but didn't even drop 1 size. Scale showed only 3lb lost. I got frustrated, the mega hunger had started, and I went back to poor habits. That's when I started losing weight due to the D. Not a magical metabolism fairy, much to my disappointment ;-)
Q- Was my inability to lose weight related to D? If not, any theories? Any advice on effective weight loss strategy? Is there anything different I should do because of the D? Is there anything that will lessen the hunger? Are there any prescriptions or supplements that would help me?
If you made it this far, THANK YOU! I appreciate any and all guidance you feel like sharing.
Teowyn, thanks for clarifying. I do wish our bodies were a little more predictable!
I have the feeling I'm going to take issue with my insurance as well. They've already made some errors that I need to get fixed.
"Reply by snarkymonkey -- Wow, you all take WAY less than me. Does anyone here take as much as I do? Anywhere near 80/90 units? Does this mean I'm very insulin resistant? Eating too many carbs?"
(Hey there, I moved this down because it ran out of reply levels.)
At first 80/90 units in a T1 seemed awfully high to me, but I found this link for understanding how the starting dose might be calculated, and there is quite a huge range in how much insulin is needed by each person to cover carbs:
It says (regarding the possible range): "Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress."
Diabetes is not a "one size fits all" disease!
Sorry, I don't remember if they measured her c-peptide levels or not? Too many replies to sift through.
I still have a c-peptide of 1.1. So, once the b-cells I have left get over glucose toxicity, they'll start pushing out a little insulin here and there which will further confound things..
Also... I may be on a low level right now, but it's not entirely controlling it... especially when they tried to set me up with a I:C ratio of 1:20. My body laughed at that and it sent my glucose skyrocketing. The 'Using Insulin' book came in the mail the next day, and I love it. It is helping so much. I like it much better than Think Like A Pancreas, though that book has been a good read as well. It's just somewhat basic.
I used the website LaGuitariste sent and I suppose based on weight 35 units is where they might typically start someone my size out at. But as already said, everyone is different.
Exercise is very important for everyone, especially if you have diabetes.. it can help control your BG a little better. I like to play 'Dance Central' for the xbox kinect (yes, i will admit it!) and it helps bring down my glucose. If I could kick myself into a regular routine, there's a good chance that'll cut down on the amount of insulin you need too..
Also, depending on how much you want to read about the disease... there is an endocrinology textbook on Type 1 Diabetes that I just got and is wonderful because it explains some of the major theories and incorporates current literature as well as talking about treatments and such..
The ADA also has a book on clinical management of type 1 diabetes, and though I have gotten it, I have not read through much of it yet.
Having information makes me feel better, for some reason.
I think exercise -- applied correctly -- is the magic bullet for insulin resistance for most (not all) diabetics. I have met slender, middle-aged marathon runners and triathletes who developed insulin resistance anyway -- they're just folks who lost the genetics lottery in that way.
For most of us with insulin resistance, slowly ramping up to a regular exercise routine (combining resistance training with aerobics like walking, biking, running, dancing, etc.) will chip away at the insulin resistance over time.
However, like some diabetics with insulin resistance, I have a problem in that my blood glucose doesn't drop, really, while I exercise. I have confirmed this time and again while working out over a half-year period with Team in Training: measuring my blood glucose before and every thirty minutes while walking briskly for two, three, even four hours showed no drop in BG -- and sometimes even a slight elevation in BG -- thank you, liver?!?
Instead, I get delayed exercise-induced hypoglycemia -- erratically dropping like a rock twelve, fifteen, even twenty-four hours later. Gah.
That's why I believe in slowly ramping up exercise over time and making it regular. For me, ramping up to walking an hour every morning is a much safer way of reducing my insulin resistance than not walking for several days and then going for a three-hour hike on Saturday. In my body, doing the "weekend warrior" thing on Saturday is a formula for a BIG hypo at some unpredictable time between bedtime Saturday night and noon on Sunday.
BG increases with exercise because of increased demand for glucose by tissues that are using it up for energy.
My BG will be elevated during/after exercise, but does drop to lower levels several hours later.
Some people deplete their glycogen and available blood glucose fairly quickly during endurance exercise. My liver must be super-efficient because even a four-hour hike over a VERY hilly course (the first two hours was on an up-hill gradient almost the entire way) didn't faze it. I was huffing and puffing and sweating like crazy -- drinking lots of water to replace fluids -- but my blood sugar stayed high-normal the entire time. Over 27,000 steps that day on my pedometer (over seven miles) but I didn't see any downward effect on my blood glucose until the next day and the day after that.
Hi palominovet and SMonkey,
I've really been enjoying all the information posted on this thread. It is useful to a lot of us!
And palominovet, could you post the title of the endocrinology textbook on Type 1?
Thank you to everyone who has contributed information here!
There are used ones available for $30.. which is why I went ahead and got it. It may have more information than most people want.. it is a medical textbook after all.
Thanks for the textbook title, palominovet!
I like information, also!
But yes, it may be more depth than I need at the moment.
Thank you for the link on calculating insulin needs, that's was very helpful. I think this would be a lot easier if I was on basal/bolus. It's hard to figure out what's what with the mix.
I need about 2-3 times the amount of insulin than the total daily insulin dose calculation would suggest. How would I do those calculations with the insulin resistance I seem to have?
Experimenting, gradually, is the only way. Make tiny changes, wait a couple of days, make more tiny changes if needed. We're all so different there's no real formula, unfortunately.
Exactly. I had to ramp my basal up 2 IU every three days until I started seeing some normal readings. Creep up on it so you don't go hypo.