I am going to apologize up front for this post, I am in a bit of a state and may not come across as clear as I may want to. Anyway, I was diagnosed Type 2 by my GP in Dec 2011 just in time for xmas, lost 70lbs in the months prior and my BG's were off the charts 600+. My GP put me on Metformin and Onglyza which did next to nothing. They then told me I was type 1 and put me on Victoza which is a type 2 med, yeah no idea there. Victoza had a basal type effect but I was still spiking pretty high (350 or so) when eating fairly low carb meals.
So I made an appointment with a very well respected endo. He believed I was presenting as Type 1 / LADA. Immediately went on Levemir and Novolog and immediately saw improvements and was able to start eating normally again. Went back to the endo in about 3 weeks and although I was doing well he said let's start to tighten this up, he wanted me to get to titrate up to a 20/1 carb ratio and 20/1 correction bolus. No problem, I slowly "climbed the hill" of insulin and everything was going great, I had great control no problems, I was right in the zone with my BG's, I was managing not to go low everything was right in the world and I was scheduled to see my endo in 2 months and I would get a pump which I was looking forward to because it seems better than sticking all the time.
So.... Fast forward to about a week and a half ago, I got sick.... REALLY sick, some kind of flu... The sickest I can ever remember being. My BG's were getting kinda high and sort of "wonky" which I had read will happen when you are sick, so all normal there. After 4 days of not being able to move I went to my GP who prescribed Sulfamethoxazole-tmp to help me get over the flu or whatever it was, 2 days later I was feeling a ton better and my BG's were coming into line again, I was still taking my insulin like I had been. Well here is where it goes down the rabbit hole..
About four days into taking the antibiotics I noticed my BG's were really really stable (I use a dexcom) and I thought maybe my sensor was freaking out or something so I started testing a lot and low and behold I was very stable for some reason. The next day, I started to go low which was really odd because I hadn't given a bolus just my levimir the night before. I thought wow this is odd...
Anyway long story short, on the 5th day (aprox) the Antibiotics were done and I was solid as a rock in my BG's. I would eat and barely go above 100... So I though this is very very weird but what would happen if I eat a bunch of carbs and no bolus?... I tried it and I barely went above 120 and came back down faster than ever... This is day 3 now and I just ate about 5 slices of pizza, no bolus, spiked to about 123 and came down very quickly...?????
So I am kinda totally freaking out because I have no idea what is going on. I keep trying to search and read if this is a common occurrence but I don't know if I am just searching for the wrong thing or I am a medical mystery.
Sorry for the rant but if there is anyone out there who can tell me what the heck is going on I would really appreciate it. I know some people would love to be in this position but I do not like this level of uncertainty... I have never been so freaked out by being "normal" in my life... lol..
Hi Uproden: This sounds like the classic Type 1 diabetes "honeymoon" period. Often, after starting insulin, a person will go through a period where insulin needs are greatly reduced. Here's a description from UCSF:
In type 1 diabetes the honeymoon follows diagnosis. The disease is caused by the loss of insulin-secreting beta cells in the pancreas. The honeymoon, or remission phase, refers to the period following initial diagnosis when the remaining insulin producing beta cells are functioning well. During this honeymoon, it is easier to control blood sugars, with fewers swings, less risk for hypoglycemia, and lower overall average blood-sugar levels.
Does sound like you may be honeymooning. Also, a quick Google search shows some references to potential hypoglycemic effect of Sulfamethoxazole. For example:
That particular patient had renal dysfunction, but it does show there might be some connection to BG and the drug. Also, the search showed several references to a 1975 article:
Drugs.com also includes a warning to diabetics that it may affect BG:
I would also add that I totally understand the strange feelings associated with seeming to get better after diagnosis. When it became apparent that I'm in a honeymoon period that makes it fairly easy to control my BG I was so confused. I'd gone through the acceptance phase at diagnosis and was ready to jump in with all the hard work, then there were days where I didn't need exogenous insulin at all. It was like my body was betraying me all over again. I also know that it's likely just a matter of time before I have to deal with more full blown T1 and now it's just a waiting game, which I'm not necessarily very good at.
And one other thing, if you're interested in getting more feedback from folks, the forums really seem to get a better response. You might want to post something in the T1 or General forum.
This is LADA. Sometimes those beta cells decide to come back to work and, yes, it is as freaky as the roller coaster ride, and, in its way, as tricky and scary to ride through. Rather than enjoy the near-normalcy, I wait for the bottom to drop out again. Sometimes the plotting of points in my log looks like the Rocky Mountains and sometimes the plotted points look like the soybean fields in Central Illinois.
Thanks everybody, I was thinking it might be the honeymoon but I never expected it to be tied to an event. I have a deeper aprpeciation of what we all have to struggle with now as I see this roller coaster goes up and down..
I really apprecaite your comments and making me feel like I'm not some kind of freakish experiment gone horribly wrong or horribly right whichever way you look at it :)
What infection did the GP say you have? As a general rule, they never give abx for the flu because its a virus and abx do not kill viruses. I question whether you possibly had an infection in the pancreas and the bactrim took care of it. That's just based on the timing of your diagnosis. That's a lot of med changes in 5 months. Did they do any testing to determine you were/were not type 1? Thinking c-peptide, ICA, GAD...?
GP Said that almost everyone who got this flu was getting strep so the antibotics were preventative and my throat looked pretty bad.
As for testing, C-Peptide was on the low side, GAD was negative but endo said there are a lot of false negatives on that test so I went for IA-2 last week (hope the antibiotics didn't mess up that test) results should be in this week apt with endo Tuesday. Also, I am noticing my numbers starting to creep back up as of last night and this morning.... so maybe this was short lived??
That makes more sense.
Abx should not interfere with that test as the antibodies are in the bloodstream without regard to unrelated infections. Also be aware of what different medications can do to BG. As Shawnmarie said above, some will lower it while others,like steroids, can elevate it. Good luck!
Well today is Monday and as of last night I seem to be back to being a diabetic, numbers are back to where they were pre illness. I suppose I should look back at this experience and be happy that I was a regular old person with a properly functioning pancreas for a few days. But I gotta tell you, having this come at you out of nowhere after only being a diabetic for a few months and working hard to develop your treatment regiment is really confusing. I hope someone gets some comfort out of this post if they experience a similar situation. I have a funny feeling I will go to my endo tomorrow and he will say "um yeah that happens all the time" and I will feel right silly....
Reminds me of this post from a dad who blogs about his daughter's T1. He calls them "cured" days.
To a T really... Wish I had seen it before I got sick :) Thank you thought, I will call them "cured" days from now on :)
I was thinking about what you said about eating and not needing as much or no insulin. Usually when I am sick my sugar is really high but the times I have had infections and taken anitbotics my sugar is so much easier to control, I almost wonder how much of a role in lowering sugar does the actual antibotic play? Just a thought.