What in the world is going on?

Hi,

I’m new to this site, but from looking through it so far I believe it would be a good place to start with my questions and situation.

A little background info about myself and my situation:

I’m a 22 year old college student. I’m a healthy weight (5’6"/135lbs). I work out at least 3-4 times per week, I’ve always played sports, and I love to hike. I’m an Army ROTC cadet and I always excel on my physical fitness tests. Contrary to most college kid’s diets, I actually eat very well. Very rarely do I eat fast food or heavily processed foods. The only family history I have of diabetes is my Aunt who is Type 2, and my grandfather who is pre-diabetic.

In March 2015, I was at a training event with ROTC at Fort Jackson, South Carolina when I first had any symptoms/issues that could be diabetes related. I had nausea, headache, I was completely exhausted no matter how much rest I got, and I was so dizzy that I could barely walk. I was taken to the hospital on post where they didn’t do any tests and told me I more than likely had a virus and needed to stay hydrated and take it easy. My instructors gave me gatorade after gatorade and it didn’t make me feel better at all (probably because gatorade mine as well be sugar water). Because I was nauseous, I didn’t have much of an appetite so I drank lots of fluids (water and gatorade) to make up for the lack of food.

When I returned home from training a day later, I still felt awful. All I wanted was to drink water. A couple of days later I finally went to my doctor at home and requested to have blood work done. Initially, my creatinine levels came back slightly elevated and my non-fasting blood glucose level was 64 mg/dL. However, they didn’t say anything about the low-ish blood sugar and focused on the creatinine levels. Three weeks later (April 2015) I repeated the same blood tests, but this time I fasted. On this go around, my blood glucose level was 96 mg/dL.

Fast forward to three months later in July and I was still having much of the same issues as before, only now they were lasting for days at a time rather than a day here and there. I moved home for the summer since I didn’t have to take summer classes. At this point I was able to see my regular physician, so I scheduled an appointment. He again did the same blood work, non-fasting. In fact, I had eaten frosted flakes about 45 minutes before coming in for the appointment. On this occasion, by blood glucose level (non-fasting) was 51 mg/dL. So they took notice of the low level and told me I more than like was experiencing post-prandial (after eating) hypoglycemia.

Fast forward once again to August 2015. I had my annual visit with the Ob/Gyn and when I explained to her all that was going on, she became alarmed. Someone in my physical condition should not be experiencing these symptoms as uncontrollably as I have been. So she ran numerous tests (hormone levels, thyroid, and an A1C test). Everything came back normal except the A1C test which fell into the lower end of the “pre-diabetic” range at 5.7%. The only instruction I was given was to increase cardiovascular exercise and try and maintain a low-carb diet. Well, that’s great advice, but that’s what I’m already doing and it’s not helping with my issues at all.

Which brings me to my real questions, and why I posted this within this forum. Has anyone else who was diagnosed with LADA had a similar experience? After researching a bit about the various types of diabetes, LADA seems to fit me more than any of the others. I’m not trying to self-diagnose or get an internet diagnosis on here, but I’m honestly tired of feeling awful all the time and I have absolutely no control over it. I don’t feel like myself, I don’t look like myself because I’ve lost weight, and I just generally feel defeated. I’ve watched my blood glucose levels go up and down in the beginning and now they seem to be slowly increasing, and no one can seem to give me any guidance. I’ve spoken with my Ob/Gyn about getting a referral to an endocrinologist. They agreed to set me up and appointment, but I have yet to hear back. At this point, I’m just really frustrated and I don’t know where to go from here. How does someone who is young, of a healthy weight, with a healthy lifestyle end up type 2 pre-diabetic?

On another note, this is also a huge issue with my potential military career. Having already spent four years in ROTC working toward a commission, it puts me in a huge bind. For anyone who may have experience, is being pre-diabetic a permanent disqualification for the military? I am supposed to graduate in December, but I can’t even really plan what to do with my life next because I don’t know if I’ll be in the military or not. If I can’t go into the military that’s fine, life goes on, but I don’t even know where to begin if I don’t have any clue where I might end up.

Thank you all so much for your time, help, and suggestions. I apologize for the long post, but I don’t know where else to go at this point.

-Kate

this post might be helpful

you might want to ask for the antibody tests @Melitta mentions

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I’m not sure what’s going on. None of the numbers you’ve seen with your bg support the A1C of 5.7— which is also pretty much the upper end of normal. But something seems off… If I were in your shoes I’d consider buying an inexpensive meter and testing 1 hour and 2 hours after you eat for a couple days…

Some of your symptoms seem contrary to one another— extreme thirst would generally be seen at extremely high sugar levels, but you report them when at very low levels…

You may be having significantly high levels that your body is slow to react to, so instead of keeping them in check in real time it’s always trying to catch up and sometimes over corrects as seen in the lower numbers… But until you can determine if/ when you’re having high blood sugars it’s hard to know what’s going on or if it’s diabetes at all. One test that doctors can do to see how your blood sugar reacts to carbohydrates is called an oral glucose tolerance test…

I believe that insulin usage is disqualifying in the military but other diabetes meds are not. That’s based on old information though it’s not s subject I keep up to date on.

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Pre-diabetes can be either pre-Type 1 diabetes OR pre-Type 2 diabetes. In addition to the OGTT, a c-peptide test and autoantibody testing may be very useful to help figure out what is going on.

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Thank you Melitta. My physician made it seem as if it was all lumped into one as pre-Type 2. I guess my biggest concern is that things, although slowly, continue to worsen and I can’t control it. If things continue, hopefully these tests will help find some sort of answer.

And here’s another very informative post on LADA

You’d have to ask. The problem would be finding someone who could answer based on what the actual requirements and typical practice is these days in the military versus someone (like me) who is only speculating based on old, anecdotal experience.

FWIW, my guess is that it depends on some combination of which branch of service is involved and at what point in your “enlistment” you are considered to be. And I really don’t know jack about the officer track so I have no idea what being in ROTC might entail.

I don’t believe anyone who is insulin dependent would be admitted into service. However, back in the 1980’s when I was diagnosed while in service, as long as you weren’t using insulin you could stay in if you were already active duty. And the Army & Air Force would allow someone who used insulin to stay in as long as they could be stationed in a spot where their medical condition wouldn’t impact the mission.

On the other hand, requiring insulin is a deal breaker for the Navy and, I’m guessing, probably also for the Marines. The key phrase used back in 1980 was something like “fit for duty on land and at sea”. Essentially the Navy doesn’t want to knowingly put themselves in a position where they have to divert a ship because a crew member needs medical attention. If it happens they deal with it, of course. But they don’t want to take the risk if they can avoid doing so. (Or at least didn’t … but I really doubt they would change that policy.)

Also, don’t get ahead of yourself. You don’t know if you have diabetes, the indications you do know are conflicting at best… You just know that something warrants looking into.

Frankly, it sounds like something less common than T1 or T2 is going on in your case. Perhaps it is just early T1, but the symptoms are usually clearer. I would wonder if instead you are seeing irregularities in your BG (Blood Glucose) as a result of some other condition rather than as a direct consequence of early T1.

You obviously need to find a doctor who has enough of a clue to start looking at this more closely and trying to rule things out so they can find out what is wrong. Unfortunately, I don’t know how you would find such a doctor, The ones who actually will stop and ask, “What else could it be?” seem to be few and hard to stumble upon. :disappointed:

One way to tell is by how long a doctor talks with you and how much of a case history he gets before starting to jump for a diagnosis. The good ones want to learn as much as possible before starting to toss possible fixes in your general direction.

You might look for a forum for people with hypoglycemia. You don’t have hyperglycemia. Hypoglycemia is responsive to diet only. If you don’t have a better source for hypoglycemia diet training you could try avoiding any sweets. I think the Atkins diet is recommended. That’s the low carb diet. Good luck.

Have any of your docs raised the possibility of “diabetes insipidus”? There are some other kidney and non-kidney issues that can also lead to large urine output without high bg’s. Seeing as how you’ve never been tested with a high bg, and (presumably) they’ve tested your urine too and I’m guessing they’ve not found sugar, it’s hard to conclude that this is any kind of diabetes mellitus.

Thanks for the info. I’m Army ROTC and I haven’t commissioned, so I’m not “in” yet. No one in my Chain of Command seems to have an answer as to the medical standards these days and how they apply to me either. I guess it’s just another situation of hurry up and wait.

Also, you’re right about trying to find a doctor who will actually take the time to review everything rather than just jumping to a simple conclusion. I’ve found that nurse practitioners tend to do a little more probing and take the time to gather as much information as possible. Hopefully I can find someone who can find more than five minutes of their time to talk to me.

No, I’ve been told kidney disease, post-prandial hypoglycemia and then type 2 pre-diabetes. It’s really all over the place.

The nature of both the profession and of the people who are likely to become doctors tends to push them to act like that. Worse, they will all look at you as though you’re the crazy person for asking them to stop and take the time to think it through.

It can be hard going, but I think your best chance for useful answers is to hang in there and keep politely pushing.

My (second) best guess is that what happens depends on what is actually going on and how much medical support is required to cope with it. If, best case scenario, it turns out to be something transitory or which you can control by “diet & exercise” or whatever, then I don’t think the military will care. The bottom line is … or at least should be … whether or not you can do the job.

The “not knowing” is a kind of hell.

Diabetes isn’t something you do to yourself, it’s a malfunction in the body’s insulin system, whether T1 or T2. Don’t beat yourself up with ‘if I had only done something different!’ I think you’ll finally make some progress with understanding what’s going on when you seen the endocrinologist, but it took several months to get my LADA sorted properly, and it was a simpler situation than yours sounds like.

Try to be patient - the doctors have a decision tree they need to follow, and it isn’t always the fastest way to a diagnosis. Try to be persistent - if you aren’t feeling better, they haven’t got it yet. And no one knows how you should be feeling better than you do.

Good luck!

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Hi Elle3,
Hopefully, the endocrinologist will have answers for you. When I read your post, I was amazed that your history parallels mine almost exactly. I have always been normal weight for my height, and very active.

Over many years, the symptoms I had were typical of hypoglycemia, but I didn’t know what it was back then. It was miserable, but the GPs didn’t care. Before my diagnosis (which came 20+ miserable years later), my ophthalmologist was the only doctor that was convinced that I was diabetic (retinopathy). I had abnormal 2hr postprandial tests, OGTT tests, Random glucose tests all of which had abnormal readings, but not a single diagnosis because the limits for diabetes diagnosis back then were different and the docs were complacent.

Over about 6 months, I lost 30lbs without trying. And finally I managed to get an appt with an endo. He sent me for a c-peptide test, autoantibody test, etc. I’ll never forget, at my second visit, the Dr. saying “I know what this is.” He handed me a bottle of insulin, and set me up with a dietician.

I am not a doctor so I can’t diagnose, but I believe you could be in the early stages of Type 1 diabetes, or that you may have MODY diabetes. When you see the endo, hopefully you will get blood tests that will indicate a diagnosis. If he happens to do an OGTT, I would hope that he schedules it for a 5hr one, to see if you’re blood sugar is dropping drastically by that point (which would cause your awful symptoms!). I sincerely hope that you get answers soon, because it’s so frustrating to not know what’s going on!

@Brian_BSC, do you have an opinion/guess one way or the other?

@Elle3, none of us can really diagnose you. If someone has classic diabetes the many veterans here can often suggest what might be happening. But your case is not typical. I will tell you that what you describe is not typical of any form of MODY. And like others I will tell you that diabetes can occur in anybody. Nobody gets diabetes of any kind from simply not eating well and being a couch potato. It is a myth that only overweight people get diabetes. In fact people of asian heritage are often thin but still end up with T2 diabetes.

Some of what you are describing sounds like Reactive Hypoglycemia (RH). This can be caused by all kinds of things. Certainly RH can be observed in emerging diabetes, but it can also be due to things like hypothyroidism. And the fact that your A1c is 5.7% means that while you have observed low blood sugars at certain times (primarily fasted), you are likely having higher than normal blood sugars after eating. I think you will just need to be persistent and hopefully your doctors can track it down. It would be good to visit an endocrinologist as they are the specialists for endocrine disorders which includes not only diabetes but thyroid conditions.

One thing that would really help you narrow down what is happening is to get a blood sugar meter and test your blood sugars before a meal, eat a fairly carby meal and measure your blood sugar every 30 minutes. You can get a cheap meter and strips at Walmart.

And as to whether you can be commissioned that will really depend on what you find that is wrong with you. I will tell you that the current DOD instruction on the matter says you will be rejected if you currently or have a history of prediabetes (as defined by fasting glucose > 110 mg/dl or HbA1c > 5.7%). I’m sorry.

Of note— none of those parameters define her current condition.

Thank you all for the advice, suggestions, comments. I apologize for posting and then kind of skipping town. My appointment with an endocrinologist is tomorrow. Hopefully I will have a better understanding of all of this soon.