Technically, right now you do have medically induced diabetes caused by the steroids. This can become permanent with long time steroid use (I have a good friend who is dealing with this now even though she is no longer on steroid treatment). Your doctor needs to recognize that this is a valid type of diabetes and it should be treated as long as you are on steroids - and if you are using them for RA, then it is a long term treatment, so you need to keep your blood glucose levels managed.
It is unfortunate your doctor does not realize you do need to be treated for diabetes, even if it might go away when you stop prednisone. A full panel blood work isnât going to give her any more useful information for a diabetes diagnosis than she already has. You should be seen by an endocrinologist for as long as you have elevated blood glucose levels.
You can buy blood test strips most cheaply on Amazon so you may wish to do that if you cannot get them covered by a prescription. I am so sorry you have to deal with the obvious ignorance of this doctor who is not even able to recognize when she is out of her knowledge base.
My insurance doesnât cover supplies at all. I pay about 10 dollars for 50 test strips with no insurance, cash. Easy touch at sams and also glucocard expression at a small pharmacy best prices so far. I keep at least two different meters. I also use freestyle libre paying cash and it varies from 32 dollars to 66 dollars for a two week senser. I donât ask why the price varies because they want to charge even more. Today it is 63.05 for two sensors cash price wallmart. I am LADA and it has been a real journey. A1c started rising about 10 years ago, 50 year old then. I am still in the honeymoon phase, I still produce some insulin, and I swim every morning. Diet and exercise probably keeping me in honeymoon phase. I test positive for antibodies, the test is expensive and I donât retest much. some labs want over a thousand for the antibody test,(gad 65) is something they test for. Libre is a big help but not always accurate so you have to back up test sometimes just after swimming, but if it is a bad sensor you have to test much more 5 to 10 times a day if your blood is swinging a lot, i.e. carby or bigger meal, heavy exercise means more testing. After a fast swim because rapid decent of bg might not be caught by the meter due to 15 to 20 minute delay, then a blood test is needed.
Thanks so much Mark for the information and welcome to the community! You have given me a lot to think about and I will definitely check Walmart when I need strips. I checked the website about the Libre when Jules suggested it but it looks like Iâll need a script from my doctor and since sheâs adamant that Iâm not diabetic she wonât be any help. Iâll definitely need to find a new primary first.
Do your test results list normal ranges? WebMD says normal is below 5.7. My results lists 5.9 and below as normal. I think depending on the specific test, ranges can vary. WebMD lists pre-diabetes as 5.7-6.4 and diabetes as 6.5 or more.
Some hopefully useful arguments: Point out that this is with strict efforts to maintain control. Without testing, that is extremely difficult. The point is to delay/avoid diabetes, or treating it as soon as possible. Many people with indubitable diagnosis have HA1cs lower than yourâs. Stopping or reducing treatment would be tantamount to malpractice. She wouldnât consider taking a type 1 off insulin with a HA1c below 6.5, would she? This is known problem; why ignore it? Why stop a treatment plan the is obviously working in order to wait for things to get worse? If a history of your HA1câs shows a trend, that can be helpful. Even if your levels are caused by steroids, it still needs to be treated. Finally, if she doesnât relent, tell her straight out that you fear she is compromising your health and causing you harm and ask for a referral.
Before CGM, at one point I was testing 8-10 x per day. My endo remarked that I donât need to test that much and that I should cut back. I asked, âWhat was my last HA1c again?â He look at the file and said, âYeah, okay. Keep doing what youâre doing.â
No I have not had any of the LADA exclusion test such as c-peptide, GAD, or ICA tests. When I get another PCP and referral for endo I will ask for those tests to be run.
Iâm still running between 123 - 150. A couple of nights ago I didnât feel like eating, skipped supper, and went to bed early. The next morning, I had a fasting BG of 94 like I my previous endo wanted my BG to run. But I felt extremely weak I guess from running at a higher BG for the last couple of months.
But now that Iâm on the keto diet, my diet is mostly protein and a little fat rather than carbs so the run on my BG is still perplexingâŚ? Except my PCP is still pushing the prednisoneâŚand now that Iâm quarantined at home Iâve lost some weight and still drinking lots of water. Blood pressure is really goodâ114/64, 86 pulse.
Iâm no longer following a keto way of life (I will again some day) but the fat content of your diet should be the majority of your diet (~70%), followed by protein (~25%), followed by carbs (~5%).
Not doing so could be why your blood sugars arenât as low as youâd like them to be.
The protein in your diet is being converted to carbohydrate (almost as if you were eating carbs) and youâre burning that (carbs) for energy instead of burning fat.
Thanks Tapestry, that makes sense. If thatâs the case, as you stated, Iâll never get my numbers down because my cardiologist doesnât want me to have alot of fat, heâs o.k. with the protein to replace the carbs (starch).
Kate25, you might want to look at the way I eat. I eat very little fat, but many healthy plant based carbs. My numbers are very low. I seldom have an A1c over 5.3.
I take an average of 2 units more insulin than when I was low carbing, but eat about 10 times more carbs.
I follow the advice of the type 1 diabetics at Mastering Diabetes.
After 50 yrs of being a type 1, I suddenly needed two heart stents. I was following the Bernstein diet and had a very high LDL number, which I foolishly ignored. I have no other serious diabetic complications. Now after having diabetes for 61 yrs, I am still pretty healthy except for the stents. I have been following the low fat plant based diet for almost 4 yrs.
I got to tell you that this is 1 of the weirdest stories that Iâve read in over 10 years that Iâve had Diabetes. And it brings me back to thinking about the basics. When youâre first diagnosed, the explanations are not complete about anything. And it was up to me to start the journey of finding out how to manage the rest of my life. But I never went into the âhow do you diagnose?â part of it. I took it for granted that it had to do with A1c and daily blood sugar readings.
