Background - T2 for 15 years, most of which spent in denial. Somewhat controlled on metformin, then met + glyburide. 6/08 - moved across country, high stress, problems, then new doc which also meant all new meds (Actos, Januvia, Glipizide), I go seriously downhill fast.
In December, I begin educating myself and finally take control of my diabetes. I spent a month on nothing but metformin and practically no carbs so I could document my numbers. I discover a trend of ok pp #s and poor fasting #s (whether overnight or day time between means).
In January, I finally switch to an Endo (1st time ever) - she seems to agree with most of my conclusions and prescribes Lantus to get my fasting #s under control, along with Amaryl. I start the Lantus - never touch the Amaryl - and continue very low carb. After a few adjustments (Lantus in am, not pm) and despite the fact that Lantus is not always stable, things are fairly good.
So, in 3 months, it was time for blood work, including C-peptide, which I’d never had. Here’s what
happened in my visit to review the results:
Glad #1 - My A1c went from a whopping 8.9% to 6.1% - what a triumph and I have to say a big THANK YOU to Jenny Ruhl and her book. With all the horrible “medical establishment” advice out there, how wonderful to find something that really works and flies in the face of all the nonsense.
Glad #2 - My cholesterol!!! AND - this is without those awful statins - overall went from 228 to 169, triglycerides from 169 to 65!!!, HDL went unchanged at 49, LDL from 145 to 107. Thank you eggs, meat, veggies.
Sad #1 - I had a C-peptide test for the first time (after I mentioned it to the Endo, she never suggested it). The result was low - 0.5 - and she announced to me that I am now a T1 diabetic. This kind of hit me hard. Is this true? If so, I guess I’ll never know if it was just the normal progression of my T2 or the result of all the horrible meds I was given from the new doc when I moved here - did that burn up my remaining beta cells? OR, was I never a T2 and was really some other type - considering I had gestational diabetes, near normal weight, hypothyroid, and both autoimmune diseases (diabetes & thyroid) run all through my family? Should I insist on a GAD antibodies test? Does it matter at this point?
Sad #2 - I asked her if my C-peptide could change for the better and she said no. Really took the wind out of my sails - it this true? Is it really not possible for it to improve?
By the way, she said, “You can stop taking the Amaryl because you’re T1 now.” I said, that’s ok, I never took it. I felt like saying, wonder how many beta cells have been burned out by that horrible class of drugs! She also told me to continue Metformin, but didn’t explain why and I didn’t ask (was still stunned) - probably about weight. I’m near normal but have struggled with 15 lbs or so since hysterectomy despite low carb and exercise.
Mad - I asked to be switched from Lantus to Levemir and she refused. Why, she said? Weight? Well, I said, that’s a consideration but it’s more about tighter control as the Lantus isn’t always consistent. Then she says, Why would you want to take 2 shots a day when you only need 1 now? I said, that doesn’t matter to me, I want more stability. She said I was doing well and shouldn’t “switch things around.” I’m thinking, IS SHE GETTING A KICK-BACK OR SOMETHING? I should have insisted and am considering contacting her again to insist - what do you think?
Confused #1 - BUN/Creatinine Ratio. It was very high (42) and the range is 8-27. Endo didn’t even mention it - I saw it on my copy of the tests (I now always ask for a copy). She said not to worry, I just needed to drink more water the morning of the blood test. Is this true? I drank a 16 oz bottle on my way to the lab cuz I thought I’d have a urine test. I know dehydration can cause this, but so can high protein diet, or kidney issues. Should I be concerned? Should I insist on further tests? I asked why no urine test and they said it was only needed once a year.
Confused #2 - Rarely is my pp # high - about the only time it gets high is if my overnight fast or daytime fasting # (3 to 4 hours without eating) is high. But she prescribed Novolog for me to take before meals on days when I’m running high OR if I “go to a wedding” and want to eat more carbs. 1 Unit per 15 carbs. Is it me, or is this crazy?? Isn’t this (a) ignoring the fact that stable fasting #s are a bigger problem for me than pp, and (b) encouraging me to eat more carbs? And how do I use it when I’m doing low carb? If the ratio she mentioned is correct - I’d need 1 U per meal. And what about times when my fasting is too high before I eat?
That’s it. Thanks for reading through this - and thanks in advance for any comments / advice.