Conflicting information. Diabetic or not?

My doctor gave me insulin upon my request.

I didn't have diabetes prior to August 2009. My diabetes developed between August 2009 and October 2009.

It may have been medications I took last year for severe headaches.

I have since discovered that I am highly allergic to Splenda.

Typically I use Humulog at mealtime. Most of the time I get the dosage right, but rarely ever take too much - if anything, I take the right amount or slightly too little.

I am concerned that my endo will stop prescribing insulin. Without it, I spike into the upper 100's to mid/upper 200's postprandial. I even spike that high with insulin sometimes.

This morning I woke up to a fasting BS of 96. I want that number to be 15 points lower.

Hypoglycemia does run in my family on my mother's side, but not diabetes - never has.

I agree that meters are inaccurate. However, mine seems to be pretty close. My a1c matched my average blood sugars within a few points.

It's so frustrating the not knowing part. I want this disease/condition treated quickly and accurately.

I spent a year battling this so far. It is consuming my time significantly.

Please note: Low blood sugars do not affect your a1c. It's the fasting and high spikes that do, versus the time you have those numbers.

The 3-hour rule I mentioned works exactly right for me anyway.

I try to dose at mealtime so as to NOT have high spikes 2-3 hours later.

It's extremely hard to dose correctly in the high heat of summertime for me. And the cold is intolerable. Even the cold of winter causes higher than normal blood sugars for me.

Springtime/early summertime it the absolute best time of year for my blood sugars.

I wish you the best. If you don't trust your doctor, I recommend asking around and finding a new one. Given that you still don't know the type of diabetes, you should really not be making medical decisions on your own. I believe that patients with diabetes should be VERY active and informed in decision-making, but I don't think that we should do it alone. I'm SO glad that I finally found an endo that I trust and we make good decisions together. I know a lot more about my body than she does, but she sees hundreds of patients and can make some decisions about diabetes much better than I can. I used to have your attitude and managed my diabetes on my own for years, but never as well as I am doing now with a GOOD endo who is actively involved.

A1c is an average of your blood sugar. It is possible to measure because when red blood cells are produced they are "marked" with the current blood sugar value. These red blood cells survive for 2-3 months and therefore we can measure our 2-3 month average blood sugar by averaging the "marked" levels on the red blood cells.

This means that all blood sugar levels affect your A1c. I once got my A1c down, but I was having 2-3 lows per day. I do not consider this good control. Now I was able to achieve the same A1c level with only 1-2 lows per week. I consider this much better control.

There is newer research into the fact that blood sugar variability is as important as average blood sugar levels. Conscientious diabetics and endos now measure A1c and standard deviation of blood sugar readings to judge control. A less sophisticated way of measuring this is to consider how many low blood sugars you are having that are bringing down your blood sugar average.

I usually don't go hypo. But once in a while I do.

Apparently, with my a1c of 5.2, I must be doing something right.

Could you tell me the source of this statement please:

"It is possible to measure because when red blood cells are produced they are "marked" with the current blood sugar value."

I do trust my endo - to a point.

The reason I don't trust her is because when I met her I requested some specific blood tests and she only did a few of them.

Eventually I will get those blood tests. Should I discover that if she had done those blood tests when I asked and the information gleaned from those tests could have treated me more safly and efficiently, then I would have a big problem with her.

I do not tolerate doctors that want to milk me for money by doing a test here a test there.

Get them all done in 2-3 visits.

I am armed with knowledge. I can self treat this the rest of my life if I have to.

I would rather do this the right way, but if I can't then what other choice do I have?

It's extremely hard to find an endo that has openings where I live.

I really don't trust any doctor. Had a bad experience with one that almost killed me. Until I fired him and got another one who actually did the tests that I wanted. I then immediately went into the hospital for 8 days getting treatment.

So, I investigate as much as I can for any diagnosis or treatment a doctor prescribes.

Another example: My first doctor wanted me to see a nutritionist. OK, so I did. That nutritionist wanted me to eat 75g of carbs, 3 times a day plus two 15g carb snacks.

I about fell over.

I already knew that 5g of carbs back then would send my blood sugars into orbit (into the mid 200's).

So, I didn't follow her 'suggestions' and went out on my own. I followed a modified Dr Bernstein diet.

By making that decision, I dropped my a1c from 6.8 down to 5.7 in 6 weeks.

Doctors have a 'practice'. It's just that - a 'practice' . A lot of schooling & experience, but still just 'practicing' on the patients.

There are millions of diabetics out there that I can obtain information from. If I see a trend that shows a particular treatment or change is beneficial, I will try it, with a few exceptions.

I figure that if it works for most of the millions out there it should work for me. At least that is the theory. And it seems to work.

I hate the waiting. I can't get in to see my endo but every 3-4 months. No fun sitting in the dark waiting.

About the A1c, here is a link that explains what the test measures: click here

Many people have had very bad experiences with nutritionist. I will admit that I am very skeptical of their advice in general and I have yet to find one that I trust.

I definitely did not want to push you to blindly accept what doctors say. In many ways, I have a similar approach as you do. As I prepared for a pregnancy with type 1 diabetes, I found that I could not get my blood sugars in good enough control alone. Thankfully I found a great endo who is working with me and I am now 12 weeks pregnant with great blood sugars and few lows.

I just wonder if you have an uncommon type of diabetes. The lows WITHOUT insulin or other medications are what are most concerning for me. You would need an extremely knowledgeable and committed endo to be able to recognize and take the time to test for this.

I think that you are doing things right to get an A1c of 5.2, as long as you are not having lows every day to get it. I would encourage you to keep it up and not to worry about being under 5.

Best wishes!

Many Type 2 or prediabetes have hypos long before they go on medication. The reason is that they have lost their first phase insulin secretion, but then the second phase sees the BG so high and goes into overdrive trying to bring it down, resuting in a hypo. There is dysregulation of the beta cells well before frank Type 2 shows up, and scientists are finding multiple causes of this dysregulation. The true cause and mechanisms of Type 2 are far from clear (Type 1 is much better understood), and most people go undiagnosed, and therefore unhelped for a long time.

I saw my GP today. He can't figure out why I am diabetic either. But I am.

As I said many times before - I am only diabetic when I eat.

It seems I have to get MORE tests when I see the endo or get a second opinion.

Blood pressure up slightly. 119/76. Could be due to the stress of the idiots out there that don't know how to drive...

I even asked my Pharmacist about being a type 2 and not having insulin resistance. They couldn't explain it either.

The Ob/Gyn doctor who diagnosed me as having borderline diabetes and PCOS has also given me conflicting information. First, she just handed me Metformin and told me to increase the dose gradually up to 2,000 mg per day. I had to go to the ER from my first hypo because I didn’t know what was going on since I couldn’t test my BG without a meter at the time. The ER doctor was shocked that she would put me on Metformin without a monitor and gave me a prescription for one. When I started testing my fasting BG, it seemed like it was back under control for a little while after I tried going off Metformin for a little while as I strived to control it through diet and exercise alone. That didn’t work, so I went back on the Metformin and have been dealing with the roller coaster with BG ever since. Meanwhile, the Ob/Gyn said that since my A1C was “normal”, I didn’t need to test myself anymore, even though my fasting BG still goes over 100 every other day. I think I should just see what my PCP has to say about all this nonsense. I’m scheduling an apointment with her today.

Pinky,

I too get strange spikes for no reason. That is part of the disease.
But FBS of 100 is normal by any standard. I prefer mine a bit lower though. My goal is 85, but I can’t attain that while it’s hot or cold outside.

And I cannot fathom WHY people don’t want to take insulin. It’s GREAT!
You can eat a LOT more variety of foods. Just be careful not to eat too much of the wrong stuff. It can make you fat in a hurry.

My FBG has gone as high as 135. My doctor says that anyone with fasting blood glucose over 100 is prediabetic.

My PCP appointment is on the 28th. I plan to ask her many tough questions, including about insulin since my Metformin reactions are considered to be bizzare by members of the group “Metformin for Us”.

Your doctor is wrong.
Google ‘Blood Sugar 101’.

The ADA and AACE are at odds as to what your FBS and PP should be as well as your A1C.

Rule of thumb: get it as low as you can without going under 70 or going over 100.
Those are targets, and NOT attainable most of the time.

I read your other long message. I will reply when I get a chance.

Note: if the quacks out there had you do what they wanted you to, you would have high blood sugars with complications/heart attack/stroke.

I hope you are seeing an endocrinologist and not a regular doctor.

All the dietitians and CDE’s are absolutely positively 100% WRONG.

Carbs are the enemy, FAT is your friend. I am proof of that in both directions.

The food pyramid is all mixed up and mostly upside down.

When I get a chance, I will make 2 food pyramids. One for non diabetics and one for diabetics.

Both of those are quite similar but with small differences.

For me:

Carb free or low carb + high fat & protein = PERFECT blood pressure, PERFECT blood sugars, PERFECT body weight, and near PERFECT lipid profile! I had few bowel movements, and the one’s I did have were quite normal.

Now, I began to eat loads of carbs.

I gained 25 pounds in one month, my blood pressure went up 50%, and my next A1C should also be about 20% higher. My bowel movements are now soft and mushy.

All this was because I altered my lifestyle back to what it used to be before diabetes.

So, I have evidence in both directions that carbs are the enemy and fat + protein are my friends.

And I NEVER eat veggies! Never have, never will. Except for potatoes, yams, rarely raw carrots, and rarely sweet peas. Onions are OK. I eat them once in a while.

But with the exception of sweet peas, I eat nothing green.

If I can’t get my strips, and/or my endo won’t Rx insulin for me, I will buy regular insulin and guess on the dosage.

I have enough experience now to know what low feels like and when one is impending. I also know when my sugars are high too. High sugars make me really cranky (aggressive), and sleepy.

If my BS is between 250 & 300, and I take a short nap for a couple of hours, I can actually go into a diabetic rage from time to time.

So, eating then sleeping is a bad direction for me.

I can’t see an endocrinologist unless my PCP refers me to one. That’s how my insurance works.

Bummer! That’s one of the areas where insurance companies discriminate against Type 2’s figuring that Type 2 is easier and can be handled by PCP’s. That may be true in a lot of cases, but not always. So what it means is that you’re going to have to do a lot of self-advocacy by teaching yourself about diabetes, and if you’re lucky guiding your PCP to cooperate with your needs. Some PCPs are wonderful about letting you be a part of the team, and others really should be drowned! Good luck!

Maybe you should change PCP’s??
List an Endo as your PCP and see if that will work.

For me, either they treat me or I will self treat. They don’t like to hear that. Seems they can’t make $$$ off me that way…

In most states, you can buy regular insulin and syringes without a prescription.

Go to isletsofhope web site. They have a list of what is what by state.

If you never tried insulin before, GO SLOW with it. Start at 5 units or a ratio of 1 unit to 50g of carbs.
Adjust as your tester dictates.

For me, sometimes I need 1 unit for every 10g of carbs, other times 1 unit for 50g of carbs. Depends on the type of carbs, when I eat them, and my exercise level about 1 hour after eating.

My random lifestyle makes it extremely difficult to treat my blood sugars properly. Basically, I just have to guess.
Even the doc can’t give me a good guide to follow.

So, I let my meter be my guide, and some experience too.

Note: Walmart has the cheapest regular insulin and syringes I found. About $26 for a bottle of rely-on brand insulin, about $14 per 100 syringes.

I strongly suggest buying both at the same time to avoid any hassles. Many pharmacies won’t sell the syringes without the purchase of insulin, unless you have a prescription.

For me, I can’t use one without the other, so I buy both.

PS other pharmacies make you sign for syringes. Again, not really a problem, but depends on the state you live in.

I am GLAD I skipped those pills. Insulin does give me better food choices most of the time.
(Hooray! I get to eat a peanut butter sandwich more often and not have to exercise for 3 hours to burn off the spike!))

My insurance doesn’t consider an Endo to be a PCP, so they won’t let me do that. My insurance is very strict with that kind of stuff. And since most Endos near me don’t take my insurance, I need help finding one anyway. I’ll have to check to see if I can get insulin without a prescription at Walgreens or Target since Walmart is too far away for me to get to regularly. Thanks!

If you have free long distance, I can give you my cell number.

If you live close to me, I can help even more.

I do have free long distance, but I live in California and you’re in Ohio.

Hmmmm…