Confused Type 2

Type 2 New to Type 2 diabetes
1

Hey, everyone. I was diagnosed as being a Type 2 back in 2014 with an A1C of 7.3. I also had a very high blood sugar reading of 250 when I was in the ER in 2013 for a possible second round of blood clots. I guess the blood clot situation was so pressing that they failed to mention the high blood sugar. Which, looking back now, was probably why I was not feeling well at the time. I found this by performing a thorough review of my medical records. I have a lot of different really strange medical problems happening as well as the diabetes. I made some dietary changes, stopped smoking, and became slightly more active, but that had only dropped my A1C to 7.1. I have permanently given up all sugar drinks and swapped them out for Splenda. I also gave up alcohol. I gave up most sweets. I just can’t give up bread and pasta. I’m a foodie and food is all I have left. If I do not eat some bread with a meal I will not be sated. Now, that being said, I only eat half of what I used to eat pre-diagnosis. Well, I was not happy with my BG numbers, so I decided to start meal time insulin on my own. I bought Novolin R from Wal-Mart without a script and 100 syringes. I carefully titrated up to the proper dose of insulin and began to have tight control of my BG levels. After a few weeks of this, I told my doctor and he then began to prescribe the insulin to me. I started with a lot of insulin, but over time my resistance started to go down. I have good BG numbers in between meals. I do not need basal insulin. I only spike into the 200’s after meals.

Well, as of last week, after having a hypo into the low 40’s. I have these sometimes, even when I am not taking any meds, so I always have candy bars next to my bed for this reason. I decided to stop using insulin like I did a few weeks ago when this happed. I have been able to eat whatever I want for over seven days now and my blood sugar has not spiked higher than 130. It is mostly spiking up to 112, and then back down to 100, or even 90 within 2 hours of eating. I know the test strips are not bad, because I know what it feels like to have high blood sugar and be all tired and feeling like death. I haven’t felt that at all this week. I decided to test drive my pancreas today with a meal of 200 grams of carbs. I ate 4 servings of cereal with 4 cups of milk. This very meal not even 2 week ago would require 45 units of Novolin R just to keep my blood sugar at 150 an hour after the meal, then back to normal within 3 hours. My blood sugar was 112 an hour after the meal, and then 90 2 hours after that. I can’t explain this. Now I did lose 30 pounds last year due to a bout of severe depression, but that didn’t change my numbers. I know this is temporary, and I have not stopped my Metformin as that drug is the only reason why my BG remains normal in between meals. If I stop the Metformin, my fasting BGs will go back into the 115-130 range. I just wish I knew what was going on here.

A bit of family history here. My grandfather and all of his brothers, and even one niece had either type 1 or type 2 diabetes. They all had one form of the disease. I know it is genetic. I know this is why I have it as well. I am 80 pounds overweight, I was a truck driver in a stressful job and never exercised. These are some pretty big risk factors. I have moderate untreated sleep apnea. I have 20 apneas an hour with oxygen sats in the low 80’s all night long. I have blood clotting disorders, gallstones, fatty liver disease as seen on ultrasound with high liver enzymes. I have supposed COPD and I suffer from chronic pain in my right leg. I have old calcified blood clots in my leg that are blocking off circulation to my leg. This has caused me to become very inactive as walking and standing causes a lot of pain and swelling in this leg. I also have a weird issue with my blood pressure. I have high blood pressure and heart rate when I am standing/walking. Sometimes it can go into the hypertensive crisis level. The highest reading was 170/155. But here’s the kicker, my blood pressure and heart rate will be completely normal/low within 5 minutes of sitting down, and it will remain normal until I stand up again. I had to stop the BP meds; because they were working well when standing, but lowering my BP too low when sitting down. I just check my BP when I’m walking around, and if it is too high, I take a break. Now, what I’m thinking is that there is some type of problem with the nerves in my body causing my BP to be all whacked out. Maybe the same thing is happening with my BG. I really don’t know.

I know I should be on a low carb diet, but food is all I have. I have cut back on a lot, but I still eat some bad foods. What do you guys think about the miraculous BG numbers this week. I test 5 times a day. All of my fasting levels have been normal. 100 and under. Today my fasting levels were 85. Also, on the eating thing. Ever since the clots in my leg an lungs, I have been sick a lot. I can’t even force myself to eat as much as I used to eat five years ago. That is a big reason why I don’t eat a lot anymore. Some days when I am really unwell, I can only eat Ritz crackers and drink water. I also stopped smoking because smoking makes me sicker than a dog now. I’ve been forced out of it. The last cigarette I had in 2014 made me sick for 24 hours. I think my lungs have been damaged. I know stopping the 10 sodas a day I used to drink has really helped, and also reducing my food intake. Any how, please forgive me for rambling and not making a lot of sense. I’m not good at describing things. I just wanted to know if you guys think this is a type 1 honeymoon period? I know I am also insulin resistant as my mealtime insulin can be as high as 50 units for 150 grams of carbs. Most type 1’s are on a 1:10 ration and I am sometimes on a 1:4 ratio. I will keep you guys posted on all of this.

My last A1C was 5.4. My liver enzymes have returned to normal with Atorvastatin, and my cholesterol is also completely normal now. Thanks for any advice. I really appreciate it.

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I also wanted to add that this might be a form of brittle diabetes. I think this because my resistance changes from week to week. One week it will take 30 units for a meal, then the next week it will take 45 units, then one week It will take 20 units to cover the same meal. I also have severe low blood sugar, even when I do not use any insulin at all. I can go into the low 40’s after a high carb meal, even without insulin. It usually happens five hours after the meal has been consumed. Maybe my pancreas is still in the process of breaking down and works some days and not others? My sleep doctor told me I will never have normal blood sugar or lose weight until I start treating my sleep apnea. I just can’t sleep with the mask on unless I’m completely blasted on Nyquil and other meds to sleep. If I do not take the sleeping meds, I cant fall asleep with the mask on no matter how many times I try. Even Ambien will not work. I have to slam a double/triple dose of Nyquil with pain meds to get 4 hours of sleep with the mask on. I can’t do this every night for the rest of my life and I don’t want to be dependent on benzos for sleep, so I just returned the BIPAP machine and will let the sleep apnea play itself out for now. Any how, thanks for reading my long convoluted post. I really appreciate it.

I also don’t recommend starting insulin without your doctor. I have many other diseases and I tend to take charge and try and get the things under control. I read carefully how to dose and started out slow. The only disease I can’t control is the sleep apnea, because I can’t wear the mask due to anxiety issues. I’m considering getting a treach, or some other surgery for it.

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I forgot to add that the only reason I started the insulin and didn’t go onto the SULFA drugs is because they are known to interact with Warfarin and cause severe hypos. Some so low you can fall and break bones. I didn’t want to take that chance so I skipped that class of meds.

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@blizzard2014, welcome to our community. It sounds like you are dealing with a whole bunch of health issues. My experience is that disturbed sleep can significantly impact my insulin resistance. If I have a bad nights sleep I’ll have high blood sugars the next day and require more insulin. We currently have a discussion going on about sleep apnea. I have it as do a number of other members.

Even if you can’t use a PAP machine, there are some other devices that might help such as oral appliances.

If there is any way for our community to support you I hope you know we are here.

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That is almost always a sign of insulin resistance in Type 2 diabetics, and is called “reactive hypoglycemia.” It sounds to me like you have a “stop-start” pancreas, that is sometimes producing sufficient quantities of insulin and sometimes isn’t. Or, alternatively, something is radically affecting your insulin sensitivity on those days where you drop into the 40s with or without exogenous insulin.

Are you possibly getting more or less exercise on different days, and could that correlate with your hypos? That your BGs are steady overnight and between meals with Metformin is strong evidence that you are producing significant amounts of endogenous insulin (why you don’t need the basal). It sounds like the insulin your body is producing in response to meals is sometimes very effective and sometimes not. This also applies when you are adding exogenous insulin to the process. If you aren’t markedly changing the amount of insulin you are getting from meal to meal (and you may be by injecting sometimes but not others), then the fluctuations could be from changes in your body’s ability to “uptake” the free glucose in the blood.

For reference, although I’m LADA, I’m not yet on insulin (but will be whenever my new endo can get around to scheduling me for a freaking appointment), so I control with exercise, diet (lowish carb), and Metformin. And mostly, I am in control. However, I work out pretty intensely, and I do a lot of walking and bike-riding (to work, meetings, when traveling, etc.). It sounds like you aren’t doing that, but you are walking more (or being more active). Long story short, walking to work at a brisk pace, or biking up hill back to my house at a good clip instead of taking it easy, or going to the gym and lifting weights, can change my insulin sensitivity for 48 hours. And although I normally am quite sensitive to carbohydrate, after a good walk or ride I can eat double or triple the amount of carbs in a meal without “spiking” out of my preferred range (don’t like being over 126 mg/dL). I also take simple carbs with and test frequently if I’m doing real exercise (two hour ride, hiking/backpacking, playing football, etc.). In those circumstances, I will definitely go low about 45 minutes into exercise.

Anyhow, those are all I have in terms of tracking down your pattern. “Brittle Diabetes” almost exclusively refers to Type 1s who have frequent and dramatic BG swings, so if you’re sure you’re T2 (although who of us is really sure about that haha), it probably isn’t that.

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Thanks for the advice Brian and David. The start and stop pancreas seems to be the best explanation for all of this. Perhaps I caught this disease in time to slow it down. I know I need to go on a low carb diet, but I love food. I should be trying to preserve what pancreatic function I do have. I will never eat sweets like I used to or drink sugary drinks, but maybe I need to cut back on the carbs even more. I can be happy with under 100 carbs a day. I just can’t go down to 30. I would be miserable. That high carb cereal meal is bad, I only eat that three times a month though and only eat my snickers bars when I have a severe low blood sugar. I do not treat lows until they are in the 60. I have it down to a science. If my BG is 50 and I eat 1 snickers bar, my BG will go to 100-110 in 30 minutes. I noticed that when my BG levels are lower it is because I am sleeping more and my stress/depression is lower. I have a lot of depression due to my blood clotting disorder. Basically it goes out of control sometimes and it can cause me to throw more clots to my lungs and kill me. I am always on high alert because of this. It creates a lot of stress for me. I also have been dreaming a lot this week which means I’m getting REM sleep. I can go for months without dreaming, then I dream a lot and seem to get better sleep. Who knows. I’m going to see the eye doctor for an exam to see if there is any damage to my eyes from the high blood sugar. If not, at least I have caught it early enough. I will always treat the high BG with insulin whenever it comes back. I won’t allow it to get high. Tonight I had 50 grams of carbs in the form of two ham sandwiches and my BG never went over 100. It just feels weird to have normal blood sugar right now. Less stress as I am on the older insulin and have to dose and then wait 30-45 minutes before I eat. I don’t have to live my life on a timer right now. That is a good thing.

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I have also been exercising more. I have been working around the house three hours a week. This is a lot for me as I have chronic pain and swelling in my right leg from damage from blood clots. I am only able to do this because I have adequate pain meds. Without pain meds, I have to lay around to prevent pain. If I were to walk just around the block briskly, I would be limping for two days after. I did a 6 minute walk test at the doc’s three months ago and it jacked me up for two days afterwards. My leg has so much energy and the more I use it, the faster it goes out on me. My good leg can walk day and night. I also have to climb stairs with my left leg only and drag the right one behind it. It doesn’t matter how many times I walk and try and strengthen the leg, it always goes out after a hour of standing/walking and then I am in pain for two days doubling up on my pain meds. It makes exercising very difficult. Maybe that is why my BG went up. I had my accident in 2011 when my leg became semi-crippled and was so bad I could not get off the couch at times until I went to the hospital. I have been sort of couch-ridden for almost 6 years now. I spend most of my day sitting on the couch with my right leg elevated to prevent pain and swelling. That is not good for a diabetic. My arms are weak too and feel like I have worked a construction job just from vacuuming and mopping the house. They don’t get stronger either. Maybe something else is going on, or it is just deconditioning. Any how, I’m sorry for being so winded Thanks for the advice.

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So, just a thought on that front, based in my own experience (I eat just about 100 carbs a day right now, with 30 of that being fiber). One of the nice side-effects of eating relatively low-carb is that hypos can become more rare. Why? Because as you adjust to eating fewer carbs, your body will produce less insulin. This means that there is less circulating insulin to cause reactive hypos, exercise-related hypos, and even to store fat when one eats too much!

Low-carb is great for many people: reduces the lows and the highs, which is ultimately a good thing in terms of day to day life and long term avoidance of complications. But, I haven’t found the need to go “ultra-low” or “no” carb, in my own case. Everyone is different, and the key to managing any type of diabetes is to be open to new experience, new methods, and to experiment like crazy. You can definitely find a combination that works for you :slight_smile:

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So true Dave. For the most part I eat lower carb a few days a week and then sometimes give myself a break from it. I usually eat a lot of TV dinners because the carb counts are on them. Sometimes I only eat once a day, other times twice a day. I still need to work on this though. I also know the Splenda is not good for me. I drink 1 cup of iced tea and two glasses of Koolaid per day with 2 tablespoons of Splenda in each. I hate straight water. I see it as the lesser of two evils. I get the sugar taste without the sugar spikes. I can even bake sweets with Splenda and almond flour to have a small chocolate cake with only 4 net grams of carbs. It just gets dicey when you start mixing all kinds of fresh carbs together. That is why the packaged food or sandwiches where I can see the amount of carbs in the buns are the best for good control. I was actually having a good three month period with no hypos before I had the 50 low and then the 40 low. I was wondering where they went to. My first hypo was back in 2009 when I almost passed out after delivering a load in Laredo Texas. I would have never been diagnosed as diabetic without having the blood clots. It scares me to think that I would have went for years undiagnosed until major damage had been done. I never went to the doctors. I had not seen a doc in 10 years before I went to the hospital in 2012. It’s scary how so many people are out there running around undiagnosed just damaging their bodies like crazy. For a while I was eating eggs and bacon for breakfast, salad, and steak with veggies for dinner. Sometimes a steak and a whole baked potato with the full skins left on it. I had relatively little BG spikes on this diet, but it became too boring for me. I can deal without the pancakes, but I love biscuits and gravy in the morning.

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@blizzard14. It sounds like you are doing extremely well in managing multiple problems! Good for you!!

Check @MarieB-she has loads of GREAT advice!

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I’ve read that some people were able to get some help without giving up bread by switching from the usual white bread to rye bread. Not something I’ve tried, though.

Also, a recent thread here on Tudiabetes was from someone who tried getting a can of bean sprouts, probably draining them, then drying them in a microwave enough to give them a spaghetti consistency, then adding spaghetti sauce He found the result to be an adequate substitute for spaghetti.

My only blood clot so far was in my brain, and took away my ability to move my left arm and left leg. Not fully recovered from that even though that was 15 years ago - it forced me to retire early. However, it also resulted in my type 2 diagnosis on the same day as that stroke.

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That’s a serious gut punch! Do you use the keyboard with your right hand only? Your spirit seems to have persevered.

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Almost only my right hand now. Getting my left hand to the keyboard is slow enough that I only do it for operations that REQUIRE using both hands at once because my right hand won’t stretch far enough to do them alone.

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That really sucks Robert. I hope your are not left handed. I can move my leg, but it is permanently damaged. I can’t do any climbing with it at all. I have to gimp up and down the stairs with my left leg and baby the right leg or else it will be in excruciating pain. I can deal with a jacked leg, but we need our arms and hands. Blood clots do so much damage when they strike. That’s why I stay on blood thinners for life now. I had to skip a dose of Warfarin the other night as I had an INR of 6.3. That is not good at all. I usually do not bleed at all, but I was bleeding for 5 minutes from merely pricking my finger for a BG test. It’s all a balancing act dealing with these diseases. I used my fast acting insulin yesterday and today. I had BG at 150 for five hours. I injected 7 units and it went back to 100 in an hour. Today, I ate the same meal. I just injected 10 units of fast acting insulin and my BG was 90 two hours after the meal. Not too bad. My pancreas is still working at times which makes managing the diabetes easier. But it will get worse. It always does. Kudos on you for having such a strong spirit. I feel broken at times because of the pain my leg causes me. I can’t stand up longer than 2 hours a day, or sit in a regular chair long without pain meds. It has been a huge blow to me as a man to admit that I’m semi-disabled and can no longer perform many of the jobs I used to be able to perform. It is what it is. We just have to live in our new normal and press forward.

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I’ve always been right-handed. I can climb a little, but only in ways that don’t require my left leg to have any strength when bent, and don’t need use of my left hand. Ramps can help, if not too steep.

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