Diabetes and Me. I just don't understand it

I woke up with FBS of 288, and I think it must have been high all night because my cat actually stayed laying on me all night. That never happens. My mouth tasted funny too early AM and then when I actually got up. BS has been weird all day. :frowning:

I am new to diabetes, and never thought this would or could happen to me. I had RNY Gastric Bypass on January 22nd, 2007 and have lost about a whole person off of me, and have been healthier physically for some part, although I am not surprised that I have a vitamin B12 deficiency at the tissue level, I knew this could happen, and I have to give myself a shot once a month which is coincidentally the same as doing insulin shots. Odd, how this has turned out. I never knew my BS was high or that I was having that as the acutal problem because my A1C level was 5.4, and I was having symptoms of HYPOglycemia. My PCP said there was no way that I had diabetes or pre-diabetes and that she was considering sending me to an Endocrinologist to possibly diagnose “hyperinsulism” which is what she was predicting.

Well I get to him, and he tells me, no, the A1C doesn’t necessarily matter for diabetes, given my family history, and my gastric “upset” blah blah blah and he sets me up for tesing. Glucose Tolerance Testing, Blood tests for FBS, Insulin, C-Peptide, and final BS. Well I didn’t pass the test. My sugar was high when I went in, then it was high throughout the test, and then it did drop down at the end of the test in the 70’s, so he was concerned and prescribed “Glucagon” for me. I have frequent hypoglycemia attacks, but since I have been ordered to test my BS 4-6 times a day, I notice my BS is higher at times when I don’t have any idea, like when I don’t even feel bad.

So, I go to see the doctor again on February 1st, 2011, and we will see what he says. He wanted me to test 4-6 times a day for a month, before putting me on medication because of my gastric bypass history. He said my diabetes will be extremely hard to treat if we can’t control it with diet and exercise. The problem is, I do control my diet, and I get as much exercise as I can but at times, I am wheelchair bound. Grrrr. Oh well, I guess we will see what happens. I hope I can get information on this website and support, and also help others who struggle as well.

welcome to the site. did your doc say what type of diabetic you are? are you tracking your food intake/exercise/meds as well? might help w/ your doc visit in february.

Sometimes we acutely feel highs & lows. Sometimes we don’t. You’re fortunate that your endo ordered the right tests because many don’t & diagnose based on age &/or weight. Not sure what he meant by A1c not mattering given your medical & family history. An A1c doesn’t yield a total picture since it’s an average where highs & lows can balance out the results. Your hypoglycemic events are lowering the highs.

Get copies of all your test results. People can be misdiagnosed as Type 2 in the early phase of LADA (Latent Autoimmune Diabetes of Adults). Type 2 is characterized by high C-peptide & insulin in the high range.

Sorry your doctor was discouraging. I don’t know how a gastric bypass factors in regarding managing diabetes. Of course, many T2s do very well on Metformin & there are other meds also. If oral meds aren’t an option because of the bypass, there are T2s on insulin.

Hi Helen!
Welcome to this wonderful site!
You will find TONS of support as have I since i joined! There are alot of loving people on here and a WEALTH of information and experiences to help you make sure you get the right treatment, you truely have a large group of warriors behind you!!!

I related to this particular post when you mentioned your cat laying on you when your HIGH… mine does that too she also purrs and sticks her paw in my face when I am getting low… Its very strange but I am grateful.
If I dont seem to respond to her trying to wake me up… as I am a heavy sleeper… she sits on my bladder and walks up an down my body until I wake up because I have to pee!
Animals are amazing!
She was doing this before I even knew I was diabetic… and here I thought she was just being a pain in the butt!! LOL

You seem to have a complex problem! What was your c-peptide? I know one other person who developed Type 1 after a gastric bypass – so it isn’t unheard of.
Wishing you the best of luck!

Ok, there were 2 C-Peptide tests/results, which were: C-Peptide pmol/L = mine was 12 ng/mL (norm ranges were supposed to be 0.9 to 4.3) and then there was C-Peptide ng/dL= mine was 4000 pmol/L (norm ranges were supposed to be 297 to 1419). Then he checked my Insulin Level, which ws 91 (norm ranges were supposed to be 2.6 to 25). I am not sure how to interpret this but it seems REALLY high and I guess he knows what it means. Also, my FBS ws 130 when I went in, they couldn’t start the OGTT without his consent because my FBS was over 110, and then it stayed high even after the glucola, they did blood draws half hour, one hour and two hours after the test started. Except for the final 2 hour BS, which ws 73, the other draws were over 200. I hope this helps to understand some of my diagnosis, although it doesn’t help me, LOL. Also, to clarify, I have been labeled as a TYPE 2 diabetic, UNCONTROLLED. Like I don’t want it controlled?? I do, but the doctor wants to wait unti Feb 1st when he sees me to figure out a treatment plan.

geeezzzeee! If I could give you a big hug I would! what a mess!

Those values indicate T2, yep. C-peptide & insulin are directly related. If one is high, so is the other.

Did your doctor explain why he hasn’t prescribed Metformin & is waiting until Feb? Is this risky because of your by-pass? “Uncontrolled” is a crappy way to be labeled, but it has to do with the fact that you’re not on meds yet. Uncontrolled because you haven’t been given the tools for control. Not your fault or any reflection on you.

I guess I should clarify this, because I am not sure if my blog made sense when I typed it. I had gastric bypass surgery in 2007 for weight reasons and other health issues. I have NEVER had problems with my BS. There is a family history, as my grandfather was insulin dependent, and I am not completely aware of what my dad’s side had. I DID NOT have the surgery to “control” the diabetes, in fact, I don’t even believe in doing it solely for that purpose.

Gerri- He did not give me any meds because of my gastric bypass surgery, it makes it apparently extremely hard to regulate the meds and treat the diabetes, without having the possiblity of severe lows, which I already knew I was having problems with, that was why I needed to go to him in the first place. I had no idea I was having really high BS.

I hope this kinda clears things up. :slight_smile:

Oh, he did prescribe the “Glucagon Emergency Kit” because of severe lows, I have gotten down in the low 40’s but usually catch it in time . . . and he wants me to test for 4-6 times a day before putting me on medication, because he thinks for at least a month my diet can sort of control it but then when I started testing more frequently, I realized it isn’t controlled at all, so at least I am more aware. I don’t know what foods I am eating to set it off though because I am REALLY careful about what I eat since I have had the gastric bypass surgery.

When he said the A1C didn’t matter as far as me not having diabetes, he was referring to my PCP saying that she was positive I did not have diabetes or pre-diabetes because the A1C level was at 5.4 which is normal. I told him when I first went to see him that she told me this, that I didn’t have diabetes and HE said that the A1C doesn’t mean I don’t have diabetes. So now I should chew my PCP out, lol. I was devastated when he told me the results because I didn’t think it could be true. Its been a week and a half and I am still struggling. I don’t understand how this could happen since I am so careful and have had the gastric bypass (not for that reason). Its discouraging to know that I do take care of myself and this has happened. :frowning:

Gotcha, Helen. Thanks for explaining.

Understand feeling devasted. We’ve all been there. There is NOTHING to blame yourself for! No one knows the cause of T2. No one. Get the idea out of your head that you could have done something to prevent this & for being discouraged that what you’re doing now isn’t helping… Unfortunately, the message has gotten out & is replayed constantly that T2s only need to eat better, lose weight (though there are slim T2s) & exercise to prevent this disease. Utter nonsense. Yes, diet & exercise help control, but it’s not prevention or a cure.

While you’re chewing out your PCP, tell him that a 5.4 A1c is not a non-diabetic A1c. It’s certainly a great one for a person with diabetes, but it’s not one of a normal person. 5.4 is an average of 109 BG.

Eating low carb is the best way to not put further stress on your pancreas. Check out www.bloodsugar101.com & Dr. Richard Bernstein’s book Diabetes Solution.

I know this is a big shock but you will get the hang of this. if you’re not please start tracking your food/meds/blood sugar readings so you start getting a handle on what works and what doesn’t work for you. and see about getting dietician to help you figure out what and how much you can eat. You can do this.

Yup, you’re definitely hyperinsulinemic. Which points to Type 2. What is happening, is that, although you lost weight, you still have metabolic problems which are not related to weight, but to the genetics of Type 2, which you also have. What happens is that you have lost your first phase insulin response, which is the beta cells pouring out a spurt of stored insulin when you first eat, to keep the BG from going high in the first place. So you’re going high. THEN, when your normal phase 2 insulin response gets going, which is the beta cells manufacturing new insulin, they see the high BG and say “OMG better get THAT down in a hurry!” And then they oversecrete, bringing you down too low.
You also seem to have a dawn effect, which is why you woke up at 288 – that’s your liver saying “gotta wake up, gotta get the body some glucose for the day!” but overdoing it. This is NOT related to weight, but to other hormones, such as glucagon, cortisol and adrenaline. Type 2’s have lots of messed-up hormones. And even though you have a lot of insulin, it’s not enough to shut the liver up!
That’s where Metformin comes in. It works on the liver to reduce glycogenesis – the formation of new glucose. Insulin does that for the normal; and for Type 1’s more insulin in the wee hours of the morning does the same thing. However, your doc may, for good reasons, be reluctant to give you more insulin when you’re already so hyperinsulinemic.
Frequent small amounts of carb combined with protein and fat (a must) may help with the hypoglycemia – but the key word is SMALL – too much, and you’re going to swing high again, and low after that.
I can’t say much more than that, because the gastric bypass complicates the situation, but you should know that you WOULD have gotten diabetes in any event – you simply have the genetics for it, and there’s nothing you could have done about it, and it’s not your fault (it’s not obese people’s fault, either). I also want you to know that I had an A1c of 4.8 when my BGs would have been diagnosable by today’s standards. A1c is NOT a reliable diagnostic tool for all people, some “experts” notwithstanding!
Please keep us informed of how you are doing – there are a lot of lovely, caring people on this site!
Natalie ._c-

Gosh after reading this I wish I could reach through my screen and hug you:) I know how scary and shocked and uneasy this can be. But do know there is lots that can help.
You said your real careful on what you eat. Can you share a days eating with us.
Try to relax, stress, worry and wondering, being scared can raise you BS too.

I was 16 when I was diagnosed and so alone, I felt like the freak ghost. My Mother swore it wasn’t HER fault…that didn’t help this scared teen. Nothing made sense to me…you so very lucky to be grown up, and there is so much help here and with Dr’s these days…

So keep checkig your BS, it will all get better:) hugs Debbie