You have hashimoto’s? So you already have an autoimmune disorder. That makes it more likely that you have type 1/LADA. Just because your endo has been practicing a long time doesn’t mean he’s up on the latest – I would definitely get the specifics, and possibly ask for a second opinion (this time with an endo who specializes in treating T1D and LADA, because I’ll bet anything it’s LADA). And, LOL, I said this BEFORE I read all the other comments about getting a new endo!
Yes, diabetes IS a progressive condition. But that is the difference between Type 2 and LADA and true Type 1 - the rate at which it progresses. When Type 2’s work as hard as you do at diet and exercise they can often put off taking meds for years and put off insulin use for a couple decades! Type 1’s go right to insulin because their pancreas no longer makes any. LADAs are in between. I used oral meds for about 15 months before my numbers started to rise. The reason for these differences is the rate at which beta cells are destroyed. Type 2 is a condition largely of insulin resistance, not insulin deficiency. But over time the pancreas makes less insulin of its own and it needs to be injected. I know two type 2 diabetics both of which progressed to insulin between the 10 and 15 year mark but neither were very committed to diet and exercise.
But I have a funny feeling you “hope it’s type 2” because you see insulin use as a dire last resort catastrophy. It isn’t. Treating diabetes with diet and exercise, with oral meds and with insulin each have their own difficulties. For example diet and exercise means you have to really be strict with diet and spend lots of concentrated time exercising and if you slack off, numbers rise, it’s a lot of work. Meds have their own drawbacks such as side effects and cost. Insulin means more freedom to eat and less need for exercise, but you have to test more often and keep the balance between tight control and lows. Each category can be adjusted to and “well lived”.
Im going to give you my personal experience as a type 2 who rides a bike about 12 miles a day every other day. I have been a type 2 for about 8 years and I was on insulin for the first year and now I am on metformin. The type 2 body is different than type 1 and for some reason some type 2s have pancreas that work whenever they feel like it. I am one of them. To me from reading all this blogs the common thing is type 2’s who tend to do extensive workouts lasting from one hour to two have issues with bgs all over the chart.
When I started to reduce carbs my bg’s would actually go higher without metformin. This would happen when I excercised at a decent heart rate for an hour without adding carbs to sustain the workout and it seemed to me that my body thought that I needed more glucose during work out so It would over shoot and I would wind up in the 180 to 200 range. Now that I am on metformin when i work out I tank and hit the low 60’s during work out without carbs. So it became a 1 year experiment between carbs and metformin and excercise to achieve a 6.7 A1C. A little higher than most people like but it is as good as I can do to be able to do long bike rides that I like.
Now with metformin and workouts I tank and chase numbers in the 60’s constantly because my body does not know when to stop. I recommend you start testing whenever you eat and workout. I used to test every 15 minutes during a 1.5 hour workout and the numbers were instering. I found out that i would tank during workouts and the body supplied too much glucose and put me in the sky. Some doctors dont think that type 2’s should test but once or twice a day. I test 10 to 12 times a day and check and see how food and workouts impact my numbers. I learn to adjust to the right number of carbs per activity per hour. It stinks because I have to load carbs in order to stay between 80 and 120 during a workout.
It seems to me that if you feed the body enough carbs at the correct time you can keep the body from dumping clugose from its natural stores. I test every two hours and eat 15 grams of carbs to keep my body thinking that it does not need more glucose from the body.
Now going on medicine really stinks cause then you are inviting some nasty stomach problems from the meds that are given to us type 2’s. If all the test point to a type 2 then you may be one of those type 2s with systems that work whenever they want with no consistant pattern.
Hi LilMama,
I remember your thread when you were waiting for the test results to see if you were in fact Type 1 or 2 and my assumption was that they did the specific tests for that.
Regardless of what type you are, it sounds like you are getting worse and no meds. What is with this doctor? And no, meds will not make you lazy. The meds only do so much and you still got do your low carb and exercise. But if you are a Type 2 and no meds, than you still might have that liver glucose spill going on. I WISH I could be lazy with just my metformin. No, such luck - it is still alot of work but it help control my numbers. I mean, you HAVE to eat - if it gets to the point where you are eating no carbs at all - than you might not be eating very much. Not good since we are thin and need to gain some weight! 
And just like those people they say are 'pre-diabetic" - your pancreas starts to wear out dealing with the high numbers. The meds will help. You never will become ‘non-diabetic’ from being ‘pre-diabetic’ - you will always progress to diabetic.
My c-peptide was 12 (I did peek at the sheet and saw the 12) which is how my doctor (not an endo) decided I didn’t need any insulin. I didn’t know what the 12 really meant but he just said it was normal range and meant my body was still producing insulin. They didn’t do any other tests after that. My metformin regime (lowest starter dosage is 500mg 2x daily - but I know people who only do 1 daily - you have to wait and see how it is working) nis working so I don’t think I am misdiagnosed - as of right now. But we can get worse (or change- depending on how you want to look at it) someday and might need different treatment.
I think if your c-peptide looks low or your current treatment is still not working than they would be checking your antibodies - that should be negative or positive to see if you need a different treatment.
But definately sounds like you are ready for meds. and if he won’t help you, find someone who will! (and remember just becuase we are thin doesn’t mean we are automatically not Type 2!)
Keep us updated,
Thats exactly what I do…I eat every 2 hours 10-25 carbs and usually 2 hours and workout for about 10 minutes sometime between the two hours before testing again and my blood sugar is usually 85-150. Is that good?
I wouldn’t say you have to eat every two hours as a rule. I know alot of people on here don’t do that. Eat when you are hungry (or if you go on meds eat when you take those or insulin) Otherwise you don’t have to eat every two hours as a rule - as you are adding more carbs you might not need them.
No wonder you are tired - that is quite a schedule to keep up with! You should have to do all that exercising like that. Those are good numbers for not being on any meds. But that schedule will be possible to keep up in the long term. You will tired out your body from all that exercise. I dont think that most people on here exercise that much - esp. after only 10 carbs - I wouldn’t think it necessary to exercise but if your numbers skyrocket after only ten carbs - you definately need some meds or insulin.
Does goes on meds help save your beta cells??
Meds don’t mean your lazy! Oh my gosh! I was having the same problem as your having before I got put on my insulin! Now my blood sugar is perfect plus I actually feel a whole lot better! I tried pills but that wasn’t enough for me. I take a 24 hour insulin plus another short acting insulin to cover my food. Id get a new doctor if I were you! Sometimes diet and excersise is just not enough! This is not your fault! My gosh! Its a disease and not everyone can control it without the help of meds! Its that simple ! Its nothing you have done or didn’t do! Your endo has to go! For your own health you need a doc who will work with you in establishing a good treatment plan one that fits your needs! Don’t ever let anyone tell you needing meds/insulin is a personal failure because that’s simply NOT true! These things help us achieve our goals! You need a real doc and soon! Do yourself a favor and get out the phone book and find a new endo! Asap! You should not be made to suffer like this! That’s total bulls***! You deserve a chance to establish a proper treatment plan. Sometimes we need to try many things before we get it right! That’s normal. Please I urge you to get a new endo! This ones a idiot! Good luck to you and please let us know what happens!
Anything that will help keep your numbers down will help. This is because (If i understand it right) that whether you need insulin or orals, the higher your sugar in your blood is the harder your pancreas will work to combat that extra sugar - this is taxing on your beta cells. If you are type 2 and your body still produces insulin but just doens’t use it properly (meaning you are insulin resistant), you pancreas works hard by overproducing insulin because the body isn’t using it properly. So, yes, if you go on meds, and they help with lowering the amount of sugar in your blood, than your pancreas won’t end up being taxed as much (and your beta cells too) and it can help give them a “longer life”. I know many people on here have said this about going on insulin (even for type 2s). But it really depends on what your c-peptide is and how what sort of treatment works best. I am sure a more senior members might have a more technical advanced description but that is the basic premise.
If you try Met and still have the same problems. You might needs a different med or you might need insulin. From those numbers you gave though. I think that Met or another oral med would be a good starting point. Your numbers don’t look high enough to indicate you have no insulin being produced. You would probably see numbers but in the higher 100s for that. 85 is a a very normal (non-diabetic) number to be at.
What are your fasting numbers like?
My fasting has been anywhere from 87 (one or two times lol)-120
ok, around 85 is a normal number to wake up at (like meaning non-diabetic). If you are normally over 100 in your waking number, than yeah I would say (as everyone else is saying too) you need some help with meds… I know most peoples goal on here is to have waking numbers between 80 and 100. Lots of people don’t always have those and might have closer to the 120. But you don’t want to be too high (over 140) or too low (under 70 - but not everyone who goes below 70 will feel hypo - I haven’t).
When I was DX, my fasting was 205! Eeek! Now, my normal fasting numbers are in the 80s and 90s the majority of the time. Once I started taking my met, is when I started having more consistent waking numbers (and other numbers throught the day).
I would start shopping around for a new dr. One thing I have noticed is that any older doctors I have seen, don’t always keep up on new treatments and info. Not saying all the older doctors do this but the closer to retirement they are I think they sometimes often don’t bother to change their methods because they figure why bother. 40plus experience doesn’t mean they are doing it right. Hey, we have the most experience for ourselves right! We have been us for umpteenth years so we know ourselves better than the doctor does! Don’t be afraid to question - if the dr. isn’t listening to you, find one that will. There are so many out there now, that you don’t have to settle. If I don’t like the doctors attitude towards me, chances are I won’t go back to them.
Yeah I was thinking of maybe starting Metformin in the evenings taking half a dose (250) to try and bring down my fasting numbers because I have tried everything in my power to do so…how much metformin do you take?
I take 500mg 2x daily. That is what I started on and I haven’t had to change it. Some people do end up not having to take their second dose after a while. I think the 500mg is the lowest available.
Either way you will need a prescription so your (new) doctor will prescribe what he thinks you will need. I think the 500 twice a day is a normal starting dose and than you take it from there. I take with breakfast and dinner. There are two forms regular and extended release. They will probably start you off with regular and if you have stomach problems from that that don’t go away, you can switch to the extended one. Some people have no stomach trouble on the extended for some reason, I take the regular.
I have only visited my current endo twice (as I was just diagnosed last January and demanded to see an endo with which I first saw in March) I will be going back to him and demanding answers and possibly a low dose of Metformin if my blood sugars continue on in this fashion. He seems to think that when my thyroid is straight then my numbers will be pretty straight so maybe my thyroid is off as well which screws everything up ahhh!! If he is not compliant or understanding after this next appt I will prob take all of your advice and find a new endo…problem he is the only endo in the area other than the other endos in his practice but not sure if I could see one of them for a 2nd opinion. I will keep you all updated, and as always you guys are awesome and thanks for all of the wonderful advice. Not sure where I’d be on this diabetes journey without this forum. God bless you all!
In fact the antibody and C-peptide tests, for a LADA in the long throes of losing insulin production, can be less than crystal clear. There may or may not be a lot of antibodies depending on what battles the immune system is choosing to battle like Don Quixote battling windmills. And the C-peptide numbers might look normalish even though not enough insulin is being made.
I wish I could offer you a clear path, except to say that to me it’s obvious that you’re not T2, you are LADA/T1.
Still, some docs are reluctant to make the T1 pronouncement because of the permanence and stigma associated with that diagnosis. This is especially true with older docs but I’ve heard about it with younger ones too.
I think I am going to ask my Dr to prescribe a half dose Metformin at night so I can have a normal blood sugar all night and upon rising (which would account for more than half of my day at a normal number) I do not really have a problem with my blood sugar until around 1pm… I eat 25 carbs for breakfast everyday (skim milk,almonds,and 1/4cup oatmeal) and ride the bike for only 5 minutes and 2 hours afterwards I am usually 70-100 and then I have a graham cracker with tbsp PB which is another 25 carbs and I exercise for 15 minutes then I have about 15 carbs for lunch my blood sugar before lunch is usually 90-120, so basically after lunch I eat no carbs because my blood sugar just cannot handle it. Is this common among Type 2s? I usually hear the opposite problem…high blood sugars after breakfast.
Actually it varies with some people. Yes, lots have breakfast problems but some people have more problems at dinner - I remember someone had a thread on this but I think it was Type 1 and 2’s. I think the reasoning for most people having more breakfast problems is that apparently Type 2 are more insulin resistant in the morning than at night. I don’t know why this is. Maybe has something to do with the fasting period during sleep. I don’t think it is anything to worry about though
If you had problems in the morning, 25 carbs would be a high carb breakfast, I can’t do oatmeal. Oatmeal is a cereal and lots of diabetics can’t do cereals very well (unless they cover them with insulin). I remember I had oatmeal on my first day on Met. 258 at 2 hours and it was unsweetened oatmeal too. Bleech… Wasn’t worth it. I used to love the instant oatmeal too so that was hard to give up. I have to have sweetener in mine though.
Once you go on Met, I would take it at whatever time of day you have the most problem with keeping the numbers low. So it sounds like dinner time would be the best for you, since you only want to do one dosage a day. If that doesn’t work, you might have to go to a higher dosage though.
If your picture is accurate what the doc is saying is weird. I’m a fat type 2 on Insulin and Metformin. If I’d started the Insulin earlier like I asked I would be in better shape.
I haven’t gotten lazier and I’ve only gained 3 pounds in almost a year and it is my fault from diet not the meds.
Lil Mama -
It sounds you are a type 1.5. 4 Years ago senior in college, I started going to the bathroom alot at night, sweating etc went to the hospital for blood work and found my blood sugar to be in the 500’s. Once I spent the night there I went to the doctor on campus and he said I was a type 2 and prescribed me meds, diet etc. My blood sugar was under control for the most part for about a year and when I finally went to a friend recommended endo, they did the correct tests and she was shocked they thought I was a type 2. I honeymooned for about 2.5 years which is good i believe? but ultimately they had to put me on insulin which to say has been a blessing. Most of my A1C’s have been under 6.5 all the way to 5.8 and I’m still trying to get better. I would hate to see you waste your time with meds that may not work and have an easier way to control your diabetes i.e PUMP or CGM. Diet and exercise is key but sometimes its not enough. Hope this helps
Ross
What is a correct or good c peptide number?