Mild hyperglycemia —> LADA?

TL;DR: My fasting glucose is consistently 98-108, and my blood sugar regularly climbs to 160ish 1-2 hours after a meal of, say, tofu/broccoli/brown rice or a falafel wrap and chips. I’m 30, female, thin, vegan (of the non-militant variety :wink: ), I run 35-45 miles per week, don’t drink, and avoid refined sugar. I realize that my numbers are in the pre-diabetes range, right? Should I be concerned? Does this sort of elevation indicate that I’m heading to Type 2 Diabetes, or could this be early LADA?

Long version:
I know, I know. I shouldn’t be asking Dr. Google to solve my problems. And, I’m not really. I’m just wondering whether I should be concerned.

A few weeks ago, I ran two half marathons on back-to-back weekends. I wasn’t racing them, just using them as long runs with friends. Anyway, on mile 2 of the first race and mile 6 of the second, I got super lightheaded, dizzy, and shaky, and I thought I was going to pass out. The distance wasn’t unusual for me, and I had no idea what was going on. Another runner mentioned that this looked like a classic low blood sugar, so I went out and bought a meter.

I thought I’d get some baseline data for a few days and then go on a run and see what happened. Instead, I’ve seen three weeks of readings between 98 and 180, with the exception of two readings in the upper 80s. (I’ve only run a few times during this time, as I’ve had some serious fatigue. I’m attributing some of that to anemia—which I’m treating and which isn’t supposed to affect my meter’s readings.)

The Internet told me that this puts me squarely in the pre-diabetes range. But, I guess my question is whether that makes sense given my lifestyle. Every Type 1 story I’ve come across mentions very high numbers, and every “lean Type 2” story I’ve read states that staying active keeps you from getting sick. And, this sort of sounded like MODY Glucokinase, except that I have no family history of diabetes and was a normal birthweight (which, I guess, rules out an independent mutation). Could this be LADA? Basically, how much should I try to self-advocate to get tested, or how much should I be concerned? Is this just a case of having too much data (i.e., I’m not super sick, so I wouldn’t know any of this if I didn’t have a meter)?

Two days into my having the meter, I’d mentioned my fasting glucose to my GP at my annual checkup, but she didn’t seem to think this was worrisome. And, I know that the Internet is full of scary information, but I think that the facts seem to point toward at least further investigation.

I’d love any thoughts you might have.

I’d be curious about having a GTT. If you are glucose intolerant, that’s sure going to point it out.

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@Dash, your eating habits and lifestyle are great! I would not worry too much about the bgs as such, since you do appear to be in a normal range. I have heard from Endocrinologists that many gluco-norms have short glucose spikes after eating. If you are truly concerned, you could ask your Dr to prescribe a Freesyle Libre, and wear it for 14 days or so to see what if any glucose issues you might have. Also as @Dave44 suggested a GTT will also illustrate glucose problems (though IMHO I would never want to take another one of those - ever! blech!)

It is also possible that you might have a non-diabetes related hypoglycemia disorder. My spouse has this issue, so we deal with the hangries at every meal. It could definitely happen during an exercise period. Again this is where a Freestyle Libre will help. It will track your glucose data points every 5 minutes for you and your Dr to analyse together (instead of Dr Google). :slight_smile:

Welcome to the forum @Dash!

Given your diet and the shape you’re in, I’d be far more suspect of low electrolyte levels than blood glucose. You mentioned you avoid refined sugars. Are you currently in ketosis?

Whether or not you have low sodium levels would be high on my list of plausible causes for weakness / dizziness.

Skip the electrolyte drinks (mostly full of refined sugars) and get some refined sea salts. A teaspoon or 2 in the morning could make all the difference in the world.
Jim

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So, Type 2 isn’t a lifestyle disorder or disease. There are thin people that get it (famously including a female Olympic runner from Jamaica), there are fat people that get it, there are young and old people that get it. If you have the genetics that predispose you to Type 2, of course, then carrying a high percentage of body fat (especially around the core) makes it more likely to progress to full-blown diabetes.

All that being said, it does sound as if you have pre-diabetes. Could be Type 2, could be LADA, could be something else entirely (MODY, or any number of other things). For the record, I’m active, fit, and had (initially) mildly elevated fasting and A1c that got diagnosed as Type 2. I was later (correctly) diagnosed as LADA based on antibody tests. Adult-onset Type 1 can be very slowly progressive, as it has been for me.

Ultimately, you need to talk to your doctor. Ask for comprehensive metabolic panel and an OGTT. Don’t take “you’re healthy” as an answer if it isn’t backed up by labwork and sound reasoning. Your body, you deserve to know (as best one can) what’s going on. If nothing else, it sounds like a situation worth keeping an eye on.

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I would be suspicious. But I’m not sure unless you get really insistent and have someone in your family that is type 1 or maybe fight to see an endo and depending on the endo that might not help either. I am a vegan too and was swimming 75 laps 4 times a week in a larger/longer gym pool. I caught it with my meter when I first started waking up to 115 and rushed to the doctors. I had always woken up to a 100-102 range, never went over 140 after eating. The first 2 years they called it fluctuations, you’re fine. Because my A1C was normal still although it kept going up. Keep losing weight you’ll be fine, I was told. It wasn’t until I started waking up to 160-180 that they decided they should put me on meds. I have always been overweight so they assumed I was type 2, Even though I told them I had an uncle that died from type 1, even an endo they sent me to, kept insisting I was type 2 and never tested me. Luckily the meds made me sick so I was put on insulin after 3-4 years. But I refused to go back to the endo who just wanted me back on meds that made me sick.

It wasn’t until I switched doctors to an internist, she added a fast acting insulin and then they hired a new endo that my doctor sent me too right away that they tested me and I was properly diagnosed a type 1. LADA. LADA takes years to fully develop. You have a honeymoon phase that your blood sugars and insulin levels start to fluctuate and slowly you stop making insulin.

Start keeping a log of your sugars, a daily log. This is pretty much what you would have to do anyway if diabetic. When you first get up, before you eat, 2 hours after you eat and maybe 3-4 hours after would be good too. Before and after exercise. Do this for 2 weeks, 4 would even be better. Then you can take that to the doctor and it’s harder to ignore if something is going on when they see the numbers in front of them. It will also give you a better idea if something is going on. If you can get your doctor to prescribe the Libre CGM it’s obviously easier, but I’m not sure they will without “proof” of blood sugar issues.

I remember reading somewhere that with type 2 you start by getting hypoglycemia at first. Type 2 has a tendency to run in families too. This is more easily controlled with tweaking your diet. Make sure you eat protein for exercising as it will keep your BG;s more stable.

But if you have diabetes or what kind, it’s not an easy answer. I just wanted you to be aware of the pitfalls of being diagnosed, because being misdiagnosed, turns out it happens a lot, and is usually caught the most when someone has switched doctors and a doctor decides to test for it. So start a log, The information it gives won’t hurt you to know and it might tell a lot more.

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Hello all,

After a couple of months of doctor appointments and testing, I wanted to check back in. @Jim_in_Calgary, you were fairly close to the issue…or at least close to a treatment. It turns out I have dysautonomia. Basically, my autonomic nervous system is wired incorrectly, and everything from my HR to my digestion to my pupil dilation is affected. Fun times! It means that—when I’m not mid-flare, as I was in the spring—as long as I take in water and electrolytes all day, I’m fine while moving, but standing still can make me pass out. (It’s like I was destined to be an ultramarathoner. :upside_down_face:)

Anyway, I thought I should update this thread, in case the search function leads others to it.

Best wishes, and thank you all for your advice and thoughtfulness!

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@Dash, that was nice of you, you never can tell when your information can help someone else!

Dash - Glad to hear you have a diagnosis, even though it’s not the one you wanted. I was also told I have autonomic neuropathy (another name for dysautonomia) after I began having balance issues and extreme postural hypotension.

My endo’s suggestion that I might have autonomic neuropathy was vague at best (there are no definitive tests). My neurologist concurred and added that there are any number of causes of progressive autonomic failure including diabetes and pre-diabetes, lupus, MG, lyme disease, physical trauma and some pharmaceuticals.

For the past 3 years my balance has been severely impaired -especially when just standing still - to the point where I need a cane. Over the past year I’ve been walking 2+ miles / day on a treadmill, and I’ve slowly rewired my brain’s wiring to the point where I now can leave my cane in the car. Stairs are kinda tricky, but that’s a work in progress.

Like you said, staying hydrated and taking large quantities of sodium are the keys to improving BP.

Management & Treatment of Autonomic Neuropathy

Hope things improve for you!

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