My Family - I am no longer alone

Type 2
1

So I am back in Australia for holidays:-

I've got to test my sisters and brother, none of them are on any medications (except sister no. 5 who is on lithium and also thyroid meds).

Twin Sister, 43 YO: HBA1c = 5.6, fasting typically just above 100.

Sister No. 3, 41 YO: HBA1c = 5.6, says her FBS is consistently at about 95.

Sister No. 4, 40 YO: No Hba1c, just gave birth last week, gestational diabetes this pregnancy well controlled with diet.

Brother, 38 YO; Fasting this morning 112 (will testing him after eating a substantial meal). I was really shocked by this. He is tall, slim, eats lower carb and very health conscious, exercises.

Sister No. 5: 37 YO: Hba1c = 5.3

Mother (68), has totally normal fasting and post eating blood sugars and has always tested with bs < 90 regardless of what and when she ate. Father deceased. He never had his blood sugar tested.

Looks like all of them (except my mum) are at least 'prediabetic'. I am doing my best to make them all aware. They all totally believe this is not really a problem and they will be able to manage indefinitely with diet and exercise.

So diabetes now becomes a family issue.

I am guessing that this is possibly some form of mody? We don't fit a 'typical' type 2 profile. None of us are obese (though some of us will do well to lose a few kg) or fit the metabolic syndrome profile - we all have low cholesterol, normal blood pressure, are physically active, and relatively young.

2

Maybe your meter reads 10 points high?

3

He should do a gtt and a1c/antibody/cpeptide testing.

4

This sounds like MODY to me, but there's another form of genetic diabetes that it actually sounds like you fit the profile better for.

There is a type of diabetes called Maternally Inherited Diabetes (it has lots of other names, but this is the basis). It's a mitochondrial disease that can only be inherited from the mother because you only get mitochondria from your mother.

The reason why I think it's MID rather than MODY is because the chances of all five of you having diabetes from MODY is 1/32 (1/2*1/2*1/2*1/2*1/2), whereas the chances of you all having MID if your mother has it is 100% (minus a percent or two because having the gene doesn't necessarily mean showing symptoms). Therefore, it is possible for you to have MID even though your mother shows no symptoms. MID is much, much more rare than MODY, though.

My recommendation? Has anyone in your family ever had a blood test called hsCRP? People with one type of MODY (MODY3, the most common MODY subtype) have abnormally low hsCRP levels when compared to all the other forms of MODY, T2, T1, and non-diabetics. If you don't have metabolic syndrome and have an hsCRP below .4, your chances of having MODY3 are about 75%.

I just did a paper on MODY and the characteristics of its various subtypes, which I'd be happy to send you if you want. It's very technical, but I think most diabetics wouldn't have a problem with it. :-)

1 Like
5

There are good reasons why doctors don’t use bg meters to diagnose diabetes, we shouldn’t either.

6

Similar thing going on as well...

Was out to dinner with my sister and she wanted to test "just to see".

She had a good size glass of lemonade to drink along with some flour tortilla tacos and chips/salsa.

She came out at 178.

I thought that can't be right. Some of the lemonade is on your hand. Go wash them.

Comes back and got 171.

Advised her to go buy a meter and test when she got home, and the typical fasting, before and after meals for a few days.

She got home about 3 hours after the meal and was 83.

Today was 130 after tea and toast breakfast. Back down to 83 an hour after (with activity).

Dinner was pasta, chicken, bread and was 143 at an hour, and then 2 hours was 130.

Certainly, the cheapo meter she bought is not as accurate as a lab result but applying the + or - 20% allowable still puts the post meal reading above 140 nearly 2 hours after the lemonade.

I reckon this can still be possible in someone that is normal, but my reading has left me under the impression that a truly normal person wouldn't really go above 140 even under a bottle of Fanta type of sugar load.

Hope everything works out for your family and those that are dealing with any indications of impairment take the actions they need to.

7

I took a shipboard medical course a few years ago. The instructor had random people from the class drink a large rock star energy drink… Then tested their bg some time later. Every single one of them was between 200-210. The point the instructor was trying to make is that a blood glucose meter reading taken without the proper context is meaningless, and that there can be tremendous variability shortly after eating. This was before I had diabetes so I didn’t put much thought into it at the time, but discussions like this bring it to the forefront of my memory.

8

I'm concerned for everyone... This is getting ridiculous.

I've had 2 friends and another family member get the "pre-diabetes" dx in the past 3 months. There have been many more folks I've encountered with T2 diag that think a 120 meter reading at any time is low enough. And I have done random tests of other friends that were in the "well that doesn't seem right" area - as in above 130 after not crazy carb meals.

Soylent Green is People.

9

I'm going to disagree, as well.

The ADA, however misguided it tends to be with diagnostic criteria (ie, not strict enough), says that any random BG over 200 is indicative of diabetes no matter when that BG is taken.

My guess? That instructor's meter is waaay off.

10

I just sent you a friend request so you can message me your e-mail address.

While doing research, I found a very comprehensive paper about MIDD. I only have one (very long) paragraph about MIDD, but the paper's listed in my bibliography.

That paper said that the hearing loss associated with MIDD is gradual, just more quick than hearing loss due to aging.

The thing about genetic diseases is that they're often variable--the same, exact mutation can cause different things in different people, and we don't usually know why.

MIDD is actually not a form of diabetes (stay with me here). Most people with mitochondrial diseases have muscular deficiencies and, often enough, vision problems (especially night vision). Mitochondria make ATP, which is the body's form of energy. The organs that use the most ATP are most affected by mitochondrial diseases--muscles, eyes, pancreas, ears. MIDD as a result of mitochondrial diseases is actually not as common as some of the other parts of the syndrome. And it's possible for the same family's worth of mutations to cause different symptoms. I remember you said something about your mother having muscular problems--that could be the source of the mitochondrial diseasse.

11

Doesn't give me much confidence in my readings then...

12

Also, I have a friend who's morbidly obese, and she worries about her BG because everyone knows obesity causes diabetes (*sigh*). No matter when I test her--an hour after having a giant bowl of pasta, after ice cream, after juice or soda or hot chocolate--I've never seen her above 124. Now, she could have abnormally good glucose metabolism or not everyone hits 200 after lots of sugar. I've done this with a bunch of friends, not just her, and I see the same thing every time. In fact, she's the only one I've seen go over 120.

And when I had my OGTT, I drank 75g of sugar (yuck) and had my BG tested every half hour. If I remember correctly, I didn't go above 140 or so.