Need advice

Type 2 New to Type 2 diabetes
1

Hello all,

I guess it's time to join the forum as I seem to have questions even after reading all this useful information for hours.

I had gestational diabetes that was controlled with a diet/exercise and was so happy to see it disappear a couple of weeks after the baby was born. I kept my meter close though and was checking my glucose every 4-5 months after large meals - it was always below 100 by 2 hours mark).

Now exactly 2 years later the diabetes got back (my meter told me that when I started feeling thirsty/sleepy) with the spike of 142, 2 hours after meal.

I should probably mention that I'm 31 years old, thin and have always had healthy active lifestyle. My aunt had type 1 - she got blind and then passed away after kidney failure at the age of 30...

So I got to research all the information I found on the internet (including very helpful website Blood Sugar 101), reduced my carbs and added more exercise (I swim every day, ride a bicycle, walk a lot), apart from that I take care of a super active 2 year old child and work as an event photographer (that means running around with 7-10 kg equipment).

For 2 months of diet my blood glucose level was lower than 120 - 1 hour after meal, and below 110/100 2 hours after meal most of the time. Two or three times though I was unpleasantly surprised to see borderline meter readings after a tiny healthy snack. My diet didn't do any good for my fasting level - it is around 86-95, though my last meal of the day is a small snack at least 3 hours before I go to bed.

I'm worried to notice that for the last week I get higher numbers (15-20 points difference) for the same meals I had a month ago. My portions get smaller and smaller but the numbers creep up.

What is happening? My body would need me to eat next to nothing, exercise more (by the way, all my physical activities work up the appetite and I don't think I would be able to handle 30 grams of carbs diet and keep exercising - I just won't have energy for that).

Also starting from the day I saw the abnormal blood glucose numbers my hands tingle while I sleep. In fact sometimes I wake up at night because my hands feel so numb...Am I getting neuropathy already?

Please help me understand what is going on. As soon as I can I will get tested for Type 1.5

2

Well, the numbers you've shared aren't quite in the clinical range for diabetes -- more like "pre-diabetes".

Second, the variation you're seeing is perfectly normal for a non-diabetic. Also, don't forget that meters have an accuracy of +/- 15%, which in practice is really more like 20%. So, an actual BG of 100 mg/dl can show anywhere between 80-120 on current meters. Well within the variability you're seeing.

All that said, there are two "accuracy" issues with meters that are interdependent, but not strictly linked: The accuracy of the reading itself, and the consistency of readings from a meter. The latter is much more meaningful in analyzing variability in your BG. Most meters are pretty good with consistency, and it's easy to test yours -- take a batch of 5 readings or so at once, and see how much they vary.

Bottom line, I wouldn't call you diabetic yet, but you're at risk. Good time to see an endo for an evaluation to find out what's going on, develop a monitoring plan, and carry on with a great life!

3

Dave, thank you for your comment.

I'm aware that these numbers are pre-diabetic but I guess the fact that I have my blood glucose level abnormal at the age of 31 (though my doctor during gestational diabetes was saying I might have diabetes when I'm around 50) and that my diet stopped working so soon gives me the message of where I'm heading to.

I don't always trust the meter and do retest when I see unusual numbers. But the fluctuations I see are insignificant - so the meter gives me the right range...

I will see an endo soon, I'm trying to find a really good one (especially after reading so many frustrating posts after visiting a doctor.
4

You're doing everything right -- something most of us T2's wish we could say about this disease in its early stages.

Given the direction things are going, consider changing over to a low-carb diet from now on to help preserve pancreatic function and insulin sensitivity to the max. This might keep you "pre-diabetes" forever, but it's no guarantee... this disease is genetic, and progresses despite doing everything "right".

Low-carbing is something I resisted for a long time, and dismissed as a bunch granola hippie BS (granola hippie members of TuD excepted :-)). It was TuD that gave me the scholarly information -- I'm that kind of guy -- to turn around 180 on this.

So much so that I'm going to try the 30-day ketotic-adaptation and see what happens. This is essentially eating NO carbohydrates at all. Check out the links here and here.

I'm a scientist/engineer by profession. I gotta be convinced with solid data, theory, and experiment before I'll consider it. Natural skeptic. I'm convinced enough by what I've read to give it a try and see if it works.

Anyway, back to you: Insulin is necessary almost exculsively for processing digested carbohydrates. Eliminate them, and insulin needs drop dramatically -- down to a baseline necessary to metabolize what little glucose is generated via gluconeogenesis in the liver (converting protein to glucose).

5

Hi Tati: Many, many women here on TuD developed GDM that was actually autoimmune gestational diabetes (I wrote a blog about autoimmune GDM here). You are smart to get tested for "1.5" which is really just slowly progressive Type 1 diabetes. It's important to get the full suite of autoantibody tests (GAD, ICA, IAA, IA-2, ZnT8; I explain autoantibody testing in this blog.). Please see an endo as Dave suggests and get the testing done. If you do have slowly progressive Type 1 diabetes, you should be treated with insulin--all the diet and exercise in the world won't do it (though it helps). I am glad you found TuD, welcome. Best of luck to you!

6

Melitta,

I have read many of your useful posts already, thank you for that! I will have all autoantibody tests

P.S. After reading loads for the last 2 months about diabetes I cannot figure out which one is easier to live with - LADA or Type 2 (diagnosed at my age).

7

Well, which one would you prefer to have, the "good" one or the "bad" one?

(that's a rather pointed inside joke among diabetics :-))

8

Diabetes isn't easy to live with regardless of type lol. I'd say this is the hardest thing I've dealt with in my life so far and I'm saying this as someone who barely survived being born and had a somewhat sickly childhood.

I mean I was misdiagnosed as type 2 despite being slim and otherwise healthy and 22 years old , type 2 drugs didn't work for me after months and I then was found to be a type 1 instead and I've been pretty good since (not counting my TERRIBLE experience with the insulin pump and current mental health struggles). My experience is unfortunately common and it might be your experience if your pre-diabetic sounding numbers are actually LADA, slow onset Type 1 in adults. If you do get an official diabetes diagnosis, I think you understand this, but get as much further testing as you can. Do not settle with a type 2 diagnosis until you know you're a type 2.

9

Hmmm...definitely haven't heard of mental health problems.

And what is the insulin pump bad experience if you don't mind me asking?

10

See, Dave, being new to diabetes I don't get it. yet :)

11

Hi Tati,

Because you had gestational diabetes, as I'm sure you know, you're at risk for type 1 or type 2 diabetes so I would go back to your endo and have a work up. Ask for c peptide and antibody testing. The numbers don't always tell the full story- I had a non fasting 106 6 months before dka and I'm sure now I had much higher bg at times I just didn't have testing or test myself when I had high bg symptoms. I would do a lot of testing and do my own glucose tolerance test if I were you. Another sign you could be type one is slow beginning of loss of fat and muscle. That started happening to me the summer before the 106 October reading. By May I was in the hospital.

12

I am testing like crazy and that's why I've noticed this sudden bigger rise in my BG during the last days for no reason. Will ask for c peptide and antibody testing.

13

After browsing posts of people with Type 1 it seems that it's way more difficult for them to keep BG control (fasting below 110, pp below 120). True?

14

I rather not explain it other than it was just not for me at all. A lot of diabetics have depression and anxiety, it's just a part of having a chronic illness for the rest of your life.

15

I would say very true.

16

Hi Tati: I know it's nerve-wracking to be in this "not knowing" place when you are watching the numbers on your meter climb, especially when you had an aunt with Type 1 diabetes who died young of complications. I will try to give a bit of perspective, just my 2 cents. First, it is important to get a good doctor who will help you get to a correct diagnosis (too many adult-onset Type 1s are misdiagnosed as Type 2). If you have Type 1 diabetes, it is important to start insulin as soon as possible, even at low doses (I can explain why if you want to know). Type 1 is not an easy disease to have (nor is Type 2), but at 19+ years into this T1 journey my opinion is that you can live well in spite of diabetes. With good control and modern technology (I use an insulin pump and Dexcom continuous glucose monitor (CGM)), you can greatly reduce the risk of complications. Regarding insulin pumps, I have been using a pump for 16 years, and I would not go back to MDI for anything--most people with pumps will say the same thing. Finally, I can see by your posts that you are proactive and smart, and not sticking your head in the sand in denial. Very good qualities to have on this journey. Let us know when you have the appointment with the doc.

17

So that means that people with Type 1 spend a lot of time with dangerously high numbers?

18

Tati, again, welcome to our community. I'm glad you found us! I've been type1 for almost 47 years, and pumping for 25 of those. like Melitta, I'd never want to go back to shots, I enjoy the flexibility of pumping, and being able to fine tune my insulin delivery. I have had pretty good control since pumping, and even better since I joined TuDiabetes over 6 years ago. my a1cs have been in the 6s. I do get some highs from time to time, and I just correct and continue on. Hopefully, you will get some answers soon about your dx. It really must be stressful for you right now. We are here to help, and here to listen. let us know what you find out.

19

Hi Tati,
You have been getting such excellent advice so I hope you will make way to getting answers from dx testing. As for your questions about it being difficult to keep BG control I can say that it can be done, and with today's methods and insulin it's not exactly "difficult". It's not fun, it's a job, but it's doable. Even the best managed diabetics have bad days and deal with highs and even lows. I do not spend a lot of time with dangerously high numbers, mine are rare and when they happen they can be fixed pretty quick. I want to repeat what Melitta said in that "that you can live well in spite of diabetes." I've been doing it for decades and we have lots of members who have, too. Get that appointment on your calendar.

20

All the studies I've ever read, indicate that average bg control is the best indicator of long term complications.


Obviously a single hypo can kill me in seconds (e.g. crashing the car) so while close watch on bg's all the time is important there are some times where it's super-important.


"Blood Sugar 101" site you are quoting gets many things out there with a poor perspective. They love to quote those 120 and 140 numbers over and over again but never once do they mention hypos. They seem real sure of themselves though.