Something very puzzling..thoughts anyone


#1

when I first became aware of Diabetes was when I was tested at 59 as part of routine exam. 2 years ago.

at that time I had been overweight by 20 lbs for 10 years. I had however exercised aggressively throughout my life. my diet was junk and a lot of booze.

anyway I had pre-diabetic readings. right at the margin of pre and actual diabetes.

with diet and exercise over the next year I managed to shave off a few points, on FBGL and A1C.

then I decided to go to 500 mg metformin. not much improvement.

this AM I tested FBGL at 149, an anomalous high for me after about 100 carbs the day before. in fact FBGL testing in the past 60 days have shown numbers out of pre-diabetes and firmly in diabetic range. on average FBGL 130.

here is the thing, for the last 60 days I have drunk 2 beers. that amount of alcohol is down substantially from I guess and average of 6 -8 cocktails a week.

so my question, because I tested at high end pre-diabetic at 59 after doing nothing but nothing to moderate diet or medicate, why 2 years later with diet and metformin, should I show higher numbers?


#2

You may be a slow onset LADA (Type 1). Ask your doctor to test for autoantibodies.


#3

Like @Willow4 says. The broad outlines, anyway, fit a lot of misdiagnosis stories we’ve seen around here. Better to know for sure.


#4

Same here, I agree with @Willow4. I was misdiagnosed as a Type 2, went into DKA, yet even the ER doctors argued over what type of diabetes I had. Please get tested.


#5

i didn’t want to prejudice responses. I was wondering about the effects of alcohol on diabetes. I don’t have much to go on but times when I don’t drink at all, perhaps no drinks at all for a month or so, I think my numbers go up.

if I look at my numbers before total abstinence 2 months ago, those numbers for previous 5 months averaged lower than 126 FBGL and 6.3 A1C


#6

Type 2 diabetes is a progressive disease with autoimmune components, so it gets worse on its own over time.


#7

So the question is whether this is a causal relationship or a coincidence of timing. In other words, has abstinence over time been causing BGs to rise, or were they rising due to other causes and would have done so whether or not you were abstaining. I’ve never heard of alcohol having that effect (those of us on insulin are warned that alcohol can cause our BG to drop, but that’s about an immediate, not long term result), so I’m guessing it’s the latter. It may just be your Type 2 insulin resistance is advancing, which is what it tends to do. But Type 1 in its LADA form can in many (not all) cases have a slow onset due to gradual degradation of insulin producing cells, so the two can be hard to distinguish. Virtually everyone who was so mis-diagnosed talks about being put on Metformin and finding it didn’t seem to help.

You could test the alcohol hypothesis by taking up heavy drinking again, but that’s probably not the best option :wink: Better to get tested for T1 instead!


#8

Alcohol does effect the liver so it does not dump as much glucose. I have no idea if this makes a major difference. But your fasting numbers are much higher than i would accept


#9

i was happier than you can imagine to find out rum or whiskey or both had no carbs.


#10

just to be clear you are saying that the liver dumps glucose(sugar) into bloodstream as a it metaloizes booze. suggesting that BGL should be higher?


#11

No, the opposite: it causes the liver to be more resistant to dumping glucose, which is why people on insulin are warned that you have to be careful when you’re having drinks because it can make you go low.

I was dx’d with T1 (still called “juvenile”) in 1983 at age 28, and right at the top of the list of Don’ts they handed me was… beer. "Beer??? I can handle the shots, but… beeeeerrrr???" My doc at the time understood, and kindly pointed out that distilled liquors were essentially zero carb. And that scotch is distilled beer. Been a single-malt drinker ever since.


#12

gothcha BB

btw one of the reasons i stopped drinking was cause those shots are way tooo easy

what’s that song…1 tequila 2 tequila 3 tequila…floor

working on a happy medium, say adding water…….


#13

BB …while i have you here, ur thoughts if i went back to drinking say 2 shot equiv per day. do you think i would see any empirically noticeable lowering of BGL.

if so how come not much is said about alcohol as a treatment?


#14

As I understand it, in layman’s terms the mechanism is that your liver gets so occupied processing the alcohol that it can’t do anything else for a while, including releasing glucose. But I’m skeptical that it has a more sustained, long-term effect. And of course stressing the liver with alcohol is detrimental to the organ, even if there’s a temporary side “benefit” of suppressing BG, soI don’t think the AMA is going to be recommending it as a treatment for diabetes (which also stresses the liver in its own right) any time soon. :wink:


#15

okay dokey thanks


#16

The amount of Metformin you are taking is at the very low end, and it might be time for your doctor to bump it up. Unfortunately sometimes numbers creep up as our pancreas get more and more tired, despite good “behavior” on our part. What are your two hour post blood glucose levels? While your fasting is higher than one would want, I think the two hour post meal number is more important. If, for example, two hours after eating your BG is less than 160 that would be still within the range that Joslin Diabetes Foundation says is OK.


#17

Two hour after start of meal 120 or less. Morning readings 90 to 100.
LCHF and exercise only. No metformin. Last A1c was 5.7
I personally believe the Joslin numbers are too high to avoid long term issues.


#18

eileeen, my probably flawed thinking goes like this.

my 2hr post meal #'s are around 140 or so. well within pre-diabetes range. my FBGL on average, started landing in 130’s so I started on the 500mg. basically I was trying to lower overnite glucose levels. I cannot determine if it is due to morning phenom. I test sometimes at 5 AM and sometimes at 6 , or 7 or 8AM. that doesn’t seem to matter.

but what has happened since I got on MF 6 months ago that slowly my FBGL has risen from slightly below 126 to 130. a small increase but according to the tables takes you from pre to diabetic diagonosis. I also went from <100 carbs to 150-200 carbs/day , because, of course, I figured lets the meds do the work.

I am lazy and undisciplined I know. years of conditioning!


#19

You may have what is called “sunrise effect,” a well known phenomena where glucose levels rise during the middle of the night, only to come back down again during the day. I don’t know what time of day you take your Metformin, but with your doctor’s approval I would suggest taking it at bedtime instead of during the day. If you are only taking 500 mg/24 hours it doesn’t matter much when in the 24 hour cycle you take it, and it might help the overnight rise by taking it before bed. I am sorry for your frustration. I have often felt that too, and after 15 years past diagnosis still hate that I can not be the care free eater I once was. Be careful about reaching diabetic burnout and know that it sounds like you are very much on the right track, as bumpy and frustrating as it might be. The ADA says an A1C under 7.0 is wirhin good control, and it sounds as though you are meeting that important goal. If switching to night time taking metformin does not help you might want to ask your doctor about taking it twice a day. Personally, I take 1000 mg twice a day, morning and night, so you are well within the area of being able to add more if needed. Good luck.