Treatment advice needed please

Update: This morning I ate about 43g of carbs. Glucerna cereal (3/4 cup), 1/2 grapefruit, and 2 eggs.

I spiked to 214! I immediately tested again on another finger, and it was 204.

The 43g represents a little over 1/2 the carbs per meal that they want me to eat.
If I ate the 75g of carbs, I would be near or above the 300 mark.

It takes about 4 hours for my blood sugars to return to the safe zone (under 140).

Do I need insulin? Byetta? What meds do I need so I can eat? I REALLY do not want to take pills. I can’t carry them in my pocket all day long without risking getting them messed up, especially in the summer time when everything gets all sweaty. And where I live, you MUST have the original medication container with the meds in it, even if it’s a stinking aspirin. The cops can arrest you for carrying ‘counterfeit’ drugs.
I can carry an insulin pen though.

Metformin is supposed to help, but I am unsure if that will do the trick.

Please note: I have absolutely NO diabetes symptoms whatsoever. No thirst, no bathroom visits (unless I drink coffee), nothing. I might feel a little sleepy if my blood sugars are high, but nothing too unusual.
Of course, avoiding carbs makes me weak.

For the past several days, I have been eating like a pig. Trying to see if I can get more energy. Nope. Very little extra energy. I have been eating about 1600 carbs +/- 400 carbs every day.
I can’t keep this up for long as both my blood sugars and my weight will go up.
So, back to the 800 calories per day again until I see the endo.

Stay low carb and get in and see your Endo for testing.

I was low carb, but had to increase the carbs in anticipation of the snow we just got and the snow we will get here in a couple of days. I have a 130ft long driveway and another 150ft of sidewalk to hand shovel.

Kinda hard when you are weak from no carbs. And all that extra protein I have been eating lately is making my urine begin to foam.

I was HOPING to get enough snow so I can shovel for about 4 hours - then I can have a special treat before I start… A MILKY WAY! LOL

It’s been in the frig for months, waiting for me to eat it. But I can’t work off the sugar without lots of SNOW! LOL

what testing should I ask for?

I am hoping to get Byetta or similar, or even insulin, so I can eat some carbs. Pills just are not very practical for me to lug around.

My husband tried to entice me to help shovel with a Snicker’s bar–lol! Feel free to come to VA to work off some candy bars. We’ve got about 18", in addition to snow from earlier this week.

Are you joking about foaming urine?

Syringes & insulin have to brought along also.

No, I am NOT joking about foaming urine.

Sometimes it foams like dish soap, other times almost nothing.

I had my creatinine tests done, but everything came back in the normal range so far.

I noticed that if I am dehydrated and eating a LOT of protein, I have that problem. Usually in the mornings. But when I drink a lot of water, the foaming goes away and all I get is maybe a scant few bubbles. This started a few weeks after I had my blood and urine tests.

Is there something I should be worried about? What does it mean?

You got me worried now, VERY worried.

If I could get there, I probably would shovel snow for you, just to be able to eat a candy bar.

No, don’t worry! So sorry. I was going to ask if you’re drinking enough water.

The only way I know if I am dehydrated is if I get a huge blood sugar spike, like I did yesterday morning. For that typical meal at breakfast I shouldn’t have gone over the 150’s. But I spiked to 214 on one finger and immediately on a different finger got 204.

I then proceeded to drink 30 ounces of water. 1 hour after that, my blood sugar dropped to 147. An hour and a half after that, it was at 81.

Right now, my kidneys hurt a bit, but that could be due to shoveling snow earlier today.

If I urinate on the porcelain and not in the water, I get virtually no foaming at all.

Yep, readings are never the same even if you use the same finger.

Wow, that’s a lot to drink at once. Makes me queasy to think of that much water.

Really foamy again, but bubbles seem to break up in a few minutes. This is peeing int eh water not on the porcelain.
Getting worried here about kidney problems…

Can eating too much protein cause this problem?

It seems to be more foamy in the AM than other times.

Yep, I will drink as much water as it takes to get that blood sugar back down to safer levels.

You mentioned that your kidney tests were fine, so please don’t worry. You could call your doctor tomorrow to put your mind at ease. Drinking this much water & the force of eliminating a lot of urine into the water would cause bubbles:) I’d be in the bathroom all day from regularly drinking almost a quart of water at once. How many times a day do you drink this much?

I never drink water unless I feel the need to lower blood sugars fast. I am never thirsty.

I usually have about 1 - 16 ounce mug of Lipton black tea per hour, unless I am not home, Then I drink nothing. Except for the occasional decaf coffee.

Urine creatinine came back at 256.8, microalbumin was 12.0, and MALB/UCRAT was 4.7

The lab results say everything is within limits, except creatinine, which does not specify any ranges.

Zolar1 You are understandably stressing about your health and whether your self-imposed treatments are working. You appear to be clinically depressed ,and as one whio has been there, done that ; Depression does not help to stabilize blood glucose levels at all. Your refusal to even consider eating veggies is tied to this depression. Please get some help so that you can overcome this trauma… If war veterans can recover post traumatic stress disorder, you too can triumph over your memories of childhood abuse!! You are the adult now and do not have to puniush yourself nor your own health by not eating vegetables… You are strong and smart…not a little child anymore.
I am guessing as have many other posters here, that you have LADA and need insulin so that you can live a more normal life. I am praying for you to have the proper medications, peace of mind and a more positive outlook…Have you seen an endocrinologist , CDE, Nutrionist,? A clinical Psychologist or Social Worker? You cannot do this by yourself…

Please seek out help, so you can stop stresssing/obsessing.

God Bless,

Brunettas

Thanks for the support and suggestions.

I was supposed to see a psychiatrist today, but due to the heavy snow and my son’s school was closed i had to cancel.

I am unsure about the LADA. I generally have reasonably good morning numbers, and my spikes don’t stay for much more than 3-4 hours, depending on the spike and the type of carbs I eat.

I saw a nutritionist about 3 months ago. She gave me a low fat diet ignoring the diabetes. She wanted me to eat 75g of carbs, 3 times a day plus two 15g carb snacks. I absolutely refused to follow that diet. I refuse to walk around every day for months with blood sugars in the 200-300 range. This is suicidal, not to mention it can cost me my eyes and kidneys.

If 15-20g of carbs spike me into the 120’s to 140’s, and 30-35g of carbs spike me into the 160’s-180’s, and 50g of carbs spike me to 200+, I cannot eat that much food that they want.

The stupid doctor ignored the diabetes and wanted to treat me for high cholesterol. Mine wasn’t that high either. At Dx, it was around 245. Last test was around 221.

I am supposed to see an Endocrinologist next Tuesday for more treatment, and if I am lucky, some meds. I have no idea why people are afraid of meds. That’s what they are there for - to help you control this disease without sacrificing your entire life to it. I am not looking to abuse the meds just to eat cr@ppy foods again. I do need them to eat some carbs, especially grains. Before the past couple of weeks or so, I had really loose bowels and could only go tot he bathroom about every 3-4 days. I started eating some grains like spaghetti and very little bread. Yes, I spikes, but yes, my stool became more regular, and daily too. So that tells me that I need the fiber from the grains. I love oatmeal, but the resulting spikes are too high. Even a couple of spoonfuls spike me.
I try my best to keep my spikes under the 140 threshold and still be able to keep my weight from dropping like a rock. Hard to do most of the time.

I doubt that the endo will want to medicate me. My numbers are too good for a diabetic, and I significantly slowed/stopped my weight loss for the time being. But I cannot keep this up for too much longer. I did this by eating nuts and more carbs. So, I have higher blood sugars as a result.

About the veggies - not only do they cause me grief with flashbacks, they taste AWFUL. I really did try, but I just can’t do it. Even peanut butter on celery I couldn’t do. I refuse to eat veggies because of the whole childhood abuse over them. This is ingrained so deeply that there is no way for anyone to get me through that. Let’s assumes that you were violently raped every day when you were very young all the way until you were 18. How easy, if at all, could you recover from that trauma? I was violently raped (mentally) with veggies.
I will eat a scant few veggies though. All the one’s that are bad for diabetics, like corn, potatoes, raw carrots, sweet peas. Maybe another one or two, but the only green thing I will eat is the sweet peas. And they have to have butter and a lot of salt on them for me to eat them.

If the Endo can medicate me to be able to eat carbs, especially grains, I can control the other problems myself. Heck, I am struggling to control them now. But I am doing it, reluctantly.

Also, I was feeling a bit depressed the other day. I ate a REAL doughnut from the bakery. It has chocolate icing on it. I fully expected my spike to be about 200ish.
I was shocked when I tested my blood sugar. It was LOWER than if I didn’t eat it at all. Go figure?
I am not dumb enough to eat doughnuts the rest of my life. I just needed a break from this disease. Something as simple as a doughnut made me feel much better, more normal. If even once in 5 months.

About my health - I suspect that there may be more wrong with me than just diabetes. My urine is very foamy in the mornings, but reduces throughout the day. Sometimes no foam at all. Maybe dehydration? Dunno.

I am having some abdominal pains as well. Sometimes it’s like a long needle stabbing me from the left side of my stomach under the ribs straight through me, other times it’s on the right side like that. And still other times a moderate pain where my appendix used to be.

So, I am faced with a few choices here:

Get the right kinds of meds so I can eat normally (less the sugary stuff but once in a great while).

Don’t get meds, fight this on my own until either my kidneys fail or I lose so much weight that I die.

Eat normally anyway, go blind and be on dialysis, then die from diabetic complications.

I am not looking forward to taking shots, but if I have to just to be able to eat ONE real meal per week with my family, and perhaps some birthday cake & ice cream on my son’s birthday, I would gladly do it.

I know doctors and how they think - most if not all of them won’t want to medicate me, and if they do, it’s not going to accommodate my dietary and lifestyle needs. My a1c at Dx was 6.8 . My last a1c on Jan 5, 2010 was 5.7 . Now, do you think any doctor would want to medicate me with numbers that good? My next a1c should be around 5.2 or 5.3 maybe.
I have absolutely NO energy. Always weak and dizzy from not being able to eat carbs. But I gave the doctors 2/3 of what they wanted - lower a1c and lower body weight. I just can’t get the cholesterol issues low enough. Cholesterol in my family is usually around 250. My dad is like that, he has no heart disease or any other problems. He’s been like that his whole life, eating right, exercising, all the stuff. And he’s nearly 80!

When the warm weather rolls around, I can’t take pills with me. They would get ruined by the heat and sweat & being jostled around. An insulin pen I can take as it fits quite nicely in my pocket. And if you’re thinking that I can take a baggie with my meds in it, nope. Not where I live. You MUST have the medication bottle on you, even if it’s for an aspirin, or the police can bust you.

Also, when the warm weather rolls around, I will be able to eat in the morning and in the evening. II will be unable to carry anything with me, nor be able to eat 5-6 small meals per day. This is my fair weather lifestyle. I can’t drop my whole life, run home, prepare something to eat, eat it, then run back out. Unless they want me to eat junk food at McDonald’s like a McDouble, Fries, and a coke. I don’t eat any foods that I cannot identify, like wraps, tacos, burritos, and most of the other foods they consider ‘healthy’ nor do I eat ‘non-American’ foods. I have always been a meat & potatoes person, bread too.

My favorite food is a simple peanut butter and jelly sandwich. But they make me spike now. So I can eat one only if I am going to do a lot of exercise.

Yeah, loads of fun. Eat, then walk until I have to eat again, repeating this routing throughout the day, every day. This is not life, it is an existence. A prisoner of this disease. The only ‘parole’ I can have is to get meds.

Let me ask you this: let’s say you worked at Walmart or GM on an assembly line or in a chemical plant. Do you honestly think that they would let someone eat every 2 hours, then walk off the resulting blood sugar spike, then eat, then walk, throughout the work day and on the company time? No they wouldn’t.
A NORMAL life is eating 2-3 large meals per day maximum. This includes eating a lot of carbs in those meals, not just protein and fat. With the right meds, I can have a normal life again. So, either way, I will have a normal life (with or without meds) or die.

If I can get my energy back, things will become easier for me to handle much of this disease. My mind is very foggy most of the time, and my memory is failing too. I need carbs, a LOT of them to restore my mind, my energy, my vigor. All the antidepressants in the world cannot fix these problems - only food can.

Zolar1 wrote:I know doctors and how they think - most if not all of them won’t want to medicate me, and if they do, it’s not going to accommodate my dietary and lifestyle needs. My a1c at Dx was 6.8 . My last a1c on Jan 5, 2010 was 5.7 . Now, do you think any doctor would want to medicate me with numbers that good? My next a1c should be around 5.2 or 5.3 maybe.
I have absolutely NO energy. Always weak and dizzy from not being able to eat carbs. But I gave the doctors 2/3 of what they wanted - lower a1c and lower body weight. I just can’t get the cholesterol issues low enough. Cholesterol in my family is usually around 250. My dad is like that, he has no heart disease or any other problems. He’s been like that his whole life, eating right, exercising, all the stuff. And he’s nearly 80!

How do you know what all doctors will say? Are you in the head of every medical practitioner that there is? Have you ever seen an endo?

Your previous paragraph was also filled with “stinking thinking” negativity, in which you assumed only the worst outcomes for yourself:

So, I am faced with a few choices here:

Get the right kinds of meds so I can eat normally (less the sugary stuff but once in a great while).

Don’t get meds, fight this on my own until either my kidneys fail or I lose so much weight that I die.

Eat normally anyway, go blind and be on dialysis, then die from diabetic complications.

I am not looking forward to taking shots, but if I have to just to be able to eat ONE real meal per week with my family, and perhaps some birthday cake & ice cream on my son’s birthday, I would gladly do it.

You do not know what will be the outcome of your endo visit… so do not assume the worst… I have lived with type 1 diabetes for 42 years. and I feel that I have been blessed with the tools to stay healthy and happy. When I was plagued with depression it took more than a pill to get me out of beleiving the negativity and “stinking thinking” that had me convinced that nothing good could exist for me… I had to cancel the negative thought as soon as it came out of my head. I replaced them with " You are a special, important person who will live, and live well’" I am also a Christian and I truly beleive my reliance on the scriptures and my faith helped to eliminate the depression. I did take anti-depressants and talk therapy, which helped tremendously, but my spiritual beliefs were at the core of my emotional recovery. and yes, I have had “valley experiences” with other health issues as well…But I rebounded… You can too

God Bless, Zolar1
You will be OK

A psychologist is a better choice than a psychiatrist. Psychiatrists simply prescribe meds. For help working through mental health issues a therapist is needed.

No one needs a lot of carbs, but you seem convinced that you do. Even with meds, you have to watch what you eat. Your life has changed, as it has for all of us here. You can’t eat “normally” with meds or insulin. Sorry to sound cold, but you should try to accept that food is different now. Eating what isn’t healthy for you to feel normal isn’t a road to success.

Since you won’t eat vegetables, you can get fiber from other sources besides grains. Lots of different fiber supplements available.

Eating a doughnut & not spiking doesn’t make sense. Guess that was sheer luck.

Millions of people carry pills in hot weather & cold without a problem. I don’t understand being unable to carry anything with you. In your prescription bottle, just take the pills needed for that day. If you can carry an insulin pen in your pocket, you can carry pills. Insulin needs to be kept cool in hot weather outdoors, so it’s not as simple as you think.

You mentioned earlier drinking a lot of tea & only drinking water when BG is high. Tea is a diuretic, so you could be dehydrated.

Hope you can convince your doctor that your numbers are good because you’re not eating & that you can’t keep that up to get the meds you need.

Doctors are businessmen, plain and simple. If they can keep you coming back, they make more money. I say this from personal experiences.

My last 3 doctor visits, NONE of them honored my request to know what my insulin levels were. They wanted to treat my cholesterol levels, ignoring my diabetes. And they wanted me to follow that dietitians meal plan. Are they nuts? That will make my diabetes worse, and exacerbate my complications, thus necessitating my frequent and regular returns to get treated.

Here’s another question for you: lets say that I go to my endo next week, and they DON’T give me the meds I need to eat and accommodate my lifestyle demands.
Let’s suppose they only give me light doses of meds at best, trying the ‘wait and see’ method.

Then I would have to keep going back every 3 months to get meds adjusted.

My question is this: how wrong would I be in my assumptions on how I know that doctors are the way they are?

It’s all about money. I have yet to find a doctor that does his practice for the love of it. They ALL want money, lots of it. And to get it, it requires frequent treatments.
This is not including the kickbacks they get from the Pharma companies for pushing their ‘wares’ either.

Medicine is a ‘practice’, not a science. Especially when it comes to diabetes. It’s 1/2 guesswork, and 1/2 schooling.

I have been patient all this time, but even I have limits, which I am approaching really soon.

You might consider my thought processes as being negative thinking. Not true. I am a realist and believe in Murphys’ law(s). I strive to be a pragmatist as best I can.
I fully believe that the endo will do as little as possible to restore my life, lifestyle, and my health, at least initially. They treat according to the numbers and whatever liability they can reduce, based on what the ADA and AMA suggests. Metformin is NOT going to satisfy my needs. Glyburide might. Byetta and or insulin absolutely will.
They all want to start out with diet & exercise, then small doses of pills. As the disease worsens and control becomes difficult, THEN they move up the chain of medications.
And in the meantime, my life is made hell struggling to survive.

I grow weary of this disease already. It is wearing me down each and every day.

I used to blindly trust doctors in the past. But no more. One doctor that treated me last year gave me meds for my headaches. The ‘side effects’ in rare cases was diabetes. I trusted that the doctor would not take chances with my life, my health. I lost both my ‘life’ and my health right now. I will no longer trust ANY doctor blindly. ever again.

Did you know that one doctor wanted to do a brain biopsy just to ‘see’ what was causing my severe headaches last year? Of course I told him NO!

I discovered on my own what was causing nearly all of my headaches - I am HIGHLY allergic to Splenda (Sucralose). Now, if I blindly trusted that doctor, I would have lost most of my memories, have to learn to walk all over again, and other memory related problems. He wanted to do this so he could make money. He didn’t bother to see if there was an underlying cause first.

I want them (my life, my health) back, or as close as medication can possibly accommodate.

I pray daily to be healed, but God ignores my prayers. Just a single word from him and I can be made whole again. Apparently, I must be abandoned, forsaken…

My life defines who I am. Without my life, I am nothing.

I want to be treated, medicated the FIRST time so I can have my life back. No guesswork, no having to keep coming back over and over again and again while they try to figure out what they want to do, running up huge medical bills in the process.

Fix it so I can at least eat somewhat normally, then I can capitulate to the additional testing and experimenting. But eat first!

Creatinine on my chart says the range should be 0.5 through 1.0.

Mine is at 0.6.
Urine Cratinine came back at 137.0 for me.
Microalbumin was Less Than 0.6

My ratio was too low to calculate. What does that mean? haha.

Due to my warm weather lifestyle, meds in my pocket can get wet, lost, banged around and broken, etc. An insulin pen fits in my shirt pocket. A bottle of pills has to go into my pants pocket and is subject to being damaged far more easily.

If insulin has to be cool then how do diabetics manage the summertime? Are they prisoners in the A/C? Do they have to babysit the insulin AND the disease as well??

My last urine creatinine level was 256.8 mg/dl
Microalbumin was 12.0 mg/L
Malb/UCREAT was 4.7 mg/g

ANAchoice was negative.

Erythrocyte was 14.0

Everything else is normal that they gave me results for.

When I am not home, I drink nothing except for a decaf coffee once in a while. I normally don’t eat either. Never really have even when I wasn’t diabetic.

Supplements are NOT the answer. I should be able to eat and get the fiber I need from my diet alone.

For my head to clear, I need carbs, a lot of them. Otherwise, I am so dizzy and foggy headed I can’t think straight. I can’t even bend over to tie my shoes and straighten up without getting dizzy. Other times, it feels like the floor is falling out from under me, like a fast elevator going down suddenly.

For example - I ate 100g of carbs just before New Year’s Eve. My head wasn’t as foggy, I had some energy, but not like I used to, but I spiked to 200. For my whole life, eating carbs made my mind sharp. It gave me very quick energy for the requirements of my lifestyle.

Also, years ago, I worked at a factory and got lead poisoning really bad. Spent 8 days in the hospital over it getting chelation treatment. I wonder if this has any bearing on what’s going on with me now?

About the doughnut- for some reason, why I don’t know, I can eat smallish amounts of any chocolate and 2 hours later have lower blood sugars than if I never ate it at all. I wonder why?
Too bad french fries don’t do that - lol.

About convincing the doctor - I will tell them this: My blood sugars are reasonable because I am not eating much at all. If it takes getting a higher a1c level to get meds so I can treat this adequately, I will see them in 3 months with a number they won’t like.

I am tired of playing games with doctors that do not want to make any effort to restore my quality of life. Eventually, I will find a doctor who WILL do what I pay them to do.

I can get my number anywhere I want them to be, low, high, reasonable. But in all things, there is a trade off.

I would rather do this starting out and keep blood sugars low than to try to force their hand later on.

About eating normally - if I am LADA and not Type 2, Insulin can help me achieve my needs.

If the human pancreas can produce enough insulin to metabolize 150-200g of carbs per meal, that same amount of injected insulin can do the same thing.

The absorption rate from a single shot is pretty uniform. So, break it up into multiple shots (part doses in different areas of the body) so the insulin uptake is higher. You can predose about 1/2 hour early too.
I know others who are type 1’s that do this with great success. They keep their a1c’s in the low 4’s.

Gerri, like I said before somewhere, I have more respect for someone who speaks plainly and not beat around the bush.

Straight answers, to the point, no sugar coating. It saves everybody time and effort, and cannot be misunderstood.

I am very tired right now and need to rest a bit. Weak too.

I will reply again once someone replies to this post.

Zolar1 wrote: I want them (my life, my health) back, or as close as medication can possibly accommodate.

I pray daily to be healed, but God ignores my prayers. Just a single word from him and I can be made whole again. Apparently, I must be abandoned, forsaken…

My life defines who I am. Without my life, I am nothing.

I want to be treated, medicated the FIRST time so I can have my life back. No guesswork, no having to keep coming back over and over again and again while they try to figure out what they want to do, running up huge medical bills in the process.

Fix it so I can at least eat somewhat normally, then I can capitulate to the additional testing and experimenting. But eat first!:

God will NEVER leave you or forsake you. Your prayers may be being answered right now. Look how many people have taken the time from their day to support you and encourage you. Sometimes God allows, does not cause, suffering in our lives , just for a time. Consider the story of JOB in the Old testament. This faithful man’s suffering was allowed and he still held on. He remained faithful. Job’s health.,family ,and riches were restored tenfold…All to the glory of God. Do not let the enemy distort your thinking… you are NOT forsaken. Diabetes is not the enemy. Your perceptions of imminent doom and gloom ,what you call REALISM, is. It is that type of maligned thinking, which makes you think you are abandoned, that comes directly from the EVIL one. Do not listen . If you want to hear from God, LISTEN. to Him. Read Psalms 23 and do not consider God as a genie in a bottle. Dear heart, you are not defined by your life;and you are never to be considered as Nothing. THE DEVIL IS A LIAR!!!
Is your future endocrinolgist university -affiiated? It will help if he/she is…They generally have access to the most current research. Your prior docors, if they were GPs( General Practioners) may not even be aware of latest treatment paradigms . Take all your food, blood glucose logbooks ,testing journals and the results of your research to the first visit. I am sure that when he sees how you are “starving yourself” to get normal levels, he will order the anti-body testing. Go in with a positive, non defeatist attitude.

My prayers and support are with you;

God Bless

Brunetta

I don’t know what your warm weather lifestyle is, but millions of people carry meds with them daily. A bottle can go in a water-proof baggie, you can take only the pills you need & put a cotton ball in the bottle to keep any from getting broken. A pen needs to stay dry, too. Depending on how hot the temp, insulin needs to be kept relatively cool. People use things like Frio wallets for high temp outings.

Yes, fiber from food is best, but you won’t eat vegetables.Many people take additional fiber in the form of fiber supplements. Your choice to eat high carb things with fiber.

Very few people with A1cs in the 4’s. Higher doses of insulin to cover high carb meals are not predictable, even if you inject multiple places. It’s far from an exact science. Injected insulin is not the same as that naturally produced. You can read all the problems here T1s have with dosing & timing.