I hope some of you experts out there can share some helpful insight – something my doctors haven’t been that good at thus far (one I’ve already “fired”). I’m a 38 year old very active male with some kind of diabetes going on. In November 2010 I had a routine physical and was called back in to retest after a fasting blood sugar at 142. My next fasting blood sugar came in at 116 but I insisted on having my A1C done, thankfully. On November 22 I was a confirmed diabetic with an A1C of 8.3. My (soon to be fired) family doctor told me I was type 2 - to diet and exercise, as if I had only a mild case. He even told me not to do the diabetic education because I didn’t need it. To quote him, “who knew YOU would be diabetic,” because I’m in good shape - like that really matters at this point.
Before giving more lab readings, which I’ve had (inconclusively) – I want to share that I got diabetes after dieting and exercising. I was heavy from my school years until late 2003. Since early 2004 I’ve biked 15 miles per day 5 days per week every week of every month of every year. I lift weights at least twice per week and I am rather fit. I do have a sweet tooth and had sort of fallen off the healthy eating boat before my first 142 reading. Yet, the way I exercise I thought I could get away with that. I knew one thing for sure though, diet and exercise hadn’t helped me keep the high readings away, I needed something more.
After not being referred to a diabetes specialist I went and referred myself to one. As it turns out, just my luck, I probably didn’t find the best one. I met with him for the first time the final week in December of 2010. He looked at my labs and went along with the type 2 diagnosis, no questions asked. He put me on Metformin that day, 1000 mg twice a day. I went home thinking I finally had answers to my questions… oops.
I came back a couple days later for my education. When I saw the education nurse I explained I had a grandma with type 1 diabetes and didn’t seem to fit the profile for someone with type 2 (she agreed). I told her I had read about tests that can help determine which type I might have so she went and spoke to my doctor. Upon coming back she had a referral for me to get my GAD and C-Peptide levels… which I had done last Thursday 1/6/2011.
I’ll stop again to share I’ve been very proactive about my potential diabetes since learning of my high readings. I went out and bought a meter and started testing daily. I always do a fasting level and I experiment throughout the day at other times. My very first home reading, not fasting, was after a large bowl of carb-packed sugary cereal. An hour later my level was 540. I was quite shocked. Within a week or so I was maintaining fasting levels in the low to mid 130s by cutting out most of the carbs in my diet.
Before getting to the doctor I had to visit family in another state. Just so happens we went out to eat almost every meal for a few days. What do you know? I was waking up with fasting levels between 200-230 while “misbehaving.” When I got home I started eating healthy again and brought my fasting levels back down to the 130s-140s before finally seeing my specialist.
So I saw the specialist who put me on Metformin and I immediately saw a drop in my average fasting levels. Before Metformin (and minus the misbehaving trip) I was at 134 fasting, after Metformin it’s dropped to 114. I’ve had mornings where I wake up in the 90s, even after eating out the night before (Chinese food of all things). On January 1, 2011 I ate at a pizza buffet and totally pigged out, like I had no worries. 2 hours later my readings were in the 220s. The next morning I was at 125 for fasting. I know I shouldn’t continue to keep eating like this but for the most part I don’t, maybe once a week instead of every other day like it was before at one point. I’m still experimenting and testing to see what I can get away with and what makes my levels spike. More and more, the readings keep siding with pre-diabetes if not near-normalcy. Without a doubt the Metformin has been doing something for me. This suggests I’m insulin resistant.
So I get my GAD and C-Peptide levels back and become totally confused. My GAD is “elevated” at 70.9 (more like skyrocketed) and my C-Peptides are 1.3 with a normal level of 1.1-4.4. In other words, it looks like I’m running out of insulin but I’m still in the low end of normal. I realize this pretty much puts me in the LADA 1.5 zone, waiting for type 1 to settle in – or so I think.
What I’m confused about is as follows:
- Do I have symptoms of both type 1 and type 2 and if so, what should I be doing about it?
- Is it possible to have both type 1 and type 2 indefinitely? (would that be type 3?)
- Should I be on insulin right now or should I wait?
My A1C has also dropped from 8.3 to 6.8 in 2 months. In 2 more months I could be under diabetic levels for both A1C and blood sugar levels simply by diet, exercise, and Metformin alone. Since I was already dieting and exercising, that would leave most of the credit to Metformin. If Metformin is helping me, I must be type 2 but my GAD says I’m heading for type 1 in a hurry. I honestly don’t know if I should be considered type 1.5, 2, or simply pre-diabetes. I feel like I should take the advice my teacher once gave me and just pick “E) all of the above”.
My doctors have been no help. My specialist has had the lab report for 3 days and not told me what I need to do next. I’m about to fire him next.
I realize I’m lucky to have caught it early but I want to figure this out before the complications show up. My readings have improved so much since I got proactive about it but so many questions still remain.
I gratefully appreciate any and all insight / advice you may have and am thankful such a forum to discuss this exists.
Fasting Blood Sugar 11/8/10: 142
Fasting Blood Sugar December, 2010 Average: 135
Fasting Blood Sugar January, 2011 Average: 114
A1C 11/20/10 8.3
A1C 01/13/11 6.8
GAD 01/06/11 70.9
C-Peptide 1.3 (normal 1.1-4.4)