I asked my endo today what type of diabetes I have. He said he doesn’t want to label me and we can call it ‘pre-diabetes’ for now. His rationale is that we are just using insulin because I am ttc. And regardless what type of diabetes, at this stage the management is the same. He is not interested to test further.
I am 39 yo australian. Hypothyroid for 10+ years, overweight (80 kg @ 165 cm), physically active (I run 3 x a week for 40 - 60 minutes). I have a reasonable diet and strictly limit junk food.
Long story short: I had GD starting about 3 months pregnant with my daugher 2 years ago.
Having fertility treatment now in hope of baby no. 2. They gave me dexamethasone (2 mg x 2 doses) 2 weeks ago. Overnight my blood sugars were high. Fasting 130 plus, after meals 180 - 190. After 4 days of this I contacted my endo and he said to start insulin. That was 1 week ago. Currently up to 8 units humulin 70/30 in the evenings and 8 units in the morning (but still need to increase further to get to target sugars).
Needing this level of insulin wouldn’t be called prediabetic anymore? Right?
I am trying to limit carbs to about 120 - 160 g/day at the moment (and mostly succeeding so far).
Will using insulin if I am not “diabetic” cause problems? My endo is basically leaving the adjustment to me at the moment (told me I’m doing excellent), but I only have humulin 70/30 to work with for now, combined with diet and exercise.
Target fasting FBS, before meals < 95.
Target 1 hour after eating < 140
Target 2 hours after eating < 120
A correct diagnosis is needed for the correct treatment. Sorry, don’t know what “ttc” means. I don’t know what the healthcare situation is your country, but in the US a diagnosis is needed for health insurance to cover appropriate treatment.
Since you’re not in target range & are increasing your insulin doses, you need it. Injecting unnecessary insulin would result in life threatening lows, coma & death. If you’re a Type 2 (& some are on insulin), you may need oral meds to help insulin resistance.
Hard to control BG while taking steroids, so at least for now you need insulin & this won’t cause problems.
Lowering carbs helps greatly with weight loss & reducing insulin doses.
Other people have also questioned if steroids may have tipped their balance…
Takes months here to get an endo appointment. Yes, far better to control what you can with diet, exercise & insulin. Wish your doctor would agree to tests since you’re paying for this yourself anyway,
The tests usually given to diagnose what type of diabetes you have is GAD Antibody test and C peptide test (other test may include ketones, tryglicerides,and uric acid). And in the Philippines, yes, you can request these done in laboratories even without the doctor’s requests if it will not be covered by health insurance. A reputable laboratory (like hospitals) is highly advisable.
You have been given steroids, presumably to help you “ttc.” If you have any blood sugar problems, “pre-diabetic” or not, steroids will make your blood sugar go crazy. In my view, “pre-diabetic” does not exist, you are either diabetic or not. As to what type, that is not clear and it only matters as a guide for appropriate treatment.
That being said, given you already have blood sugar problems, I would consider tightening up you diet and following a low carb diet. Just giving up junk food is probably not sufficient. It is great that you are exercising. If you are going to use insulin, you need to be very dilligent. Being in where you are, you are unlikely to get a lot of detailed help with your insulin. Trying to tightly control your blood sugar with insulin without a lot of knowledge can be difficult and potentially dangerous. I would just caution you to protect yourself against lows.
ps. Your daughter is beautiful. I really like her ears, they are even bigger than mine.
Low carb is a relative term:) Did your endo give you a target A1c before becoming pregnant? Many diabetic moms here for guidance & group devoted to pregnancy.
You’re not being obsessive/compulsive. Those who want to control this beast do have to stay on top it, so some obsessive behavior comes with the territory, I’m afraid.
180 to 190 is definitely diabetic. 120 to 16o grams of carbs/ day is probably way too much. Your targets are great if you can achieve them without going too low.
It would be nice to discover if you are type 1 or type 2. If you are type 1 then lows are a much more serious affair. You could have a carby breakfast and go for a C-peptide test to see if you are producing a fair bit of your own insulin.
Taking insulin won’t effect the C-peptide test results, so take your insulin. You don’t need to fast either. The other test is a GAD antibody test to see if your pancreas is under autoimmune attack.
For many reasons, it does matter what type of diabetes you have. Since T1 and T2 are different diseases, with different causes, treatments, and cures, it is important to know what type you have. You say you have been hypothyroid, is it autoimmune? If so, it is highly likely you have autoimmune diabetes (T1). If you have Type 1, you must be on exogenous insulin to survive. Yes, T1s can survive for a time without insulin, just as they did before 1922, but it’s not the right thing to do. The definitive test for T1 autoimmune diabetes is antibody testing (GADA, ICA, IA2). Good luck to you! Melitta
Actually taking exogenous insulin will affect your c-peptide test, but not in a way that will invalidate a fasting c-peptide test. Your body will generally continue to make basal insulin (and c-peptide) at whatever rate it can, but insulin secretion that is affected by glucose levels and other things will be affected by the exogenous insulin use. In particular, using insulin during a stimulated c-peptide test would likely taint the results.
Melitta gives you prudent advice. I am perhaps not as totally convinced you are at risk of T1 as you have been given steroids which make your blood sugar crazy. But you do need to understand that for some reason we don’t understand, something like 10% of pregnant women who have GD end up having T1. There is something about being pregnant that puts the immune system. And those with one autoimmune condition (like with your thyroid) are also at higher risk of T1. So if you add up all your risk factors, it is not some chance in a million, but a real possibility.
While I was apartment hunting a ran into a woman who couldn’t show me an apartment because she had a family emergency. Long story short the landlord had uncontroled diabetes and had an episode to where her BS level were all over the place. After the episode I asked if she was Type 1 or Type 2. She could not give me answer all she knew was that she possible insulin resistant???!!! she said her doctor didn’t want to label her and decided to control her with just diet and pills from time to time. Being a Type 2, I told her she needed to find a ENDO that will give her a diagnosis so they can start proper treatment and develop a pattern with her. This wave riding BS levels is only good to hurt her and lifestyle in the long run. Labels are not bad they just start a journey.
Just because you describe yourself as “overweight” does not put you in one catagory or another. You can be either Type 1 or Type 2. Either way you are just as beautiful. Don’t get mad get educated and become your own advocate. This is what i have done.
All the information you have recieved thus far is good. I can only suggest that you may want to seek a 2nd opinion with a ENDO that will give you a definate diagnoses. You might find another ENDO that has dealt with diabetic pregrancy issues. Thats half the battle. Treatment is dependant on your diagnsos. Just like Mellita, T1 and T2 have the same symptoms but the therapies are very different. I hope this helps
