It seems my wife is diabetic, and I have questions

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It seems my wife is diabetic, and I have questions


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Old 01-05-2011, 14:37   #1
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Default It seems my wife is diabetic, and I have questions

Hello. My wife recently went to the doctor, and while a definitive diagnosis of diabetes has not yet been made, it seems likely to come soon. Her fasting glucose was 300 and her A1C was 13. These are, to my knowledge, high numbers even for a diabetic. She is 32 and is in good health, for the most part. Since both she and I are young and tend to feel healthy, neither of us has felt a need to visit a doctor for a few years. However, my wife has experienced slow but steady unexplained weight loss over the last few years to the point that she is obviously has too low a body fat percentage, and that was the motivation for her to see the doctor (with a lot of encouragement from me and other family members). Besides the very high blood sugar, her triglycerides are high although not as shockingly high as blood sugar. She is also slightly above 200 on cholesterol and at the bottom end (40) on HDL. She has high hematocrit (about 54), high hemoglobin (about 18), and high red blood cell count. Her vitamin D is out of the range low. (She's already been prescribed vitamin D.) Her resting heart rate is 110-120 (as measured at the clinic) and her sleeping heart rate is about 90 (as measured by me). She sometimes suffers insomnia and often falls asleep on the sofa before a normal bed time although she sleeps well and normally more often than not. She has indigestion somewhat frequently although not all that frequently. Besides all this, she seems quite healthy and seems to have a decent immune system. She doesn't exercise a lot (although she suddenly seems a lot more interested now) but she performs pretty well when we play sports with friends that require constant running. She doesn't seem very irritable, especially for someone who has to put up with me all the time. Her paternal grandmother was diabetic. (FWIW, she was also my wife's only grandparent to live well into her 80's.) My wife's diet has, to this point, had a fair amount of sugar in it, but it's hardly worse than mine or most people I know, and I think my diet isn't very bad. I would not say she consumes an above average amount of sugary foods. She likes desserts, but doesn't have them more than a couple times a week, and she doesn't consume a lot of sugary drinks, including fruit juice. She drinks water much more than anything else.

Anyway, given that I'm both very curious about all this and very concerned about my wife's health, I was wondering...

1) How is it determined if diabetes is type 1 or type 2? I know the physiological difference between the two, but given that my wife is at an age where she could be getting type 1 late or type 2 early, I am curious to know how doctors determine whether or not she would be type 1 or type 2. Most of what I've found online isn't helpful at differentiating between type 1 and type 2 as far as how diabetes is diagnosed.

2) Are the specific characteristics of my wife's symptoms, situation, blood results, etc. similar to anyone else's at the time (or after) you found out you had diabetes? I realize diabetics may have much in common as far as how diabetes should be treated and controlled, but I am interested to hear from anyone who can relate to the specifics of my wife's situation. For instance, many diabetics need to avoid weight gain, but my wife needs to gain weight, at least at this point, while still controlling her blood sugar.

Thank you for your time and concern.

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Old 01-05-2011, 15:08   #2
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To answer your questions 1) Type 1 is sometimes interpreted as insulin deficiency; C-peptide tests for this. Autoimmune activity is usual in Type 1 -- but some people consider insulin-dependence as the definition of Type 1. Others consider it the autoimmune activity. It depends on the doc.

2) Was your wife diagnosed in diabetic ketoacidosis? That would indicate insufficient insulin production. Which may, or may not, be permanent. But at the same time, not being in DKA would not necessarily rule out autoimmune D.

I was diagnosed in DKA but presumed Type 2 until, 6 mos of requesting it later, I got antibody testing. This changed my course of treatment -- I was given basal insulin in addition to my metformin, and no longer was solicited for additional oral meds. I do consider this a good thing.

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Old 01-05-2011, 15:28   #3
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Originally Posted by mcgruff View Post
1) How is it determined if diabetes is type 1 or type 2? I know the physiological difference between the two, but given that my wife is at an age where she could be getting type 1 late or type 2 early, I am curious to know how doctors determine whether or not she would be type 1 or type 2. Most of what I've found online isn't helpful at differentiating between type 1 and type 2 as far as how diabetes is diagnosed.

2) Are the specific characteristics of my wife's symptoms, situation, blood results, etc. similar to anyone else's at the time (or after) you found out you had diabetes? I realize diabetics may have much in common as far as how diabetes should be treated and controlled, but I am interested to hear from anyone who can relate to the specifics of my wife's situation. For instance, many diabetics need to avoid weight gain, but my wife needs to gain weight, at least at this point, while still controlling her blood sugar.

Thank you for your time and concern.
1) there is a blood test they can do to determine if she is type 1 or 2 but they are different diesases type 1 make no insulin and type 2 make little or have ineffective insulin. type 1 will probably go on insulin right away type 2 will probably try changes in diet/exercise first before going to meds (or start w/ meds then ween them off if sugars get under control) . talk w/ your doc and set up appointment for a diabetes eductor to learn more

2)i was diagnosed a T2 at the age of 26 (13 years ago) when I was training for 5k runs and triathlons so you never can tell

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Old 01-05-2011, 15:31   #4
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Joe I agree with 2 -- there are thin Type 2's.

But ... as someone who has both antibodies AND IR, I prefer to see D as a "spectrum disease," ie, there is a spectrum of causes of hyperglycemia, it is not just one thing or the other.

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Old 01-05-2011, 15:40   #5
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Before I was dx'd 4 years ago I thought I was very healthy too. I was only 148 pounds, exercised 2-3 hours a day and ate mostly vegetarian. When I was dx'd I found my fasting was 240, LDL was 187, Trigs were 125 and HDL was 75. So I was not as healthy as I thought. I learned as a diabetic I had a problem eating any kind of carb, even the healthy ones like whole wheat and fruit. I have now drastically cut my carb consumpiton and eat meat again. I have actually cut down my exercise to no more than an hour most days, sometimes less except when I play tennis. After 4 years my fasting are closer to 100, LDL is under 100, HDL is almost 90, Trigs have gone up a little -96 but still good. It also sounds that your wife may have some kind of inflammation that is causing the high pulse rate. This past summer I was having inflammation from a statin drug and my pulse went from 67 up to almost 100. Once I got rid of the inflammation my pulse fell back to normal range and bgs fell too.

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Old 01-05-2011, 18:06   #6
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Quote:
Originally Posted by mcgruff View Post
Hello. My wife recently went to the doctor, and while a definitive diagnosis of diabetes has not yet been made, it seems likely to come soon. Her fasting glucose was 300 and her A1C was 13. These are, to my knowledge, high numbers even for a diabetic. She is 32 and is in good health, for the most part. Since both she and I are young and tend to feel healthy, neither of us has felt a need to visit a doctor for a few years. However, my wife has experienced slow but steady unexplained weight loss over the last few years to the point that she is obviously has too low a body fat percentage, and that was the motivation for her to see the doctor (with a lot of encouragement from me and other family members). Besides the very high blood sugar, her triglycerides are high although not as shockingly high as blood sugar. She is also slightly above 200 on cholesterol and at the bottom end (40) on HDL. She has high hematocrit (about 54), high hemoglobin (about 18), and high red blood cell count. Her vitamin D is out of the range low. (She's already been prescribed vitamin D.) Her resting heart rate is 110-120 (as measured at the clinic) and her sleeping heart rate is about 90 (as measured by me). She sometimes suffers insomnia and often falls asleep on the sofa before a normal bed time although she sleeps well and normally more often than not. She has indigestion somewhat frequently although not all that frequently. Besides all this, she seems quite healthy and seems to have a decent immune system. She doesn't exercise a lot (although she suddenly seems a lot more interested now) but she performs pretty well when we play sports with friends that require constant running. She doesn't seem very irritable, especially for someone who has to put up with me all the time. Her paternal grandmother was diabetic. (FWIW, she was also my wife's only grandparent to live well into her 80's.) My wife's diet has, to this point, had a fair amount of sugar in it, but it's hardly worse than mine or most people I know, and I think my diet isn't very bad. I would not say she consumes an above average amount of sugary foods. She likes desserts, but doesn't have them more than a couple times a week, and she doesn't consume a lot of sugary drinks, including fruit juice. She drinks water much more than anything else.

Anyway, given that I'm both very curious about all this and very concerned about my wife's health, I was wondering...

1) How is it determined if diabetes is type 1 or type 2? I know the physiological difference between the two, but given that my wife is at an age where she could be getting type 1 late or type 2 early, I am curious to know how doctors determine whether or not she would be type 1 or type 2. Most of what I've found online isn't helpful at differentiating between type 1 and type 2 as far as how diabetes is diagnosed.

2) Are the specific characteristics of my wife's symptoms, situation, blood results, etc. similar to anyone else's at the time (or after) you found out you had diabetes? I realize diabetics may have much in common as far as how diabetes should be treated and controlled, but I am interested to hear from anyone who can relate to the specifics of my wife's situation. For instance, many diabetics need to avoid weight gain, but my wife needs to gain weight, at least at this point, while still controlling her blood sugar.

Thank you for your time and concern.
Hello and welcome to the forum! I can relate to a couple of your wife's problems. Her low body weight may be caused by her diabetes and her fasting blood glucose level and A1C are high enough for a diagnosis to be made. I stopped taking care of my diabetes for a few years and it took that few years to finally start to realize that my high blood sugar was the reason why I lost over 60 pounds in 6 months without making any changes to my diet. I did have a doctor tell me that I was losing calories in my urine, in addition to the weight loss, I was urinating quite often. Lipid levels can be out of whack when your blood sugar is out of control, get that under control and then have her lipid levels checked. If her lipid levels don't go down after getting her blood sugar under control, then your doctor may want to start your wife on a statin drug. Sometimes, high cholesterol is hereditary. I don't have any clue as to why her other blood levels are not normal. I think it would be a good idea to see an endocrinologist and get all of these things checked out in more detail. I can tell that you really care about your wife, you know so much about her and that is precious. Good luck.

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Old 01-05-2011, 21:02   #7
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Thanks all. We'll know more, of course, after she sees a specialist, but it seems most likely that she has LADA. I'm guessing that a lot, maybe most, of her carb consumption is being excreted via the kidneys and that her unexplained weight loss is due to using stored fat for energy via ketones. With ketone byproducts and excess sugar needing to be expelled, I'm guessing that her kidneys are taking out lots of fluid and forcing her to play catch-up with replenishing fluids, causing her to be hypovolemic, which could explain the high hepatocrit, red blood cell concentration, and hemoglobin. That could then cause her to have elevated adrenaline levels, which could be causing the high heart rate. I'm also wondering if her somewhat high triglycerides are because fat in her is more likely to be actively used as fuel rather than stored away for a rainy day the way it is with me. Does all that sound plausible?

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Old 01-05-2011, 21:07   #8
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Hello and welcome, McGruff. All bases are covered & I won't strain your eyes by repeating . . .

I have a brother-in-law who became very thin & somewhat ill during his early-40s, was diagnosed type 2, but continued to deteriorate. When they finally tested further, he was determined to be LADA (type 1.5), put on insulin, regained the weight & is a thriving 50-year-old now.

Do stay tuned, and if/when your wife is ready, perhaps she'll want to join us too. It makes all the difference when there are people to talk to who REALLY understand what you're going through.

Your interpretations are all possibilities, but the important thing is to get her blood sugar down and stabilized. Most of us have discovered that tight control of our blood sugars can bring all the other irregularities into alignment - especially the lipids.





Last edited by Shanny; 01-05-2011 at 21:10.
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Old 01-05-2011, 23:10   #9
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Quote:
Originally Posted by mcgruff View Post
Hello. My wife recently went to the doctor, and while a definitive diagnosis of diabetes has not yet been made, it seems likely to come soon. Her fasting glucose was 300 and her A1C was 13. These are, to my knowledge, high numbers even for a diabetic. She is 32 and is in good health, for the most part. Since both she and I are young and tend to feel healthy, neither of us has felt a need to visit a doctor for a few years. However, my wife has experienced slow but steady unexplained weight loss over the last few years to the point that she is obviously has too low a body fat percentage, and that was the motivation for her to see the doctor (with a lot of encouragement from me and other family members). Besides the very high blood sugar, her triglycerides are high although not as shockingly high as blood sugar. She is also slightly above 200 on cholesterol and at the bottom end (40) on HDL. She has high hematocrit (about 54), high hemoglobin (about 18), and high red blood cell count. Her vitamin D is out of the range low. (She's already been prescribed vitamin D.) Her resting heart rate is 110-120 (as measured at the clinic) and her sleeping heart rate is about 90 (as measured by me). She sometimes suffers insomnia and often falls asleep on the sofa before a normal bed time although she sleeps well and normally more often than not. She has indigestion somewhat frequently although not all that frequently. Besides all this, she seems quite healthy and seems to have a decent immune system. She doesn't exercise a lot (although she suddenly seems a lot more interested now) but she performs pretty well when we play sports with friends that require constant running. She doesn't seem very irritable, especially for someone who has to put up with me all the time. Her paternal grandmother was diabetic. (FWIW, she was also my wife's only grandparent to live well into her 80's.) My wife's diet has, to this point, had a fair amount of sugar in it, but it's hardly worse than mine or most people I know, and I think my diet isn't very bad. I would not say she consumes an above average amount of sugary foods. She likes desserts, but doesn't have them more than a couple times a week, and she doesn't consume a lot of sugary drinks, including fruit juice. She drinks water much more than anything else.

Anyway, given that I'm both very curious about all this and very concerned about my wife's health, I was wondering...

1) How is it determined if diabetes is type 1 or type 2? I know the physiological difference between the two, but given that my wife is at an age where she could be getting type 1 late or type 2 early, I am curious to know how doctors determine whether or not she would be type 1 or type 2. Most of what I've found online isn't helpful at differentiating between type 1 and type 2 as far as how diabetes is diagnosed.

2) Are the specific characteristics of my wife's symptoms, situation, blood results, etc. similar to anyone else's at the time (or after) you found out you had diabetes? I realize diabetics may have much in common as far as how diabetes should be treated and controlled, but I am interested to hear from anyone who can relate to the specifics of my wife's situation. For instance, many diabetics need to avoid weight gain, but my wife needs to gain weight, at least at this point, while still controlling her blood sugar.

Thank you for your time and concern.
They will test your wife for antibodies to tell if she is T1 or T2. T1 will be positive for the antibodies that destroy the insulin producing cells in the pancreas. Simply needing insulin wont tell you one way or the other. I am completely insulin dependant even though I am T2 (I was diagnosed at the age of 16) since I no longer produce insulin. As far as treatment and diet options between the types there are some differences obviously, but one thing in common is that we all need to be aware of how many carbs we are consuming and we all need some sort of moderate, regular exercise. Even though she needs to gain some weight, she still needs to be aware of how many carbs she eating, either because she will be diet controlled, or because she will need to know in order to dose her insulin correctly.

I dont remember now what my blood sugar was when I was diagnosed. Its been a long time I do know that the highest I am aware of was when my meter simply read HI....I believe it does that over 600. The highest my A1C has been that I can remember was a little over 13...I dont remember the exact number.

Many diabetics are low in vitamin D. I know quite a few of us take supplements.

Please feel free to ask plenty of questions, maybe your wife might like to join in We are all here to help each other out!

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Old 01-05-2011, 23:13   #10
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Welcome to the forum. I hope you find out the information you are looking for. This can be an interesting time and we are here to encourage you through it. Please visit often and send your wife this way!
Good luck.

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