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knarfny 03-14-2014 11:54

New Diabetic
 
I'm new here. Interested in learning and understand a bit more about being a type 2 diabetic.

Here are some statistics so you can better understand my situation.

For the record, I never drink regular soda and have not in about 20-years. I've always preferred the taste of diet. I generally have about a half glass of diet soda daily and with dinner only. I drink about a gallon of water daily and have been for years. I never use sugar in my coffee, I've been using Splenda for as long as I can remember. My father was diagnosed with type 2 when he was 55-years old, hit me about 20-years earlier. I have exercised regularly for as long as I can remember. I never had a desire to eat junk food during the day, but for some reason at night, it's all I want. So while I never drink regular soda or use sugar in my coffee; not that it matters, I am the type of person that will eat an entire bag of Oreos if they are in front of me.

January 2014

- Out of no where, I started to wake up about twenty times at night to use the bathroom. I was also very thirsty. Not realizing what was going on, I would drink a half gallon of orange juice or apple juice throughout the night.

- Went to my primary doctor for blood work and he basically laughed at me. He told me that I should just diet and exercise and I would be fine. At this point, I tested myself using my father's glucose meter and I was a 496. Doctor told me not to be concerned.

- At this visit, I was age 35, 195-pounds and in pretty "decent" shape.

- Fast forward a week, the doctor called me and was concerned because my A1C was a 9.0. Told me he would give me a month to take care of myself and then we would take it from there.

February 2014

- Purchased my own glucose meter and daily readings were all over the place. I'd wake up after 10-hours of not eating at 450. I'd have no carbs and no sugar throughout the day and I'd still read at 400.

- Dropped down too 180-pounds, total weight loss of 15-pounds.

- Even with the weight loss, my readings were still high.

March 2014

- Back to doctor for A1C. Confirmed 15-pound weight loss.

- A1C results were 11.2. Went from 9.0 too 11.2.

- Primary doctor prescribed Metformin 500MG; once daily.

- Even with Metformin, daily readings were getting higher and higher. Now waking up at 400 or greater. No carbs or sugar throughout the day and I'd remain higher than 350 but lower than 450.

- Mother-in-law pushed me to go see a specialist right away so I went to a local endocrinologist.

- He stated that I should have been treated with insulin after my first A1C of 9.0, no exceptions.

- Took me off Metformin and put me on Kombiglyze XR 5MG/500MG once daily in the morning and 20-units of Insulin once daily at night.

- Took about a day or two, but I now wake up at around 200 and as long as I don't have any sugar or carbs throughout the day, I can get myself down to 90 prior to dinner.

- About 2-hours after dinner, with my meal consisting of about 30% carbs, I stay under 200.

- Last night, I guess I took advantage of the low numbers. Before bed, I decided to bake one of those delicious pretzels and eat it. I also thought it would be a good idea to put a little Nutella on my plate to dip my pretzel. In any event, I woke up this morning at 465.

I guess Nutella and pretzels are off the "menu". :rolleyes:

Synopsis

Age: 35
Height: 5' 8"

01/2014 Weight: 195-Pounds
01/2014 A1C: 9.0

03/2014 Weight: 180-Pounds
03/2014 A1C: 11.2

Current Medication: 20-Units Daily Insulin & 5MG/500MG Kombiglyze XR Daily

-----

I'm just so confused at this point. I understand the situation and I don't. I take it seriously and I don't. My primary doctor tells me this isn't really a big deal. The endocrinologist tells me it's a very big deal.

I'm also very confused about the "diet". Fruit or no fruit? Whole grains or no whole grains? Is there really a difference between brown and white? I know brown breaks down slower but does it really matter when you're diabetic? At the end, it all turns into sugar.

My father has been living as a type 2 for about 15-years now with consistent A1Cs of 9.0 or greater. Most of his readings are at about 250. He takes 40 units of insulin daily, Metformin and fast-acting insulin after meals. He basically eats whatever he wants and just pumps more insulin into himself.

My preference would be to not live that way and try to control this.

I'd like to hear other opinions at this point.

Is it true that once you're on insulin, you're on it for life?

I don't mind exercising daily and I also don't mind skipping traditional junk food. I do have a major problem with regular food. While I don't need to eat a big plate of pasta every single night, I enjoy food and there are times when I want to eat.

Sorry about this post being all over the place, I'm extremely frustrated.

carbcrazydog 03-14-2014 12:17

Sigh! i understand your frustration of being hit with this in your 30s. I am yet to be 33 and am a pre-diabetic. Just means i got to know about it before my numbers went crazy. I still see crazy numbers and i hate sticking to healthy food at times. But the good part- 1) you will make lots of friends here who will tell you about LCHF (low carb high fat) diet 2) you will actually start loving that food 3) go to the recipes section and it has everything from pizzas to icecreams that u can make and eat, hence you become a good chef 4) one day u will slip on your diet and eat all the food that u missed and realize that you actually dont feel so good eating it anymore.

we all have good days and we all struggle. good thing is that chances are once u come to this forum, with support and advice (provided u follow)- it just gets better from here.

i would advise give up diet soda too (i am an addict of 1 a day and am trying to give up). it does not directly increase ur sugar readings but increases metabolic disorders and insulin resistance. in any case we all know that its not good for health! here is hoping to both of us giving up diet soda!

carbcrazydog 03-14-2014 12:19

A great site you might want to explore is Blood Sugar 101 and How to Lower Your Blood Sugar

http://www.bloodsugar101.com/

http://www.phlaunt.com/diabetes/14045524.php

Gizmo 03-14-2014 12:20

Hi. Have you had any tests to determine which type you are? It is possible that you are type 1. IMHO, if your doc doesn't take this seriously, you need to find one who does.

Most of us eat low carb, high fat to control our diabetes. You can read about it here: LCHF For Beginners.

Also, you very much need to do some reading at the links you were given above.

Welcome aboard.

knarfny 03-14-2014 12:46

@Gizmo:

I've only had the A1C test and I'm assuming I'm type 2. My primary doctor did not make an official statement to tell me that I was diabetic. At the end of my appointment with the endocrinologist; someone other than my primary doctor, I asked him if I was officially a diabetic and he said it shouldn't even be a question. So that was that. He did not say if I was type 1 or type 2.

Honestly, the endocrinologist was so busy, he rushed me out of the office. I asked him questions and his answer to everything was simply "because you're not taking insulin". He is a leading endocrinologist in the area, that much I do know.

As mentioned, my primary doctor didn't take this seriously, which is why I did find one that does, which was the endocrinologist.

I'm more than familiar with the low-carb high-fat diet as my personal trainer uses that method. When I was training, I was not getting the results he desired so he sent me for blood work. My cholesterol was so low, he wanted me to raise it so I started eating center-cut bacon, high-quality steaks and things of that nature. According to him, normal levels of cholesterol are needed to produce testosterone. Who knows, I never really read up on it, I only took his advice. It did work though, at that time last year, I got my body fat down to about 10%.

Understanding a "diet" or meal plan is one thing, living up to it is completely different.

Aside from when I eat traditional junk food, which is not too frequent, my meals consist of about 60% protein, 20% fat and 20% carbs. I'd consider that pretty good.

I'll check out those links you posted and do a little reading.

Thanks.

Mary, 03-14-2014 13:30

Quote:

Originally Posted by knarfny (Post 489577)
I tested myself using my father's glucose meter and I was a 496. Doctor told me not to be concerned.

Seriously? This doctor shouldn't even be practicing medicine. There is no excuse, ever, for a doctor to see this type of blood sugar reading and dismiss it. Ever.

Quote:

Originally Posted by knarfny (Post 489577)
The doctor called me and was concerned because my A1C was a 9.0. Told me he would give me a month to take care of myself and then we would take it from there.

And no medicine or insulin with an A1C of 9.0, which equals an average blood sugar level of about 243? Oh boy. Glad you're in with the endo.

Quote:

Originally Posted by knarfny (Post 489577)
Even with the weight loss, my readings were still high.

Because diabetes doesn't distinguish based on weight, height, or some other characteristic. While some people may be more prone to it, it can hit any person regardless of weight, at any time. :(

Quote:

Originally Posted by knarfny (Post 489577)
Primary doctor prescribed Metformin 500MG; once daily.

This is a ridiculously low dose given your A1C. This isn't even considered a therapeutic dose. You may want to consider asking the endo. for Metformin again in the future. It does help with insulin resistance. You should have been started on 500 mg. and built up to the maximum over a period of a few weeks, which is 2,000 mg. (We build it up over a few weeks so there's less chance of stomach upset.) A 500 mg. dose for you is insane. You need the full dose and/or insulin.

Quote:

Originally Posted by knarfny (Post 489577)
He stated that I should have been treated with insulin after my first A1C of 9.0, no exceptions.

Yes, this. You really weren't being treated at all by the primary doctor. He did absolutely nothing to help you achieve lower blood sugar. While he may have thought that it was 'no big deal,' extended blood sugar at high numbers is very dangerous and can lead to organ damage.

Quote:

Originally Posted by knarfny (Post 489577)
Took about a day or two, but I now wake up at around 200 and as long as I don't have any sugar or carbs throughout the day, I can get myself down to 90 prior to dinner.

Most of us also eat low carb or very low carb to keep our blood sugar down. Your higher blood sugar in the morning may be attributed to dawn phenomenon. (Search the forum for it. We have many threads on it.)

Quote:

Originally Posted by knarfny (Post 489577)
Last night, I guess I took advantage of the low numbers. Before bed, I decided to bake one of those delicious pretzels and eat it. I also thought it would be a good idea to put a little Nutella on my plate to dip my pretzel. In any event, I woke up this morning at 465.

You should really try to get it under control before you try another type of high carb food. You're too unstable right now, as far as blood sugar, in order to see what foods like this do to you. You've got to try and keep it down, and get it stable.

It is not true that if you're on insulin, you're on it for life. While you may be, there is no 100% rule that states you must be, once it has been started. You can do yourself many favors by maintaining a LCHF diet, and sticking to it. You shouldn't restrict calories, but you're in a place right now where you need to be really diligent about carbs.

Personally, I wouldn't even go back to your primary doctor. His attitude was unprofessional and completely unacceptable! Your endo. sounds like he is right on track. You should ask the endo. for type testing to make sure you're not a type 1. It's a simple blood test.

:welcome:

mbuster 03-14-2014 14:11

I don't know that I would go back to that endo either. NO testing to determine type is almost as criminal as your PCP inactions. Type 1 or 1.5 should not be ruled out and just an assumption of type 2. Then, giving you the Kombiglyze AND insulin. The come/big/lies is trying to force your body to make insulin and he doesn't even know if your beta cells do anything. It is a combination of saxagliptin and metformin. Read this and decide. Why not just do insulin. If more needs to be done then ask about adding basal insulin (slow acting} to your bolus (fast acting) insulin.

If type 1 or type 2, especially if type 2, consider LCHF way of eating. If you put less carbs in, you end up with less BG to deal with. You've said you don't want to do like your dad and eat what he wants and just takes more insulin to cover it. Our objective here is to try to never go above 140 mg/dL. If that is your goal, you may have to give up more than what you think on foods. It is entirely your decision if you want the pasta or your health. At least give it a try and watch the magic. You will probably see insulin needs reduced no matter what type you are.

Shanny 03-14-2014 14:44

Welcome, knarfny. I agree with all that's been said already and only want to specify the tests you need to determine type. Not sure you don't need to fire BOTH of your doctors, but at least request that the endo order tests for GAD autoimmune antibodies and c-peptide. If you have antibodies, then you are type 1 or 1.5 (LADA). If he's too busy to order these tests, then I think your best interests are served by firing both docs and finding one who actually listens and treats his patients with respect.

Stay tuned here and please keep us posted. You deserve so much better than what you've gotten so far from the medical community.




knarfny 03-14-2014 15:53

Well, that's a bit scary. :(

I've called the endocrinologist three times this week and they are never available. Now, their service claims they are closed until the 17th. Another doctor is covering his patients but when I call, they know nothing about me and can't answer questions.

Is it safe for me to stop the Kombiglyze XR? Today is only my third day.

I'm not worried about the diet aspect on all of this, I can control that.

I'll chalk up the bad eating habits following my diagnosis to being a little depressed about the situation. Being thirty-five, healthy, constantly exercising and being active only to find this out; kind of made me wonder what the point of all that was.

Thanks for the advice, I do appreciate it.

Quote:

Originally Posted by mbuster (Post 489849)
I don't know that I would go back to that endo either. NO testing to determine type is almost as criminal as your PCP inactions. Type 1 or 1.5 should not be ruled out and just an assumption of type 2. Then, giving you the Kombiglyze AND insulin. The come/big/lies is trying to force your body to make insulin and he doesn't even know if your beta cells do anything. It is a combination of saxagliptin and metformin. Read -- REMOVED, NEW USER -- and decide. Why not just do insulin. If more needs to be done then ask about adding basal insulin (slow acting} to your bolus (fast acting) insulin.

If type 1 or type 2, especially if type 2, consider LCHF way of eating. If you put less carbs in, you end up with less BG to deal with. You've said you don't want to do like your dad and eat what he wants and just takes more insulin to cover it. Our objective here is to try to never go above 140 mg/dL. If that is your goal, you may have to give up more than what you think on foods. It is entirely your decision if you want the pasta or your health. At least give it a try and watch the magic. You will probably see insulin needs reduced no matter what type you are.


jademuffin 03-14-2014 16:21

KnarfNY, you may find that your macronutrient profile is sabotaging you a little as well. There are a number of folks on this forum that have elevated blood sugar with too much protien. Mine are: 10% carb, 20% protein, 70% fat (but I'm a girl, and not really pushing exercise for building muscle).


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