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Old 02-28-2009, 06:23 AM   #1
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Question the numbers game advice

Hi all, I will give you a quick run down of what has gone done here in my life over the last 24 hrs. Back about 3 yrs ago when I had my physical my glucose level was 132 after fasting. My doctor never made a big stink about,sorta blew it off, not knowing anything about diabetes i thought it was ok.
Over the last year between the downing a 12 pack of diet pepsi daily, urinating like a mad man,especially at night and oh that urge to go that comes out of no where, actually usually happens when I am pumping gas,lol, and the tiredness, along with some blurred vision, i knew something was up. My friend told me to go the drug store and buy a meter. He said to fast for 12 hrs and see what happens, normal range 70-90, well mine was 353. Called my doc, come in right away, dont worry,its just a number. Tested again 2 hrs after a light lunch 475. Had my appointment, getting my blood tested today, another appointment 8am on monday. Tested my urine @ the office, urine was perfect except for the 5lb bag of sugar in it,lol. Tested last night 2 hrs after lite diner 479, then before i went to bed at 11 was 425 , and this morning it was 300 when i got up(fasting for 10 hrs). So I guess what do or should I expect from my doctor as for what to do. No one in my family has diabetes, and I am in good shape,45, and eat pretty good. He says maybe diet and exercise may control it, but I eat good, and do exercise. I quess I just want to know if he is on the right path, especially knowing he blew that 132 number off a few yrs ago.
thanks everyone

 
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Old 02-28-2009, 11:10 AM   #2
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Re: the numbers game advice

[QUOTE=sirrob28 He says maybe diet and exercise may control it, but I eat good, and do exercise. I quess I just want to know if he is on the right path, especially knowing he blew that 132 number off a few yrs ago.
thanks everyone[/QUOTE]

It's very possible that diet and exercise will be able to control it. You said that you eat "good" but your idea of good may not be good enough. I wish I could have a dollar for everyone who claims to eat "good" when actually there's a lot of room for improvement. I'd be a very rich man!

I once met a man who claimed to eat a lot of vegetables and I believed him. I was imagining all kinds of dark green, orange and yellow vegetables. I later found out that he mostly ate a lot of white potatoes and very little of any other vegetables.

Try making some meatless, breadless meals with bean or lentil soup. You can add a 1/4 cup of whole grain rice or whole grain pasta (measured dry). Also include some garlic cloves, onion and various colored vegetables. You should be able to fit about 3 to 4 servings of vegetables in with the beans or lentils. After cooking, add about 1 or two teaspoons of extra virgin olive oil. (It's best to start with dry beans and soak them overnight....soaking is important so as to nutralize certain substances in the beans.)

Be sure not to undercook the beans or overcook the other ingredients.

Good luck!

Last edited by JohnR41; 02-28-2009 at 11:18 AM. Reason: Spelling

 
Old 02-28-2009, 02:14 PM   #3
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Re: the numbers game advice

Sirrob,
The first thing I would do is find another doctor. A doctor who "blows off" a fasting blood glucose level of 132 is not experienced at all with diabetes, and probably will not be able to treat it appropriately.

It has been many, MANY years since the standard for diagnosing T2, especially, has been two fasting blood glucose levels of 126 or greater. This is not new, and your doctor should have been aware enough to, at the very least, have you come back for another fasting test a few weeks after the one that showed up as 132.

Now your blood sugars are running quite high. As John said, it may still be possible to treat this with diet and exercise alone, but if you've already had T2 for 3 years, your pancreas may already be worn out and you may need oral medication as well, and possibly insulin, although that's less likely. You also need referrals to a registered dietician who can actually teach you how to eat better and educate you as to portion sizes, and guide you to a plan of eating that works for you.

It's also possible that you could have adult-onset T1. The only way to tell for sure is to have a GAD antibody test and a C-peptide test done. These MUST be done for an accurate diagnosis and in order for you to get the best treatment for whichever type of diabetes you do have. I seriously doubt that a doctor who ignored elevated fasting glucose levels is going to run these tests.

If you can see an endocrinologist who specializes in diabetes, that would be best, but at least see if you can find a primary care physician who is more experienced in treating diabetes. And do this ASAP...this doctor has already wasted 3 years, and you don't want to waste any more time at this point.

Ruth

 
Old 02-28-2009, 03:35 PM   #4
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Re: the numbers game advice

Thanks Guys. Well I have the appt Monday morning and then from there he will sent me to the local hospital diabetes center. I gotta tell ya tho today I had a good scare. I went to get my blood tested, and the girl kept saying how thick my blood was, and how fast it was coagulating, then she said I have something very serious going on, talk about a scare! Im thinking,hoping its because of a combo of stress, and untreated diabetes, but i don't know. I spoke with my doc and he said its prolly the diabetes, and not to worry, how can u not worry tho??

 
Old 02-28-2009, 10:50 PM   #5
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Re: the numbers game advice

sirrob28. the same situation happened to my father. He had his blood sugars tested in 1991 and they were 360 and his doctor at the time just told him to "just lose some weight." Three years later he got very very sick and the same doctor told him he had the flu. He was drinking 4-5 4L jugs of water a day, was practically bed ridden and was in very rough shape. When he pushed and said it wasn't the flu he got his blood sugars tested and they were 540. Essentially, he had gone at least three years of undiagnosed diabetes and who knows how many years before that.

Thankfully that doctor retired and he got a new doctor who gives dad a lecture if his sugars stay over 110! I agree that you should find a doctor who knows a bit more about diabetes because shrugging off a sugar level of 132 is not cool.

Given my father's history, he was immediately put on diabeta (glyburide: I don't even know if this is prescribed anymore) because his pancreas was pretty worn out from such high levels for so long. He was put on insulin in 2000 along with metformin and has been doing well.

I also agree that you should be tested to see which type of diabetes you have. If you are not overweight you could have either, although type one onset is more common for those under 30. However, if you are type one you would need to go on insulin immediately. Insulin isn't that bad though. I take four to five shots a day depending on what I eat and I don't even feel the needles so it's pretty simple!

Catheryn

 
Old 03-01-2009, 11:53 AM   #6
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Re: the numbers game advice

Quote:
Originally Posted by sirrob28 View Post
... Over the last year between the downing a 12 pack of diet pepsi daily, ...
You might consider cutting back, or doing without the diet pepsi, and see if that helps. Both diet soda and caffeine have been linked to problems with Diabetes.
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Old 03-01-2009, 03:58 PM   #7
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Re: the numbers game advice

Catheryn,
Just to clarify, actually over 50% of new T1s are adults.

Sirrob,
I would personally consider NOT waiting until tomorrow for the medical help. It doesn't sound like your doctor is very quick in his treatment, or else he wouldn't have waited this long to act. Given the amount of time you've clearly gone untreated, I'd go to the hospital and get help. I don't know if this is an option, and I guess your appt. is only tomorrow. But I would demand treatment TOMORROW. Your blood sugar is very high at 400s, and every hour you stay there you are damaging yourself. Don't wait, and DO demand the GAD and c-peptide test just to be sure.
Wallis

 
Old 03-01-2009, 06:20 PM   #8
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Re: the numbers game advice

Wallis: I'm curious, what is the average adult age for the 50% of new T1 diagnoses? Everything that I've ever read says it's not common to see a T1 diagnoses over the age of thirty. So perhaps this 50% is concentrated in the 20-30 year range?

 
Old 03-02-2009, 08:34 AM   #9
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Re: the numbers game advice

thanks everyone for your advice! I just got back from the Doc's and I am being referred to the local diabetes clinic. He never said it type 1, or 2, but here are the numbers, sorta thinking its t2. These numbers are all fasting numbers
Glucose- 305
H A1c- 11.6
Insulin - 11
and my wbc was also slightly elevated and then this number,
microalbumin - 44 was never discussed, found it while reviewing my bloodwork at home - normal range is 0.00 -23.0 I goggled it, and it sounds like a scary number to me

He has me started on Metformin, diet exercise. Don't know what all these numbers mean yet, but it would be good to here from you guys on this

Last edited by sirrob28; 03-02-2009 at 09:07 AM. Reason: added new numbers

 
Old 03-02-2009, 12:21 PM   #10
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Re: the numbers game advice

Microalbumin is related to your kidney function. If you are spilling this protein in your urine it could indicate some kidney damage. HOWEVER! I don't want to alarm you. There are medications that help this, and it can correct itself to some degree. I had an increase in my microalbumin levels a few years back and was on medication for some time. I'm off of it now and the blood test report I got this afternoon from my doctor said all is normal.

Your A1c is also quite high, but it is like this because your sugars have been so out of control for so long. Once you get your sugars stabilized it'll go down. Aiming for 6 is good, but it won't happen overnight. A1cs are test the past three months, so you'll have to wait at least that long before you see any major movement.

I'm alarmed about your story. Your doctor let you go undiagnosed for so long and today didn't mention your microalbumin levels. Not only should you be going to the diabetes centre, you should be seeing an endocrinologist where you should be given a c-peptide test to find out what type you are. If you are type 1 then the metformin and diet/exercise won't help a whole lot, and since you have already been hyperglycemic for so long, I wouldn't take the "wait and see" approach. If you are t1 you need to be on insulin now! Ask for a referral from the diabetes clinic to an endocrinologist. That's where I got my referral. You should also ask about seeing an opthamologist too because your eyes need to be tested every year!

I hope your diabetes educator is able to help you make the transition. You'll probably feel crummy for a bit as your sugars lower, but hang in there. Once they're normal on a consistent basis, you'll feel better than you ever have, and when you get into a routine it won't seem as daunting as it does at first.

 
Old 03-02-2009, 01:30 PM   #11
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Re: the numbers game advice

Sirrob,
When, exactly, are you going to the diabetes clinic? I think Wallis is absolutely right...you should not delay any further! With blood sugars as high as 400, you are in danger of going into diabetic ketoacidosis, which is a life-threateneing condition. Metformin can take several weeks to a couple of months to bring your numbers down, and if you're a T1, it won't help at all. Frankly, this doctor sounds majorly incompetent, and I don't say that lightly.

Wallis is also correct that many people develop T1 in adulthood and it is absolutely necessary to do the GAD antibody tests and the C-peptide to be certain what type of diabetes you're dealing with. If it's T1, all the oral meds in the world aren't going to lower your blood sugar levels. There's also a type called LADA (Latent onset diabetes of adults, sometimes referred to as T1.5). In this type of diabetes, the insulin-producing cells aren't destroyed all at once, as in T1, but rather over a period of many months and even a couple of years. In T1.5, oral meds may seem to work for a while, but will eventually fail.

If you're very much overweight, then it would be logical to suspect T2; on the other hand, if you're at a normal weight or even just slightly overweight (such as by only ten pounds or so), it's quite possible this could be T1 or T1.5. So insist that those tests be done.

The other thing you can do for now is to get some Ketostix at the drugstore. These are reagent strips which change color depending on the ketones in your urine. You simple hold the strip in your urine stream, shake it off, wait 15 seconds, and compare the color of the reagent part to the colors on the bottle. This will tell you if you're producing ketones. If it shows moderate to severe ketones, you need to go to the ER asap. If there are no ketones, or very mild ketones, you can probably just drink lots of water to flush them out.

I am not one to think that doctors should be Gods. They are human and heaven knows, they can make honest mistakes just like the rest of us. But this man has ignored your diabetes for three years and possibly caused you to have kidney damage. If it were me, I would have nothing more to do with him and might even consider a lawsuit...and believe me, I don't say that lightly. But whatever you do, Sirrob, you need to get IMMEDIATE help for your diabetes.

Ruth

 
Old 03-02-2009, 04:00 PM   #12
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Re: the numbers game advice

Thanks Girls,Machaon, and John, I cant get into the clinic until the 23! I am waiting on a referral as I type this. I have been using the ketone test strips, usually they r on the lower side, but there are some present. I am maybe slightly over weight at best. I will def go to a endocrinologist. Hopefully I can get in soon. It bothers me that I called my Doctors office today around noon for a referral and here it 6 and no call. I started taking the meds this afternoon, checked my blood levels after a light lunch, 2 hrs later, 389. Well hopefully I will have some news of seeing the right doctor soon. I will insist on those test being done. This is really dragging me down, plus I think im getting a cold,grrrrrr. I really appreciate all the comments and great advice. I will keep you all posted on what happens next.

Last edited by sirrob28; 03-02-2009 at 04:02 PM.

 
Old 03-02-2009, 07:35 PM   #13
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Re: the numbers game advice

Perhaps, sirrob, you should make an appointment with another family doctor? Sooner rather than later? My former family doctor wouldn't listen to me about anything (diabetes or non diabetes related). When he refused to check something I wanted to have checked (blood test-wise) I knew it was time to find another doctor. I did, and a) she actually listens to me and b) she's A LOT more proactive. My first doctor would apparently send in referrals, but I'd never EVER hear anything. With my new doctor I got my referrals almost immediately.

SamQKitty's absolutely right: with your sugars that high, you need more than metformin to bring them down. Your A1c is VERY high. A friend of mine has type two and when he was diagnosed his numbers were lower than yours and his doctors put him on insulin at the onset to lower his blood sugars faster than oral meds could, and they also wanted him on insulin until he had the c-peptide test to be safe rather than sorry.

Also, find a doctor who will be pushy enough to get you into the diabetes clinic sooner. Waiting almost a month after a NEW diagnosis is unacceptable. My doctor was pushy and called the local clinic at the hospital and demanded they get me in the next day. And they did. Your current doctor isn't take your health seriously. Find someone who will.

 
Old 03-03-2009, 06:05 PM   #14
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Re: the numbers game advice

Sirrob,
I still really think you should just go to the ER. That way you can get this taken care of NOW, not in THREE WEEKS! That is ridiculous! Your doctor clearly doesn't care that these three weeks are potentially life threatening for you. Ditch that doctor asap. get help.

 
Old 03-03-2009, 06:58 PM   #15
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Re: the numbers game advice

If there's a walk in clinic in your area I'd go in asap. Tell them your situation and how your doctor has been pretty much useless and that you need help because honestly, it wouldn't hurt to put you on insulin for a bit to help your sugars to come down.

Metformin takes at least 5 days to work. With sugars as high as yours you won't see an improvement overnight, and your pancreas could be worn out from being hyperglycemic for so long. If it is, you'll need insulin not metformin alone.

Bring your blood test results with you!

 
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