Question for people who are knowledgeable about diabetes
 

I have been lowcarbing for over 11 years. I was a gestational diabetic 38 years ago (I'm 56 yrs. old, with autoimmune diseases: Hashimoto's, RA, OA, Sjogrens, Hyper IgE, Celiac, on steroid inhalers all the time, and presently on oral steroid with injection of Medrol 'as needed'). I was also placed on Metformin about ten years ago for a high fasting insulin (not bg) while I HAD to be on large oral steroid dosage, then weaned off the Metformin.

Anyway, to cut to the chase, I just saw my PCP and wanted to know what my A1c and BG was back when they took them in July. And I want to make this very clear: I eat NO sugar, NO gluten, no fruit (not even berries) and limit my gross carbs to less than 30 - 40 most days. I was not on any oral steroids at the time the A1c or bg was done, btw.

My Aic back in July was 6 and my BG was 98. I had fasted for well OVER 16 hours. I also had them do a fasting BG while I was there yesterday (I'd not eaten since 6pm the night before and it was after 10:30 am when blood was drawn).

I am just a little 'quizzical' at how my A1c is a 6 and my BG was 98..it's not ever been over say, 89 or so and I'd never had a A1c, that was my first. I have diabetic symptoms, I just had high pressure in the eyes and the opthalmologist kept remarking that he'd 'swear' he had tested a diabetic.

My question? WHY is my BG and A1c even 'that high' (and no offense to those of you who are diabetic, Im not 'whining'...I just want to 'catch' whatever might be creeping in here...hubby's family has a long line of 'oh, you're fine' go straight to 'lost her leg and on dialysis'..so I'm a little 'paranoid').

Is that right that it should be that high, and should I have a fasting insulin done now? And at what 'point' should I be speaking to someone about this beyond just my family PCP (who goes right by the ranges, no give or take, as if we all came out the same mold...I do have access to endocrinologist, but he's a really learned thyroid doctor who tends to only do thyroid as a specialty).

Am I worrying needlessly? I have sores that aren't healing (could by my excessively high IgE), fatigued (could be old age)..??? If I am, please don't hesitate to just tell me to stop being quizzical about it, lol. TIA

Pam, I don't think you're being stupid at all. From everything I have read, 6 is not acceptable for a non-diabetic. It's not even acceptable for a diabetic. I am trying to get mine under 5, in fact.

It is possible that they made a mistake with your labs, so you should have it retested right away, particularly given how your ophthalmologist reacted. I was basically diagnosed by my ophthalmologist, so this is a big concern.

Don't panic. Stay calm and focused, and get them to do another HA1C test. Being low carb is going to help, but you may need some help with insulin resistance (you may need to go back on the Metformin for example). If you have diabetes it's not the end of the world, and you are already equipped to do the things that help because of your low carb diet.

Whatever you do do NOT let them put you on a lowfat/high carb diet. Try to avoid drugs that simply cause your pancreas to push out more insulin. Ask to start with the Metformin if you are diagnosed with diabetes.

::hugs:: Good luck, I'll be sending positive thoughts your way.

About FBGs'....

the reading you will get at 12, 13, 14, 15 or 16 hours into a fast will most likely not be the same and I'd almost bet that at 16, it will always be higher than at 12 for most folks....

About A1C results of 6 which is indicative of an average BG reading of about 120... http://www.elviradarknight.com/diabetes/a1cnumbers.html

If you're curious about how you got an FBG of 98 and an A1C of 6, perhaps you might check your BG at 1 hour, 2 hours, 3 hours & 4 hours after eating so you can see how hight it goes after meals and how long it takes to come down... Also, test what your BG does after eating different types of meals....

That might help paint an image you can understand a bit better... and all that is said, assuming your tests were all done accurately....

You might look and see what sort of readings you get 1 hour after eating a typical meal. Maybe it goes super high then?

Thanks everyone for your input. I much appreciate it. I don't have a BG meter (which I suppose I can just buy without an Rx, right?). So, I'll get meself to a pharmacy for one while I'm waiting for a fasting insulin (I am hypothyroid, on lots of steroids (inhalant all the time, no let up for over 10 years) and oral steroids right now, but that test was done back in July when I was not on oral steroids, and not over 25 grams (net) a day).

It just kind of 'weirded' me out that the doctor just turned around and steadfastly pointed out that 'see where the 6 is? You have nothing to worry about until the 7's or so and your fasting BG was well under 100". When I remarked 'How many of your patients are under 30net grams of carb for 10 years of their lives and spring numbers like that?" He said 'Just you'.

I spread my carbs out, no soy, no frankenfoods, just veggie carbs...so I will take your suggestions of charting that after I get a meter. Thank you all.

Great advice. Um, they kind of 'can't' put me on a lowfat/high carb diet....I'm Celiac, have Hyper IgE (meaning I'm allergic to lots of things, and if I'm not now, I can become so as soon as sensitized). I had pancreatitis 10 times from the ages of 7 to 14 when young...with no explanation. I have grown up in a family of Type I's and I was the only one NOT taking insulin...until gestationally dx'd.

I'd been on Metformin eight years ago because my fasting insulin was so far over range (thinking it was because of all the steroids...still don't have a pat answer for it).

What tests do they do to find out if your pancreas just isn't putting up with any nonsense and has run out of ways to help you?

I just bought a reli-on meter at WalMart for $8.95 and 100 meter strips for $36.... That's down from $12.95 on the meter and the strips were at $22 for 50 strips and not available in the 100 strips size.... That's about all that is going down these days as we're approaching the $4 mark for a gallon of gasoline.

I think you could get a lot of information from a meter; my local chain drugstore gives them away!

There's a discussion downthread about magnesium helping with insulin resistance. I started taking the chelated kind and feel good; no tummy issues!

Oh, yeah, on the rising gas prices Cajunboy...(one of my dreams is to visit Louisiana...one of my favorite performers from there is Tab Benoit and we just saw him over the line in Michigan...you folks' Southern drawl ...goodness!). I'm hoping to get to the pharmacy sometime in the next couple days...I'm on about 9 RX'd meds anyway...so they 'know' me, I'll go and get one and some strips.

WereBear, I'm a patient advocate IRL (before I got too disabled to really work a lot) and I've been hitting the magnesium for the past three years...and yes, it did help with quite a bit of my health problems...but I'm quite concerned with the fact that my MD just looked at the chart and pointed to 'normal' while my opthalmologist is concerned, my entire family (save for a brother a year older) is all dead and gone and ALL of them had either juvenile or Type autoimmune diabetes.

Also, just the fact I was insulin injection gestational all those years ago, (well, um...and over 300 lbs. at delivery) and also the fact that I've not ever had much over 50net grams carb in the last 10 years...I just feel like something is going on with me (besides my other disabilities/autoimmunity).

Doc acts like it's 'no biggie' and that 'we'll catch it by doing a FBG every year, and an A1c. Um...no...we'll probably catch it by seeing another doctor who knows what they're doing. NO doctor 'likes' lowcarb around my area...most still talk about how that 'Neanderpam woman lost all that water weight'.

Thyroid...I know...thyroid...not many have my knowledge, but I've 'specialized' in that area, not in the diabetes area. Any info you good folks can give me about this will be worth gold to me. The advocate needs an advocate :)

jillybean, I've been lowcarbing for over 11 years, maintaining loss for over eight. I 'was' currently in school for a BS nutrition. I do menu planning, etc. and am a thyroid patient advocate. I am already disabled, and yes, I know about macros and all.

I don't really think 60 to 82 grams of protein a day could readily be converted to glucose in a 56 yrs. old woman who lifts weights. And that's already been discussed between my endocrinologist and the other doctors I work with/for.

My fat % stay around 70%, my protein is around 20 to 23% and my carbs are the rest. No real sugar, no flour, no gluten (Celiac) no corn (I have HIE...Hyper IgE Syndrome).

I just called my endo and my NP (BFF) and they would like to see your research proof of that 'at the rate of 50%' conversion cuz it's a new one on them (and myself). I didn't finish medical school, but attended.

They feel I have type 1.5 given my several bouts of pancreatitis when young, and my family history with HIE. And of course, if you know much about HIE, you KNOW that I am a heavy steroid user (for those of you thinking I'm Hulk Hogan'ish...I'm talking about corticosteroids, although I'm giggling just trying to imagine that in a 56 yr. old Grandma).

When the patient (me) has HIE there's not a lot you are going to be able to do to manipulate the diet and still allow me to eat. It's certainly a dilemma. Thanks for thinking about it though...perhaps if we get enough people who are 'savvy' about HIE, and diabetes, and lowcarb we can figure something out here. I appreciate your time.

Ok, I just got my copy of Thursday mornings newest FBG....and it's even higher. It's 143.

I have a lot of the signs of having diabetes...the thirst (omg..neverending...I get shaky if I don't have a water with me), the up peeing allllll nightttt loongggg, my toes are bleeding into my socks now....I'm tired, but jumpy (but the steroids have my adrenals going gangbusters too)....and a new development had been added...I'm not hungry...I'd rather drink than eat).

I have to go back Thursday morning (I'm gonna start making Doc buy me breakfast if this keeps up!)...but I think my MD is a little in over his head, and I don't need a referral, but when I picked up the copy of labs today (BUN and creatinine are way off the mark of course, was expecting that)...the one new nurse actually started handing me an exchange diet sheet, and if it weren't for the nurse who's been there 20 years and knows me well...oh my...she started in on why I should be eating whole grains....holy Hannah....I flipped the sheet back at her and told her just looking at her backside was the reason NO ONE should be eating whole grains...

Um...does acting irrational come up on the 'diabetic symptoms list'? (Hangs head in shame).

hey Neanderpam :)

am certainly no expert, but I def have metabolic syndrome and fairly recently rather lost control of my sugar metabolism (um.. wasn't low carbing though I had done it before for several years.. mistake going off obviously).
But, I'm thinking, if your fasting plasma insulin is raised, and your peripheral sugars are escaping control, are we perhaps looking at an issue at the level of the insulin receptors? Some inability or disability, in the capacity of your tissue insulin receptors to respond properly or fully to your plenty of insulin.

Going back onto Metformin may in fact help. And also, maybe looking into Vit D3 status and whether or not you may have become magesium deficient. If those two have become deficient, supplementing may assist in sugar metabolism?

oh sorry, missed where you mentioned you'd already been mag supplementing:)

I know you were kind of kidding there, but actually, crankiness or change in personality can accompany erratic blood glucose levels, either too high or too low.

And yeah, I'm bad, I lawled that you told off the nurse who gave you the moronic exchange diet. :lol: