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Medical Forum / Diseases and Disorders / Diabetes / May 2008I might be type 1!
Met with the nurse again today and she was baffled by my numbers. She suspects that I might in fact be type 1 and not 2, and she wants more tests to be run. C-Peptide was run about 3 years ago and I was producing a ton of insulin at that time. Also suspects that I may be low on something. Calcium, magnesium, something. Am having bad muscle cramps. In the meantime I am to up the Lantus to 25 units tonight and then 27 in a few days (can't remember the exact day) if that isn't enough. Odd thing is how high I am spiking now after eating. Given the amount of carbs I've been eating, she said I should be going up about 50 points, but I am going up 200 or more points. And it's not coming back down in the morning. The hope is that my Endo. will return her call some time today, but it might not be until tomorrow. She has faxed him my numbers. I asked her about testing for ketones. My friend urged me to do this. Her dad is type 1. The nurse explained that people with type 2 do not get ketones. This would explain the link that Alan gave me where the man tested for ketones and was found to have them. No further testing was done. If I had any strips left to check, I would check myself. But I don't. Bought a box and used them maybe once or twice a year or so ago, and then they expired. So now I just sit here, feeling like a huge ball of sugar and I wait. > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more tests [quoted text clipped - 10 lines] > am going up 200 or more points. And it's not coming back down in the > morning. Why on earth would a nurse tell you to eat enough carbs to spike you 50 points??? > The hope is that my Endo. will return her call some time today, but it might > not be until tomorrow. She has faxed him my numbers. [quoted text clipped - 8 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. Julie, your friend is wrong. Everyone gets ketones, they're healthy and normal. What type 1's get, with inadequate insulin and high bg is *ketoacidosis* which is a whole other kettle of fish and very dangerous. Susan > x-no-archive: yes > [quoted text clipped - 15 lines] > Why on earth would a nurse tell you to eat enough carbs to spike you 50 > points??? She didn't. The dietician did. They both insist that by skipping a meal or eating only peanuts I am going to have a liver dump from not eating enough carbs. And yeah, I know it does happen. It has happened to me. But this time it didn't happen. It didn't happen twice. I proved it to them. They still said I was wrong and need to eat the two servings of carbs. >> The hope is that my Endo. will return her call some time today, but it >> might not be until tomorrow. She has faxed him my numbers. [quoted text clipped - 12 lines] > normal. What type 1's get, with inadequate insulin and high bg is > *ketoacidosis* which is a whole other kettle of fish and very dangerous. Hmmm... > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more tests [quoted text clipped - 23 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. You should request testing for GAD antibodies, islet cell antibodies and insulin antibodies. If you are T1, it's probably LADA and the antibody tests would either confirm or refute it. John C. On May 1, 4:39 pm, "Julie Bove" <julieb...@verizon.net> wrote: > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more [quoted text clipped - 28 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. You should request testing for GAD antibodies, islet cell antibodies and insulin antibodies. If you are T1, it's probably LADA and the antibody tests would either confirm or refute it. Well, hopefully he will run the right tests. > "John" <jcarney44@verizon.net> wrote in message > On May 1, 4:39 pm, "Julie Bove" <julieb...@verizon.net> wrote: [quoted text clipped - 4 lines] > > Well, hopefully he will run the right tests. But it's your body and your life. You've got to ask! If he says no, make him explain why.  SignatureNick. Support severely wounded and disabled Veterans and their families! I've known US vets who served as far back as the Spanish American War. They are all my heroes! Thank a Veteran and Support Our Troops. You are not forgotten. Thanks ! ! ~Semper Fi~ >> "John" <jcarney44@verizon.net> wrote in message >> On May 1, 4:39 pm, "Julie Bove" <julieb...@verizon.net> wrote: [quoted text clipped - 7 lines] > But it's your body and your life. You've got to ask! If he says no, make > him explain why. All I can do is wait and see. Not likely he will call me back. But he might. It sounds more like you have finally killed the pancreas with high bg's and now need a bolus as well as a the Lantus. I cannot fathom why no one is suggesting it. 50 points?? Can you see a problem with the nurse's recommendations there?? No wonder type 2 progresses! > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more [quoted text clipped - 23 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. > It sounds more like you have finally killed the pancreas with high bg's > and now need a bolus as well as a the Lantus. I cannot fathom why no one > is suggesting it. 50 points?? Can you see a problem with the nurse's > recommendations there?? No wonder type 2 progresses! Dunno. All I know is my BG has gotten progressively higher and higher. Food does not seem to affect it, except if I eat too many carbs of course. But eating low carb didn't lower the numbers at all. If one's BG were 80 to start with and it raised 50 points, that would be 130. Not likely that's going to happen since I would most probably eat some fat in that meal to delay the absorption of carbs. Doesn't seem like an unreasonably high number to me. >> It sounds more like you have finally killed the pancreas with high bg's >> and now need a bolus as well as a the Lantus. I cannot fathom why no one [quoted text clipped - 8 lines] > meal to delay the absorption of carbs. Doesn't seem like an unreasonably > high number to me. Once the body detects a rise in bg it pumps out insulin. It doesn't matter where you start, the fact is the more the rise the more insulin needed and the more stress it puts on your ailing pancreas. And one day it just stops returning to normal range and on to the next level. In your case it is now insulin, so I am very surprised it was only Lantus you were given and nothing to counteract the effects of a meal. Lantus isn't there for those times. > In your case it is now > insulin, so I am very surprised it was only Lantus you were given and > nothing to counteract the effects of a meal. Lantus isn't there for those > times. Some of us (e.g. me) might talk about taking an insulin shot as something that happens many times a day and no big deal, but that's only because we've been doing it for so long that we cannot remember not doing it. Even docs and nurses dealing with diabetes daily don't go around putting every single patient with high numbers on MDI insulin regimes. For an older person, everything I read makes it sound like a gradual process. Even for me as a T1, at diagnosis the doc (just a GP, not an endo, there were no endos in my hometown) really tried to make a single shot of R and N each day work. It obviously didn't work very well, that's why he sent me to the research hospital! But it was a textbook approach at the time. The textbook approach to older patients formerly diagnosed as T2 is, for better or for worse, usually to start them off on one shot of Lantus a day. To me it's perfectly obvious that this won't work except in the most ideal cases (in fact I'm pretty sure it won't work well even in a lot of ideal cases but I'm highly biased by my quarter-century as a T1) Tim. >>> It sounds more like you have finally killed the pancreas with high bg's >>> and now need a bolus as well as a the Lantus. I cannot fathom why no one [quoted text clipped - 16 lines] > nothing to counteract the effects of a meal. Lantus isn't there for those > times. Well, given my BG records prior to the insulin, my highest numbers were often the morning fasting. Perhaps this is why? Don't know really. But the nurse says it is as though the meds I am taking are not doing a thing. Seems that way. And now my BG is up again. Grrr... Remained steady at 224 for a 4 hour period last night before bed. Was 326 when I awoke. This is annoying and frustrating. >Well, given my BG records prior to the insulin, my highest numbers were >often the morning fasting. Perhaps this is why? Don't know really. But >the nurse says it is as though the meds I am taking are not doing a thing. >Seems that way. And now my BG is up again. Grrr... Remained steady at 224 >for a 4 hour period last night before bed. Was 326 when I awoke. This is >annoying and frustrating. From over here it looks like since you started the lantus your pancreas has gone on strike, and the basal is now the *only* insulin you have. And there's not enough of it. Either that or your liver has freaked out and is permanently dumping glucose. The only thing that will help is a PROPER doctor, my dearest wish is that you could find a competent one as there are obviously weird things occurring which your current lot aren't being sufficiently proactive about. Could be LADA, complicated by insulin resistance? >>Well, given my BG records prior to the insulin, my highest numbers were >>often the morning fasting. Perhaps this is why? Don't know really. But [quoted text clipped - 7 lines] > pancreas has gone on strike, and the basal is now the *only* insulin > you have. And there's not enough of it. That could be. Or the nurse said sometimes lantus just doesn't work for people and I might need another kind like Levemir. > Either that or your liver has freaked out and is permanently dumping > glucose. That could be too. Not having any more hypos though. Had one when I first started on it and had a few lower numbers when I first started on it. Oddly last night I dropped to 224 (too high still, I know) and stayed there for 4 hours. Shot up to 336 fasting. Stayed at about that (dropped a few points) before lunch. > The only thing that will help is a PROPER doctor, my dearest wish is > that you could find a competent one as there are obviously weird > things occurring which your current lot aren't being sufficiently > proactive about. The Endo. I go to is highly rated. There is only one other Endo. in these parts and I've heard tell he is terrible. I just wish my Dr. would call the nurse or me or something, but that hasn't happened. > Could be LADA, complicated by insulin resistance? I have no idea. Is there some test they can do for insulin resistance? >>>Well, given my BG records prior to the insulin, my highest numbers were >>>often the morning fasting. Perhaps this is why? Don't know really. But [quoted text clipped - 34 lines] > > I have no idea. Is there some test they can do for insulin resistance? The simplest test is to ask if as a type 2 you are still overweight? Getting back to normal weight if often the absolutely best way to reduce insulin resistance to a minimum. If you are overweight (as a type 2) you could almost guarantee you have insulin resistance. > The simplest test is to ask if as a type 2 you are still overweight? Getting > back to normal weight if often the absolutely best way to reduce insulin > resistance to a minimum. If you are overweight (as a type 2) you could > almost guarantee you have insulin resistance. Not so simple. I was very slim at my most IR, and gained at my least, due to hypercortisolemia, which is a very commonly undiagnosed cause of diabetes. I am extremely sensitive to insulin. Like Julie, I recently have had periods of time where my bg responses to meals have no relation to what amount of carb I've eaten, it's due to high or low cortisol levels that I have high or low bg. High insulin levels lower cortisol synthesis in the adrenals, and also lower cortisol binding globulin, which delivers cortisol to the cells, with very erratic results. Susan >>>>Well, given my BG records prior to the insulin, my highest numbers were >>>>often the morning fasting. Perhaps this is why? Don't know really. [quoted text clipped - 40 lines] > insulin resistance to a minimum. If you are overweight (as a type 2) you > could almost guarantee you have insulin resistance. I am overweight and my weight is stable. I can not seem to lose any more despite eating reduced calories. >>>Well, given my BG records prior to the insulin, my highest numbers were >>>often the morning fasting. Perhaps this is why? Don't know really. But [quoted text clipped - 10 lines] >That could be. Or the nurse said sometimes lantus just doesn't work for >people and I might need another kind like Levemir. I suppose it's possible. Whatever it looks like a sudden change. I suppose the way your BG has been acting up you could have had a prolonged honeymoon which is not uncommon in LADA but with all your other problems it could be something completely different, Lantus allergy? >> Either that or your liver has freaked out and is permanently dumping >> glucose. [quoted text clipped - 4 lines] >hours. Shot up to 336 fasting. Stayed at about that (dropped a few points) >before lunch. Yes since starting on the Lantus you seem to have gone from not having quite enough insulin to having nowhere near enough. :( >> The only thing that will help is a PROPER doctor, my dearest wish is >> that you could find a competent one as there are obviously weird [quoted text clipped - 4 lines] >parts and I've heard tell he is terrible. I just wish my Dr. would call the >nurse or me or something, but that hasn't happened. Yes that's the problem, you aren't getting nearly enough feedback. >> Could be LADA, complicated by insulin resistance? > >I have no idea. Is there some test they can do for insulin resistance? A simple indication is the trigs/HDL ratio, theoretically the lower that is the lower the IR >>>>Well, given my BG records prior to the insulin, my highest numbers were >>>>often the morning fasting. Perhaps this is why? Don't know really. [quoted text clipped - 53 lines] > A simple indication is the trigs/HDL ratio, theoretically the lower > that is the lower the IR Hmmm... My Trigs are slightly high but I think the HDL was fairly normal. Overall cholesterol is fine. everyone gets ketons..most all low carbers test positive for them and in fact in my body building days we used keto strips to be sure we were in the zone. I think the test your thinkin of test for ketones plus a specific protien marker along with the ketones..i forget tho. KROM > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more [quoted text clipped - 23 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. > everyone gets ketons..most all low carbers test positive for them and in > fact in my body building days we used keto strips to be sure we were in > the zone. > > I think the test your thinkin of test for ketones plus a specific protien > marker along with the ketones..i forget tho. Dunno. http://HeartMDPhD.com/Convicts/PrayForJulie > Met with the nurse again today and she was baffled by my numbers. She > suspects that I might in fact be type 1 and not 2, and she wants more tests [quoted text clipped - 23 lines] > > So now I just sit here, feeling like a huge ball of sugar and I wait. You would be in the hospital with diabetic ketoacidosis (DKA) if you were a type-1 diabetic. <>< http://HeartMDPhD.com/HolySpirit/Counsels On May 2, 5:27 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > You would be in the hospital with diabetic ketoacidosis (DKA) if you > were a type-1 diabetic. Ever hear of LADA? John C. On May 2, 5:27 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > You would be in the hospital with diabetic ketoacidosis (DKA) if you > were a type-1 diabetic. Ever hear of LADA? You're talking to a troll. http://HeartMDPhD.com/Convicts/PrayForJulie <>< http://HeartMDPhD.com/HolySpirit/Counsels >So now I just sit here, feeling like a huge ball of sugar and I wait. I'm a type 1 and have been for almost all of my life. I don't know first hand of the type 2 experience, but from what I have read on lengthy discussions here, I much prefer being a type 1 to a type 2. The reason being is I have complete control over my blood sugar levels throughout the day via insulin injections without needing to follow unusual diets. I am careful not to over eat, but I balance my carb intake with my insulin dosage for control. It works well for me, and I have no need to take any medications other than insulin injections. I do not require large amounts of insulin (I only inject 16 units of Lantus), but my weight is within a good range for my height. It may be easy for me to think this, but if indeed you require more insulin injections, you will find in time that your control will be much better than it was previously. It'll take time to learn how to get in control via injections though. The light at the end of the tunnel is actually the exit... >>So now I just sit here, feeling like a huge ball of sugar and I wait. > [quoted text clipped - 17 lines] > > The light at the end of the tunnel is actually the exit... Yeah, but right now it's looking pretty dim. I took 25 units of lantus and it did, nada. <jamil@onepost.net> wrote in message news:141m145l2kv0neq76v39b096ka5fjuv9d5@4ax.com... > On Thu, 01 May 2008 20:39:12 GMT, "Julie Bove" <juliebove@verizon.net> > wrote: [quoted text clipped - 20 lines] > > The light at the end of the tunnel is actually the exit... Yeah, but right now it's looking pretty dim. I took 25 units of lantus and it did, nada. Then it's very doubtful you would be a T1. T1's almost always need very little insulin. Even with having IR a T1 would probably use 1/2 the insuiln then a T2 would have to use. I'm a T1 and about 15lbs over what I should weigh. I have other health issues that cause me to have IR, some days it's quite high, other days it isn't so high. Rarely do I need to change my Insulin dose other than what I take as a bolus. You're best bet is to demand testing for Insulin autibodies, C-Reactive Protein that will check if you have any inflammation in your body causing high IR, GAD65 and a C-Peptide. One thing many forget is that when you start taking Insulin your body detects the Insulin and stops the body from making it's own. This is why when you go to get a C-Peptide test done the lab will have you fast for a minimum of 14hrs but no more than 16hrs. That way your system makes sure the insulin you've injected is out of your system for the most part and you don't overstress your system to dump. Or at least this is what my lab told me moons ago when I had to get my cpeptide done for the insurance to determine that I was a T1 so they'd pay for certain items I was requesting. You'll just have to learn to play with the dosages and get your doctor to get you a bolus insulin, if they won't give you one, you can purchase Regular Insulin and that certainly will help you with that extra little kick you probably need after you eat to get your numbers down. Lantus isn't a fast acting insulin and figure whatever amount you take break that down over 24hrs and that is how much you are getting every hour, which at 24u, it isn't very much. dman > <jamil@onepost.net> wrote in message > news:141m145l2kv0neq76v39b096ka5fjuv9d5@4ax.com... [quoted text clipped - 26 lines] > and > it did, nada. Hmmm... > Then it's very doubtful you would be a T1. T1's almost always need very > little insulin. Even with having IR a T1 would probably use 1/2 the [quoted text clipped - 4 lines] > Insulin > dose other than what I take as a bolus. Okay... > You're best bet is to demand testing for Insulin autibodies, C-Reactive > Protein > that will check if you have any inflammation in your body causing high IR, > GAD65 > and a C-Peptide. Okay... > One thing many forget is that when you start taking Insulin your body > detects [quoted text clipped - 11 lines] > for > certain items I was requesting. When I had a C-Peptide done before, it wasn't fasting. > You'll just have to learn to play with the dosages and get your doctor to > get you [quoted text clipped - 7 lines] > getting > every hour, which at 24u, it isn't very much. Can not purchase insulin here without a prescription. Nor can you purchase the needles or syringes. > dman > <jamil@onepost.net> wrote in message > news:141m145l2kv0neq76v39b096ka5fjuv9d5@4ax.com... [quoted text clipped - 24 lines] > and > it did, nada. Hmmm... > Then it's very doubtful you would be a T1. T1's almost always need very > little insulin. Even with having IR a T1 would probably use 1/2 the [quoted text clipped - 4 lines] > Insulin > dose other than what I take as a bolus. Okay... > You're best bet is to demand testing for Insulin autibodies, C-Reactive > Protein > that will check if you have any inflammation in your body causing high IR, > GAD65 > and a C-Peptide. Okay... > One thing many forget is that when you start taking Insulin your body > detects [quoted text clipped - 11 lines] > for > certain items I was requesting. When I had a C-Peptide done before, it wasn't fasting. --Then more than likely it's results weren't correct. I know I've had a few C-Peptides done over the past few decades and only recently like the past 6yrs did I find out that a C-Peptide has to be fasting. I'd call your lab and ask them to investigate, because even my lab said it wasn't but my doctor called back and told them to triple check it and sure enough, it was a 12hr fast. > You'll just have to learn to play with the dosages and get your doctor to > get you [quoted text clipped - 7 lines] > getting > every hour, which at 24u, it isn't very much. Can not purchase insulin here without a prescription. Nor can you purchase the needles or syringes. -- Yes you can. You cannot purchase any of the fast acting insulins or newer long acting, but you can purchase NPH and Regular without a prescription. Call your local pharmacy and ask them specifically about them before telling me what I know since I'm a long time Insulin user. Often once your pharmacist learns who you are and you're on Insulin, they'll not have a problem with selling you syringes. You can also use syringes over again, granted not like a Lancet but I can get a good 6 injections before mine start to dull and hurt. Just trying to give you options and like normal from what I've seen over the years lurking your negativity is ................ > dman > -- Yes you can. You cannot purchase any of the fast acting insulins or > newer [quoted text clipped - 12 lines] > the > years lurking your negativity is ................ In WA state you can not purchase without prescription. > In WA state you can not purchase without prescription. Okay, so I have been misinformed. I have checked and from what I can see, both can be purchased without a prescription. However, they would not be covered by insurance and I can't afford to pay out of pocket for them. Nor would I know what to do with them. I don't think insulin is something one should try to do on their own. >> In WA state you can not purchase without prescription. > [quoted text clipped - 3 lines] > Nor would I know what to do with them. I don't think insulin is something > one should try to do on their own. The rules for whether you need a prescription to purchase them vary from state. >>> In WA state you can not purchase without prescription. >> [quoted text clipped - 5 lines] > The rules for whether you need a prescription to purchase them vary from > state. Yes. I found this. http://members.tripod.com/diabetics_world/InsulinRx.html snip > In WA state you can not purchase without prescription. Washington State does not require a prescription for retail purchase of syringes. However, current law (RCW 70.115.050) does stipulate that on the sale at retail of any syringe or other device used to inject drugs, "the retailer shall satisfy himself or herself that the device will be used for the legal use intended." http://www.metrokc.gov/health/apu/harmred/syringe_campaign.htm Vicki > snip >> [quoted text clipped - 7 lines] > > http://www.metrokc.gov/health/apu/harmred/syringe_campaign.htm Thanks! > > -- Yes you can. You cannot purchase any of the fast acting insulins or > > newer [quoted text clipped - 14 lines] > > In WA state you can not purchase without prescription. I don't think that's a state law (because I've bought them there in the recent past without a prescription), but maybe it's a local law. In my experience, 26 years as a diabetic, sometimes (in my "non-Buck- Owens phase") with long messy hair especially when I was a teenager, 90% of the time when the pharmacist tells you that he can't sell you a syringe it's not because it's illegal but because he doesn't think you'll do what you say you'll do with them. Tim. On May 7, 1:00 am, "Julie Bove" <julieb...@verizon.net> wrote: > "cocoa" <co...@butter.cv> wrote in message > [quoted text clipped - 20 lines] > > In WA state you can not purchase without prescription. I don't think that's a state law (because I've bought them there in the recent past without a prescription), but maybe it's a local law. In my experience, 26 years as a diabetic, sometimes (in my "non-Buck- Owens phase") with long messy hair especially when I was a teenager, 90% of the time when the pharmacist tells you that he can't sell you a syringe it's not because it's illegal but because he doesn't think you'll do what you say you'll do with them. I haven't actually had a pharmacist tell me that and they know me at the local pharmacy. I had thought I had read somewhere or been told by someone that I needed a prescription. I've seen since this is not true, but without one, my insurance will not pay and I can't afford that. Julie, I just took a gander at the group and read your post. I am sorry to hear this news but do you think you might have been misdiagnosed from the beginning. Loretta > Julie, I just took a gander at the group and read your post. I am sorry > to hear this news but do you think you might have been misdiagnosed from > the beginning. Could be. Nothing about me seems typical. I just wish something good would happen. Numbers went up to 449 after lunch today. I forgot to test before lunch. Nurse said not to bother testing after at this point in time. Most of the time, my numbers before and after are pretty much the same or sometimes slightly lower after. Grrr... I am calling first thing Monday morning since nobody got back to me. |
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