Question

[ecp123]

I am a college student with suspected type 1. I've had all the usual symptoms and have been told to monitor my blood sugar levels and report anything too high. Well, on Thursday I was between 220 and 250mg/dl for 2 hours before dropping to 150mg/dl after 4 hours. The next morning I was 126mg/dl fasting. I realize that these numbers aren't excessively high but I called the doctor and I have an appointment on Monday. The thing is that this weekend I have had pretty normal readings (hovering around 100mg/dl). Any ideas what is going on? My A1c a month ago was slightly elevated and until this weekend all my numbers were between 110mg/dl (fasting) and 190mg/dl (2 hours post meal). I'm a bit annoyed because I was hoping they would finally figure out why I keep losing weight and drinking alot but now it seems that my pancreas has decided to be somewhat normal again. Is that possible?

[Jeff]

The readings you describe are diagnostic for diabetes. Seek treatment immediately.

[Momof4gr8kids]

When a person is developing, or has developed diabetes the pancease's cells that produce insulin (beta cells) are under attack by the immune system. The attack can go on, and off for a long pireod of time.

I agree with Jeff, go to your appointment monday, and if your B/G's rise seek medical attention quickly. Are you also monitering your ketones? I would suggest if you have a b/g over 240 measuring your ketones with a urine strip you can buy at the pharmacy (no script needed)

If you are female, your monthly hormone cycle (not just menstration) can effect your b/g, specially if you have diabetes, or are developing it. There are a number of things such as stress, illness, exersize, or the lack of that can cause different b/g levels in a person with diabetes.

Good luck. I hope it is a fluke. Jamie

[ecp123]

Thanks for the replys.
I just tried to do my own improvised glucose tolerance test. That was a dumb idea. Now I feel really gross. Yuck.

[MrsBadshoe]

When people are first DX there pancreas is typically doing most of the work. It continues to lose efficiency until it is totally gone. Usually about 12 to 24 months post DX. Your symptoms sound very typical for a case of Diabetes caught in the early stages.

[ecp123]

I had my doctor appt. today. I've lost another 2 pounds...I've always been skinny but this is rediculous. My fasting level was 120mg/dl and they decided to do antibody tests. Would a positive antibody test be diagnostic for type 1? I've already met the criteria for diagnosis (random glucose level over 200mg/dl+symptoms) but they think I may just have a "hypermetabolic state". I don't think a "hypermetabolic state" would cause such continuously high bg levels but I'm not a doctor...yet.

[Momof4gr8kids]

It would probably conclude that you are in the begining stages of Type 1. Good luck, I hope it turns out well.

[MrsBadshoe]

FYI my endo says there are T1 diabetics out there that don't have antibodies. So, if you continue to feel bad over the next few weeks and your test comes back negative please continue to monitor your BG.

[hold48398]

You did the right thig by going to the appointment. At the beginning of a D diagnoses your pancreas will still have some functioning beta cells left which will continue to produce insulin...at random and for a period of time (the honeymoon). After initial diagnosis my daughter Mia was take off insulin completely for almost 2 weeks!! Just beware that you can get sick very quickly if your cells don't produce any insulin for a period of time, so check your ketones often. Best of luck to you.

[Twinklet]

My daughter was diagnosed with Type 1 almost 6 months ago and shows no antibodies (negative for ICA, anti-GAD, and has an average C-Peptide number). As time progressed, her insulin requirements have increased.

Let us know what your doctor says!

[jeep_bluetj]

Isn't it that if the antibodies are there, that's not diagnostic criteria, but highly indicitive if accompanied with symptoms. Not there happens in 30% or so of T1 diags. (iow, false negatives are common).

Twinklet: I love the screen name. Dunno why, I just think it's neat.

[Momof4gr8kids]

The C peptide which measures insulin levels in the blood is really the true indicator, but an antibody test with someone running high would add to the picture. The C peptide will show normal, or close to normal results if you are still producing enough insulin on your own so it isn't a completely true indicator either. I think for a T1 dx for someone that isn't extremely ill, and doesn't have b/g's above 200 all of the time, or fasting above 129 it is important for them to look at the whole picture, not just the numbers, so I can see where an antibody test would help.

[Chase's mom]

I was told that any time your numbers were over three hundred that your automatically dx'd with type 1. They told me that when I took my son to the ER and his numbers was 672.I didn't want them to label him as diabetic just yet and thats when they told me they had to.:(

[ecp123]

You guys are amazing, you know that right?
It will be about a week before I know the results of the antibody test but I'm still checking my bg twice a day and the numbers are still not normal.

Also, this is a bit random but as a science major I decided to experiment on myself to find out how high a controlled ammount of carbs would make my bg go. Fifteen minutes after ingesting 2 packets of sugar (8g of carbs total, 4g each) my blood sugar had shot up 100mg/dl from the 100's to the low 200's. I know after meal spikes are common but this seems excessive.

[Momof4gr8kids]

That is a huge spike. Maybe you could try corn syrup if you wanted a higher amount of concentrated carbs that is. Corn syrup os 30g of carbs for 2 tablespoons.

Anyway, I am glad the doc's are doing testing to find out what is going on. Please keep us posted, and take care. Jamie

[jeep_bluetj]

You guys are amazing, you know that right?
It will be about a week before I know the results of the antibody test but I'm still checking my bg twice a day and the numbers are still not normal.

Also, this is a bit random but as a science major I decided to experiment on myself to find out how high a controlled ammount of carbs would make my bg go. Fifteen minutes after ingesting 2 packets of sugar (8g of carbs total, 4g each) my blood sugar had shot up 100mg/dl from the 100's to the low 200's. I know after meal spikes are common but this seems excessive.

That does seem excessive.

Fasting above 126 is diagnostic (with lab equipment, not fingerstick meters)
GTT with a 45 gram load, 2 hours later, above 200 is diagnostic.

Did they do a 2 hour GTT?

[LantusFiend]

Type 2s can go up as high as type 1s can, but an anytime bg of over 200 is diagnostic of some type of diabetes.
I was diagnosed with a random bg of 425, and my doctor thought that I had type 2 until she saw that I was in DKA. DKA is highly indicative of type 1.

[ecp123]

I got the antibody test results and they are negative. The doctor has dismissed my elevated fasting glucose and the fairly common postparindal readings over 200mg/dl as related to "diet". I'm a bit angry about that. I'm fit, I'm on my college's track team. I don't eat much sugar.
But according to the doctor I'm "fine".
I don't know where the doctor gets her definition of "fine" but I don't see elevated bg, weight loss, dry mouth, getting up 3 times a night to pee, and going to bed at 8:30pm (remember, I'm in college) even on weekends as fine. :(
This weekend all my friends were out partying but I was in bed, tired and nauseated.
Lastnight I had a sandwhich, a potato, a salad and water for dinner. After one hour my bg was 167 mg/dl. After 2 hours it was 190 mg/dl. I didn't think this was normal so I looked it up and found this from the ADA, " In nondiabetic people, blood glucose concentrations peak about 60 minutes after the beginning of a meal, rarely exceeding 140mg/dL, and then return to premeal concentrations within two to three hours."
So, my question is: should I ignore everything (symptoms etc.) and accept that I am "fine"? The doctor is a small town doctor and I don't know if I trust her.

[coni]

Please get a second opinion.

[Momof4gr8kids]

I got the antibody test results and they are negative. The doctor has dismissed my elevated fasting glucose and the fairly common postparindal readings over 200mg/dl as related to "diet". I'm a bit angry about that. I'm fit, I'm on my college's track team. I don't eat much sugar.
But according to the doctor I'm "fine".
I don't know where the doctor gets her definition of "fine" but I don't see elevated bg, weight loss, dry mouth, getting up 3 times a night to pee, and going to bed at 8:30pm (remember, I'm in college) even on weekends as fine. :(
This weekend all my friends were out partying but I was in bed, tired and nauseated.
Lastnight I had a sandwhich, a potato, a salad and water for dinner. After one hour my bg was 167 mg/dl. After 2 hours it was 190 mg/dl. I didn't think this was normal so I looked it up and found this from the ADA, " In nondiabetic people, blood glucose concentrations peak about 60 minutes after the beginning of a meal, rarely exceeding 140mg/dL, and then return to premeal concentrations within two to three hours."
So, my question is: should I ignore everything (symptoms etc.) and accept that I am "fine"? The doctor is a small town doctor and I don't know if I trust her.

Please get a second opinion, even if you have to go to the E.R. Ask for a C-peptide, and a glucose tolerance test. Those should get to the bottom of it. I would also like to point out that if there is another problem with your pancrease that could also cause elevate b/g's. A fast b/g over 129, or a after meal b/g over 200 is dx of diabetes, but with a negative antibody test could mean something else is wrong.
You have had symptoms for quite some time now, and I am very concerned about you, and your well being. Please have this checked out again. I would really hate for it to get to the point that you are so ill you can't get yourself there, or worse.

[MrsBadshoe]

Many Drs that aren't Endos don't always understand D. Your numbers clearly indicate there are issues. When it first comes on your pancreas is working so your numbers would fluctuate between normal and mid range high. Have you tested for ketones yet?

I definately would seek another opinon. Either go to a larger city or find an general practioner who will prescribe the above tests.

[iamslh]

My daughter was diagnosed with type 1 diabetes wand her highest recorded blood sugar to date is 177. Her a1c is 5.5%. We have a strong family history. We have not done an antibody test or a c-peptide level. Before starting insulin her fasting was typically between 100-160. Her 2 hr PP sugars were typically 150-180. As of yet, her blood sugars from my testing, I have never seen her over 200. With the addition of lantus though, her blood sugars have not gone up over 150. The doctor says we have caught her diabetes very early. Gracie gets ketotic very easily, and even with sugars in the 150's to the 170's she will start building up trace to moderate ketones, which makes her tummy hurt. Since starting the insulin, she basically has not had any ketones in her urine, except for one day that she ran 136-150 all day, and then she had trace. If you think the doctor is wrong, which I think he is, go back.

[Kaylee's Mommy]

If your dr does not dx you with Type 1 I would find a NEW dr ASAP, what you are describing are symptoms of Type 1.. your blood glucose readings are high.. your fasting and your 2 hour post meal..you are probably catching it early.. so you are still producing your own insulin, for now.. if you haven't already go the pharmacy and pick up Ketosix.. they are urine dip sticks to check for ketones.. if you are losing weight you most likely have ketones..

good luck and keep us posted

[jeep_bluetj]

Yup. Unfortunately the BG you describe are classic T1 levels. A negative antibody test does not rule out t1. A positive indicates it when accompanied with symptoms. T2 is a possibility even with a fit person, it's just unlikely.

Go now. Get a real GTT done. Your readings aren't "fine". Sorry. Get the GTT before you get worse. See an endo if you have to.

[astodder]

please, please, please get an endo to check you out! Your symptoms indicate type 1 D.....Don't wait untl you're in ketoacidosis.....:(

[ecp123]

Wow. I'm glad I'm not the only person who thinks my results are abnormal.
Here is another question. Can I just call an endocrinologist or do I need a referral? I wish I could just phone a doctor who knows their stuff, explain my concerns and then be told if I need to make a trip (a long ordeal for a college student in a rural town who doesn't have a car) to see them.

[Kaylee's Mommy]

whether youneed a referral or not depends on your insurance company.. Iwould definitely at least call an endo and ask a nurse or someone to call you back.. or leave a message telling them what is going on.. and that your dr is telling you you are fine.. your readings ARE NOT FINE.. you aren't fine.. you need to see a compitent dr asap.. if you can't get to one, do you have an urgent care center or even an ER that is near you.. bring your log book along with you when you go..

[ecp123]

Ok, I think I'm going to try calling an endocrinologist's office sometime soon. I'm so intimidated.
Any suggestions? I'm a really shy person and I know I wouldn't call normally but I think there is something very wrong.

[astodder]

Where do you live??? What kind of insurance do you have???

[ecp123]

I go to college in Iowa. I have Aetna insurance.

[astodder]

try going to this aetna insurance site...http://www.aetna.com/docfind/DocFind?this_page=%2Fdocfind%2Fdocfind_specialty_s earch.jsp&continue.y=1&type_of_search=ADDITIONAL&groups=50&fs=Y&city=&zipcode=&miles=&sort=&geo=county&county=&search_cat=phys_bhp&geo3=county&langpref=en&search_type=Find+A+Specialist&site_id=docfind&state=IA&continue.x=76&continue.y=13 type in your county and state and search for a specialist in your area....The website should also tell you if you need a referal or if you can refer yourself....let me know what happens...Anne

[astodder]

Or start here http://www.aetna.com/index.htm good luck....

[TaeandTiff]

Why don't you go to the ER and call you parents? (or have you already done that?) You are insured under them right? Also I would def, get your hands on some keto stix, because you sound like you have ketones. Do you have a family doctor where you are from? if you are far from home can your parents send you tickets to fly home? YOu are on break as of Friday right?

[Momof4gr8kids]

Ok, I think I'm going to try calling an endocrinologist's office sometime soon. I'm so intimidated.
Any suggestions? I'm a really shy person and I know I wouldn't call normally but I think there is something very wrong.

What I would do is go to the E.R., and start there. Have them give you the referal to the endo. The reason for this is that they see many cases a day, and have alot of different tests at their disposal. Tell them you are a non diabetic who is having high b/g, and describe symptoms. I bet they can help to get the ball rolling. If it isn't diabetes, I would suggest seeing an internist. Ask for the tests that we have mentioned, the C-peptide, and the glucose tollerance test.
Good luck, I hope you can get someone to help you soon. Jamie

[ecp123]

I called an endocrinology clinic and left a message with a diabetes nurse. They will call me back tomorrow.

[coni]

Good for you! Call them back if they don't call you. Go to the ER if you need to. Pursue finding what's going on with your health until someone helps you. Let us know what happens, please. We are concerned about you.

[astodder]

Yes, please let us know what's going on....I hope everything is okay!!!

[ecp123]

They actually called back today but I was in class. The nurse left a message and said I should schedule an appt. with them and to keep monitoring bg in the meantime.

[astodder]

call and make an appointment FIRST thing in the morning!!! (that's the mom in me coming out!!! ha ha ha)

[sheila]

Check back in and let us know how you are doing.

[Momof4gr8kids]

So glad they called back!!! Make the appointment ASAP, and please let us know how it goes, and if you need anything we are all here.
Jamie

[coni]

Any word on an appointment? I'm hoping you're safely off on Thanksgiving break. Let us know what's up.