38 yr old newly diabetic. please

[MrsHaloFIRE]

...please offer encouragement as I need it

Im tall, thin, active, and eat less than 50 g carbs a day. I had gestational diabetes and had to take a 75g glucose test after baby to make sure it went away. Endo neighbor had me be sure and eat 150g carbs 3 days prior and I tested this morning. My 2 hr number was 278. Welcome to diabetes land. I have a telehealth with PCM in the morning, already talked to neighbor endo. Of interest, my fasting is 83 and my a1c is 4.8. Like I said i eat cleanly and exercise and havent been screwing around bc I knew this was a risk after the gestational diabetes diagnosis. Im here to ask, has anyone here been dagnosed this young and can offer me encouragement? I will have to live with this for many years assuming something doesnt carry me off.

THank you. Its been a hard day, to say the least. I have a tiny baby and now I have this cross to bear.

 

[skyking1]

I have no experience but offer our well wishes to you. I know that several people will be along who know more about how you feel.

 

[Teacher Terry]

My cousin was diagnosed with type one diabetes as a baby. His parents were told he would never reach adulthood. He is now 71. They took excellent care of him and followed a diabetic diet and still does. You sound very healthy and I am sure you will manage it well. I understand it’s concerning to develop a chronic disease so young. Wishing you all the best.

 

[audreyh1]

...please offer encouragement as I need it

Im tall, thin, active, and eat less than 50 g carbs a day. I had gestational diabetes and had to take a 75g glucose test after baby to make sure it went away. Endo neighbor had me be sure and eat 150g carbs 3 days prior and I tested this morning. My 2 hr number was 278. Welcome to diabetes land. I have a telehealth with PCM in the morning, already talked to neighbor endo. Of interest, my fasting is 83 and my a1c is 4.8. Like I said i eat cleanly and exercise and havent been screwing around bc I knew this was a risk after the gestational diabetes diagnosis. Im here to ask, has anyone here been dagnosed this young and can offer me encouragement? I will have to live with this for many years assuming something doesnt carry me off.

THank you. Its been a hard day, to say the least. I have a tiny baby and now I have this cross to bear.

How can you be diabetic if your A1C is 4.8? And your fasting glucose is 83?

I think you should get a second opinion.

This does not add up. And is your Endo neighbor your doctor? Why are you eating high carbs before test? Aren’t they giving you the dose you need for the test?

Also, if you are having high blood sugar reactions to carbs then not eating high carbs is a good solution to help keep your blood sugar in check.

 

[street]

I knew two young boys I had in T-ball that I coached that had it from birth. Both are late 30's and live a normal active life. I wish you all the best and I hope someday there is more help medically for diabetics.

 

[Rickt]

Mrs. Halofire:

with A1C at 4.8 and fasting BSL reading at 83, I don't see how they are saying you are diabetic. I know a lot of people in their 40's, 50's, 60's and 70's who have been successful in becoming diabetes medicine free, many have reveresed long term type-2 diabetes condition by changing their lifestyle by following Plant based Whole Foods diet/Intermittent fasting /exercise including walking 10K steps a day.

Here's a website that may help:
https://www.forksoverknives.com/

Best wishes to you,
Rick

 

[ivinsfan]

OK folks I'm not a doctor but Medline say the 2 hour result after a 75g glucose test should be under 153...so please don't stress out Mrs H by questioning her DR and her diagnosis.



MRS HF it good to be proactive about this and it happens more then you think. My DD's best friend had the exact same situation. She has her blood sugar under control and gave birth to another baby. Don't give up hope and just do your best.

 

[EastWest Gal]

I’m in agreement here. It is not at all clear that you have diabetes. You may have insulin resistance, a risk factor for diabetes. You are probably at risk for diabetes if you eat a high carbohydrate diet, which you are not doing, except at the odd advice of a physician neighbor. Anyway, many people are treating type 2 diabetes with a low carb diet. The main thing is to avoid hyperglycemia.

You should repeat the glucose tolerance test without the days of carb loading beforehand. Be sure not to repeat the test too soon, as there may be residual effects of the carb load you just did. A single abnormal test needs to be repeated and verified. Errors happen. There is absolutely no requirement that you should eat a high carbohydrate diet for 3 days prior to the oral GTT, especially since a high carbohydrate diet in someone with insulin resistance is likely to cause hyperglycemia, and a high carbohydrate diet isn’t your normal diet.

When you repeat the test, ask that a fasting insulin level be done as well. An elevated fasting insulin means that you have insulin resistance. You may not be able to fix that, but you may not need to.

It seems like your maintaining a healthy weight and low carbohydrate intake is keeping the glucose in check anyway. They aren’t going to put you on an oral med like metformin if your fasting glucose and hemoglobin A1c are normal , since the first line of treatment is diet and exercise-low carb, or at least low glycemic index foods.

It sure would be nice if you could wear a continuous glucose monitor for a couple of weeks to see what your glucose is in real time. But they are expensive and insurance won’t cover it without a diabetes diagnosis.

And ignore the advice of us strangers on the internet recommending drastic diet changes. You do you.

 

[Bamaman]

You really need to follow up with your doctor and understand exactly what your situation. Follow their instructions exactly.

I'm type II diabetic on an insulin pump and using a continuous glucose monitor. I am stable and watch myself on and off all day long.

The numbers don't make any sense to me. I prefer to stay 110-120 and stable. If I get under 100, I get nervous. Most normal meals are about 50 carbs, so 150 carbs per day would be normal and should produce normal A1C's.

Diabetics that have very high glucose levels have a danger of burning out their kidneys over a long time period. That' terrible as dialysis is hell on earth and usually only lasts 4 years.

But diabetics that have very low glucose levels--like a 70--are even in more danger. When they're that low, chances are their glucose can even drop like a rock. Get down to 30ish, and you won't know your name. Organs start shutting down and potassium skyrockets--and you die.

Know your numbers and what actions to take to moderate your situation.

 

[ivinsfan]

At this time there is no downside to Mrs HF being monitored, its a good thing. Way back in the day sometimes they would tell people "you are prediabetic" but I think they did away with that term and try to more proactive.

 

[Time2]

You need to get yourself a Glucose monitoring device, so you can see how different foods affect your glucose level. Surely listen to your Dr. but don't be quick to accept what he/she says. The have medicine to treat disease, but a lot of disease is highly dependent on what we put in our mouth. There are dozens of Youtube videos, by doctors describing how to control your glucose with diet. I suggest you spend some hours getting a look at those and see any of it clicks with you. I'm not diabetic, but have had slightly elevated Glucose levels, I have changed my diet (eliminated carbs) and this morning my Glucose is 84 and my Ketones are 4.8. This means I'm running on Ketones rather than Glucose, most peoples Ketones would run about 0.5.

 

[eytonxav]

I am not sure about test you took with respect to the advice you were given to eat 150g carbs/day for 3 days prior to the test. I would ask questions about that aspect. That said, I would love to have your A1C and fasting glucose #s as I am a type 2 diabetic, and wouldn't be in that class with such #s. I would feel encouraged if I were you.

 

[jldavid47]

How can you be diabetic if your A1C is 4.8? And your fasting glucose is 83?

I think you should get a second opinion.

This does not add up. And is your Endo neighbor your doctor? Why are you eating high carbs before test? Aren’t they giving you the dose you need for the test?

Also, if you are having high blood sugar reactions to carbs then not eating high carbs is a good solution to help keep your blood sugar in check.

+1

 

[braumeister]

Endo neighbor had me be sure and eat 150g carbs 3 days prior

I agree with others that this makes no sense.

 

[euro]

I am not sure about test you took with respect to the advice you were given to eat 150g carbs/day for 3 days prior to the test. I would ask questions about that aspect. That said, I would love to have your A1C and fasting glucose #s as I am a type 2 diabetic, and wouldn't be in that class with such #s. I would feel encouraged if I were you.

That advice was in fact excellent. If OP was on 50g carbs for an extended period, she was in ketosis. Taking the full sugar shot of an oral glucose tolerance test can lead to unreliable results or can even be dangerous because the system isn’t used to processing such a large bolus of carbs. Recalibrating with a higher dose of sugar for a few days before the test is exactly right.

 

[euro]

You need to get yourself a Glucose monitoring device, so you can see how different foods affect your glucose level. Surely listen to your Dr. but don't be quick to accept what he/she says. The have medicine to treat disease, but a lot of disease is highly dependent on what we put in our mouth. There are dozens of Youtube videos, by doctors describing how to control your glucose with diet. I suggest you spend some hours getting a look at those and see any of it clicks with you. I'm not diabetic, but have had slightly elevated Glucose levels, I have changed my diet (eliminated carbs) and this morning my Glucose is 84 and my Ketones are 4.8. This means I'm running on Ketones rather than Glucose, most peoples Ketones would run about 0.5.

I agree, time for continuous glucose monitoring. The fasting glucose and ultra low A1C are indeed very puzzling for someone who has 250 2hour postprandial glucose. Seems to me that OP may actually still have a highly functioning insulin response. For someone with insulin resistance, those kinds of peaks would lead to much higher A1C.
Eating a low carb diet is definitely the way to go for OP, but more information should be collected (with CGM - super easy, super convenient and super helpful for instant feedback on any food you eat).

 

[Time2]

That advice was in fact excellent. If OP was on 50g carbs for an extended period, she was in ketosis. Taking the full sugar shot of an oral glucose tolerance test can lead to unreliable results or can even be dangerous because the system isn’t used to processing such a large bonus of carbs. Recalibrating with a higher dose of sugar for a few days before the test is exactly right.

I was on a strict keto for three months, 20 grams of carbs, I weighed every thing and logged in a nutrient calculator. Even then, I was lucky to get my ketones over 2. Now, I've been carnivore for 27 days and this morning my ketones are 4.8.


Ketosis >> https://www.healthline.com/nutrition/what-is-ketosis#definition

 

[euro]

I was on a strict keto for the months, 20 grams of carbs, I weighed every thing and logged in a nutrient calculator. Even then, I was lucky to get my ketones over 2. Now, I've been carnivore for 27 days and this morning my ketones are 4.8.


Ketosis >> https://www.healthline.com/nutrition/what-is-ketosis#definition

True, different people will go into ketosis easier than others. But even if OP was not in full ketosis, it doesn't change the fact that her metabolic state is/was not used to handling the type of sugar bolus connected with the Oral Glucose Tolerance Test. So, re-training the glucose response system with a few days of moderate carb load is very sound advice.

 

[MrsHaloFIRE]

Im here with an update. My PCM has put me on 500mg metformin and punted me to endocrinology to their opinion. I had telehealth with ehr this morning

The background data is I was diagnostic with gesttational diabetes by 2 glucose tolerance tests in pregnancy. I was diet controlled. Baby was born with no issues and no blood sugar issues for her. I have continued to eat very low carb and exercise everyday (well the vast majority of days) since ehr birth 10 or so mos ago. The 1c and fasting were done at my request as we tried to get my TSH back in line after pregnancy. FOllowing gesttational diabetes, the diagnositic criteria for diabetes is via a 75g 2 hour oral glucose test. WHich I finally did yesterday. The carb loading is done prior to the glucose test bc if not done, you can get false positives by introducing that much glucose into your body that hasnt seen that much glucose in a long time. This is kind of a 50/50 thing based on my reading, about half of OBGYNs have people be sure they eat 150g 2 days prior. and about half dont. My neighbor was the head of endocrinology at the hospital where I recieve all my care. HE has been retired about 5 years. He gave me a 2nd opinion on my synthroid dose when my PCM had me take too much and sent me into extreme hyPERthyroidism complete with pounding hard, drastic weight loss and almost fainting one fun morning with a tiny baby. So I listened to his dosing and got my TSH back where is needs to be. adn I flat out told my PCM and she was like I dont care as long as your TSH is fine.

My a1c is low bc I eat so low carb. I wore a continuous glucse monitor for 14 days at 1 point bc my dad had one and i slapped it on. It told me i have extreme lows at night. SO those are further lowering my a1c. the 75g oral test is considered the gold standard diagnostic test. a1c is easier to administer and people are more likely to do it, but it aint the be all end all. It missed alot of people. THe reason I went through with the oral test is I am 38 years old, and if I had a carbohydrate problem Im going to have to live with it hopefully a long time. So I would rather know than not know. Ya know? I was running from this bear anyway based on gesttational diabetes being a major risk factor for type 2. and my Dad developed type 2. You may not hear people talk about this test bc some practitioners done have their patients do it following delivery, and some folks just plain out arent going to do a 12 hour fasting, 2 hour in office glusocse test that really takes mroe like 3 hours bc they have to result the fasting before you can even start. Not a popular way to spend a morning. If the metformin can help me and has minimal downsides, im all for it.

 

[pacergal]

OK, better background info given.
Unfortunately, many gestational diabetic women go onto full blown diabetes. Sorry that happened to you, but it is not a death sentence!
Many folks live well with diabetes and have a good long life.
It depends on how well you take to heart the diet and glucose monitoring.
You sound well educated, but a visit with a Registered Dietician might help, especially since you have a young baby and probably spend so much time caring for her. The RD may give you some quick guidelines, daily menus, etc. that you can follow until Carb Counting becomes innate.

We have diabetes in our family. My nephew developed Type 1 at age 18. He is an expert at carb counting, eats practically anything he wants, exercises well and just completed a 26 mile marathon this year.
There is so much new/updated diabetes continuous monitoring and even continuous insulin pumps that make daily life much easier than poking your finger several times a day along with insulin shots.

I take metformin as a "pre"diabetic. I split my dose as the full dose at one time gave me diarrhea, doesn't; matter as long as I get the full dose every 24 hours.

Take a deep breath. You will handle this just fine.
Many endocrine docs have full diabetic clinics, with RDs and RNs on staff for each visit to check in and help with any questions or equipment problems.

Best Wishes for good health!

 

[Time2]

I take metformin as a "pre"diabetic. I split my dose as the full dose at one time gave me diarrhea, doesn't; matter as long as I get the full dose every 24 hours.

I did take metformin but not for diabetes, and found it caused diarrhea. I gave it up. I was watching a lot of longevity videos and metformin was one of the drugs mentioned often for longevity, when my doc mentioned M-tor one visit, I ask, what do you think about metfomin, he said he thinks it's great so he wrote me a prescription.
I have looked a a couple studies and they say the diarrhea form Metformin use is temporary and rarely continues. ¯\_(ツ)_/¯

 

[euro]

Im here with an update. My PCM has put me on 500mg metformin and punted me to endocrinology to their opinion. I had telehealth with ehr this morning

The background data is I was diagnostic with gesttational diabetes by 2 glucose tolerance tests in pregnancy. I was diet controlled. Baby was born with no issues and no blood sugar issues for her. I have continued to eat very low carb and exercise everyday (well the vast majority of days) since ehr birth 10 or so mos ago. The 1c and fasting were done at my request as we tried to get my TSH back in line after pregnancy. FOllowing gesttational diabetes, the diagnositic criteria for diabetes is via a 75g 2 hour oral glucose test. WHich I finally did yesterday. The carb loading is done prior to the glucose test bc if not done, you can get false positives by introducing that much glucose into your body that hasnt seen that much glucose in a long time. This is kind of a 50/50 thing based on my reading, about half of OBGYNs have people be sure they eat 150g 2 days prior. and about half dont. My neighbor was the head of endocrinology at the hospital where I recieve all my care. HE has been retired about 5 years. He gave me a 2nd opinion on my synthroid dose when my PCM had me take too much and sent me into extreme hyPERthyroidism complete with pounding hard, drastic weight loss and almost fainting one fun morning with a tiny baby. So I listened to his dosing and got my TSH back where is needs to be. adn I flat out told my PCM and she was like I dont care as long as your TSH is fine.

My a1c is low bc I eat so low carb. I wore a continuous glucse monitor for 14 days at 1 point bc my dad had one and i slapped it on. It told me i have extreme lows at night. SO those are further lowering my a1c. the 75g oral test is considered the gold standard diagnostic test. a1c is easier to administer and people are more likely to do it, but it aint the be all end all. It missed alot of people. THe reason I went through with the oral test is I am 38 years old, and if I had a carbohydrate problem Im going to have to live with it hopefully a long time. So I would rather know than not know. Ya know? I was running from this bear anyway based on gesttational diabetes being a major risk factor for type 2. and my Dad developed type 2. You may not hear people talk about this test bc some practitioners done have their patients do it following delivery, and some folks just plain out arent going to do a 12 hour fasting, 2 hour in office glusocse test that really takes mroe like 3 hours bc they have to result the fasting before you can even start. Not a popular way to spend a morning. If the metformin can help me and has minimal downsides, im all for it.

I would hope your endo agrees with this (but may not...): Definitely get your thyroid numbers (TSH, T3, T4, reverse T3 - not just TSH! Mybe even measure several of the thyroid antibodies) under control and stable for some time before you start tinkering with diabetes medications. If the thyroid is out of kilter, other metabolic parameters like glucose or lipids can be meaningless.
That said, metformin is pretty harmless and, as the previous poster pointed out, may have longevity advantages beyond insulin/glucose.

 

[RetiredHappy]

You are likely to be pre-diabetic, but certainly not diabetic. If your blood sugar is low when you are sleeping, it means that your pancreas is doing its job to counter the glucose produced by the liver. If you are diabetic, your fasting glucose in the morning would be above 100, i.e. no matter how few carbs you eat the day before.

If I eat 150g of carb for 2 days, I would have fasting glucose above 100 in the morning. I am pre-diabetic but none of my A1C and fasting glucose shows that because I am strict with my carb intake, under 100g for golf days and under 80g for non-golf days. I realized I was prediabetic 15 years ago, at the age of 45. While it is a life sentence, I enjoy my food and live my life without worrying about something that I have some control over.

You need a good endocrinologist to decipher your situation. Personally, I don't believe you need Metformin at this point. My husband is diabetic for about 23 years now, we control his diabetes and he eats fewer than 30 g carb a day, on Metformin and Trulicity shot once a week. He didn't have an endocrinologist until 2 months ago. They ran another blood test on him, called GAD65. No doctor had ever run that test before. It turned out that he is LADA, also called 1.5, i.e. not type 1 and not type 2, sort of an in-betweeen. His autoimmune is attacking his pancreas. It was an eye opener for us. It explains why he cannot have carbs. His lunch is 0 carb. Breakfast about 10g and dinner about 10g of carbs. Ultimately, his autoimmune will completely destroy his pancreas but for now, he has great A1C and fasting glucose number in the morning.

 

[Sarah S]

I was prescribed metformin off label as it is currently in a small trial to treat my genetic neurological disease. It made me very sick with vomiting and diarrhea impossible to work through I then switched to extended release and can tolerate that well. OP I hope it isn’t necessary but if metformin is difficult ask to try Metformin ER