When I was first diagnosed, I had a fasting of 457 and my A1c was 15, so I was not only high, but had been for a long time. I was functioning just fine- no 'diabetic' symptoms. I was diagnosed when I asked for a diflucan prescription for a yeast infection so I wouldn't have to travel with messy creams. Having spent a year in a diabetes research lab, I knew how bad my sugar level was and asked to be put on insulin with the intention of dropping that number as fast as possible. My doctor told me that dropping from the 400's to 100 would be about the same thing as going through heroin withdrawal cold turkey and that she didn't recommend it. Put me on 500 mg of metformin + 15 mg of Actos for a month, sent me to a dietitian, and CDE.
My numbers dropped about 50 points average the first month- and I felt ok- I did not do well on the Actos and started to get bloaty. The high carb diet from the dietitian left me craving carbs every minute of the day and night plus I was gaining weight. My bg level seemed to be stalled between 350- 380.
I got frustrated. I found the Bernstein website and a friend on a different forum who controlled his diabetes by Bernstein and serious exercise. I joined this forum and asked for advice about Bernstein and being a vegetarian. I got great advice from Fergusc and several others that convinced me to give low carbing and exercise a try. It took 2 days for my sugar to drop from 380 to 220. That's when I hit the ER - thinking I was dying.
Basically, my sugar level had been cut in half and my body didn't know how to deal with that even though those numbers were still deadly. The nurse in the ER taught me that whenever I experienced those 'low' symptoms which for me are shaking, headache, tingling around the mouth, hostility, and confusion- I should test my blood sugar level, then take 15 grams of carb (I use sweet tarts), wait 15 minutes and test again and note the lowest sugar level where I felt comfortable. She told me to try and stay at that low level as much as possible and then try and bring it down with gentle exercise (treadmilling) by 15-20 points and see how I felt then. If I felt good, I'd try and keep myself at the lower level for 5-6 days, then try and go lower again. I did this over and over until I got to the point where staying at a non-diabetic level felt good. This allowed me to continue working at my job (which I love), keeping my travel schedule with no interruption- I took 1 sick day that year- the day after my diagnosis. It took me about 4 months to drop to my current level consistently. By the 6 month mark, my A1c was 5.0 and it has stayed between 5.0 and 5.2 for the last year.
Over the next 3 months, my doctor took me off of the actos which I refused to take, upped my metformin to 2000 mg and put me on 2.5 mg of glipizide which made me roller coaster like crazy- thank God I had that technique to fall back on. I also moved from the Bernstein plan to the Insulin-Resistance Plan which gave me enough carbs not to go crazy. Stopping glipizide and moving to Januvia was the best thing that ever happened to me drug-wise. Januvia keeps me as steady as a rock- no matter how many time zones I am crossing, how many 18 hour days I have to work- my sugar is steady. I am in the 80-90 range 95% of the time. I drop into the 70's after exercise (sometimes into the 60's), sometimes rise as high as 125 at the 90 minute mark after eating too many carbs. I still carry my sweet tarts- but I haven't needed them in a while.