Impaired Glucose Tolerance Diagnosis

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cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/19/2005 3:27 PM (GMT -7)   
I am a new member a male age 64 who was first tested for Glucose Tolerance two years ago. At the time my HBA1C was 6, Fasting Glucose was 115. Now it they are 5.4 and 100 respectively. My weight is down from 205 to 195 lbs.
 
Current morning BS=101 on average, sometimes 126 but mostly 96-107. I had been using Accu-Chek Advantage. My Endo uses the faster BD Logic Monitor, which they suggested I use for my daily use claiming the Accu-Chek Advantage was outdated. I did so and my readings went up by anywhere from 10 to 25 points vs the Accu-Chek Advantage. I think I trust the slower Accu-Chek as more accurate and its readings correspond more closely with the periodic lab test results.  
 
Even with the progress I have made the Endo wants me on Actos to control the morning BS readings over 100. I am resisting medication in favor of diet( perhaps initiating an evening snack), exercise and further weight loss.
 
The only symptoms that I think may be associated with diabetes would possibly be occasional mild sensitivity/burning/numbness on the top of my thighs, moreso on the right. Also some periodic right heel edge numbness. I have no bottom foot numbness. The orthopedic doc says these sypmtoms are due to back problems. On the other hand, one nerve study tech did comment on the thigh numbness about 3 years ago that I may want to get my blood sugar checked. 
 
I am of the mind that through changes in diet over the past two years, my numbers from lab tests and my Accu-Chek, I have been successful in working to avoid being actually diagnosed diabetic. I think the Endo doc may never quite pushing for ever lower numbers and eventually getting me on meds. What say you in the forum?
 
I also would appreciate hearing from you on this business of the blood sugar monitors. Do they go out of date? Is one better than another and in particular does anyone have evidence that the BD reads higher?
 
I have rambled, I know and should probably taken three separate posts for all of this. I would appreciate your opinions and suggestions.
 
cago

Pin Cushion
Regular Member


Date Joined Feb 2003
Total Posts : 442
   Posted 11/19/2005 8:39 PM (GMT -7)   
I hve been using the accu-chek advantage for over 5 years now and a few months ago I tested it against the fancy pro model in the hospital and my reading was excactly the same as theirs, so I am staying with it.

As far as yor bs reading they look great to me, I wouldn't change a thing if it was me.
Sigmoid Colostomy / Crohns / Type 1 Diabetic / Ostioarthritus / Fibromyalgia / Asthma / High Blood Pressure / High Colesterol / Migraines. Ain't life a joy?



* I think it may be time for a colorful metaphor*


wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 11/20/2005 8:09 AM (GMT -7)   
A1c of 6 seems borderline, right? I, like you, don't have much confidence in blood glucose monitor numbers. The manuals seem to tell us they are only accuate +_15 % so 85 ng/dl or 100 or 115 could all be around 100 mg/dl. Actually I don't even have this much confidence in these "portable", "battery* operated, variable temperature# gadgets with strips that seem to vary another 10-20 points per batch, and the standard solutions are seldom used or even understood by most folks. In the last three years I have seen many sudden jumps of 10- 20 mg/dl in my blood sugar numbers(up or down) just changing from one set of strips to another. And my standard(s) also shows the same change. Sure I call the factory(s) but they always do the "you messed up" dance (very politely!) ....always....probably because people usually do mess up..we all do.
I have adopted my personal standard….if unmedicated !! I eat very lightly all day (moderated normal activity) and don’t eat after 6pm, go to bed early and sleep 8+ hours. Check my blood sugar when I first wake (forget reactive blood sugar!) if its around 100+_20 mg/dl …then I check 2-3 more times in 1/2 hour. This is my fasting baseline. If it is over 110 I have found that either my standard(s) solution also measures high 10-30 points ….or ….I am in the beginning or middle of some sort of medical issue…flu, cold, light food poisoning, ….I find when I am sick my BG readings are always higher.(this is what I think reactive blood sugars are..)
Then A1c tell how close we were, right? (“trust me not” …do you trust the labs?)

(I have been normo glycemic ,A1c 5.3-6, for two years after starting out at A1c of 11.6 three years ago…but only lost 60-80 lbs and 100 more to loose…yes, I’m a big old guy..)

*(condition of which is continuously degrading!!...voltage gets lower every time you use it ..., right? That is how batteries work…some last a long time admittedly in glucometers,,,but still they must be getting weaker every time..).

#home- and/or office- room, car interior, or where ever... all different temperatures..
(s) I use several standard solutions and several glucometers and always keep 6-8 strips from the previous lot to see if there is a dramatic difference in lots using standard solution(s). eyes eyes

Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 11/21/2005 3:19 PM (GMT -7)   
Pin cushion gets my vote!  I'd go with those numbers even with the variance (and you have to trust your meter.  Even if it is off, you are then CONSISTENTLY off and thats ok also)
 
I've grown up with the 70-120 fasting as the normal range, so regardless, you are still in what I was taught was "normal".  To start medicating your endocrine system when your A1C is sub 6 just doesn't seem right to me.  And when things don't smell right the solution is a second opinion.  Don't be scared to see a different Endo guy and have him check your data and discuss it with you.
 
Hope this helps
 
scool  Warren

cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/21/2005 5:56 PM (GMT -7)   
I want to thank each of you for your responses. I have already asked my PCP for the name of another Endo man. My current Endo is a woman. Not sure that makes a difference, but thought I would mention it for the record.
 
Although skeptical, I still view this as of a wake-up call of some degree and am seeking outside comment here, because I do not want to be a victim of self denial. 
 
I did not mention it in my first post, but my first glucose tolerance test went like this.
                                                               Range
April '03 Fasting 109       April '04  106           70-105
            0.5Hr   192                   174          110-170
            1.0      183                   139          120-170
            2.0      141                   113            70-120
            3.0       69                     61            70-110
 
There was no retesting of GT requested by the Endo for 2005.
 
Thank you all again and if you may have further comments, I would appreciate hearing from you. 
 
cago

Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6056
   Posted 11/22/2005 12:33 PM (GMT -7)   
I would ask your current endo what she based her decision for actos on... I can't find it in your readings... In my humble opinion, and I'm not a doctor I believe that your doc is being overly conservative. Warren is dead on. Get another opinion for sure.
~ Jeannie

"As one goes through life one learns if you don't paddle your own canoe you don't move."
-Katherine Hepburn


"Madness takes its toll.
Please have exact change."


cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/22/2005 2:14 PM (GMT -7)   
Jeannie,
 
The endo wants me to take 15mg of Actos once per day to moderate the morning blood sugars which although averaging 102 or so, do reach 115 and sometimes 126 on occassion on my Accu-Chek. 
 
I have another question. Occassionally my mouth feels dry and when this happens water does not seem to help. I sometimes wonder if this is a symptom of diabetes for me. It will happen for instance when I drink decaf coffee. Any ideas?

Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 11/22/2005 2:40 PM (GMT -7)   
Hi Cago,
 
I have been through the acute symptoms of Diabetes and for me my mouth doesn't get dry but omg, I have to pee every 20 mins and then the thirst drives you nuts and you drink gallons of water.  Really!!  and unlike what you described, the water actually satisfies your thirst but then again you eliminate it literally a half an hour later and go through the cycle again. 
 
I think perhaps what you are describing is simply a reaction to the decaf coffee.  Try a decaf where they use the spring water process to decafinate it!
 
scool  Warren

wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 11/22/2005 9:44 PM (GMT -7)   
eyes If your endo is basing medications on morning BGs of 100-120 , I assume you talking about glucometer readings, or lab results? If you use a Glucometer to determine this......well ....how do you know that the 115 or 120 isn't 95 or 100 (120+_15-20%=96-102...stardard error..).....maybe serum corrected...? Still close to normal , right??


Are you using a standard solution to see if strips, battery, glucometer and operator are close (calibrated)?


This would be a handy, or quite valuable!, situation to have a standard solution that reads 80-120 mg/dl (though I have been trying to find a soution of this value for a long time with no luck). confused

cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/23/2005 11:58 AM (GMT -7)   
Hi wa5ekh
 
I did check with a control solution that came with the Accu-Chek, and my meter scores in the middle of the the test range. However, I notice that the solution is out of date and will purchase a new bottle and recheck.
Also regarding the control solution, the instructions say to discard 3 month after opening. Is this gospel or does it last longer?
 
Thank you all for your resoponses.
 
cago 

wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 11/23/2005 4:33 PM (GMT -7)   
probably replace it. Keep the old one if you want to see if there is a dfference, right? I am no authority...I just have my own rituals. ALways looking for better or just different ideas.

cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/24/2005 1:36 PM (GMT -7)   
To all:
 
In prior posts I failed to mention that along with my endo's claim that I am pre-diabetic, my free testosterone has dropped in two years from 1.23 to is down to about 0.33.
 
I bring this up now because today I saw on the web that low T has been linked to diabetes.
 
The endo and my PCP suggest that 2.5 gms of Androgel per day may be an option to see if the Free T level will come up.
 
Any comments out there?
 
cago

wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 11/24/2005 8:32 PM (GMT -7)   
interesting! Androgel? What is that?

cago
New Member


Date Joined Nov 2005
Total Posts : 11
   Posted 11/25/2005 10:58 AM (GMT -7)   
Hi we5ekh,
 
Androgel is the brand name of a testosterone replacement gel product availabile by prescription applied daily by rubbing it into one's shoulders.
 
The other day, since coming on this forum, I read on Web MD that, in some men, diabetes and Low T occur together. Although it suggests that one's pre-diabetic/ diabetic condition causes Low T, they admit all the information is not in yet.    
 
This new information is now important to me because the primary reason I went to an endo two years ago, was to check out the cause of my Low T. Her observation that I was pre-diabetic came up as a secondary issue, but to my recollection she has never suggested a link of the two problems.
 
Rather, for the Low T, an MRI showed a very small pituitary edenoma(tumor) which commonly causes the pituitary to over produce prolactin, a hormone promoting lactation in women following child birth. It has the effect of lowering the testerosterone. Men also have this hormone, but when out of wack it causes the lowering testosterone.
 
Two years ago Dostinex was prescribed to control the prolactin over production and during that period my Total T and Free T became normal again for a brief time. Then while the Total T continued to get better, the Free T number( more important )began to drop off to the current 0.33 level. The normal  range is 1.0-2.5. 
 
So, now I am thinking that if the Androgel helps my Free T then maybe the pre-diabetic condition would be helped?
 
If this is confusing to you, it is to me too. When I told my father who is 88 about my intention to start the testosterone therapy he said you look good to me, how do you feel?  When I responded, "fine", he said, "then forget the testosterone stuff". Something to ponder.
 
However, my wife has been taking estrogen for years following a hysterecotomy to balance her hormones. I think Androgel is like doing the same thing.
 
cago
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