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Need Help with Fasting Levels

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rootsmith
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Joined : Jan 2004
Posts : 629
Posted 4/12/2019 5:27 PM (GMT -8)
Hello, I used to be active on these forums but not so much in the last few years. I became aware that I had a blood sugar problem around 2005. My fasting level was always normal . It was post meals that was the problem. The Joslin Clinic diagnosed me with diabetes based on an oral GTT. I took starlix for awhile but eventually just monitored the situation by an A1C every 3 months. I've come close to needing medication a few times. Well, I started taking Crestor late 2018 and my A1C in Jan 2019 was 7.8, and a fasting level shortly after that was 169. I freaked out and was sure it was due to Crestor. Switched back to lipitor and the same thing happened. After a few weeks went off that and my fasting level is still elevated, anywhere between 130-160. What could be causing this? I am convinced that while the statin might have aggravated the situation it was not the only cause, since I still have the elevated fasting level every morning and have been off a statin for weeks. My most recent A1C was 6.7 and my primary NP said everything is ok. I questioned the elevated fasting levels and she said not to worry, it all evens out. Really? I've been reading about "dawn phenomenon" and "Smogyi effect" so I am testing my blood sugar at 3 am Last night it was 137, definitely not low. I'm not sure what to do.
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Lanie G
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Joined : Nov 2006
Posts : 6974
Posted 4/12/2019 6:10 PM (GMT -8)
Good evening, rootsmith, and welcome to the forum. I know your frustration. Regardless of other factors, I will tell you that the GTT is about the only test that will truly diagnose diabetes. Back ten years ago, I could have perfectly normal fasting and A1c tests but the GTT showed I could not metabolize carbohydrates normally at all.

Can you write what other medications you've been taking? And, what you've been eating for all your meals? Knowing those two elements will help to figure out what's going on. I did look up Crestor and I don't think that's doing it.

Glad you posted!
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rootsmith
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Joined : Jan 2004
Posts : 629
Posted 4/13/2019 12:12 AM (GMT -8)
Hi, thank you for your response. I'm confused about Crestor though. Several people have told me that it couldnt be responsible yet when I researched it Crestor is known for raising blood sugar levels. In fact, I clipped an article back when this all started about 2005 that said that a side effect of statins could be Type 2 diabetes. I've never had a problem with lipitor in the past. Now that many weeks have past I now realize that either drug is most likely not the cause of my current problem with my blood sugar, although it could be adding to it. I am also on Remicade for a rheumatology disease but this elevated fasting level started before I started it. No other changes in meds- levothyroxine, losartan, amlodipine and setraline. I know I don't eat like I should as a diabetic. Not much junk, but too many carbs. I thought I was doing ok, monitoring with A1C every 3 months. This elevated fasting level is a major change which makes me question what is going on and I now have to change my ways. The last normal fasting level I had, as far as I know, was Jan 2018. I had no reason to suspect anything was wrong but now I understand that was probably not the right conclusion to make. I have been told that diabetes is a progressive disorder. Guess I'm progressing. Blood sugar before lunch yesterday was 89. 3 am this morning, 178. (6 hrs after eating). I'm looking for a local support group. Back in 2005 I was actually laughed at by many health care providers about worrying about a GTT when I had a normal fasting level.
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Lanie G
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Posted 4/13/2019 5:49 AM (GMT -8)
I think there might be rare effects on blood sugar but I'm not sure if that's the case here. I am also on generic Synthroid and Lipitor. (For women, the latest recommendation for statins is to take only 3x a week, by the way.)

When we're told that diabetes is progressive it really means that the pancreas decreases the output of insulin and/or we are becoming more insulin resistant. One way to overwork the pancreas is to eat too many carbs, so this is why the 'low carb' diets evolved.

And this is why I have been eating low carb for over ten years. It's become my normal eating plan and thank goodness there are several ways to prepare cauliflower to mimic potatoes and rice. In fact, I keep frozen Green Giant Riced Cauliflower bags in our freezer. It has no added salt (Bird's Eye brand does have salt.) Making mashed cauliflower is totally worth it - if you make it right! I use a head of fresh cauliflower, chop it up, boil it, drain it, mash it with part of a package of cream cheese and some butter. The cauliflower rice does look and act like real rice from the package. ( can't be bothered ricing a head of cauliflower.lol)

So, honestly, what it comes down to is what you're eating at this point. Potatoes, fruit, anything made with flour will result in very high blood sugar. High blood sugar over time will result in kidney, eye, heart, and circulation problems without a doubt.

Wanna talk food? I have some ideas. smile
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rootsmith
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Posts : 629
Posted 4/13/2019 7:32 AM (GMT -8)
I envy you in that you have worked out a routine you are satisfied with. I thought I had but now I need to revise that but no way could I do cauliflower the way you describe. I agree with you, I don't think statins are causing the problem I have now. Crestor was a new drug and the only thing I was doing differently when my A1C jumped to 7.8 (from 6.5 3 months prior) My diet had not changed at all. I did find lots of articles on its effects on blood sugar in some people. I never had any problems with lipitor raising blood sugar (in a significant way) in the past so when lipitor did the same thing as crestor this time (when i went back on lipitor) I knew there was something else going on. I'm almost 70 yrs old and keep up with the recommended annual checks (eyes etc), trying to stay on top of lipids, controlling blood pressure. I guess what I am worried about most is that this elevated fasting level I am experiencing (since the end of 2018) is a major change leading me to believe there is something else going on. I've thought about infections since I am also on immunosuppressives but don't seem to have anything obvious. Do you think my health care provider should be ignoring this because my A1C is now 6.7 (down from 7.8)? I don't think 6.7 is that good either. People are diagnosed with diabetes based on a fasting level over 126 on at least 2 occasions so it doesnt seem right to be told that's ok as long as your A1C is below 7. I cant control this problem by strictly reducing carbs because I have done that (back in 2005, which is why I was on starlix for awhile) and lost too much weight. I am definitely going to start reducing carbs though. I am so disappointed in my primary NP not having any recommendations other than "watch the carbs". I've asked to see a CDE which I have done in the past but have to admit I didnt take it too seriously at that time. I'm not opposed to medication but which one? The old time generics will most likely cause hypoglycemia if I am not very careful. I tried metformin in the past and couldnt tolerate the side effects. The newer noninsulin injections are expensive and do not have a proven track record (i.e. the possible connection to genital flesh eating bacteria) I guess the first step is to reduce carbs to a limit I can live with and see what effect that has. I have so many health issues and have seen so many specialists I really hesitate to see another endocrinologist. THanks for your input
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rootsmith
Veteran Member
Joined : Jan 2004
Posts : 629
Posted 4/13/2019 7:37 AM (GMT -8)
How do you change the info at the bottom of posts? What is there now is old, havent been on prednisone for over a year
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Lanie G
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Joined : Nov 2006
Posts : 6974
Posted 4/13/2019 8:46 AM (GMT -8)
I just turned 70 in December. Talk about a shock. Just saying the number is a shock. I don't feel 70. When I sort of got over that (still comes back and shocks me though...), I had to get a grip on myself and get back on track. I do have other 'things' going on, too. I have glaucoma. I use eye drops for that. I have irregular EKGs now and I have a cardiologist because of them. I've had nuclear stress tests and a heart cath to make sure there are no blockages. He says simply that the irregular EKGs are now my "normal". I take BP medication, which had to be reduced recently because he said it was too strong for me. (Losing weight and regular, sustained exercise like walking will cause a need to reduce the dosage, so the patient and the doctor need to be aware of this.) I seem to have a specialist for almost every part of my body. haha But am thankful I'm my own health advocate which is why I eat low carb.

Please read the link in my signature for more important info on blood sugar. You'll find studies, research and advice. And - I personally found that the guidelines from the ADA will keep blood sugar very high. My own family doctor gave me pamphlets from the Heart and Diabetes associations. I was sent to a RD (registered dietitian) who gave me a meal plan that I followed to two days and my blood sugar was higher than I'd ever seen it! Of course it was, because whole grain bread and potatoes were on the menu. I'm only on 1000 mg of metformin a day (500 morning and 500 night). If I ate what the ADA and that RD recommended, I'd be on stronger diabetes meds, multiple meds in fact. You'll read on the website in my signature that diabetes complications start at certain levels over time and those levels may be different for people but those levels fall within the guidelines of the ADA. THIS is why I eat low carb.

My own family: diabetes killed my grandmother and my mother. My mother was on insulin (type 2, like me) but ate whatever she wanted, did no kind of exercise. She had glaucoma and heart disease, had a heart attack, gangrene that started in a foot, that leg amputated and died at 72. My brother just had a triple bypass at 75 and my sister has kidney disease (and not sure what else) at 79. We three have diabetes. So, you see I have quite an incentive to keep my blood sugar as near normal as possible and that really starts with my eating plan. Of course I make an exception; I'm not perfect or crazy! My husband and I went out to dinner last week and I ate a piece of bread with my chicken salad meal.

What do I eat? Lots of veggies (not potatoes or carrots), meat, fish and chicken, nuts, yogurt, greens, tuna or chicken salad, cheese, some berries, dark chocolate, peanut butter.

You asked about changing your signature (what's under your post). When you're signed in, click on your name and then "My profile" and you can edit your signature. If you have a problem, let me know!
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rootsmith
Veteran Member
Joined : Jan 2004
Posts : 629
Posted 4/13/2019 11:22 AM (GMT -8)
I checked out your link. Only have time to read one now, will read the rest later. Very interesting and so easy to understand (although somewhat overwhelming at this point lol) The one I read "Why is Blood Sugar Highest in the Morninhg"- something jumped out at me. Blood pressure medication. At the time my cardiologist switched me to crestor he also upped my losartan from 50mg to 75 mg. Never thought anything of that because my blood pressure didnt seem to be any better or worse. Hmmmmmm
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Lanie G
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Joined : Nov 2006
Posts : 6974
Posted 4/13/2019 12:18 PM (GMT -8)
I have a blood pressure monitor at home. (Three, in fact, but I actively only use one mostly.) Anyway, every time I'm at the doctor's office (and especially in the cardio's) my blood pressure is high. Every time. Yet when I'm at home, it's normal and even low. For years my former doctor prescribed BP meds based on those readings (the ones in the office), and I also weighed more. Last fall it got to the point that I passed out upon getting out of bed, which led to the cardio finally re-assessing the dosage of the benazepril and determining it was too high. Looking over my readings at home convinced him (and my GP) to lower the dosage from 40 to 5 mg.

Now, I take random readings and take them with me along with the monitor to my app'ts to confirm how my monitor is recording my bp. When the nurse gets an elevated reading, I used my own meter to see what it records and it's always just a few points off. This way, they know that my home readings are ok.

In my case, I also found that anxiety makes my bp very very high. ugh
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rootsmith
Veteran Member
Joined : Jan 2004
Posts : 629
Posted 4/13/2019 12:51 PM (GMT -8)
I used to go into my appointments with scrolls of blood pressure readings. Now I rarely take it. I go to doctor's appt's often enough for it to be checked. Its usually acceptable. I know what you are talking about when you stand up. I had that years ago and had to reduce and then dc the meds. I was actually off the 3 bp meds I was on for several years. I kept telling them, 3 bp meds and still not great. Something is going on. I was on metoprolol xl, valsartan and amlodipine. Now I refuse to take a beta blocker.
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Lanie G
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Joined : Nov 2006
Posts : 6974
Posted 4/13/2019 5:00 PM (GMT -8)
Getting control of your blood sugar is important and I found the best way is to keep a journal with time, food and blood sugar reading right before eating and then about two hours after. If you try doing that in the evening, you might be able to get better control of the morning fasting numbers. If you need to snack on something after dinner, try some nuts, or cheese, or part of a small container of unsweetened fruit yogurt. Trial and error will guide you.
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Sometimes i am me (HT)...
Elite Member
Joined : Mar 2009
Posts : 22598
Posted 4/13/2019 9:18 PM (GMT -8)
Hi guys...yep same stuff in lanies family with me... diabetic retinapathy, neuropathy, double by pass and teeth removed. Mum half a foot with gangreen.

Yep it is a creeper. I slowly read all posts, on a pH so a tad hard at times. With no remember ya fluids... kidney's regulate BP. Am on two statins no increase in bgl, albeit night time Mirtazapine small dose to help with sleep prep is munchie city. Some meds in combo can raise bgl.

Glyxambi is very effective and I am using less insulin. It is a combo med with jardiance and another med. Metformin is best suited with insulin as it promotes the longevity of insulin in ya system.

From reading both your ages I am the youngen, lol. Diabetic educators are good, an endo even better, esp if it gets complex. Lanie given ya good info. Keep strong guys. HT
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rootsmith
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Joined : Jan 2004
Posts : 629
Posted 4/14/2019 5:02 PM (GMT -8)
I read most of the information in the link. I found it very informative. I notice on the one about drugs it does talk about statins increasing insulin resistance. Well, I don't think that's the whole explanation for my current problem, or maybe not even any of it. Do you know anything about Type 1.5 diabetes aka LADA (late autoimmune diabetes in adults)? I already have 3 autoimmune diseases. I'll probably be talking to my NP tomorrow. In the meantime, working on my diet.
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Sometimes i am me (HT)...
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Joined : Mar 2009
Posts : 22598
Posted 4/15/2019 2:29 AM (GMT -8)
Hi, think an endo appt would be helpful. HT no wisdom on Lada.
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msOuchie
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Joined : Dec 2011
Posts : 601
Posted 4/15/2019 5:43 AM (GMT -8)
I was going to suggest that maybe you have LADA. There isn't much to know about. LADA is a mix between Type 1 and Type 2 and strikes adults. Many doctors do not know about it and just diagnose the person with Type 2.

LADA(Type 1.5) is an autoimmune disease and starts out like Type 2 and should be controlled with diet and exercise. After 2-3 years(depends on the person and when dxd.), LADA patients need to take Insulin along with diet, exercise, testing blood sugar often and quarterly visits to an Endo for lab work.

https://www.lvhn.org/conditions_treatments/diabetes/latent_autoimmune_diabetes_in_adults_lada/overview/symptoms

Post Edited (msOuchie) : 4/15/2019 7:51:16 AM (GMT-6)

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Lanie G
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Posts : 6974
Posted 4/15/2019 7:28 AM (GMT -8)
Good suggestion! Would it be correct to describe LADA as a transition between types 1 and 2? If a person starts out as a type 2 and then absolutely needs insulin because his or her pancreas stops producing insulin, is this LADA? Managing blood sugar would be tricky, I imagine, if there are spurts of insulin and then not.

Hope all is well with you, msOuchie!
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rootsmith
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Posts : 629
Posted 4/15/2019 9:13 AM (GMT -8)
LADA is like Type 1 diabetes except that it isnt a sudden as Type 1 usually is. Beta cells are destroyed gradually and the person doesnt need insulin right away. Some doctors will test for antibodies and C-peptide. Others don't, they treat you for Type 2 and when it doesnt seem to be working well change treatment. It stands for Late Autoimmune Diabetes of Adults. (usually occurs in adults) Its also been called Type 1.5 or the "thin type 2's" I'm not an anti-vaxxer but.... just before this sudden rise in fasting glucose level I had my flu shot. Since I have a screwed up immune system to begin with, I have to wonder. I had my flu shot 10/31 (my A1C at the end of Sept was similar to what it was 3 months prior to that) Then in less than 3 months my fasting level is 169 and A1C is 7.8
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rootsmith
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Posted 4/15/2019 9:21 AM (GMT -8)
I also read back in the day when this all started with me is that Type 2 diabetics often develop antibodies to beta cells as well as Type 1's. Maybe those are the type 2's that end up on insulin. I guess this is why doctors dont bother testing for antibodies. At least back then, its over 10 yrs now maybe they do now. When I was first diagnosed they were just starting to recognize "prediabetes" Like I said earlier, I was laughed at by many. My ob-gyn told me "you have to go by the fasting level" when I told him my fasting was normal. It was the Joslin Clinic that told me yes, I had diabetes btw Lanie, I meant to comment on what you wrote about your family history. I agree, that puts you at great risk. I don't know of one person in my extended family with diabetes. But I do have other autoimmune diseases- autoimmune thyroiditis (Hashimoto's), autoimmune hepatitis (stable) , spondyloarthropathy, and I've had vasculitis.
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cyclinglady
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Posted 4/15/2019 7:43 PM (GMT -8)
I would suggest that you find a doctor who will test your antibodies for type 1 diabetes (TD1/(autoimmune diabetes). You may very well have LADA which is sometimes referred to as TD1.5 as it is autoimmune but it develops more slowly. Determining what type of diabetes you might have is important for correct treatment. If you have autoimmune diabetes, insulin might be better at preserving any remaining beta cells as you progress. Other Type 2 diabetes medications may cause you to lose beta cells faster. You can develop TD1 at any age. It is also linked genetically to celiac disease and Hashimoto’s which can develop at anytime too. I urge you to research this further.

I have celiac disease, Hashimoto’s and autoimmune gastritis. My doctor and I have determined that as of now, I am a thin type 2. I am insulin resistance and maintain my HA1C under 6% with a low carb high fat diet. Fat is critical as it does not increase your blood sugar. If you reduce your carbs and increase fat, you should not lose weight. My cholesterol lab results are good. All Lani’s links are great. Eating to my meter has become a way of life for me (five years to date).

I also strongly think that statins can cause diabetes in some people. I refuse to take them personally. Instead, I think managing my diabetes correctly will help prevent cardiovascular disease.

You already have several autoimmune disorders. I can not believe your doctor would not test you for antibodies for diabetes.
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rootsmith
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Posted 4/16/2019 4:21 AM (GMT -8)
Thank you for your input cycling lady I have to admit I am disappointed in my NP (although to be fair, I've had MD's in the past who were clueless) This sudden increase in fasting level is such a sudden change for me I dont understand why she is not asking what is going on here. I have learned to take charge of my own healthcare so I will definitely follow through on investigating this change. I am going to see a certified diabetes educator soon. Right before this sudden change I had a flu vaccine. I only recently started getting them (past 5 yrs ) I read several reports in reputable mainstream medical sources that flu vaccines can cause problems in people with autoimmune diseases. I also read that drugs like humira, remicade etc can slow the progression of the destruction of beta cells. I was on humira for 6 years and started back on remicade recently (for another problem) I am off statins until this problem is resolved, or at least until it is figured out. Untreated, my LDL has been as high as 189. I have a 60% occlusion of my right carotid artery and with a family history of stroke, that is not a good thing. The good news is that it has been stable for 2 years (determined by ultrasound) Lipitor also stabilizes plaque so that could be helpful in this situation. I like the idea that someone said that lipitor can be taken only 3 times a week and still be effective. Even though I said I have taken charge of my healthcare I am so tired of having to do so.
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cyclinglady
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Joined : Aug 2015
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Posted 4/16/2019 9:45 AM (GMT -8)
You have the right attitude. We all have unique issues and treatment must be modified to accommodate them. It is unfortunate that we must be in charge of our health. It is rare to find a doctor who can keep current on the latest in medical information and think wholisticly. Like you, I get tired of having to treat myself. Celiac disease is one of the few diseases where the treatment, a gluten free diet, is entirely in the hands of the patient. But I am thankful, because there is no treatment for chronic autoimmune gastritis or Hashimoto’s.

I think the medical community is still learning about diabetes. Unfortunately, by the time they figure it out, many will suffer from kidney, eye, and amputations. I am glad that Lani is here spreading the word about effective dietary changes.

As it stands now, I am thin type 2 diabetic. Type 2 diabetes runs strong in my family as well as autoimmune. So, a type 1 diagnosis is not impossible for me. I monitor my blood sugar at home and also follow up with my supportive GP. Diet is working for me now. I am trying to avoid Metformin because frankly one of the side effects is GI upset and I do not need more of that! Other drugs? I am very leery because I have some pretty severe allergies to medications. Heck, I am even allergic to acetaminophen, ibuprofen, and aspirin (anaphylactic). I also avoid most vaccinations for the same reasons as you —immune system reactions.

I had a complete heart work up a few years ago. No heart issues at all. They admitted me to the hospital because they suspected a heart attack. Turns out I had spinal fractures due to osteoporosis thanks to celiac disease! So, I will not take a statin. I figure my heart and arteries must be doing well despite elevated LDL due to a high fat diet. Cholesterol? I used to be praised for having very low cholesterol. So low that now they know it is just as bad as being high. That too, was due to celiac disease. I was malnourished! Hubby is on a statin, but he had a valve replacement (birth defect) and aneurysm repair. So, again, individualized treatment is necessary.

If you do have TD1, I hope that the Remicade will prevent beta cell loss. That would be a great bonus. My niece is on Remicade for Crohn’s and is doing well.

Take care and keep advocating for yourself!
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Sometimes i am me (HT)...
Elite Member
Joined : Mar 2009
Posts : 22598
Posted 4/17/2019 12:24 AM (GMT -8)
Yep individualized treatment. And yep, being proactive with diabetes, whatever type or severity is everything. Knowledge is gold. I keep learning. Keep strong. HT
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rootsmith
Veteran Member
Joined : Jan 2004
Posts : 629
Posted 4/30/2019 6:20 PM (GMT -8)
I thought I would post an update to my situation. I saw the endocrinology NP (I thought I only had an appt for the diabetes educator but it turned out I saw the NP and then the educator in a week) She was very nice. I think things will work well with her. She ordered the two blood tests, C-peptide and GAD-65. My C-Peptide level ws 6.5 (normal 1.4-4.4 ng/ml) which I think indicates I am making enough insulin, which rules out LADA? GAD-65 was interesting. The report states that the antibody was detected, level 0.19 (normal less than 0,02) Both of these seem like small abnormalities (in the opposite direction) but I have no frame of reference. Since I have autoimmune diseases it isnt really a surprise to have a low level of these GAD antibodies. I have a low level of P-ANCA, as well as a relatively high level of SMA (smooth muscle antibody) and have had high thyroid antibodies in the past (last test in the past year they were low) I also have a positive ANA in the past, but not very high. I havent spoken with the NP about these results yet. She put me on metformin XL and had no gi problems until 1 week on the drug. Will see if they persist. My blood sugar readings are great. So that's where I am right now, as usual more confused I have tweaked my diet to reduce carbs. Chris
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Lanie G
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Posted 5/1/2019 5:02 PM (GMT -8)
Hi again! Thanks for coming back with an update! Sometimes posters don't do that and we never know how those members are doing. I'm glad you're ok.

As for the metformin, I'm not on the same dosage. I'm on 500 in the morning and 500 at dinner. I found that I'll have acid indigestion if I eat too much, or if I eat too many carbs or food that's greasy, or if I take the metformin on an empty stomach. This might be an individual reaction so sometimes changing what you're eating may help. Certainly, if you're eating carbs like potatoes, rice and/or bread, the metformin will make you sorry you did. :-/ ugh
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rootsmith
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Joined : Jan 2004
Posts : 629
Posted 5/1/2019 6:57 PM (GMT -8)
Many years ago I tried metformin, cant remember the dose but it was not the xl version. I had bad gi issues and stopped after 3 weeks. I think maybe I had a bug this time because today its ok and my diet hasnt changed much from before I had the issues at the 1 week mark. Will see how it goes.
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