Newly diagnosed but not sure which type

[Phili]

I have just got out of a 5 day stay in hospital for a planned investigation of a 72 hour fast which was the most terrifying experience of my life and then a glucose tolerance test at the end of the stay. The 72 hour fast I got down to 1.9 and colapsed but on the lab test came back as 4.9 (crazy difference) . 2 hours after the glucose test I was 15.9.

The dr then demanded a urine test and ketones test which I think was 1.0. He then ran from clinic to meet with me and gave me the terrifying news I was diabetic and needed a blood test before I left to determine what type I was as I fit both categories. I'm now trying to carry on anxiously at work and in general feeling like I could do anything wrong whilst I wait for an answer, treatment and education. Any help?

 

[dancer]

I would steer clear of cakes, sweets etc but eat "normally" until you're diagnosed fully.
It's strange that fasting sent you hypo, if you're diabetic, but I've never before heard of anyone doing a 72 hour fast.

 

[Phili]

Thats what i thought. They were testing me additionally for hypoglycemia so i have no idea whats going on.

 

[azure]

Thats what i thought. They were testing me additionally for hypoglycemia so i have no idea whats going on.

Are they doing a GAD test for Type 1? And a C Peptide test?

If it was me, I'd ask what tests they were doing so I could be sure an answer would be found asap.

 

[Sid Bonkers]

Hi Phili, I can understand your feelings and in fact everyone here has felt similarly scared , worried and confused when first told we were diabetic.

But the good news is that it sounds as if your health care team are on top of things and doing tests to determine what type of diabetic you are which doesnt always happen as many here can testify as they had to fight to get the relevant tests done to get their answers, and many others were told they were one type and then later re diagnosed as another so at least you should have a definitive answer when your test results are back.

Once you get the good news have a good look around that section of the forum and get talking to others who share your type, there are some well informed members here who will be happy to answer your questions and offer any advice you may need.

Good luck on your new journey.

 

[dancer]

Excuse my ignorance, but are there tests for Reactive Hypoglycemia? @azure ? Sorry I can't remember who has RH.

 

[azure]

I'll tag @Lamont D I think a prolonged OGTT can show RH @dancer

 

[SimonCrox]

yes - difficult.

Ketones of 1 after 72 hour fast are probably just about normal.

The GTT result leading to a diagnosis of diabetes is in correct in you.
Firstly, a one off high glucose level does not mean diabetes; it needs confirmatory evidence such as another raised level, diabetes symptoms or diabetes signs.
Secondly, the test is meant to be done after 3 days of normal calorie / CHO intake, not a fast

The difference between the finger prick glucose and the armful of blood suggests to me that you were fluid depleted with a slow peripheral circulation, or whatever gave you the funny turn also gave you a slow peripheral circulation.. I am assuming that the fingerprick glucose test was done properly and that your skin was not cleaned with an alcohol wipe.

It was said that in the very early stages of developing diabetes, folk can go a bit hypo, but I have never really believed this or seen it, your GTT was not performed properly and you did not go properly hypo.

I would stay calm about the diabetes diagnosis, but interrogate your clinicians about the need for a proper diet before GTT, the need for confirmatory evidence to make a diagnosis of diabetes and I would de a repeat modified GTT ie glucose load and a 2 hour blood test cos that was the sample that was high and to comprehensively refute (or confirm) the diagnosis of diabetes (if it is false) else it might affect insurance etc.

I think you and your clinicians need to think again about glucose abnormalities as the cause of your problems. You might have diabetes type 2 cos it is very common, but your information when critically examined does not provide definite evidence for this

Best wishes

 

[SimonCrox]

Reactive hypoglycaemia is shown by a long (3 hour) GTT with samples every 30 mins - ouch.
WHy most folk get it is not clear, but surgical proceedures on stomach for peptic ulcers were a common cause 50 years ago (before my time).
I think it is a case of eating a diet without excess refined CHO if this is what is happenning

 

[Lamont D]

Excuse my ignorance, but are there tests for Reactive Hypoglycemia? @azure ? Sorry I can't remember who has RH.

Hi, yes, but most of the tests are to eliminate other conditions, such as insulinoma, pancreatitis or pancreatic cancer.
First is a eOGTT, which is an extended glucose tolerance test, this is to determine whether you hypo and to take necessary blood tests such as c-peptide and GAD. Other bloods are sent to labs, for anything else that needs to be looked at.
There is also a breakfast test, it's a glucose test but using bread and butter, jam.
Then there there is a 72 hours fasting test. This is to determine if you have other conditions and to diagnose RH if you stay at normal levels through out the test.
You may also get allergy tests or wheat tolerance, I have had those and of course dairy and lactose intolerance tests. I've not heard of a potato or starch tolerance test!
All these are conducted in hospital under supervision.

 

[Lamont D]

Reactive hypoglycaemia is shown by a long (3 hour) GTT with samples every 30 mins - ouch.
WHy most folk get it is not clear, but surgical proceedures on stomach for peptic ulcers were a common cause 50 years ago (before my time).
I think it is a case of eating a diet without excess refined CHO if this is what is happenning

It can be much longer depending on how long after the glucose is taken that you start to hypo, one of mine was just over four hours.
It can be used to discount other conditions as I have listed in my previous post.
And, yes, a very low carb diet is necessary to give you good future health.

 

[Lamont D]

I have just got out of a 5 day stay in hospital for a planned investigation of a 72 hour fast which was the most terrifying experience of my life and then a glucose tolerance test at the end of the stay. The 72 hour fast I got down to 1.9 and colapsed but on the lab test came back as 4.9 (crazy difference) . 2 hours after the glucose test I was 15.9.

The dr then demanded a urine test and ketones test which I think was 1.0. He then ran from clinic to meet with me and gave me the terrifying news I was diabetic and needed a blood test before I left to determine what type I was as I fit both categories. I'm now trying to carry on anxiously at work and in general feeling like I could do anything wrong whilst I wait for an answer, treatment and education. Any help?

I would wait for your doctor's report before taking too drastic a change.
This could well be insulinoma.
And having normal hba1c and going hypo when fasting can be because of your pancreas.
I have RH and having normal blood levels is only one symptom of the condition.
Then spiking high then hypo after a few hours.
There are more diabetic types than type one and two.
Hypoglycaemia is more common than is thought and most doctors don't know or recognise the symptoms.

 

[Lamont D]

I would steer clear of cakes, sweets etc but eat "normally" until you're diagnosed fully.
It's strange that fasting sent you hypo, if you're diabetic, but I've never before heard of anyone doing a 72 hour fast.

I have and it was horrendous!
Not the fasting but the stay in a diabetic ward!
I wrote a blog about my stay!