I'm totally confused! :{<

G'Day all.
My name is Lance and I'm a 60 year old Australian male living in the Great Food Capital of the Known Universe - Penang, Malaysia.
And I'm totally confused!
Let me explain;
First, I have access to some brilliant doctors BUT the cultural practices here in Asia mean they listen, examine, diagnose and then tell you what's wrong and what course of action to take. There's no real discussion or examination of options. As I said it's cultural and I accept it. Hence this post.
OK, until a couple of years ago my blood glucose was fine.
In May 2013 I contracted a "viral haemoragic fever" strongly suspected to be Dengue (it's pretty common here).
For a month I was lethargic and had no interest in food.
I recovered but don't feel hunger (except once - more later).
About a year later a routine HbA1c blood test showed a result of 8.8 - enough to be classified as Type 2 Diabetic.
I got another blood test a couple of days later that confirmed it.
The Doctor explained Diabetes was a progressively degenerative condition that could only be managed, not cured.
OK, I accept that.
I lost weight, exercised more and worked out which foods I could eat and what foods to avoid. I also worked out what portion size was best for me to the extent I can eat just about anything but in very limited quantities.
My last two HbA1c have been in the 5s below Diabetic level and I've now been labelled as Prediabetic!
I was testing my blood every couple of hours and worked out my BG fell at the rate of 1mmol per hour. Knowing that made management so much easier.

OK, here's where it starts going wonky.

I asked my Doctor what target blood level I should aim for. He suggested 5.0. Hmmmm.....Sounds reasonable.

At this point I should mention, that even without medication, I've had Hypo episodes - the vision blurs and the concentration fades. Now I know the signs, I can keep myself topped up to ward them off.
So, my first step towards 5 was to try to find out what my Hypo boundary was - how low can I actually go?

I tried to induce a Hypo episode but instead got a 'Heatie Rush".
I was lucky one day; I'd just checked my BG level (approaching 5) when I had another. I rechecked and, sure enough, it had gone up (.2mmol).
I was self-regulating. It's happened a few times since.

Ah, hunger; one day I got ravenously hungry; I mean chew the leather off shoes hungry. I ate big (lentil and bacon soup) and peaked at 9.9. It's only happened once.
I also noticed that my BG rate had increased by about 20%. Instead of a gradual decline, it seemed to fall faster right after bolus, then slow down a bit (I don't have enough data to say for sure). I've lost my ability to predict it and, not experiencing hunger, find myself remembering to snack just before mealtimes (which probably contributes to a higher post-prandial).
Again there seems to be an element of self-regulation.

I'm starting to wonder if there is Diabetes (as a chronic condition) and Diabetes (as a symptom). If it's the former, I can keep managing it. If it's the later, what problems do I have that's caused it?

When I look at it overall I can't help think something has changed for the better but if Diabetes is incurable, then what has happened? And what is happening now?

I'm going to see the Endocronologist soon but I'm afraid the label 'Diabetic' may obscure things.

All this goes against everything I've been told or read about Diabetes.

Has anybody else had a similar experience?

Thanks for reading :{>

NoCrbs4Me said:

Welcome to the forum.

I'm confused. You say "after bolus". Does this mean you are on insulin? If you are on insulin, why would your doctor label you as "prediabetic"? If you are not on insulin, then what are your referring to by "bolus"?

Your doctor is wrong about type 2 diabetes being an incurable progressive disease. Yes, it often is, but it is not always.
If you follow the official western medically recommended diet of low fat and high carb (healthy plate) diet without self testing, then yes it will progress.

Many of us on the forum have stopped the progress and even returned to normal blood sugar regulation and no meds (is this a cure? I don't know, but close enough in my opinion - I considered myself cured). This is done by reducing carbohydrate intake, weight loss, and exercise. This sounds like what you may have done. However, if you go back to eating lots of carbs, then your high blood sugar will likely return.

What is you typical daily diet?

I also don't understand why you need to snack just before meal times.

It's possible your viral infection may have instigated your type 2, but it is more likely that you've had it for years prior to diagnosis. There are not necessarily any obvious symptoms until you've had years of elevated blood sugar.

Anyway, feel free to ask more questions.

Click to expand...

Thanks for that.
I thought bolus was the release of food from the stomach.
I've removed all 'white' food from my diet but I don't have a typical daily diet other than to say meat, fish and Veges are the main. I make a mean Curry but I also have to cook for my wife so I try to vary 'how' they are prepared. And all feature the spices Penang is famous for.
My diet is a combination of all the dietary approaches. For example, if I eat bread, no potato or rice. If I eat rice, then only a little. If I have the choice, neither. If it's a new dish, test the blood after and see the effect.
I tried very low (or no overt carbs) but that left me lethargic. So now it's 'some' carbs.
I was reasonably content with how I was going until now then confusion set it.
I've got no intention of thinking I'm 'cured' just at a loss to understand what's happening.
I'll just start from square one again until I understand it.
Cheers

Mike D said:

Gidday

A few too many factors to take into this complicated equation. You've got your numbers down and you know you need to keep them down.

But to this .....

I'm starting to wonder if there is Diabetes (as a chronic condition) and Diabetes (as a symptom). If it's the former, I can keep managing it. If it's the later, what problems do I have that's caused it?

I don't label it as either. But that's me. It is a condition thrown at you that you manage and there is no cure ... not yet at least.

Mike

Click to expand...

Thanks Mike,
I plan on keeping them down, I just don't understand what's happening at present. Or why.
I take your point about labels. I don't accept 'Prediabetic' , it's like saying 'a little bit pregnant' . I either have a problem or I don't.
Either way, it's for me to deal with.
Cheers

I

NoCrbs4Me said:

What's happening is that by keeping your carb intake low you're keeping your blood sugar levels low. I think it's that simple.

What specifically are you confused about?

Click to expand...

I get the low carb-low BG connection.

I used to go Hypo, now I don't. I get measurable squirts of glucose into my system.
My BG used to fade consistently and predictably at 1 mmol per hour. That's now a little faster and not consistent.

The snacks? I have no cues 'when' to snack so I'll forget to do it. Then remember and eat only to find out it's just before mealtime.
I guess it's the fact I've been expecting the worse and what seem like improvement happen.

Mike D said:

Dice the rice bread and potatoes ..... completely if you can ..... and then start testing again. What are you drinking in that heat?

Mike (MEL, OZ)

Click to expand...

Hi mike,
What do I drink? Water, Green Tea, Coffee. No alcohol at all.
I tried no-carb but that didn't work. Just had no energy so I have to have some carbs and more than come from just meat and Veges.
As a matter of course I don't eat them but here everything revolves around food and they are hard to avoid but I'll eat a little of one or the other. Never all three (or even two of the three). It's just my version or portion control and carb distribution.
Cheers

Th

Mike D said:

Just what is your definition of "hypo" other than blurred vision and concentration?

Click to expand...

I can add tired but That's as far as I've let them go. I know there are more symptoms but I don't want to go that far.

Mike D said:

Meds? Many people suggest T2s can't have hypos (or at least if they do, VERY rarely) if they're on metformin and not glicazade to control their condition or any other meds for T2 or related

Click to expand...

No meds. Point is I have had them; now I can't even when I try.

No, it seems to creep up. It's like I've been reading and studying all night and am really really tired - physically I'm fine but the eyesight starts to go; focussing becomes an effort and I really have to concentrate - my brain's full (takes me back to my Uni days). I eat or drink something sugary and it fixes itself.
I had my first one when on meds and that scared me enough into going the diet and exercise route.
The others occurred when I hadn't eaten for a long time - once at the end of a long flight; the other, in preparation for a festival dinner.
I try to run my BG low and in the last two cases I'd just gone too long without food.
I have a pretty fixed routine for meals and with a predicable BG decline rate I can plan well ahead and avoid problems. Occasionally thing go wrong.

I do wear glasses but the prescription is OK. No headaches. I do go3 meals plus snacks a day. In these two cases it was simply beyond my control but I learnt the lesson. I carry sugar sachets 'borrowed' from the local cafe in case.
One of the best things about being diabetic in Penang is you're never more than five minutes from suitable food. So if I think I'm going to run low, a decent pre-emptive snack is always close by.
What I've been trying to do since my last HbA1c is find my 'natural' level (there has to be one) and my lower level ie when do I start getting woozy, then I'll know.
In trying to find the lower level, I noticed the changes.

Using this forum has been of inestimable help because I've been forced to think of things from different angles. And I've gained as much from what has not been said as has been said.
I seem to be doing everything right (with the occasional glitch).
Think I'll research the side effects of Dengue Fever a little more. I haven't been in that direction yet.
Thanx