Insulin resistance

Hello!
I was hoping for a bit of support and/or advice.
I have a diagnosis of autoimmune hypothyroidism which I think is relevant.

I've been feeling a bit 'off' lately, thirsty and drinking more and subsequently weeing more, but also I'm flagging after lunch and falling asleep after dinner which is new!

I can recognise that my symptoms are mild and not enough to warrant a trip to the GP and have done some investigations of my own. I bought a blood glucose meter, testing when I wake, before a meal, and 1 and/or 2 hours after a meal.

Waking have all been low 'pre-diabetes' range,

Before meals are all 'low-normal'

2 hours after eating are all mid to high 'pre-diabetes'. in fact, last night I clocked a 13.3 2 hours after a meal!

That said, we went for a day out Sunday Arrived at 11 walked for an hour, stopped for lunch then walked until we went home at 2:30. A sizeable walk at about 7km. BG dropped to 3.2!

My hbA1c result in Jan 2022 was 35 and in Feb this year was 33. (Had it done at the GP within the year, can't remember the actual result but I remember it was in the low-mid 30's. ) So hba1c looks really low and pretty stable. So if hbA1c is stable, and looks to be a reliable test (outside of T1 diabetes), then it's pretty safe to rule out T2 diabetes.

So I'm either looking at T1, which isn't outside the realm of possibility give its autoimmune, but very unlikely. I also think my symptoms and results are much too mild for that.

So, all that is logically left is glucose intolerance... Am I on the right track here?

I had ketones in my urine last night after the 10.5 reading, no glucose at all, there were proteins in my urine this morning too but that's the first time so could be related to the big spike last night.

At this point it seems to be carbs that I'm really struggling with so was going to monitor my BG and cut out refined carbs and see if it makes a difference.

Does that sound reasonable? Is there anything my GP can do different?

Thanks!

Well, that's not quite accurate. I don't believe anything dire is going on but something is going on to do with tolerating carbs.

I assumed a diabetes forum might be a good place to start with research and information or signposting... Apparently that wasn't accurate.

What a shame.

hooha said:

You have had your first dose of information : i.e. 1]that your research so far is inadequate , 2] see your Dr . for tests. 3]Signpost points to Dr. Ok? cheers PS I can inform you that since discovering I was an early type 2 db, this forum has been a constant help to me. I was left hanging by my useless NHS GP, and the similar sounding website to this one was equally useless and out of date. Get your priorities in order, get your ducks in a row. First find out from EXPERTS what is wrong, then do your own further research if you need to. Then come back to this forum and tell how you are getting on.

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Hi Hooha,

I mean, I don't even know where to start. Your adversarial tone was quite unnecessary. I came here looking for support because I obviously had nowhere else to turn. Sticking the boot in is remarkably unhelpful.

Could you please clarify what you mean though... You've told me to go to the GP as the EXPERT but also told me you were left hanging by the NHS so they can't be both useless and expert.

I have always found peoples lived experience to be much more informative than a GP. I had hoped to find some of that here. Instead I've the first 2 responses to my post have left me feeling belittled which, naturally, is upsetting.

EllieM said:

Hi @Gloaming and welcome to the forums.

As @catinahat said, forum rules don't allow us to diagnose here, but I'll try to make a few comments.

An hba1c gives you an average blood sugar over the last 3 months. If yours was last done in February then I can see that your GP might be reluctant to do another one so soon. That doesn't mean you aren't diabetic/prediabetic (insulin resistant?) but it seems to me that if you are symptoms have probably come on pretty fast.

You've got one "off" blood glucose reading but given the inaccuracies in bg meters I'm not sure whether your GP will find it that significant.

But you've got symptoms, even if you think they are too mild to take to the GP. There are lots of things which can cause those symptoms, not just diabetes, and your GP is in the best position to check it all out. It could be anything from a vitamin deficiency to <insert your favourite serious illness from google> , but your GP will be in a position to tell.

I urge you to talk to him/her.

Good luck.

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Hi Ellie,

Thank you for the warmer response.

I appreciate it does sound like I'm looking for a diagnosis but I was hoping for a dialogue, I suppose.

Yes, symptoms came on quickly but also are mild; more of an nuisance than a worry at this stage. Vast majority of my readings have been 'pre-diabetic' with one 'diabetic' reading but you're right, if I consider those results with the level of inaccuracy they come with then coupled with a low hbA1c then I'm likely making a fuss about nothing.

I did the Zoe health test in January and wore a CGM for a fortnight as part of that and can see that even then I had poor blood glucose control.

Ultimately I guess my question is 'does poor BG control always point to prediabetes?' Can it just be that I don't process refined carbs well and that's that? Avoid them where possible but otherwise go about your day? Is it necessary to overhaul my diet at this stage?

If poor BG control always equated to prediabetes/diabetes can I get in front of it?

EllieM said:

If it's insulin resistance then a lot of folk here improve things by reducing the carbs in their diets but an hba1c of 32 is pretty low so I find it hard to justify a prediabetes diagnosis at this stage. (But I'm not a doctor or a prediabetic so am not really in a position to comment).

And I've just re-read your first post. Are you getting treatment for the hypothyroidism? An obvious thing to check would be whether your current symptoms are related to that but am guessing you have already done that?

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This was my thinking also. I think it's unlikely to be prediabetes with such a low hba1c (although I don't rule anything out and assuming nothing gets worse will ask for a repeat test in the summer).

My (very surface) research over the last few days has suggested that insulin resistance is the precursor to prediabetes and that most people don't know they have it so accidentally stumbling on this could be helpful if I can correct it.

Yes, my thyroid is well treated now, after several years of tweaking doses. My main 4 vitamins are at really good levels too (ferritin, folate, vit D, and B12). I monitor those and my thyroid between 2 & 4 times a year. So I'm fairly confident it's not my thyroid directly but since thyroid and diabetes are 2 sides of the same coin it might be that the system is disrupted at the moment.

I am under the care of an endocrinologist at the moment but privately so to see him about this will be an appointment and £150! So I wanted to try and further my own understanding of what could be happening, what may be happening, and what is actually likely to be happening so that the appointment is actually useful and worth the time and money!

Antje77 said:

I'd do some more testing, and double check results that seem out of your usual margins like the 13.3 and the 3.2, you can have a rogue teststrip or something on your finger skewing the result.
If you do see more of the higher numbers, this can be a good reason to push your GP for another hba1c.

A hba1c test cannot differentiate between types of diabetes, it's accurate for all types.
If your test results are usually in the 'prediabetic range' (what sort of numbers do you usually see?) the hba1c's in the low 30's are odd.

What did the graphs look like?

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I've attached the last 3 days of testing results.

The 3.2 did seem odd but we'd just finished a 7km walk so assumed it was that.

Frustratingly, I cant see the data anymore from Zoe because I switched my phone. I do have the daily averages though. I'll attach them here too.

The hba1c threw me too because something is going on and it looks like it could be insulin resistance but obviously I'm just grabbing in the dark at the moment.

Antje77 said:

Those averages seem to add up with the hba1c you had at the time, but not so much with your fingerpricking.

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It's weird, isn't it? My diet hasn't changed since those 2 weeks, neither have my exercise levels.

Antje77 said:

Is this a screenshot from LibreView?
If so, it's possible you can still log into LibreView on a laptop and view the rest of your data, it should look like this (but in English for you of course):

View attachment 59949

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Unfortunately because it's from Zoe I don't have that level of access. I do have a 'report' of the data so if there's something in particular you're looking for I can see if I can find it!

Antje77 said:

If they ordered the Libre at the time and not you, you may still be able to apply for a new Libre trial. It's only available for first time users but if you aren't connected to the first sensor you used it might work.

Home | FreeStyle Libre | Abbott

Discover how to manage your diabetes easily with Flash & Continuous Glucose Monitoring - user-friendly & discreet sensor-based glucose monitoring systems.

www.freestyle.abbott

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I looked at this yesterday, apparently I'm eligible but I had an error message at checkout every time I tried so I've been in touch. Hoping they'll come back to me soon. A CGM would be super helpful I think.

Antje77 said:

It would definitely tell you a bit more about what (if anything) is going on.
Mind, if you can get hold of a sensor, do not trust it blindly. Mine always read lower than a finger prick and you may want to account for such discrepancies so do some double checks with a fingerprick, especially if Libre says you're low.

I'm a T1 on insulin, and if I'd believe my Libre I'd be forever treating non existant hypos.
It's a very useful tool, and I wouldn't want to do without, but it's not without its perks!

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That's good to know! I've got loads of test strips and lancets so I can double check if I do get my freebie!

Antje77 said:

It would definitely tell you a bit more about what (if anything) is going on.
Mind, if you can get hold of a sensor, do not trust it blindly. Mine always read lower than a finger prick and you may want to account for such discrepancies so do some double checks with a fingerprick, especially if Libre says you're low.

I'm a T1 on insulin, and if I'd believe my Libre I'd be forever treating non existant hypos.
It's a very useful tool, and I wouldn't want to do without, but it's not without its perks!

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Thank you so much for all your help.

Antje77 said:

You're welcome!
I'm mainly a curious person, and your thread made me curious, so please share how things proceed.

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I will! I'll keep en eye on things over the next fortnight and experiment with my diet and see what I can find out!

Thanks for taking the time to chat it through with me; it helps me make sense of all the new information.