Insulin Resistant but perhaps diabetic?

[marjfra]

Hi, I'm a newbie and very grateful to have found this forum as since I was rediagnosed last July, I've been frightened, frustrated and quite alone with this. I'm ploughing through the posts and am trying to absorb all the information which I really need and regret that I didn't get. This surely is a meeting of expert minds here. Basically, I need to get some advice - I've just had my third glucose tolerance test yesterday morning and I was shocked to see how dramatic the figures have become:

Fasting level - 6.3
plus 1/2 hour - 15.2
plus 1/2 hour 17.1
plus 1/2 hour - 15.4
plus 1/2 hour - 5.4

I am still feeling sick and weak after it. On the last test (my second one) the final level was 2.4 and I was also diagnosed as having reactive hypoglycaemia. I am very concerned about the levels from yesterday but my next appointment with my endocrinologist isn't scheduled until October although the phlebotomist said that she would probably call me on receipt of them. But in the meantime and because I'm worried, could anyone tell me if this looks like a diabetic pattern? I'm doing everything I can in terms of diet to control blood glucose levels and I', only 9st 2lb (I'm 5'7.5") and lost a further 3lbs without trying this last month. I'm feeling fairly desperate about this as I can't seem to control anything.

Just to say I'm taking 2500g metformin per day. It was 2 tablets after breakfast, 1 after lunch and two after dinner but my doc changed it last week as my highest levels of the day were occurring in the morning so she changed it to 3 tablets after breakfast, 1 after lunch and 1 after dinner.

I really am in need of guidance and friendship with this as its hard for the people in my life (however patient) to understand how awful it can be when you just can't balance out the blood, have no energy and are worried about diabetes.

Look forward to hearing from you.

Marjfra x

 

[MaryJ]

Welcome Marjfra

I may be being a bit thick here (certainly possible) is insulin resitant not diabetic? or are we talking pre-diabetic.

You numbers are certainly going high, perhaps you could give some detail as to what you had eaten?

Mary x

 

[marjfra]

Hi Mary,

Thanks for getting back to me so soon, really appreciate it. I have Insulin Resistance (or Metabolic Syndrome as I think it is also called) and it is a pre-diabetic condition. There is a remarkably goo section on this condition on this website.

But I really fear that it has now progressed into diabetes (Insulin Resistance will descend into Type II Diabetes). The figures above are the test results from the Glucose tolerance test I had yesterday morning. The first level was the fasting one and then I drank a liquid glucose drink and the other figures were the levels of blood glucose taken at half hourly intervals after the drink which as you can see rose sharply.

Could you, or anyone, tell me what the readings are for a diabetes diagnoses?

Looking forward to hearing from you.

Marjfra

 

[Clover]

Hi Marjfra

I find the below a useful resource;

http://www.rajeun.net/gtt.html

with conversion help here

http://www.rajeun.net/HbA1c_glucose.html

Moya

 

[MaryJ]

Yep I was being thick! lol or better put ill-informed.

I do hope you get it sorted soon

mary x

 

[marjfra]

Thank you Moya, am going to check this site now. Thanks again Mary! No, you're definitely not thick! It's me really, but it's great to go somewhere (here) to become educated on this. Feeling very sick at the moment and a little scared

marjfra

 

[marjfra]

Hi, checked the site, Moya, but found there is a converter on this site which seems pretty accurate. Still worrying though as the figures break down as:

113.4
273.6
307.8
277.2
97.2

Could anyone say if this looks like a diabetic pattern? Would just like to be a little forewarned before I go into see the doc. I hate bombshells!

Thanks

Marjfra

 

[phoenix]

I think that I would take anything from the rajeun site with a large pinch of salt. The owner of the site is into pushing injected growth hormones for anti aging
see here for the official diagnosis cut offs
http://www.diabetes.org.uk/About_us/Our ... diabetes_/
Your fasting level is above the cut off point for impaired fasting glucose, 2 hours later your levels are back to normal but as you point out the levels in between are high . The trouble is we can't second guess as to why that is happening.* We aren't doctors and you are obviously already seeing an endo who knows your history. If you were taking the metformin at the time of the test then this would also influence the levels on the test.

Metabolic syndrome is normally associated with obesity(or central obesity) There are several slightly different lists of features from different authorities see here:http://en.wikipedia.org/wiki/Metabolic_syndrome

Try not to worry about exactly what the test results mean. Have a look at the introductory thread viewtopic.php?f=20&t=17088. It gives some basic advice that would be just as applicable to someone with pre diabetes. If you have or are able to get hold of a glucose meter do some testing before and after meals (lots of threads on this).
I think exercise also plays a very important part in increasing insulin sensitivity so if you are able to do so then it can be really helpful. The recently released NICE guidelines on preventing diabetes stress the importance of some regular physical activity, (minimum of 150 min moderate exercise or 75 min vigorous exercise which can be in short 10 min sessions)



* From what I can see there is very little research on what the intermediate points on a glucose tolerance test signify. A study in China in 2006 looked at various curves, including those from people with impaired glucose tolerance/impaired fasting tolerance, diabetes and those with normal fasting and glucose tolerance results.
Their study did find people who were not diabetic and also people who did not have impaired fasting or glucose tolerance but who still had relatively high intermediate points This study was only designed to look at what happens, they have no evidence to suggest what this signifies. (they suggested that people with high intermediate points should be followed by their doctors)
A paper from Saudi suggested that many of their patients with high one hour levels were those with insulin resistance and the metabolic syndrome. (Both the Chinese study and Saudi observations only included people from the local ethnic group)
http://eje-online.org/content/155/1/191.long
http://www.ncbi.nlm.nih.gov/pubmed/1174 ... t=Abstract

 

[marjfra]

Thanks Phoenix,

Checking this out.

marjfra

 

[Clover]

Hi Marjfra

I've been offline for a couple of days and missed your post.

I agree with Phoenix that the rajeun site should be taken with a pinch of salt and I certainly wouldn't consider injecting insulin as part of an anti aging process! However the site does bring together information from different sources.

My GP's letter described my blood glucose as 'a little elevated' but rajeun put an HbA1C of 6.3% into perspective and I went straight out and bought a home glucose monitor so that I could work out what was going on. I prefer to be prepared in advance too! Looking at rajeun's food thermometer brought me eventually to this forum and combining the two sources has, in 7 weeks, enabled me to bring my readings into the normal zone and my next HbA1C should be lower than 5.2% - even though I believe I would fail a glucose tolerance test.

Thinking of you

Moya

 

[marjfra]

Hi Moya!

Many thanks for the message. I found the rajeun site a bit imprecise but found a fantastic and accurate calculator on the home page on this site that's why I could give a precise recalculation above. It would appear from another part of this site that the readings would suggest diabetes but of course I'm really not sure hence my panicked messages!!! What is really bothering me is that I can't seem to control the rise and fall of the blood glucose. This wave pattern is characteristic of Insulin Resistance but even with strictly controlling my diet and metformin and exercise, it has just started going crazy. Over this past month I have lost a further 4 lbs without trying, and am now just over 9st in weight. My eye sight has worsened in the past few months. I am constantly tired, my head won't work, I have no concentration, am prone to terrible short term forgetfulness and if I try to exert myself even around the home, its as if a plug has been pulled, all power leaves me and my blood sugar levels drop like a stone.

There is though a pattern within the absence of pattern in that my blood sugar will rise at the drop of a hat in the morning while I can withstand challenges (in the form of food!) later in the day particularly the evening. To give an example - this morning I ate 2 tbls yogurt, 1 dsp chopped nuts and half a grated apple mixed together with a half slice wholemeal toast and a cup of coffee. Before breakfast my level was 5.7 but afterwards it rose (half an hour later) to 11.4. Curiously, I had chicken stirfry (my own!) last night for dinner. My level before was 6.1 but after my much larger meal it rose only to 7.8!

I appreciate that none of the members of this forum are doctors but in reading the posts on this forum I have been amazed and relieved by the level of knowledge and expertise amongst you all. My endocrinoligist is really very good but I don't know what it is about doctors, they just don't seem to give enough information and they only have so much time. I just don't want to be dismissed as a nutcase! This is why I want to tap into the knowledge base here to get everyone views. Really appreciate this.

Cheers,

marjfra

 

[marjfra]

By the way - aging is the least of my worries!!

 

[Clover]

I'm 'a little' older than you :lol:

....and a real beginner here.

Back in May I believed I was normal and healthy, but now I know I have had a problem for years.... its a lot to come to terms, I doubt I will reverse my 'prediabetic' condition because it has been so longstanding.

I hope you get an answer soon, its hard being in limbo.

 

[marjfra]

Thanks Clover,

The understanding on this board is just great. My family and friends are so supportive and my husband is really the best in the world but they can't possibly imagine how hard this can be to live with especially in our state of limbo. It's difficult when the blood sugar level can literally change every 15 mins with a rise or drop of several points and it seems there's nothing you can do. Share your story.

Cheers,

marjfra

 

[marjfra]

Hi all!

Just an update - the figures above were given to me by the nurse as she took each half hourly reading but did say that the lab results would be much more accurate. Got a letter this morning from the doc who gave the lab readings -
4.6 (82.8) fasting
12.7 (228.6)
15.1 (271.8)
14.1 (253.8)
6.1 (109.8)

She says that this is still not diagnostic of diabetes but wants me to track my levels at home on my normal diet (was way ahead of her and have already been doing this). She asks to see me in four weeks. But one thing occurs to me, I didn't have an evening snack the night before the test and hadn't eaten since 6.00pm. Would this have affected the fasting level? Anyway watch this space!

marjfra

 

[marjfra]

Don't know what happened with those emoticons!