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Weirdo BG readings - are they really the norm?

increasingly cynical said:
Hi Trinkwasser,

Thanks for the paper citations, I'll look these up. Having been passed around 5 consultants over 18 months or so, for no very obvious reason (other than that they couldn't understand the profile I was presenting them with) I have finally landed (I think) with a consultant who both seems human and appears to know what he is doing! He started swearing when he realised I had been sent 'round the houses for so long with such high BG readings and promptly oragnised some blood tests including GAD, as he (like people on the forum) feels that the profile looks like 'LADA'. He is in favour of low carb diets and definately willing to work with rather than against his patients, so its looking much more promising now that I will get some treatment and medical support to get the BGs down, I was getting close to complete despair I must say!

Many thanks for your help and support and that of everyone else following this thread.

:D

That's excellent, if belated, news!

LADA may actually progress more slowly than certain forms of Type 2, some patients may still have measurable insulin output after years and there are many horror stories of people being misdiagnosed in this way. Not all children are Type 1 and not all adults are Type 2, in fact one source reckons there are about twice as many Type 1s diagnosed in adulthood as in childhood.
Because the process is slower it can be missed.
 
Hi
Web is rife with evidence/stats, and as such a bit of googling should answer your questions. Although I think at times the med profs have a lot to answer for, I dont truly believe they 'make up' the complications. I can see why you would want to question it all and maybe as a type 1 insulin deplete person with diabetes who would die within two weeks without medication(sobering thought and not easily forgotten :shock: ) I just accept it because I have little other choice. However, throughout the philosophy, pensive reflection and analysis you are diabetic. You need to get something sorted rather than trying to 2nd guess what your pancreas is doing. Doing nothing is NOT an option., Please dont make yourself sick. I have pasted some stats for you from at least one of the hits I got on web. See below, for your 'answers'.

Heart disease and stroke
Heart disease and stroke account for about 65% of deaths in people with diabetes.
Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
The risk for stroke is 2 to 4 times higher and the risk of death from stroke is 2.8 times higher among people with diabetes.
Deaths from heart disease have decreased significantly among men with diabetes in recent years, but that trend has not been true in women. From 1971 to 2000, the rate of death from heart disease among men with diabetes decreased from 16.8 deaths per 1000 men to 8.1 deaths per 1000. Among women with diabetes, however, deaths from heart disease did not decline from 1971 to 2000, and the difference in death rate from all causes between diabetic and nondiabetic women more than doubled, from a difference of 8.3 to 18.2 annual deaths per 1000 women (Gregg et al., Annals of Internal Medicine, 2007).

High blood pressure
About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg) or use prescription medications for hypertension.

Blindness Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year making diabetes the leading cause of new cases of blindness in adults 20-74 years of age.
In people with type 1 diabetes, therapy that keeps blood sugar levels as close to normal as possible reduces damage to the eyes by 76% (New England Journal of Medicine, September 30, 1993). Experts believe that these results can also be applied to those with type 2 diabetes.

Kidney Disease
Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2005.
In 2005, 46,739 people with diabetes began treatment for end-stage renal disease (ESRD).
In 2002, a total of 178,689 people with ESRD due to diabetes were living on chronic dialysis or with a kidney transplant.
In people with type 1 diabetes, therapy that keeps blood sugar levels as close to normal as possible reduces damage to the kidneys by 35% to 56% (New England Journal of Medicine, September 30, 1993). Experts believe that these results can also be applied to those with type 2 diabetes.

Nervous system disease
About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems.
Almost 30% of people with diabetes aged 40 years or older have impaired sensation in the feet (i.e., at least one area that lacks feeling).
Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

Amputations
More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
In 2004, about 71,000 nontraumatic lower-limb amputations were performed in people with diabetes.
The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.

Dental disease
Periodontal (gum) disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
Almost one-third of people with diabetes have severe periodontal disease with loss of attachment of the gums to the teeth measuring 5 millimeters or more.
Persons with poorly controlled diabetes (A1c > 9%) were nearly 3 times more likely to have severe periodontitis than those without diabetes.

Complications of pregnancy
Poorly controlled diabetes before conception and during the first trimester of pregnancy can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of pregnancies.
Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.

Sexual Dysfunction
Diabetes significantly increases the risk for sexual dysfunction in both men and women.

Other complications
Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma
People with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes.
Persons with diabetes aged 60 years or older are 2-3 times more likely to report an inability to walk one-quarter of a mile, climb stairs, or do housework, or to use a mobility aid compared with persons without diabetes in the same age group.
 
Thank you for your concern. What is it that goes 'quickly wrong' in LADA / Type 1? i.e what should I keep an eye on.
what happened to me was I went for a bike ride after a period of inactivity, a couple of km down the road my breathing became rapid and my OH thought I was having a heart attack. We got back to civilisation in the end, went to docs who sent me to hospital, where I stayed for 10 days.
Fortunately the only long term effect seems to have been some mild background retinopathy, which took 3 years to show up (and then only with a more detailed examination than the normal one.) I was lucky.
 
Hi Pheonix, Lilibet, Trinkwasser & Sugarless Sue,

Thank you for your replies. Pheonix - many thanks for your account of what happened to you, it sounds familiar... Lilibet.. thank you for the detailed list of potential side effects (do you have citations for these and do you know whether teh studies involved controlled for other key factors like age, weight etc.?) Sugarless Sue - thank you for the advice, I have noticed 'ketostix' mentioned on the forum - are they available without prescription?.. Trinkwasser, thanks fro commenting again, its helpful - are there tests for how much insulin you are producing, if so, what are they and how reliable are they?

Thank you all again - you are such altruists - if only the medics were so supportive!

:)
 
Bear in mind that list of complications refers to *uncontrolled* diabetes. If you control not only the BG but the associated factors your complication level may not be that far off "normal" people.

The best test for insulin output is C-Peptide: as the pancreas produces insulin the molecule is split into two. Insulin has a very short half life whereas the other half, which is the c-peptide, lasts longer and can be measured. Also works if you are injecting insulin as the injected stuff is pure and only what your pancreas still produces has c-peptide alongside it.

You can get more subtle tests including an insulin clamp but they are more expensive and seldom done.
 
Hi Trinkwasser,

I mentioned the 'C-Peptide' test to the recent consultant in the context of whether I was still able to produce insulin or not.. he said that it was a 'useless test' and that GAD (a test he is arranging) is what is needed... I think they test for different things (insulin production vs anti-bodies..) Any comment?
 
If he is doing GAD test then it appears he is looking for some form of autoimmune issues (she said, stating the obvious). I suppose whether your pancreas is producing insulin or not is academic cause test results aside, you need insulin IMHO

C peptide might hint at either type 2 or LADA I suppose but whats important is that they are DOING SOMETHING

So not much help :wink: but glad things are going to start to get dealt with. I get so ****** sick of the poor treatment diabetics get.

Let us know how you go
 
Hi Lilibet,

Thanks for your comments. I know exactly what you mean regarding the approach people meet with in the medical centres , increasingly I think that (emarkably, despite how common diabetes is) the medical profession just doesn't have that many answers, hence the 'stereotypes, myths and confusion'. If you look into the research evidence, there are about 50 causes of hyperglycaemia (part of the problem with 'treatment' is that 'diabetes' is regarded as a discrete disease when it blatantly isn't , it is a symptom of an underlying disease state); even the most common causes are biochemically very complex. There are few independent trials of either the causes or the treatment, virtually all are funded by drugs companies and as yet we lack even basic data (assumptions regarding adverse outcomes of high BG levesl are based on one trial, part-funded by drug company and with unclear controls for confounding factors); trials looking at outcomes for drugs and/or insulin ALL focus on reducing BG levels (most show very minimal change) and NONE currently evaluate either micro-vascular or macro-vascular endpoints as an outcome... we are working on the basis of myth, by and large.... Type 1s about to die within 2 weeks due to lack of insulin may be an exception here, but the trial outcomes remain pretty minimal regarding long term complications..

This is my take anyway... happy to hear of any research citations that give more positive input!

:wink:
 
Interesting reading this today. I'm going to see the diabetic nurse on Tuesday. I'm on Metformin (2 a day) and Gliclazide (4 a day) and my BG can be anything from 3.4 to 34 - literally!

I can go days and days and it will be spot on and then, for no apparent reason, it will be 30+.

My last hba1c test came back at 9.1 (I think). The nurse told me at Christmas that I should go on Insulin and, like another poster, I saw this as a big failure.

I'm 6ft tall and weighed 14st 4lbs at Christmas with a 36 inch waist. I'm now 13st 7lbs with a 34 inch waist. I've made quite a few changes in my diet but my BG STILL goes mad.

My feeling now is that you can't buck the system. My body is faulty and, luckily for me, science has come up with something to compensate.

Andy
 
Hi RedCat,

Wow, your readings really sound weird - and, I'm sure, disturbing. I am guessing from your comment that 'science can compensate' that you are hoping that insulin will achieve rather more than your current meds? Have your docs checked for underlying conditions such as phaeochromocytoma which would produce the sort of swings you have noticed (and wouldn't be much helped by insulin) but coul dbe curable?

:?
 
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