Pre-Diabetic, Help!

[erinecox]

I originally posted in "Coping With" but didn't get any input and I realllly want some input, lol. THANKS!

I was dx'd with celiac 3 years ago via bloodwork and struggled with a gluten-free diet until about 6 months ago. I've been gluten-free since then 99% (the 1% being accidental). Over the past week I've had some bouts with low blood sugar. My dr did some bloodwork and I've monitored in the meantime. He's sending me to an endocrinologist in a few months (earliest appt).

My own readings are that I wake up (fasting) at between 105-117, avg 115. Throughout the day, my sugar ranges from 60 (like this morning) to 199. My average 1hr after a meal is about 150-160, 2 hours is around 130. Those aren't HORRIBLE, but pre-diabetic to me from what I read at Joslin's Center online (harvard diabetes people).

My pcp is more concerned about the hypo than the higher numbers. I'm bothered by the fasting level b/c those are consistently above the threshold. Not diabetic, but borderline. Based on the irregularity of the numbers I think my pancrease is kind of "giving out". I say this b/c on Sat night I ate salad, soup and had a small soda... 199 at 1hr. On sun to experiment I had the exact same meal, same qty, etc and it was 83. Basically it's doing it's job sometimes and not others... sometimes way too much insulin (like hitting 60 this morning after a glass of milk) and sometimes too much like hitting 199 after the other meal.

So my bloodwork.

c-peptide 1.3 Normal is .9-7.1

insulin fasting 4.8 normal is 1.9-23

I am within normal range on both of those. However, I am hugging the very bottom of normal on the c-peptide. This was proof in my mind of what I had thought... my pancrease is still working but not quite enough or well.

So, I'm looking for some "expert" opinions. Is a c-peptide thats .4 away from abnormal normal enough? Coupled with a low-end of normal insulin level coupled with high fasting glucose levels, hypo spells and I'm having the typical blurry vision and thirst/urination that you'd only see with much higher levels (so I assume).

Also, does your pancrease "start shutting down" like over a few months/weeks or does it just quit all in one day? Does that make sense?

I'm going to pay careful attn to my diet over the next few months til I can see the endo. If I can keep things where they are and not hit true type 1 that'd be awesome but does it matter? If my pancrease is going out can my diet impact it? Also, I assume this would be type 1 as everything I've read about a low c-peptide indicated type 1 rather than type 2.

Thanks so much guys!

Erin, 29

DX'd Celiac via bloodwork 7/08

[RollingAlong]

You've only been on the diet for 6 months, but what are you eating?

Are you eating whole foods or a lot of gluten free versions of the Standard American Diet (SAD) foods?

The fasting blood sugars are a concern, but actually I am more concerned about the #'s over 140. Anytime that anyone goes over 140, (diabetic or not) they are damaging beta cells and other parts of the body, like nerves, arteries and kidneys. You can read up on this at the Bloodsugar101.com website. Or there's a book, if you'd rather read offline.

Are you having symptoms from the hypos? If not, they really can be an issue. The best way to handle all of these numbers is to reduce your carbs until you can sort this out better. The website I mentioned explains how to do this and all will talk about how beta cell function deteriorates.

it is also possible that you have additional food intolerances that are showing up as erratic BG levels. In other words, maybe you don't need to reduce all your carbs, only certain grains or dairy or some sort of artificial sweetener. This is a very individual thing; an excellent food log is a must for you right now.

Given your medical history, and blood work, it is very possible that you are dealing with an autoimmune attack on your pancreas and those can be very sudden or erratic and gradual. This would be some form of Type 1, or 1.5 or LADA. The terminology is confusing.

There's really no way to know what is likely to happen, but the sooner you get your BG levels under control, the more beta cell function you can maintain and the easier BG control will be, along with your general health, in the long run. Were you told to contact the doc at a certain blood sugar level? My spouse was told to do this if his FBG jumped by 50 points.

One thing you can look into is the autoimmune form of the Paleo diet; it can help stabilize your BG levels and possibly lengthen your "honeymoon" which is the period of time when your pancreas recovers function after an autoimmune attack.

I am within normal range on both of those. However, I am hugging the very bottom of normal on the c-peptide. This was proof in my mind of what I had thought... my pancrease is still working but not quite enough or well.

These test results need to be considered in light of your current diet. Also, did you have a BG reading done at the same time as these test?

In addition to bloodsugar101; there are a lot of experts at the Bernstein Diabetes Forum - lots of Type 1 diabetics and many diabetics of all stripes who also have food intolerances. Open Original Shared Link

Good luck with your research and keep us posted, please and congrats on grabbing this by the horns - your diligence will pay off!

[GFinDC]

I had slightly elevated readings for a while. My endo said the same thing possibly pre-diabetic. My numbers were not as high as yours, more like 119 fasting. I got a monitor and started checking my levels for a couple weeks. I quit eating rice during that time. When I went back to the endo for follow up my results were back in normal range. I also stopped having cramps in my legs upon waking.

So for me I think the rice was causing the blood glucose readings to elevate. I seemed to get cramps in the morning if I ate rice at night. All this just to say, that yes, you may have a problem with a food you are eating and it is affecting your glucose readings. I was also taking Sominex at the time and quit that the same time period. So, could have been that also or maybe both the Sominex and the rice. But I only got the cramps when I ate rice at night.

[erinecox]

Thanks for the input guys! I have always eaten relatively well... certainly not the SAD. I have my moments, but am not within the realm of "normal eating". Over the past 3 years I didn't eat crappy, but would just have a killer craving hit and since my syptoms aren't "immediate" I'd have a biscuit every 6-8 weeks. Not ok, but not the worst thing ever.

Generally, I only eat at sit-down restaurants and order grilled foods or sushi. I am into the raw milk/ soaked food, good fat thing. According to my bloodwork my cholestrol and all those numbers were perfect including my TSH. I cook our food, eat lots of fruits and veggies and have stayed away from "gluten free" packaged food for a year b/c I put on 30lbs with that crud. I could stand the first 15 but the next 15 were too much. My weakness and I don't need a lecture has been soda. I actually have stopped drinking it for a month before this whole blood sugar lollapalooza began oddly enough. I had also started exercising 2-3 times per week... light weights and light cardio before work. I'd lost 6lbs. I seem to have been punished for making a positive improvement!

I am sooo fortunate in that my endo has an opening tomorrow so I get to see him at 9:30 and then I go to my GI next week.

So, all that said... the crazy thing to me that makes me think this is type-1ish ominous is that I can eat a perfect meal and have a perfect BS. The next day I eat the same perfect meal and have a hypo or a reading of 160. When I have a hypo, I drink 4-6oz of soda (all juices make me feel soooo sick! and milk doesn't improve my #'s). Sometimes that puts me to a perfect place... sometimes 160's. Nothing is consistent to me. I imagine that (and this is only my imagination) that if it was just insulin resistance .. it would be consistently high or consistently low as in consistently resistent but I could be very wrong. However, my experimentation has found no consistency.

To answer the bloodwork question, he did the c-peptide, insulin fasting and my fasting BS that morning was 117 and at 124 after that particular (low carb) meal. That same meal got me a 150 the next day. Go fig!

Keep the input coming and I'll update ya'll tomorrow on what my endo says!

[anabananakins]

I'm glad you can get in with your doctor soon, it is a bit worrying. Reading through the posts I thought at first you were going to say you ate the SAD (in which case I would've said cut your refined carbs considerably) but it sounds like you're already eating pretty well and doing the right thing re exercise. Let us know how you went.

[erinecox]

I got to see my endo this morning... went relatively well I guess, lol. He said I am pre-diabetic and hypoclycemic. Apparently my pancrease is not functioning like it should so I need to adjust my diet to accomodate this. He did bloodwork to test for antibodies possibly attacking my pancrease, thyroid, etc. I will get that bloodwork back Mon.

My A1C was 5.5 which is good.

I have big prayers going up that my results are clear and this is plain old type 2 in the making so I can work my hiney off and get it under control. I see my GI next week and my endo has asked that he send me to a dietician to look at a hypo/pre-diabetic gluten free diet. I am very much into Nourishing Traditions and The Hormone Diet and have read some stuff about the Paelo Diet. I'm going to dive back in, re-educated myself and make it my goal to reverse it if it's possible. As long as I'm anti-body free, that shouldn't be a problem. Id appreciate any prayers for this to not be an autoimmune thing!!!

[anabananakins]

I got to see my endo this morning... went relatively well I guess, lol. He said I am pre-diabetic and hypoclycemic. Apparently my pancrease is not functioning like it should so I need to adjust my diet to accomodate this. He did bloodwork to test for antibodies possibly attacking my pancrease, thyroid, etc. I will get that bloodwork back Mon.

My A1C was 5.5 which is good.

I have big prayers going up that my results are clear and this is plain old type 2 in the making so I can work my hiney off and get it under control. I see my GI next week and my endo has asked that he send me to a dietician to look at a hypo/pre-diabetic gluten free diet. I am very much into Nourishing Traditions and The Hormone Diet and have read some stuff about the Paelo Diet. I'm going to dive back in, re-educated myself and make it my goal to reverse it if it's possible. As long as I'm anti-body free, that shouldn't be a problem. Id appreciate any prayers for this to not be an autoimmune thing!!!

Thanks for the update, Erin, glad things are ok. I am not at all medically qualified but it sounds like type 2 to me - I have insulin resistance and my understanding is that the pancreas eventually gets exhausted from making too much insulin, leading eventually to pre-diabetes to full blown diabetes. I think it's faster with type 1 and that's why so many people are so sick when they are diagnosed, because their blood sugars are through the roof.

It sounds like you've got a good plan, diet-wise. I'm not near 100% paleo, but it was a big influence. One thing with dieticians, I found that one I was sent to was still following the pyramid with regards to servings of starches and I just can't tolerate anywhere near that number of serves and keep my insulin resistance under control (and then she wondered why I wasn't losing weight!) A lot of people freak out at the idea of cutting refined starches out of the diet, so if you are educating yourself, you may well find yourself disregarding the dietician's advice, or at least taking it with a grain of salt. I found I was way better read (on recent stuff) than mine was and while she gave me some good ideas, there was too much pushing the types of eating that wasn't doing me any good (plus she used to annoy me trying to get me to try spelt when I told her I was gluten free (since I didn't have a celiac diagnosis she was in the "a little bit is ok!" camp).

I've seen another since then and she gave her blessing for me to be essentially paleo, though I have hard cheese for protein and lactose free milk because I love it.

Sending positive thoughts that it's not type 1, and you're inspiring me to work harder on my insulin resistance, thank you.

[GFinDC]

Thanks for the input guys! I have always eaten relatively well... certainly not the SAD. I have my moments, but am not within the realm of "normal eating". Over the past 3 years I didn't eat crappy, but would just have a killer craving hit and since my symptoms aren't "immediate" I'd have a biscuit every 6-8 weeks. Not ok, but not the worst thing ever.

....

Keep the input coming and I'll update ya'll tomorrow on what my endo says!

Hmm, does have a biscuit mean eating gluten? Or a gluten free biscuit? Big difference of course. One would keep your antibody reactions going, the other would just taste bad.

[erinecox]

Hmm, does have a biscuit mean eating gluten? Or a gluten free biscuit? Big difference of course. One would keep your antibody reactions going, the other would just taste bad.

Not a gluten-free biscuit... hence my admitting that I had NOT been gluten-free except for the past 6 months... hence keeping the antibodies going I'm sure. Not a good call, just the one I made. Too late now!

[beachbirdie]

Thanks for the input guys! I have always eaten relatively well... certainly not the SAD.

Generally, I only eat at sit-down restaurants and order grilled foods or sushi.

My brother is Type 2 diabetic and he says rice is one of the big killer foods on blood sugar. He NEVER eats rice, EVER. If you love rice, try substituting quinoa. It does not spike the blood sugar like rice does. And it cooks just like rice and tastes good!

Soda is terribly hard on your pancreas. A Open Original Shared Link shows the dangers of even DIET soda for Diabetes Type 2. Try cutting out soda. We don't do soda at my house anymore, we do use natural flavoring with seltzer water when we want something fizzy.

The third thing is, do you exercise? Many Type 2 diabetics are able to control blood sugar with regular exercise. According to the US Center for Disease Control, Open Original Shared Link is contributing to 95% of Type 2 diabetes.

Sending good thoughts especially for no autoimmunity!