Sorta Confused

[GracieLou]

Hello,
I'm hoping someone here can set me straight and help me understand my labs. I left the dr's office feeling very overwhelmed.

I had blood drawn last friday for a fasting glucose and also a glucose tolerance test with draws done every 30 min.

Fasting was 166. Range. Was 65-99 mg/dL

The glucose tolerance results were:

1/2 hour. 92.
1 hour. 170
1 1/2 hour. 120
2 hour. 149. These had a range of 65-139 mg/dL


On my paperwork it says ADA guidelines for dx'ing diabetes with fasting glucose are:
Normal range: 65_99
Impaired: 100-125
Provisional dx of diabetes >125

And

ADA guidelines for dx'ing diabetes with a 2hr post gllucose level are:
Normal: 65-139
Impaired glucose tolerance: 140-199
Provisional dx of diabetes: >199


She gave me a diagnosis of "insulin resistant" and having metabolic syndrome.
She had said to do diet and exercise and would not start me on metformin.

Which way of diagnosing is the "better way"? According to my fasting tests I would fall into the diabetic category, wouldn't I? Even the glucose tolerance has me in high high ranges for 3 of the 4?

I am currently seeing a podiatrist for foot pain on the bottoms of my feet. My xrays came back "ok" and the dr suggested tennis shoes only for work and taping/binding my feet to ease pain. While it helps to a very small degree I am still having pain on the feet and some in my toes. Because of this he requested fr lab work and to see the dr I saw yesterday regarding possibility of metabolic syndrome. That was with the knowledge of labwork I'd had done late Sept with a fasting glucose only @ 104. Its gone up considerably since.

I have struggled with weightloss for a long time, always feeling like a failure despite following things to the letter. So discouraging. Am I really a true diabetic with #'s like these, should I be on meds? There is so much information out there, that I am on total overload! I want to put my best foot forward in beginning a new lifestyle, but I want to make sure all my bases are covered, and also, if something like metformin would really benefit me and aide in assisting/enable me to lose weight, then gosh darnit, I want it!

So whatcha think? Any help and input is greatly appreciated!

Danielle

[Shayde]

Your fasting level seem awfully high to me. How often are you tested? Is there any way you could test it yourself everyday for a week or so, just to see if that 166 was a fluke?

The other numbers seem within range.

[BlingDangie]

Regardless, the diet and exercise advice is one that people often don't take. Metabolic syndrome means a lot of things and a lot of those things can indeed be controlled with a healthier lifestyle. Take the advice and your numbers will most likely get better. If they do not or if they continue to deteriorate, you'll definitely be on medication.

[amyAZ]

Tests can be confusing, and knowing what actions to take even more so.

Here are my suggestions:
1. get Dr. Bernstein's "Diabetes Solution" book (check your library - either edition is fine). Here's where you will learn the most
2. based on what you learn in Dr. B's book, tweak your diet to remove carbohydrates from your food choices that tend to increase your blood glucose
3. ask your doctor for a lab order for a hemoglobin A1C test, which you will have done approximately 2-3 months after eliminating problem carbs from your foods. (Dr. B explains the A1C - in a nutshell, it tells you if you are getting some really high "highs" over time, not just a single day's test value). If your doctor won't give you this lab order, get a new doctor. I routinely get my lab work done BEFORE my upcoming doctor's visit.

Best wishes to you - if someone had told me the above (and I acted!) when I first had a problem lab, but no diabetes diagnosis, I would be much better off today.

Amy

[GracieLou]

Amy, thank you!! I had an A1c done. At the end of Sept, when I got the first fasting # of 106. That was a 6.0. On the labwork I had done on Friday he didn't order a new one, but I don't think he expected the high fasting # either. I will ask him for one tho, he's been amazing. All from a podiatrist! Thanks for the tip on the book, I will look for it this weekend. Now I feel like I have a base to start from.

[CherylB]

I'm an RN and I feel that with your levels, you really would benefit from the Metformin. You're having feet issues, and that is a classic sign of complications from diabetes. Besides; I hear that Dr's are perscribing Metformin for non-diabetics who are metabolically resistant to weight loss, and people are losing weight on it.

Be assertive with your MD. If you tell him/her in no uncertain terms what you want, I'm sure they will be willing to give it a trial run, at least. I second the notion of doing finger sticks to check your sugar before meals and at bedtime; at least for a while.

How are you doing with the weight loss? Do you still have a lot of weight to lose? Type II diabetes often resolves with significant weight loss, and can be controlled by only dietary restrictions. You may not always need the Metformin.

Good luck and try not to worry. Knowing what you know is far better than not knowing. At least you can do something about it!

[chiody]

Gracie,

You're at a crucial part of your life, diabetes is nothing to take lightly. All the responses touch upon good ideas to consider. The good thing is you hopefully caught this early enough to affect the course of the future be it a confirmed case or borderline.

The vast majority who goes the traditional route following ADA / modern medicine's treatment plan lead a difficult and downhill battle in the long run. Because you've found this board it is a departure from what is commonly preached. LC'ing, specifically with Dr. Berstein is a successful treatment plan for diabetes.

I was diagnosed with levels that would put you in the hospital, prescribed medication and hard headedly refused admission going about my decided route to change "lifestyle" specifically eating regimen and exercise. However I did it the difficult way by continuing with what is preached, high carb, low saturated fat. I attribute my success staying off medication after the 1st 3 months for the ensuing 19 yrs due to my unusually high amount of exercise riding my bikes...to the tune of over 10,000 miles / year.

Unfortunately even this was not enough, as this disease progressed forcing me to seek the current VLC regimen.

What is relevant is you CAN affect your future NOW, but you MUST make permanent lifestyle changes immediately.

Good luck!!!

[Steve Parker, M.D.]

Overall, looks like pre-diabetes to me. Of course, I must defer to your personal physician, who is very familiar with your case and has examined you.

If it were me, I'd try to get my body mass index down to 25 or less and be sure to exercise regularly. Low-carb eating is probably a good way to go. If your feet hurt too much to exercise, consider bicycling. Get your doctor's clearance for vigorous exercise if you're over 35-40.

Good luck. You can still turn this thing around!

-Steve

Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physician before making any dietary or exercise changes.

[watcher513]

If you want to know the A1C, Walgreen's has an A1C kit by Bayer that's a 2-pack for 29.99. I've heard it's very accurate. I read on some board that someone took it with the kit right before or after having it done at the lab and it was the same. It's worth a try.

[Marvin]

Regardless of whether you are diabetic or pre-diabetic, you can be helped by a Low Carb regimen and moderate regular exercise. I started in July with my diagnosis, had a A1C of 7.8, and immediately went on low carb and metformin. I will go back for my A1C in a couple of weeks, but I'm estimating (based on my daily testing) it will be below 6. I attribute most of that change to my diet changes, and my doctor has affirmed that.

As others have said, you may want to be assertive with your doctor, but don't feel that metformin is the main answer.