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Question:

From Czech Republic:

I am 46, was diagnosed with type 2 diabetes two years ago, and I am having a problem finding the right way how to keep my sugar levels stable and close to normal values. The doctor found my blood sugar to be 11 mmol/l (198 mg/dl). My weight was 76 kg (about 169 pounds). First of all I have collected all available nutrition information about foods (from books and from supermarkets) and bought a One Touch Profile glucometer and a "rotoped" - the stationary bike for biking indoors. I have tested my blood sugars frequently and tried to keep healthy low fat diet with lots of vegetables.

After two weeks, my fasting plasma glucose was around 8 mmol/l (144 mg/dl). I have rapidly lost weight. It falls as down as to 68 kg (151 pounds). I had no health problems except the blood sugar readings and my weight. I looked very ill being very thin, skinny and pale. All my trousers and jackets were too big for me.

The only result -- my sugar levels remained unchanged, but doctors find acetone in my blood and advised me to increase carbohydrates as fats are, popularly said, "burned on carbohydrates" and to reduce protein income. I tried it, and more I violate my diet several times and find no significant changes in my blood sugar levels; e.g., I was invited to a party where I ate sandwiches with eggs, crackers and drank several big glasses of beer. My reading next morning was 7 mmol/l [126 mg/dl], i.e. less then my "normal" level.

One day my reading was 9 mmol/L [162 mg/dl] in the afternoon. I was very sorry, very disappointed with this result. One hour later I resigned and ate a big cheeseburger in a fast foot. Forty minutes later I returned home, checked for blood sugar again and found incredible 5 mmol/l [90 mg/dl]! So, I increased my carbohydrate intake. I have succeeded to improve my weight to 73 kg and to maintain it. I felt more stronger and more comfortable and my sugar levels were the same as before. But, during laboratory tests my HbA1c level was found 7.4% and also had sugar in my urine. My doctor prescribed one half of a small tablet of Minidiab (one of the new generation of sulfonylureas). It makes my blood sugar as low as 4.8 to 5 mmol/l [86-90 mg/dl] in the morning, while later in the afternoon, the readings are back to the values to 7 to 8 mmol/L [126 to 144 mg/dl].

Now, I am confused. My sugar levels tends to be around 7 to 8 mmol/l [126 to 144 mg/dl] except mornings when they are rather higher (but not higher than 9 mmol/l [162 mg/dl]). Exercising has immediate but only a very short term effect. Normal sugar levels reached by medication make me sick. I feel well when I follow a diet relatively high in protein (higher than recommended) but not strictly low-carb one.

The above mentioned experiences lead me to the following questions:

  1. Is there possible that some people (like me) are "genetically programmed" to higher blood sugar levels that are normal for them?
  2. Are the blood sugar levels around 8 mmol/l [144-150 mg/dl] harmful for slim people with good blood pressure and relatively slow heartbeat rate?

Answer:

I think you probably have Late-onset Autoimmune Diabetes of Adulthood (LADA). Testing for antibodies and a glucagon stimulation test might be indicated at this stage to assess what type of treatment you need (maybe even insulin), since according to your hemoglobin A1c and sugar readings, your diabetes seems to need to be better controlled. In fact, normal blood sugar values apply to every healthy person, and there are no data to my knowledge to indicate that some people might be genetically programmed to higher than normal blood sugar levels and still maintain good health.

MS

DTQ-20010605150740
Original posting 7 Jul 2001
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:22
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