From Raleigh, North Carolina, USA:
I am 26 years old, in pretty good shape, and have been under a great deal of stress over the last year or so. About seven weeks ago, I was experiencing excessive thirst and urination at night. Knowing these to be signs of diabetes, I bought a glucose meter which showed readings of 300-400 mg/dl [16.7-22.2 mmol/L].
I saw my family doctor who found glucose and ketones in my urine and non-fasting blood glucose levels around 200 mg/dl [11.1 mmol] Suspecting that I had type 1 diabetes, he referred me to a diabetes team the next day. After meeting with the dietitian and teaching nurse, my endocrinologist started me on a sulfonylurea daily, had me check blood sugars six times a day, and ordered C-peptide along with GAD antibody tests.
For the first week, my fasting and pre-meal blood sugars were pretty normal, but, since some of my post meal sugars were 175-250 mg/dl [ 9.7-13.9 mmol/L], my endocrinologist changed my medication to Starlix with meals. My blood sugars dropped immediately with the new medicine, and, over the next week or so my readings were pretty normal. I even had some post-meal readings in the 30 mg/dl [1.7 mmol/L] range. My blood sugars remained normal with the Starlix (with occasional lows) so he took me off all medication to see what will happen.
My blood sugars have been within normal ranges (pre and post meals) for the past three weeks with only diet and exercise. My C-Peptide test shows normal insulin production, but my GAD65 antibody test is positive.
I have never required any insulin, but fear I may have early type 1 diabetes. I am 5 feet, 10 inches tall, weighed around 180 pounds when all this started, and I now weigh 155-160 pounds (a combination of ketones and diet change, I assume). I am trying to follow the 2000 calorie exchange diet, eating three meals a day as well as a bowl of cereal before I go to bed, so I'm not starving my sugars. I am exercising at least five days a week, checking my blood sugars three to four times a day, and taking of vitamin C, a B-complex vitamin, a baby aspirin, and vitamin E each day.
I would like to prolong this time of good blood sugars as much as I can. My endocrinologist says right now I have diet-controlled type 2 diabetes, and only time will tell if I progress to insulin dependency. I want to be proactive if I can. Does this sound like a honeymoon period? Is there anything else I should be doing or any other tests I should be having done?
Congratulations on handling your medical conditions so well and how precisely you describe signs and findings that help distinguish typeá1 from typeá2 diabetes. That said, because of the positive GAD65 antibodies, your age, and the symptoms of diabetes you describe, I think you have Late-onset Autoimmune Diabetes of Adulthood (LADA). Actually, you're right in saying that you're in the honeymoon phase (your C-peptide is still good). Besides that, you're doing good things such as exercise, eating healthy, and taking low dosage aspirin, and vitamins (the latter are not harmful and might be good). To me, Starlix [nateglinide] is not the best way to prolong this phase. Insulin is the most logical approach even at very low dosage. Ask your diabetes team for further help.
Last Updated: Tuesday April 06, 2010 15:09:24
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