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Question:

From Holland:

I don't feel comfortable discussing this with my doctor here in Holland as I'm afraid of being laughed at or called a liar or something. I'm an American living here with my Dutch husband. When I was 10, in 1990, I was diagnosed with type 1 diabetes. There was pretty much NO possibility of it being type 2 since I was actually underweight. So, forward I went with the disease until, all of a sudden, in 1999 and 2000, my need for insulin suddenly decreased. I was having severe lows when they shouldn't happen. In early 2001, I didn't need any insulin AT ALL. My husband said that in 2000, he put his hand over my head and asked it to go away (yes, I laughed, too), but it seems to have happened. It's now 2007 and I've not taken any insulin for over six years. I'm not asking if it's possible because, obviously, it is.

So, I had a baby in 2003 and he was HUGE. Here, they don't screen you for diabetes during pregnancy and I wanted a fresh start so I didn't mention my previous history for fears I mentioned at the beginning of this. I've always kept meters and test strips in the house just to keep tabs. So far, so good, until today. I hadn't tested in months. I'm chasing a four-year-old after all! I only had a glass of milk and thought hey, when did I test last? An hour after the milk, I did and got a reading of 178 mg/dl [9.9 mmol/L]. My eyes bugged out and I retested. I tested all day. I think I used 20 strips and all readings have been 150 mg/dl [8.3 mmol/L] and above. Now, I'm scared. Did it come back? How do I approach the possibility and explain all this to a local doctor? I haven't even told my husband. I'm too scared of it all. Is 150 mg/dl [8.3 mmol/L] to 178 mg/dl [9.9 mmol/L] acceptable? I've not eaten anything else since the milk because I don't want the number to go up.

I should also mention that, for a few months now, I've been taking Wellbutrin for depression. Could this be causing the elevated blood sugars?

Can you help me understand what is going on?

Answer:

I do not think you have anything to be ashamed about. What I am not sure about was whether you had normal blood sugars during the time you did not take insulin. I would worry you did not. The level of glucose control you now have at 150 mg/dl [8.3 mmol/L] to 180 mg/dl [10.0 mmol/L] is too high for overall health. If you had some form of type 2 diabetes that was not usual and resulted in an early onset, you could still have made enough insulin to not have DKA, but still be high. That scenario would be suggested by your pregnancy and your blood sugars recently.

In my opinion, you would need to have immune markers for diabetes, including anti-GAD antibody, which are high with type 1 diabetes. You should also have your C-Peptide measured in response to a glucose challenge (after a meal or a standard 75 gram oral glucose load). You should also have a hemoglobin A1c performed. Clearly, if the A1c is elevated, people will not think you are crazy. Rather, efforts should be made to normalize your sugars. Who knows? Maybe you can be treated with a pill that normalizes your sugars and decreases your risk for long-term complications. That would be enough to get it done. Another possibility would be to make an appointment with a diabetes specialist who is more aware of the atypical presentations of diabetes.

JTL

DTQ-20070828090341
Original posting 12 Sep 2007
Posted to Diagnosis and Symptoms and Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:10:12
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