Need Help with Fasting Levels

Hello, I used to be active on these forums but not so much in the last few years. I became aware that I had a blood sugar problem around 2005. My fasting level was always normal . It was post meals that was the problem. The Joslin Clinic diagnosed me with diabetes based on an oral GTT. I took starlix for awhile but eventually just monitored the situation by an A1C every 3 months. I've come close to needing medication a few times. Well, I started taking Crestor late 2018 and my A1C in Jan 2019 was 7.8, and a fasting level shortly after that was 169. I freaked out and was sure it was due to Crestor. Switched back to lipitor and the same thing happened. After a few weeks went off that and my fasting level is still elevated, anywhere between 130-160. What could be causing this? I am convinced that while the statin might have aggravated the situation it was not the only cause, since I still have the elevated fasting level every morning and have been off a statin for weeks. My most recent A1C was 6.7 and my primary NP said everything is ok. I questioned the elevated fasting levels and she said not to worry, it all evens out. Really? I've been reading about "dawn phenomenon" and "Smogyi effect" so I am testing my blood sugar at 3 am Last night it was 137, definitely not low. I'm not sure what to do.

Hi, thank you for your response. I'm confused about Crestor though. Several people have told me that it couldnt be responsible yet when I researched it Crestor is known for raising blood sugar levels. In fact, I clipped an article back when this all started about 2005 that said that a side effect of statins could be Type 2 diabetes. I've never had a problem with lipitor in the past. Now that many weeks have past I now realize that either drug is most likely not the cause of my current problem with my blood sugar, although it could be adding to it. I am also on Remicade for a rheumatology disease but this elevated fasting level started before I started it. No other changes in meds- levothyroxine, losartan, amlodipine and setraline. I know I don't eat like I should as a diabetic. Not much junk, but too many carbs. I thought I was doing ok, monitoring with A1C every 3 months. This elevated fasting level is a major change which makes me question what is going on and I now have to change my ways. The last normal fasting level I had, as far as I know, was Jan 2018. I had no reason to suspect anything was wrong but now I understand that was probably not the right conclusion to make. I have been told that diabetes is a progressive disorder. Guess I'm progressing. Blood sugar before lunch yesterday was 89. 3 am this morning, 178. (6 hrs after eating). I'm looking for a local support group. Back in 2005 I was actually laughed at by many health care providers about worrying about a GTT when I had a normal fasting level.

I envy you in that you have worked out a routine you are satisfied with. I thought I had but now I need to revise that but no way could I do cauliflower the way you describe. I agree with you, I don't think statins are causing the problem I have now. Crestor was a new drug and the only thing I was doing differently when my A1C jumped to 7.8 (from 6.5 3 months prior) My diet had not changed at all. I did find lots of articles on its effects on blood sugar in some people. I never had any problems with lipitor raising blood sugar (in a significant way) in the past so when lipitor did the same thing as crestor this time (when i went back on lipitor) I knew there was something else going on. I'm almost 70 yrs old and keep up with the recommended annual checks (eyes etc), trying to stay on top of lipids, controlling blood pressure. I guess what I am worried about most is that this elevated fasting level I am experiencing (since the end of 2018) is a major change leading me to believe there is something else going on. I've thought about infections since I am also on immunosuppressives but don't seem to have anything obvious. Do you think my health care provider should be ignoring this because my A1C is now 6.7 (down from 7.8)? I don't think 6.7 is that good either. People are diagnosed with diabetes based on a fasting level over 126 on at least 2 occasions so it doesnt seem right to be told that's ok as long as your A1C is below 7. I cant control this problem by strictly reducing carbs because I have done that (back in 2005, which is why I was on starlix for awhile) and lost too much weight. I am definitely going to start reducing carbs though. I am so disappointed in my primary NP not having any recommendations other than "watch the carbs". I've asked to see a CDE which I have done in the past but have to admit I didnt take it too seriously at that time. I'm not opposed to medication but which one? The old time generics will most likely cause hypoglycemia if I am not very careful. I tried metformin in the past and couldnt tolerate the side effects. The newer noninsulin injections are expensive and do not have a proven track record (i.e. the possible connection to genital flesh eating bacteria) I guess the first step is to reduce carbs to a limit I can live with and see what effect that has. I have so many health issues and have seen so many specialists I really hesitate to see another endocrinologist. THanks for your input

I just turned 70 in December. Talk about a shock. Just saying the number is a shock. I don't feel 70. When I sort of got over that (still comes back and shocks me though...), I had to get a grip on myself and get back on track. I do have other 'things' going on, too. I have glaucoma. I use eye drops for that. I have irregular EKGs now and I have a cardiologist because of them. I've had nuclear stress tests and a heart cath to make sure there are no blockages. He says simply that the irregular EKGs are now my "normal". I take BP medication, which had to be reduced recently because he said it was too strong for me. (Losing weight and regular, sustained exercise like walking will cause a need to reduce the dosage, so the patient and the doctor need to be aware of this.) I seem to have a specialist for almost every part of my body. haha But am thankful I'm my own health advocate which is why I eat low carb.

Please read the link in my signature for more important info on blood sugar. You'll find studies, research and advice. And - I personally found that the guidelines from the ADA will keep blood sugar very high. My own family doctor gave me pamphlets from the Heart and Diabetes associations. I was sent to a RD (registered dietitian) who gave me a meal plan that I followed to two days and my blood sugar was higher than I'd ever seen it! Of course it was, because whole grain bread and potatoes were on the menu. I'm only on 1000 mg of metformin a day (500 morning and 500 night). If I ate what the ADA and that RD recommended, I'd be on stronger diabetes meds, multiple meds in fact. You'll read on the website in my signature that diabetes complications start at certain levels over time and those levels may be different for people but those levels fall within the guidelines of the ADA. THIS is why I eat low carb.

My own family: diabetes killed my grandmother and my mother. My mother was on insulin (type 2, like me) but ate whatever she wanted, did no kind of exercise. She had glaucoma and heart disease, had a heart attack, gangrene that started in a foot, that leg amputated and died at 72. My brother just had a triple bypass at 75 and my sister has kidney disease (and not sure what else) at 79. We three have diabetes. So, you see I have quite an incentive to keep my blood sugar as near normal as possible and that really starts with my eating plan. Of course I make an exception; I'm not perfect or crazy! My husband and I went out to dinner last week and I ate a piece of bread with my chicken salad meal.

What do I eat? Lots of veggies (not potatoes or carrots), meat, fish and chicken, nuts, yogurt, greens, tuna or chicken salad, cheese, some berries, dark chocolate, peanut butter.

You asked about changing your signature (what's under your post). When you're signed in, click on your name and then "My profile" and you can edit your signature. If you have a problem, let me know!

I have a blood pressure monitor at home. (Three, in fact, but I actively only use one mostly.) Anyway, every time I'm at the doctor's office (and especially in the cardio's) my blood pressure is high. Every time. Yet when I'm at home, it's normal and even low. For years my former doctor prescribed BP meds based on those readings (the ones in the office), and I also weighed more. Last fall it got to the point that I passed out upon getting out of bed, which led to the cardio finally re-assessing the dosage of the benazepril and determining it was too high. Looking over my readings at home convinced him (and my GP) to lower the dosage from 40 to 5 mg.

Now, I take random readings and take them with me along with the monitor to my app'ts to confirm how my monitor is recording my bp. When the nurse gets an elevated reading, I used my own meter to see what it records and it's always just a few points off. This way, they know that my home readings are ok.

In my case, I also found that anxiety makes my bp very very high. ugh

Getting control of your blood sugar is important and I found the best way is to keep a journal with time, food and blood sugar reading right before eating and then about two hours after. If you try doing that in the evening, you might be able to get better control of the morning fasting numbers. If you need to snack on something after dinner, try some nuts, or cheese, or part of a small container of unsweetened fruit yogurt. Trial and error will guide you.

I read most of the information in the link. I found it very informative. I notice on the one about drugs it does talk about statins increasing insulin resistance. Well, I don't think that's the whole explanation for my current problem, or maybe not even any of it. Do you know anything about Type 1.5 diabetes aka LADA (late autoimmune diabetes in adults)? I already have 3 autoimmune diseases. I'll probably be talking to my NP tomorrow. In the meantime, working on my diet.

I was going to suggest that maybe you have LADA. There isn't much to know about. LADA is a mix between Type 1 and Type 2 and strikes adults. Many doctors do not know about it and just diagnose the person with Type 2.

LADA(Type 1.5) is an autoimmune disease and starts out like Type 2 and should be controlled with diet and exercise. After 2-3 years(depends on the person and when dxd.), LADA patients need to take Insulin along with diet, exercise, testing blood sugar often and quarterly visits to an Endo for lab work.

https://www.lvhn.org/conditions_treatments/diabetes/latent_autoimmune_diabetes_in_adults_lada/overview/symptoms

Post Edited (msOuchie) : 4/15/2019 7:51:16 AM (GMT-6)

LADA is like Type 1 diabetes except that it isnt a sudden as Type 1 usually is. Beta cells are destroyed gradually and the person doesnt need insulin right away. Some doctors will test for antibodies and C-peptide. Others don't, they treat you for Type 2 and when it doesnt seem to be working well change treatment. It stands for Late Autoimmune Diabetes of Adults. (usually occurs in adults) Its also been called Type 1.5 or the "thin type 2's" I'm not an anti-vaxxer but.... just before this sudden rise in fasting glucose level I had my flu shot. Since I have a screwed up immune system to begin with, I have to wonder. I had my flu shot 10/31 (my A1C at the end of Sept was similar to what it was 3 months prior to that) Then in less than 3 months my fasting level is 169 and A1C is 7.8

I would suggest that you find a doctor who will test your antibodies for type 1 diabetes (TD1/(autoimmune diabetes). You may very well have LADA which is sometimes referred to as TD1.5 as it is autoimmune but it develops more slowly. Determining what type of diabetes you might have is important for correct treatment. If you have autoimmune diabetes, insulin might be better at preserving any remaining beta cells as you progress. Other Type 2 diabetes medications may cause you to lose beta cells faster. You can develop TD1 at any age. It is also linked genetically to celiac disease and Hashimoto’s which can develop at anytime too. I urge you to research this further.

I have celiac disease, Hashimoto’s and autoimmune gastritis. My doctor and I have determined that as of now, I am a thin type 2. I am insulin resistance and maintain my HA1C under 6% with a low carb high fat diet. Fat is critical as it does not increase your blood sugar. If you reduce your carbs and increase fat, you should not lose weight. My cholesterol lab results are good. All Lani’s links are great. Eating to my meter has become a way of life for me (five years to date).

I also strongly think that statins can cause diabetes in some people. I refuse to take them personally. Instead, I think managing my diabetes correctly will help prevent cardiovascular disease.

You already have several autoimmune disorders. I can not believe your doctor would not test you for antibodies for diabetes.

You have the right attitude. We all have unique issues and treatment must be modified to accommodate them. It is unfortunate that we must be in charge of our health. It is rare to find a doctor who can keep current on the latest in medical information and think wholisticly. Like you, I get tired of having to treat myself. Celiac disease is one of the few diseases where the treatment, a gluten free diet, is entirely in the hands of the patient. But I am thankful, because there is no treatment for chronic autoimmune gastritis or Hashimoto’s.

I think the medical community is still learning about diabetes. Unfortunately, by the time they figure it out, many will suffer from kidney, eye, and amputations. I am glad that Lani is here spreading the word about effective dietary changes.

As it stands now, I am thin type 2 diabetic. Type 2 diabetes runs strong in my family as well as autoimmune. So, a type 1 diagnosis is not impossible for me. I monitor my blood sugar at home and also follow up with my supportive GP. Diet is working for me now. I am trying to avoid Metformin because frankly one of the side effects is GI upset and I do not need more of that! Other drugs? I am very leery because I have some pretty severe allergies to medications. Heck, I am even allergic to acetaminophen, ibuprofen, and aspirin (anaphylactic). I also avoid most vaccinations for the same reasons as you —immune system reactions.

I had a complete heart work up a few years ago. No heart issues at all. They admitted me to the hospital because they suspected a heart attack. Turns out I had spinal fractures due to osteoporosis thanks to celiac disease! So, I will not take a statin. I figure my heart and arteries must be doing well despite elevated LDL due to a high fat diet. Cholesterol? I used to be praised for having very low cholesterol. So low that now they know it is just as bad as being high. That too, was due to celiac disease. I was malnourished! Hubby is on a statin, but he had a valve replacement (birth defect) and aneurysm repair. So, again, individualized treatment is necessary.

If you do have TD1, I hope that the Remicade will prevent beta cell loss. That would be a great bonus. My niece is on Remicade for Crohn’s and is doing well.

Take care and keep advocating for yourself!

I thought I would post an update to my situation. I saw the endocrinology NP (I thought I only had an appt for the diabetes educator but it turned out I saw the NP and then the educator in a week) She was very nice. I think things will work well with her. She ordered the two blood tests, C-peptide and GAD-65. My C-Peptide level ws 6.5 (normal 1.4-4.4 ng/ml) which I think indicates I am making enough insulin, which rules out LADA? GAD-65 was interesting. The report states that the antibody was detected, level 0.19 (normal less than 0,02) Both of these seem like small abnormalities (in the opposite direction) but I have no frame of reference. Since I have autoimmune diseases it isnt really a surprise to have a low level of these GAD antibodies. I have a low level of P-ANCA, as well as a relatively high level of SMA (smooth muscle antibody) and have had high thyroid antibodies in the past (last test in the past year they were low) I also have a positive ANA in the past, but not very high. I havent spoken with the NP about these results yet. She put me on metformin XL and had no gi problems until 1 week on the drug. Will see if they persist. My blood sugar readings are great. So that's where I am right now, as usual more confused I have tweaked my diet to reduce carbs. Chris

Many years ago I tried metformin, cant remember the dose but it was not the xl version. I had bad gi issues and stopped after 3 weeks. I think maybe I had a bug this time because today its ok and my diet hasnt changed much from before I had the issues at the 1 week mark. Will see how it goes.