In Which Things Take an Unexpected Turn
Kathryns latest diabetes diagnosis creates a new beginning for an old journey.
By Kathryn Foss
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
April 2011 — My little diabetic world has been a bit topsy-turvy over the last few months. It started out in December with blood tests showing that my C-peptide function had decreased dramatically in the one year since my previous test. I'm not spurred to action easily; however, hearing that news terrified me.
My greatest fear is to become an insulin dependent diabetic. I have talked for years about controlling diabetes with diet and exercise, but now I have a lot of momentum to do so. I scheduled an appointment with my endocrinologist, and in the meantime, I cut out all grains, started working out three to five times a week, and increased my dosage of Metformin to 3000 mg a day. I did this for the month leading up to my appointment, and with the exception of a few bites of starchy carbs here and there, my month of low carb eating was very successful.
However, no matter what I ate, how hard I exercised, or how much medication I took, I could never get my fasting blood sugar under 150. In fact, all of my numbers seemed to settle in the 130-150 range, regardless of the time taken. On top of that, no matter what I did, I couldn't lose any additional weight after losing 22 pounds in 2010. Like a good diabetic, I logged all my glucose readings, food, and exercise, and on the day of my appointment, I printed everything out. I had five pages of data for my doctor—lots of colors, graphs, and averages. I could tell he was impressed; he even said that my one-month experiment was quite scientific (and I think he was quite serious).
After looking at test results from the last three years, and taking into account my "scientific" experiment of eliminating grains and how it affected blood glucose values, my doctor announced that his suspicions were confirmed. I wasn't a type 2 diabetic, I was a type 1.5, or LADA. He ordered one more round of blood tests before he officially made the call. I asked if this whole 1.5 thing could have been avoided had I just lost the last 15-20 pounds hanging around my body, and it was then that my doctor gave me a gift. He looked at me and said quite seriously, "Your being 15 pounds over your ideal weight did not cause you to get diabetes. You could be 10 pounds underweight and the results would be the same. There is a defect in your cells causing this, not YOU."
It felt like a weight was lifted off of my shoulders. I hadn't realized how much I had been blaming myself for being a diabetic. The times I had said to myself, If only I would stop being lazy and lose these last pesky pounds, I would be ok, it wasn't my fault! I sat there stunned. I wasn't sure how to really feel about this new turn of events, I just understood that I wouldn't be controlling my diabetes with diet and exercise as planned.
My A1C was up from 6.5% to 6.9%, so something had to be done. I made my aversion to insulin clear, as well as the fact that I wanted insulin to be the absolute last resort in my treatment. So we settled on Victoza. I had read a lot about it and apparently I am a very good candidate to try it. I've educated myself on the possible side effects and have decided I'm more at risk for diabetes complications, so the potential benefits outweigh the risks.
I don't know what happens from here. I'm still trying to get my head around not being type 2 and trying not to get freaked out over the possibility of LADA. It's like a new beginning on an old journey, a fork in the road, if you will. And quite suddenly, my life as a type 1.5 diabetic begins.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from