Hello.
Not sure what's going on with my body but...I am a 27 year old female. I have been running for 1 year. Did my first half in October and training for a 5 mile (first time working speed work) right now. However three days ago I just had routine blood work done and my FBS was 285. I added a A1C and it was 12 (yes I said 12). I spent this weekend checking some sugars. My FBS are all above 250. My 2hour pp are in 400 and 500's. I see my doctor tomorrow. I am very interested if I am type I or II. All labs normal in August.
I haven't been feeling well and running has been hard so this explains a lot. But I really wonder how this will all change my running. I am hoping this will be a place to have questions answered. I can't imagine my doctor will know questions about nutiriton during races and training.
Thanks in advance.
Hi ran13,
First of all, welcome! Secondly, sorry you have to be here. I was diagnosed at 27 as well, and have been living well with Type 1 for almost 17 years now. I would personally suspect Type 1, given your age, fitness level, the blood sugars you report, and the relative suddenness of onset. Sounds like you have been researching diabetes, which is good. You have proabely already discovered that late onset Type 1's are often misdiagnosed initially as type 2, so make sure your doc is knowledgable in telling the difference (ie: doesn't just assume you are type 2 because you are not a child). The main thing is to get those numbers down, and the sooner the better. Insulin is not the enemy, and is the only treatment if you are Type 1, and sometimes best if you are Type 2. If you're not seeing an endocrinologist, I'd recommend you do so. A few visits with a certified diabetes educator, and/or a registered dietitian can also be really helpful.
Rest assured that you will still be able to run, and do almost anything else you want (there are a few restrictions on long distance trucking, aviation, military service, etc.), but it will just require more thought, planning, and flexibility on your part. Let us know how things shake out for you, and any questions you may have. There are some great books/websites, etc. as well that some of us can point you to once you know for sure if you will be on isulin.
The voice of mile 18
Tri Rule #1 of Triathlon Training/Racing - If Momma ain't happy nobody is happy
Ran13 - Carol41 is dead on with her message. My biggest message to you is to get your numbers under control, see a specialist, and understand this crappy disease. The sooner you can understand and get on a pump the better off you will be.
As for running, you will need to get your sugars under control and you should be able to continue the running. My father is a great example of how now to treat diabetes, so much so, he inspired me to start running last October and I haven't stopped since. I was an outshape T1 diabetec for 10 years (originally misdiagnosed as T2 At age 33) and running has changed my life. Its unbelievable!
As crappy as you feel with highs, the lows are dangerous and will freak you out, so I can't emphasis enough getting sugars under control and understanding the disease.
Good luck and keep running!
straw man
Mostly I just want to say ditto to the advice you've gotten so far. See a good endocrinologist.
Once you get a diagnosis and a treatment plan, please let us know how you're doing. And ask any questions that come up.
Good luck!
He who has the best time wins. Jerry
thanks everyone for your support. i am thankful that i have already been running for a year before the diagnosis. I can't imagine if i was starting now with the diagnosis and trying to start running.
I saw my doctor on Monday. She started me on Glucophage, which has been awful, gi side effects and headaches. My sugars have been somewhat better now that I am better with diet but fastings are still above 250?? I see an endo on April 12th and diabetic educator on 4/1. I am a nurse practitioner but I work in psychiatry so my knowledge is limited but my husband is our chef so he will need to learn a lot as well.
Carol, johnny, jp-thanks for the info and similar stories. I think similarly to you about the insulin. I almost wonder if I would prefer it to meds. I am not liking the glucophage.
Joe- You wonder where the insulin resistance comes from especially when you were so fit.
Do any of you have any input on how hard to train right now while my sugars are out of control? I am in a great running group right now with everyone from walking to marthoners. We are broke into different groups based on distance and speed. I had been running the 5mile speed group and was struggling a lot. Currently I am only a 10min/mi pace. I was doing a lot of speed/hill work. Should I slow down to a 5mi easy pace and just do tempo type runs? I know once i am stable I can do whatever I want but i am not sure what to do when im not stable??
believe you're not supposed to run if your sugars are over 350 but besides that no real restrictions - unless you're having problems w/ low sugars (always run w/ your meter, cellphone and extra carbs) and my .02 run w/ the group you wanna run w/ just make sure they know what to do if you're going low.
"Joe- You wonder where the insulin resistance comes from especially when you were so fit."
well i'm going to throw my grandmom sarah under the bus and blame her for giving me lousy genes - she was the only one in my family to have the Big D. I didn't help things for not taking good care of myself in college and a couple years afterwards I had a good beer belly but wasn't morbidly obese. but apparently the bad genes and bad diet was too much for my wussy pancreas
Joe, LOL on throwing Grandma Sarah under the bus! So much we don't know about the causes of either type of D, though the media would lead us to believe otherwise.
ran13, I agree with Joe, but the cutoff number for exercising is generally 250, not 350. Reason being....that if you are above 250 and your insulin levels are low, there is a good chance that you are producing ketones. If that continues or gets worse, you can wind up in really bad shape (diabetic ketoacidosis). So the general recommendations are to either not exercise if you're over 250, or at least test for ketones (urine test strips available OTC at the pharmacy) if you are, and don't run if you have moderate or above ketones.
Non-medical, and not "by the book" opinion here: If you are worried about losing running fitness as you wait for that endoc appt, you could possibly try a run when you are at or around 250. Test before, and then test when you finish to see if your blood sugar rises or falls. Sounds like you may already be aware of this, but more intense efforts (anaerobic) can actually drive our blood sugar higher, while slower runs (more aerobic) tend to drive them down (if you have some insulin working). So you might want to steer away from the speed/hill work and opt for more long slow runs until those numbers come down.
Glad you are not afraid of insulin if that winds up being what you need. I believe the GI distress is common with the meds you are taking, especially at first, so hopefully that will smooth out for you. Not trying to worry you, but please keep an eye on your blood sugars, and push to see that endoc sooner if they continue to rise.
Hope the above helps. Not sure how much you already know as a NP, so forgive me if I'm repeating what you already know.
Ran13: I am not certain how phsically fit you are (sounds like you are) or since you started running. But having a AC1 of 12 is crazy, I am not sure why your doctor has you on meds. Unless your obese or drinking regular soda or juice gatorade or high carbs etc. You should be able to get your glucose level down quickly. Maybe I'm jumping to conclusions but your appointment with your dietician maybe enlightening to you. My guess is the Endo visit should be sooner then later and you will most likely go on Insulin.
Good luck with this and sooner then later you will be feeling much better. Literally, you will see much better and your bladder will once again feel like you don't have to go every hour.
Sorry I'm not a doctor, but I play one on TV and this stuff interests me so much since I have many diabetics in my family!
Do great things!
Thanks for all the support, advice etc.
I am Type I. Insulin and cpeptide levels were low. Started Lantus 10u tonight. I will also start Humalog tomorrow. I stopped Glucophage. So Johhny to answer your question, I think I was started on meds because my doc was unsure what type it was. I am overweight, 165lbs and 5'3'', however still a good diet and active. She was very surprised and i don't think knew what to do. Honestly small town docs and not always the most experienced. I can't imagine going through this without my base as a healthcare provider.
As far as running, I am just going to take it easy and run slow and walk as much as I can. And I am glad you guys like answering questions because the diabetes team here doesn't seem used to people wanting to exercise and didn't have to have their arm twisted to do so.
Ask about getting a referral and finding yourself an endocrinologist.
Buy the book Think Like a Pancreas by Gary Scheiner. He's a type 1 diabetic and that book is very good about explaining what you will want to do as a type 1 diabetic.
Glad you got a definitive diagnosis fairly quickly. The book scratch recommended is good. Using Insulin (Walsh) is also very good and practical. It includes a concept called "ex-carbs" that provides some really good guidelines for balancing carbs, exercise and insulin. You can also google "ex-carbs" and find some of that info. Since you have a medical background, you may also eventually want to check out The Diabetic Athlete (Colberg).
First thing to do though is get your blood sugar down and titrate your insulin doses to accommodate your everyday life. Yes, you are fortunate to have a health care background AND a good attitude about accepting the transition to insulin. Keep up the good work, and know you are no alone. We're rooting for you!
I've never heard of ex-carbs. Just googled it now. I wish I had known about this idea when I was taking insulin.