If you are please let us know!!! If you have ever been told you are any of the above or insulin resistant we want to know. PM me if you don't want to be known or seen. If so please tell us a little about your situation...and read the posts that Everett123 and I have posted in the last week or so....

Okay...here is my experience...which is interesting due to the timeline.

1988...first symptom of PD...pill rolling right thumb and hand tremor.

In June 2003 I was abruptly sent from my Internist office to the hopsital. My glucose was near 700 and I was days away from being in the ICU if I had not seen the doc that day. Until THAT day, no one had checked my glucose lever...never, ever. Today I am a Lantus in the a.m. user and Novolog bolus during the day user, if needed, which I usually don't need. I keep my A1C under 6!

How does this correlate?

Well, you see my year of initial symptoms. When I reflect back upon my diabetic symptoms...sweating, thirst, urination, etc...I can track them back at least 10 to 15 years.

Apparently I was eating resonably so my diabetes was not detected until I was loosing my vision and was so weak that I could not stand without a cane for more then a minute or two. My diabetic symptoms worsened over the period of a year.

It is only in the past year or two that physicians have begun to routinely test glucose level along with annual cholestoral...about time!!...considering the diabetic peril the American population is in these days.

I think this is going to be very interesting. I have a history of hypoglycemia (low blood sugar) that started in 1970 something...possibly earlier. I had days when I couldn't get off the couch. Nothing ever showed on glucose tests. Until I had my 4th child when they screened a lot more carefully for Gestational diabetes. I saw the one and only Diabetes doctor who specialized in GD in all of BC. I told her my story and she said "You've been Hypoglycemic for years!"
I had my baby, blood tested okay so that was that. The day the Neuro told me I had PD, he sent out blood work. When I saw him for follow up he told me I tested positive for diabetes. Lost 25 lbs, and was back in the non diabetic world, no one gave my complaint about Hypo glycemia a 2nd look. By this time I had read the books and was pretty knowledgable. I have always thought there was a connection between the two. I have a horrendous bilateral tremorin legs only (although it was right side only -both hand and leg at beginning), but virtually no other notable signs of PD. I have adapted my eating to getting my meds to work, and every time I see a Neuro, they think I'm unusual, but just tell me I shouldn't be taking so much sinemet (1000+mg daily). When I'm off my legs are weak and shakey. I tire easily now, and am very anxious. I've had so many things that should have been red flags, but the test with the strange name (the one that gives them a "mean" for the last 3 months shows me close to the line but not over it.) I'll have to check your 700 reading on Rick's conversion link. I'm not sure how high that would be metrically...but my guess is it's scary high!!! The blood testing in the labs is not adequate. I have to do some more reading to find out what the meds are up here. I will post more on Monday if my computer doesn't choke and die. I have to sort through old logs and see what my problems were. Ten years of this crap is going to make me one crabby old chicken if it turns out glucose and brain damage are the root of my adventures with Parkinson's.... Stay tuned for more.

This is a very interesting thread! My husband has diabetes, but no PD. And I was diagnosed with functional hypoglycemia (low blood sugar) years ago. I have had the 4-hour glucose tolerance test several times.

Diabetes Type 1 is considered an autoimmune disorder. Defined, autoimmune disease is: disorder of the body's immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign. The most common diabetes is Type 2 (adult onset). This is only a theory, but one that is being researched. With the exception of a brain insult (head trauma or exposure to toxins - like pesticides), with autoimmune disease your body's immune system begins to attack itself. I have wondered if that is what is happening for those of us with PD? Could it be that our cells are dying (apoptosis) because we are predisposed to have something that attacks them within our own bodies? It certainly is suggestive of this as many with PD develop diabetes.

And I sincerely believe "what you eat is what you are." The National Parkinson Foundation (NPF) has an excellent registered dietitian (Kathrynne Holden) who has an email forum where people can write in with questions about diet and PD. Below are two very informative responses concerning protein and dairy products and PD medications:

Peg

Proteins in food can significantly block the absorption of the levodopa in Sinemet. In some people, milk proteins are especially formidable in this respect – some have stated that a single glass of milk in the morning can block their doses of Sinemet for the rest of the day.

Have you noticed, when dairy products are given, if the PD symptoms increase, along with the pain in the legs and back? If so, I would consider it very possible that she is particularly sensitive to milk proteins, and they are blocking the effects of the Sinemet. This could mean increased rigidity or cramping as you describe.

If this is the case, then she should avoid milk, yogurt, cheese, cottage cheese, and other dairy products. Instead, see if she will accept a soy or rice milk substitute, such as Rice Dream or soymilk; this can be very useful for putting on cereal, in coffee, or even drinking plain. Be sure to get the kind that is fortified with calcium and vitamin D, as it will be important for her to get enough of these.

Regarding the pain, unfortunately, the term is very vague; PD is associated with many kinds of pain – muscle/joint ache, cramping/dystonia, etc. If the pain she experiences tends to occur more often when the Sinemet wears off then it could be “wearing-off dystonia,” a kind of cramping that is often reduced when the next dose of Sinemet takes effect. There are several things that have been successful for some people, but unfortunately, not for all:
- quinine; this must be prescribed by her doctor
- large doses of vitamin E, usually starting with 1500-2000 IU/day for one or two weeks; if the dystonia lessens, then the amount of vitamin E is lowered by about 100 IU/day, until the pain begins to return. That amount of vitamin E is then determined to be the useful amount for that person
- calcium/magnesium/potassium – these minerals are all involved in muscle contraction and relaxation. If intake is insufficient, it can lead to a kind of cramping known as “tetany.” Also, if dystonia occurs, deficiencies of these minerals can make dystonia much worse. So, if the Sinemet absorption was blocked by milk, resulting in dystonia, and mineral deficiencies were also present, the pain could be exacerbated. I would ask her doctor to refer her to a registered dietitian who can determine whether her intake is adequate, and whether supplements might be helpful. Calcium citrate (especially if crushed) is better absorbed than calcium carbonate, and also does not constipate.

Kathrynne Holden, MS, RD
visit the "Discussion Corner" at the National Parkinson Foundation www.parkinson.org
*************************
and one more:

First, if you use levodopa, you should be aware that it is among the medications that, in some people, can lead to elevated blood glucose. Therefore, it will be extra-important for you to check your blood sugar frequently, to determine whether it is a factor for you.

Carbohydrates should be unrefined for the most part -- whole grains rather than white bread/crackers, cooked dried beans, fresh fruits rather than those canned in syrup, etc. This will be very helpful with regard to PD, because these are high in fiber, which is beneficial for constipation, as well as blood pressure, and the heart.

I recommend several servings of fish per week, it too benefits both those with PD and those with diabetes, having high-quality protein, B12, and omega-3 fatty acids that protect both the nervous system and the heart.

Cinnamon has been found to help control blood glucose, and could be a good resource for you.

I recommend you ask your endocrinologist for a referral to a registered dietitian who is a certified diabetes educator. S/he can help you plan a healthful diet for diabetes, and if willing, can also address any PD-related questions to me via this forum.

Kathrynne Holden, MS, RD
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

I find this to be a very informative thread. I have type-2 diabetes and have found it much harder to control my blood sugar level since I started taking sinemet. Prior to my dgn of PD I was able to control my glucose level with diet and exercise, but had to start meds soon after being dgn'ed with PD in 2001. The meds seemed to work for a while until I started Sinemet about 1-1/2 years ago. when I noticed my blood sugarr going higher I asked my pri- phy if PD meds would affect blood sugar levels she didn't have an answer but told me to start taking my diabetes meds twice a day. Her lack of info led me to go to an blood specialist and I ask the same question about PD meds and blood sugar levels. Guess what? He had no clue either, and suggested that I double my diabetes meds.I woke up the next night with very low blood sugar.This happened about 6-mos ago and I havent been back to either doctor. Neither phy offered to look into the issue of a conflict between PD meds and high blood sugar levels. I did some searches for info on the net but no luck.I didnt find anything on BT-1 either.
My mother and brother have type-2 diabetes but no PD
I am taking Glucovance 125/250 two to three times a day and moniter blood sugar level daily. The daily levels,while interesting, are a useful tool are not what the doctors look at. They watch the 3-mounth A1c level I must not be watching my levels close enough though because my symptoms seem to be getting worse. (tremor and freezing). I'll start a file to educate my doctors the next time I go to see them.
Lets all share as much info as possible, so we can learn as much about this serious side effect to PD and help the uniformed.
jerry

ps; I'll be testing to see if elimiting dairy protin helps my symptoms this week.

Unless I am wrong an A1c gives a "mean" or averages out the sum total of your glucose activity over 3 months....my glucometer will do that for me also. It tells me that when you add it all up and divide by 90 days you come out at your A1c score. That does not take into consideration the day to day swings ( and in our case the hoiur to hour swings in blood sugars.) Am I wrong? I'm finding if I can keep my blood sugar in the 5.5 range my meds work just like the pharmacy says they should, but if my reading is over 6 when its time to take them, some slowness to kick in, and if over 7 forget it! The articles that zucciniflower posted on our related threads are very very interesting..Thank you for your reseach ZF!!! I'm still looking at my log sheets for the past 9 days and a pattern is emerging. I totally agree with Peggy... we are what we eat. more later...

By using a glucometer, do you mean poking your finger and testing the blood?

You must understand that we are talking about something that your docs don't know about but that is making your life hell while shortening it. It has been known since 1930 that ldopa can cause hyperglycemia. But in 1930 ldopa was a useless compound. When it became the "gold standard" in 1967 that earlier work was brushed aside because the addition of the carbidopa formulation theoretically fixed the problem. Unfortunately, while it did give the numbers desired in the bloodstream, nobody looked to see what was happening in muscle tissue. Why muscles? Because that's where 90% of glucose activity happens...

Then in 2004 a paper was published that I ran across a few weeks ago and that set bells to ringing:

1: J Appl Physiol. 2004 Dec;97(6):2339-46. Epub 2004 Jul 16.

Levodopa with carbidopa diminishes glycogen concentration, glycogen synthase
activity, and insulin-stimulated glucose transport in rat skeletal muscle.

Smith JL, Ju JS, Saha BM, Racette BA, Fisher JS.

Dept. of Biology, St. Louis University, 3507 Laclede Ave., St. Louis, MO 63103,
USA. smithjl@slu.edu

We hypothesized that levodopa with carbidopa, a common therapy for patients with
Parkinson's disease, might contribute to the high prevalence of insulin
resistance reported in patients with Parkinson's disease. We examined the
effects of levodopa-carbidopa on glycogen concentration, glycogen synthase
activity, and insulin-stimulated glucose transport in skeletal muscle, the
predominant insulin-responsive tissue. In isolated muscle, levodopa-carbidopa
completely prevented insulin-stimulated glycogen accumulation and glucose
transport. The levodopa-carbidopa effects were blocked by propranolol, a
beta-adrenergic antagonist. Levodopa-carbidopa also inhibited the
insulin-stimulated increase in glycogen synthase activity, whereas propranolol
attenuated this effect. Insulin-stimulated tyrosine phosphorylation of insulin
receptor substrate (IRS)-1 was reduced by levodopa-carbidopa, although Akt
phosphorylation was unaffected by levodopa-carbidopa. A single in vivo dose of
levodopa-carbidopa increased skeletal muscle cAMP concentrations, diminished
glycogen synthase activity, and reduced tyrosine phosphorylation of IRS-1. A
separate set of rats was treated intragastrically twice daily for 4 wk with
levodopa-carbidopa. After 4 wk of treatment, oral glucose tolerance was reduced
in rats treated with drugs compared with control animals. Muscles from
drug-treated rats contained at least 15% less glycogen and approximately 50%
lower glycogen synthase activity compared with muscles from control rats. The
data demonstrate beta-adrenergic-dependent inhibition of insulin action by
levodopa-carbidopa and suggest that unrecognized insulin resistance may exist in
chronically treated patients with Parkinson's disease.


Like rosebud and others, I had been dealing with some very freaky symptoms and had been blaming H pylori, but as I looked into this things began to fall into place. The picture is still unfolding, but something very important is here.

From ScienceDaily.com...........June 2006

Abnormal Glucose Metabolism May Contribute To Chronic Nerve Disorder

Abnormal glucose metabolism, which occurs when the body has difficulty processing sugar (glucose) into energy, is twice as common among patients with chronic nerve dysfunction of unknown cause than among the general population and may be a risk factor for the condition, according to a study posted online today that will appear in the August 2006 print issue of Archives of Neurology, one of the JAMA/Archives journals.

Many older adults experience nerve disorders known as neuropathy, some of which are characterized by symptoms of "burning feet" and other unpleasant sensations in the lower leg, according to background information in the article. Diabetes, genetic disorders, exposure to toxic substances and a condition called amyloidosis in which extra protein-based substances accumulate in the body tissues can all cause neuropathy, but many cases do not have an easily identifiable underlying cause. When laboratory tests cannot determine the cause, the condition is known as chronic idiopathic axonal polyneuropathy; a cause is eventually found in only 7 to 30 percent of these cases.

Charlene Hoffman-Snyder, M.S.N., N.P.-B.C., Mayo Clinic, Arizona, and colleagues identified 100 consecutive patients (60 women and 40 men) with chronic idiopathic axonal polyneuropathy who were evaluated between January 2003 and January 2005. Patients underwent a complete neurological evaluation and had a fasting plasma glucose test, which measures the levels of glucose in the blood after eight hours of not eating, and a two-hour oral glucose tolerance test, which determines how well the body processes glucose by drawing blood two hours after fasting patients ingest a dose of glucose. "The fasting plasma glucose level alone does not always identify patients with impaired glucose tolerance and neither does the two-hour oral glucose tolerance test always detect patients with impaired glucose metabolism," the authors write. "Both tests are, however, useful to detect hyperglycemia [high blood sugar] and the consequences of disordered glucose metabolism."

According to the two-hour oral glucose tolerance test, 62 patients (62 percent) with neuropathy had abnormal fasting glucose metabolism, including 24 with undiagnosed diabetes. (This compares with 33 percent of patients of similar ages in the general population with abnormal glucose metabolism as previously estimated by the Centers for Disease Control and Prevention in other published reports.) The results of the current study suggest that abnormal glucose metabolism may be a risk factor for neuropathy.

"Conventional thinking among diabetologists is that diabetic polyneuropathies are the result of prolonged hyperglycemia," the authors write. "Like previous studies, this investigation supports the hypothesis that distal axonal polyneuropathies may occur in much earlier stages of abnormal glucose metabolism than previously thought. Recent studies suggest that the neuropathy associated with impaired glucose tolerance may be milder than neuropathies traditionally associated with diabetes mellitus and may be the earliest detectable sign of abnormal glucose metabolism."

(Arch Neurol. 2006; 63: (doi: 10.1001/archneur.63.8.noc50336). Available pre-embargo to the media at www.jamamedia.org.)

...this is from my experimentation yesterday until I ran out of test strips. Shortly after that I did begin to see-saw after some moderate stress. However, thus far (2:00) has been one of my best days in some time. Today I have been eating steadily, starting with nuts and raisins when I first got up and was taking my first meds. There has been constant "grazing" ever since and my typical late morning slump never materialized.

A suggestion, mix up some "gorp" with nuts and dried fruit. Keep it with you and have a handful everytime you feel a twinge of hunger or a hint of a symptom. See if it makes a difference.