I would like to know how you are getting such a spike on real food. Yet you do not show this spike on pure glucose in the contrived lab test which would be very quick with glucose.

Food stays in the stomach for at least an hour, to 4 hours in most people. You do not eat pure glucose but have to digest any complex carbs. This is not an instantaneous process. Any fructose would not show on your meter at all for a long time as it has to go thru the liver and be converted to glucose. This evens out any spike so that the sugars show more moderately. (this is why diabetics use fructose supplements in cooking instead of table sugar sucrose. )

I would expect the fast spike on the GTT test. The GTT test is not "real" and cannot really be compared to regular eating. It is used as a statistical test with the results determined based on many years of comparing diabetics to non-diabetics.

I think if you jump on medication at this point, with a normal A1C and no long term elevations showing, you might end up overmedicated and experience low sugar spells. Low sugars are dangerous to the brain and some studies show even one serious low sugar event can lead to dementia.

I urge caution, whenever starting drugs. ALL the diabetes oral drugs carry a pancreatitis warning and potential. I think you should really NEED the drug, to decide to use it. While you are stressing your body with those drugs for your lung condition, adding another would be problematic IMO.

As usual, sound advice/comments from MrsD!!!

Hi Stacy,

Idiopathic PN may not have diabetes or even pre-diabetes but she definitely has something going on with spiking blood sugars. Maybe she had other things that could cause the spikes. I am not a doctor nor privy to her entire medical history. I agree with YOU totally that doctors wait. When I was diagnosed, it came as a HUGE surprise to me. And get this........ the doc (a FORMER doc because of it) charted on the day he diagnosed me that I had a "history" of elevated blood sugars. NEVER did he disclose that to me in any manner shape or form. I guess when I had a 237 fasting blood sugar, he must have finally felt compelled to order an A1C 7 days later and it came back as a 10.2.

It amazes me how much a patient can learn from reading their own medical records, so many things the doc failed to mention for whatever reason. Maybe he thought not serious enough to mention or maybe he thought the patient would be too stupid to understand. Maybe he was afraid he would have too many questions to answer. That is also how I found out that I had severly reduced deep tendon reflexes. Reading my records also informed me that I have cataracts and borderline glaucoma. Never mentioned to me.

Sorry, I did not mean to go off on a tangent.

Glad we are in agreement on Idiopathic's need to get answers.

Dear mrsD,

I agree that the pancreas is affected by diabetic drugs. I agree that taking medication unnecessarily is a bad thing to do. I agree that ALL prescription drugs have side effects. Prescription drugs are by prescription only as they should be prescribed and taken only under the advice of a physician.

Many diabetic drugs WILL potentially cause a LOW blood sugar which can be dangerous. SOME diabetic drugs will NOT cause you to go low and that is why they are safe to be administered to persons BEFORE they are classified as diabetic according to the guidelines used by the ADA. There are several different classes of diabetes medications and many, but not all create low levels. I personally am a little leary of the DPP-4 class, but Metformin has been around since about 1927 if my memory is working properly and has a long track record. It appears it would not be appropriate for member Idiopathic PN due to her lung condition. If she had no contraindications, I think it would be a good test over a 30 day period to see if it helped but that is just my opinion.

There are potential dangers in anything we intake, whether it be natural or manufactured. Certain foods have potential dangers, supplements have dangers, over the counter drugs have dangers, prescriptions, too. My point is anything we ingest needs consideration and risk vs benefit determined. Even peanuts can be fatal.

I think further investigation needs to be done to determine WHY she is having spikes. I do not think she should just wait around until the day someone tells her she IS diabetic when that path need not be in her future. Maybe her spikes are due to something entirely different than diabetes or the road to it. That would be the most common thought but metabolism is not always that simple.

Sometimes I feel I am boxed against the wall (and this feeling is not pleasant). I am in pain for 2 years now, diagnosed with this hard to treat lung infection, and either due to the medications or my system simply is not doing what is supposed to do, i developed other health issues in the process... Instead of improving, the list of symptoms keep adding on.

Just take this glucose for example, I really, really dont want to add medication but on one hand, I dont want to further damage my nerves when i have spikes (my imagination is so fertile that i imagine my nerves dramatically dying like flowers withering). I want to gain weight by eating more but when i eat even just a little more, the BS goes high. Its a dilemma difficult to solve. I like the idea of Mrs.D, to BE cautious on being medicated. Dont worry MrsD, I AM.

I appreciate the mention of Hopeless on the side effect of Metformin on certain lung issues. I would never have known this. Tradjenta, on the other end, may cause pancreatitis.... Oh no, i cannot afford to have another condition. Its so difficult to weigh the risks vs benefits when your body is at stake.

--I would still think it would be instructive to have a longer glucose tolerance test--four or five hours--with an initial draw for both glucose AND insulin levels and then half hour draws at least through four hours with both glucose and insulin levels being measured.

You want to see how the insulin/blood glucose relationship is reacting much more often then every hour, and when exactly the spikes are occurring--and what the insulin levels are before the spike and in response to it.

One of the best ways to gain weight is by eating more fats.

Now this means "good fats" of course. Fats 1) slow down the emptying of the stomach, so blood sugars do not spike so quickly, and 2) provide extra calories, 3), good fats, typically are in short supply in our food chain in the US. So improving them, is a benefit to the whole body.

Nuts are a good way. Olive oil, flax oil, in salads are another option. Foods like Salmon, or other fatty fish.
You will want to avoid Trans Fats of course.

I wonder if you are having "dumping syndrome" ...IdiopathicPN?
Dumping is where the stomach releases food too soon. When this happens, it is not broken down as it should be so then it would
not provide nutrients for you...hence the weight loss?
Could this be a side effect from your lung medications?

http://www.mayoclinic.com/health/dum...ndrome/DS00715
This can happen in anyone, not just the bariatric patients.

It is something to think about. And I like Glenn's suggestions too.

Hi Glenn,

I know how frustrated Idiopathic PN must be feeling. Wouldn't it be nice if she could wear a "continuous monitoring device" for a few days. I realize she would not get a doc to order it and the expense prohibitive but it would be a nice thing for her to try for a few days if that were feasible.

I sure hope she can get some answers. As long as her levels do not warrant further testing in her doc's opinions, she will continue being frustrated. Oh, how nice if our health issues were easier to diagnose, especially the neurological ones that do not show up on MRI's etc.

I agree with your testing procedure...... it is just a matter of getting her doc to order it which appears to be VERY doubtful.

Hi mrsD,

What do you think about avocados for Idiopathic PN?

Avocados are good too. Sorry I forgot them. I love guacamole!

People lose weight when they have malabsorption syndromes.
Cancer, and diabetes uncontrolled. But her tests don't point to frank diabetes yet. Some cardiac conditions also cause weight loss, and this is called cardiac cachexia.
http://www.webmd.com/heart-disease/h...-heart-failure

And some people just lose weight as they get older. (sorry to say I am not one of those types ...sigh).

The fact that she did not show the high spike with pure glucose
means she is making insulin.

She will just have to see what happens with time, IMO.