a1C 5.8, symptoms as lousy as ever. I imagine the glucose tolerance test is a failure for me. I think I will discuss that next quarterly visit.

No one has actually told me to do the self-testing...I did that myself. When I didn't feel I was getting good feedback from doctors, I did my own research, and eventually went to a diabetes forum. Several people there took a look at all my results and said, "Yep, you've got a problem," and then provided me with links for learning about what's normal and what's not normal and how to learn what you can eat.

The process they described is "Eat to Your Meter." You basically test what different foods do to you and learn what you can and can't eat to keep your blood glucose at a reasonable level.

http://www.diabetesforum.com/diabete...tml#post131687

*************

Eat To Your Meter

Technique for eating to your meter:

- Establish your target range for blood sugar levels. Common upper limit is 140mg/dl = 7.7mmol/l. Commit to keeping your blood sugar under this level at all times.
- Test right before eating. Log the reading.
- Test again one hour after your first bite, and log the reading along with what and how much you ate. This is assumed to be about the highest peak - the spike - from the meal.
- Test a third time two hours after your first bite. This is hoped to show your blood sugar dropping back to roughly what it was before the meal. If it is, you're showing a good second phase insulin response. If it is not, you should continue testing until you find your blood sugar beginning to drop.

Analyzing these readings along with the foods you've eaten enables you to see which foods have the worst effect on your blood sugar, so you can avoid consuming them in the future.

It's fair to give each meal a second chance, in case there could be an outside influence on the elevated reading, but after two or three experiments, it is wise to avoid or sharply restrict the foods which drastically spike your blood sugar. After several weeks of extensive testing this way, you'll have compiled a personalized list of foods you can eat safely, for the most part. Not saying things don't change, and foods which were safe at one time could become troublesome later, but in the general scheme of things, eating to your meter is an excellent way to hold diabetes in check.

This can also be used to test individual foods such as fruits and things you suspect are going to spike you, but you'd like to know if perhaps you can eat small amounts.

*************

Because I already have neuropathy, I try to keep my glucose below 120.

Note I still don't know that this is the cause of my problems, but it's hard to not think it could be involved.

_______________________________________

Hi janieg

Did you mention to any medical professionals you see that this is something you were doing? If so what was their reaction? Thanks

These are the A1C guidelines set forth by the American Association of Clinical Endocrinologists which has more proactive guidelines than the American Diabetes Associations which most doctors abide by:

Hemoglobin A1C, % (as a screening test)

≤ 5.4 - Normal
5.5 - 6.4 - High risk/prediabetes; requires screening by glucose criteria
≥ 6.5 - Diabetes, confirmed by repeating the test on a different day

Thanks janieg,

I have already copy/pasted your Eat to Your Meter advice across to my Notepad so I don't lose it.

I have - along with Neurological Hypersensitivity - Neuropathic Facial Pain and, recently, needle sharp stabbing pains over and above my usual levels in my feet, legs and hands, sometimes up my arms and torso. It is definitely worse at night - like now - and my Ketamine and the Epsom cream doesn't touch it.

I am waiting for my imminent Annual Review to see whether this is a deterioration, or something new, probably Diabetes linked.

Dave.

The only doctor I've seen since I started this was my primary care physician who said "Excellent." She knows I'm being very proactive and actually asked ME at my 6 month check-up if there were any tests I wanted run. That kind of made me chuckle.

She's the one, though, who told me the OGTT indicated insulin resistance, and I needed to cut my carbs to 60g/day or less. The integrative medicine doc who ordered the test at my request didn't know what to make of the results.

As far as the neuropathy goes, my PCP is yielding to my neuro on it. I won't see him again until October. I've considered going to another one too just to get another opinion. I only live 30 minutes from Johns Hopkins, and I know there's a neuro down there doing research on neuropathy with even mildly elevated glucose issues.

Hi again janieg
Thanks for all the info. Was just sorting my bookmarks (the things you do on a rainy day!!) and refound this article which may have relevance to this discussion.

http://www.bpac.org.nz/BT/2012/Decem...ngGlucose.aspx

P.S. can I trade you my doctor for yours?

I have to do something on the diet side. Mirtazapine and Metoclopramide - and being so disabled - have made me pile on the pounds, especially in the last 2 1/2 years with the former. The latter works by emptying your stomach more rapidly, so I always feel hungry. Severe Depression, lack of distractions all add up to a recipe for Diabetic disaster. And I am not large all over, it is the dangerous stomach size I have.

Now I have a mental focus in this Forum, perhaps it is a good time to take control of my diet. Everything else seems determined to fall apart, at least I can control my size and be around longer to watch the bits fall off.

Dave.

It's interesting they're going opposite way the American recs are. I did find this, though:

"The OGTT is also an expensive, inconvenient and unpleasant test and very time-consuming for the patient and laboratory. For all these reasons, the NZSSD Working Party, in line with many other countries, has recommended that the use of OGTT in the diagnosis of diabetes be largely abandoned."


My primary care only sees patients 3 days a week, but I'm sure she could squeeze you in.

Love your sense of humor.

Just from personal experience, the low carb-high fat diet recommended on the diabetes forum has been a pretty easy adjustment. The best thing about it? You're not hungry all the time. Being hungry on diets always doomed me. You do have to give up all your munchy goodies, though, but less processed food cannot help but be a good thing.

Go for it.