Had a scare today.

[Johnwen]

randian
Couple of more questions.
Did they check your cholesterol? would like to know TOTAL
Do you take insulin?
They probably didn't do this it's called a Basal insulin test? If not talk to your regular doc about getting one done.
This checks your natural production of insulin. The basal rate is also how much insulin is shot or pumped into the system the basal test is done before shooting to see what the pancrease produces on it's own. It's just a blood draw!
If it's going to be awhile let me know what your average fasting glucose is. That'll give me an idea.
I'll go over the rest later kind of short on time right now.

[randian]

Did they check your cholesterol? would like to know TOTAL

They didn't. They did a Complete Metabolic Profile and a CBC with Differential. Besides the high glucose, the only other things I see flagged on the printout are:

CL (Chloride) 96 lab range 98-109 mmol/L
Anion Gap 17 lab range 5-15

I also see that sodium is marginal 134 (range 134-144 mmol/L) as is potassium 3.7 (range 3.5-5.0 mmol/L).

Slightly low chloride and marginal sodium: I don't eat enough salt?

Do you take insulin?

No. Just started on metformin yesterday. The GI effects aren't so hot.

They probably didn't do this it's called a Basal insulin test?

Nope. I'm seeing both my cardiologist and regular doc tomorrow, so I'll ask about it then.

If it's going to be awhile let me know what your average fasting glucose is. That'll give me an idea.

I can get a fasting number tomorrow when I wake up. The thrill of using a meter for the first time. I can't give you an average since I only got the meter yesterday, and I didn't bother taking a reading this morning because I'm told metformin doesn't work in a day.

I'll go over the rest later kind of short on time right now.

Thanks. I really appreciate it.

[Johnwen]

Randian
Welcome to the world of diabetics!
The high anion and low chloride kind of says it all "ketoacidosis."
Or ketonemia either way you more then likely are showing signs of ketones in your urine also.
Whats surprising is they didn't give you a shot of insulin in the er.
All the symptoms fit!
What happens is the body needs sugar and it's producing probably not up to par amounts of insulin and the body still is not getting it's sugar fix so it turns to converting fat into sugar which produces hi levels of glucose and residual ketones the ketones are acidic and start breaking down muscle which release lactose which is a acid also and your blood turns acidic and start doing damage. In the mean time you feel like you got hit by a truck and everything seems to hurt when you move you get thirsty, a little dizzy, your stomach senses the increase in acid and backs down it's production, food don't get digested and sits in the stomach longer your hungry and full at the same time. Should I go on? I think your doc's will get you straight on this. Metformin takes time to spool up so while your waiting bad things are still happening. A shot would have put you right!
Do a search on glyconeogenisis and ketoacidosis you'll get a good idea of whats going on.

[randian]

What happens is the body needs sugar and it's producing probably not up to par amounts of insulin and the body still is not getting it's sugar fix so it turns to converting fat into sugar

I believe I'm type II, not type I. That's resistance right, not insufficient insulin? If converting fats to glucose is bad why don't low-carb diets (which have, relatively, a greater percentage of calories from fat) make diabetics sicker?

your blood turns acidic and start doing damage. In the mean time you feel like you got hit by a truck and everything seems to hurt when you move you get thirsty, a little dizzy, your stomach senses the increase in acid and backs down it's production, food don't get digested and sits in the stomach longer your hungry and full at the same time.

That explains my horrid GI distress and sympathetic chest pain. My abdomen was rock hard. Definitely as close as I want to get to being hit by a truck.

I've probably been this way for a while before the present crisis presented itself. For example, I've only eaten twice a day for a long time because I just couldn't eat more often. I wasn't overeating, I just couldn't get hungry before 7-8 hours had passed after my last meal. Indeed, I think you'd wonder how I ate so little for somebody who ate so infrequently. I couldn't understand how other people could eat 3 meals a day.

Low acid almost certainly means I'm low in many nutrients. Iron, Bs, mag, and zinc. I've also read that low iron and B-12 suppresses thyroid function, which by itself causes a cascade of nasty side effects.

On the theory that I was suffering from low acid, this morning I tried taking betaine HCL and a digestive enzyme with meals. I've taken 4x650mg HCL with a meal without any burning sensation, pretty much confirming the low acid hypothesis. Moreover, my GI distress has almost completely disappeared along with most of my right-side pain. Still a little pain and tightness, though. I managed to get a whole night's sleep last night, I feel so much better. I can eat a little food now! Not much, say 2 regular eggs and a couple of ounces of meat before I feel full. I'm probably running 800 calories a day or less right now because I just can't eat more.

Metformin takes time to spool up so while your waiting bad things are still happening. A shot would have put you right!

Good to know. Should I ask my doc tomorrow for an insulin shot? Or maybe a short-term insulin prescription while I wait for the metformin to get going?

I wonder if the Pauling Therapy I've been doing for the last couple of months (including 10-15k mg of C a day) has been doing me no good because my high glucose is blocking the C and the low acid is blocking absorption of everything else.

By the way, is my fear of beta blockers at all justified?

[ofonorow]

Following your case with interest, I see many parallels, and thanks to johnwen!

Is this Type II idea new? or had you known? (Type 1s can become Type 2, and if you lose your ability to make insulin, then a Type 2 could also become a Type 1.) If they gave you a steroid at the hospital - that could explain that glucose number - perhaps in your IV?

Do you have a morning (fasting) glucose number?

I've noticed that with my blood sugar reading high - I am not hungry either.

I know nothing of your diet, but according the author of healingmatters.com - trans fats in processed foods are the underlying cause of Type II, and people who have followed his protocol have reported their blood sugars do in fact drop over time.

And I read somewhere that perhaps hundreds of medications will block endogenous CoQ10 (ubiquinone) production, so it is a very good idea to supplement as much as possible - remembering that there must be bile in the digestive tract for CoQ10 to be absorbed (so eat fats with your CoQ10 supplementation.)

[randian]

Is this Type II idea new? or had you known?

Brand new diagnosis.

If they gave you a steroid at the hospital - that could explain that glucose number - perhaps in your IV?

So far as I know, no steroids.

Do you have a morning (fasting) glucose number?

I've only been able to get one reading (can't seem to get blood drops to form easily) and it was 185 after a couple of days of metformin. Not sure why it was so much lower than the 260 in the ER since metformin is supposed to take awhile to work.

I know nothing of your diet, but according the author of healingmatters.com - trans fats in processed foods are the underlying cause of Type II, and people who have followed his protocol have reported their blood sugars do in fact drop over time.

I've been trying to avoid transfats and eat super low carb for a little while before this crisis. Obviously it was insufficient.

remembering that there must be bile in the digestive tract for CoQ10 to be absorbed (so eat fats with your CoQ10 supplementation.)[/color]

My gut is so screwed up I don't know what nutrients I'm absorbing. Probably low on lots of stuff.

[Johnwen]

Randian
I was trying to find an article or something to help you with your understanding and found a mercola one on insulin and what it does and don't do. I would not call it Bible, but he does a pretty good, understandable job and might help you understand things better.

http://articles.mercola.com/sites/artic ... -one.aspx#!

[tjohnson_nb]

Randian
I was trying to find an article or something to help you with your understanding and found a mercola one on insulin and what it does and don't do. I would not call it Bible, but he does a pretty good, understandable job and might help you understand things better.

http://articles.mercola.com/sites/artic ... -one.aspx#!

Very good article! Too bad it didn't incorporate the effects of mega-dose C into the discussion. There are so many theories out there - what's really needed is some consolidation, methinks.

[randian]

Very good article! Too bad it didn't incorporate the effects of mega-dose C into the discussion. There are so many theories out there - what's really needed is some consolidation, methinks.

It does a very good job of laying out the risks of excess insulin. I didn't know that insulin could still be high even though your blood glucose numbers are "good". I suspect the problems I'm having taking my glucose numbers (it's hard to get a large enough blood drop for the meter) is due to insulin making my blood clot too fast, like the article says.

[eDOC]

Get HbA1 levels checked along with a lipid profile (LDL, Lpa). You have vessel narrowing & atherosclerotic changes.

[randian]

Get HbA1 levels checked along with a lipid profile (LDL, Lpa). You have vessel narrowing & atherosclerotic changes.

Looking at the tests my doctor ordered, he ordered HbA1 but not a lipid profile. I suspect incompetence. But then, my cardiologist didn't order a lipid profile either. I specifically asked my cardiologist about blockages and he wasn't concerned, even though I can't do a heart imaging study because the 25mg metoprolol succinate isn't reducing my heart rate from its current 100-110.

I'm sure the diabetes is playing havoc with my lipids notwithstanding whatever benefits I'm getting from Pauling therapy. I've only been on metformin for a few days so that hasn't had much chance to affect anything, and I'm ramping up starting from 250mg a day because I couldn't tolerate the prescribed 1000mg straight up which I tried the two previous days (massive GI distress from internal pressure aka bloating and rock-hard gut).

The diet changes I've already implemented. I'm going very low carb because I noticed that the "soft food" diet I've had to eat the last 24 hours (dentist-mandated after tooth extraction) has spiked my glucose over 100 points. You'd think the mere 1/2 cup of unsweetened yogurt (not exactly palatable stuff; yes I'm whining) I had this morning, with its mere 8g of carbs, wouldn't be so bad. Two hours after a no-carb lunch I've clawed all of that back.

[eDOC]

What are your BP readings with & without meds?

[randian]

What are your BP readings with & without meds?

I don't have a reading with meds. They were all taken before I started the metoprolol. Without meds, I've seen everything from 122/75 (when I first walked into the ER, amusingly enough) to 148/85 (in the cardiologists office, the worst) and readings in between.

[eDOC]

Ask him to put you on Cozar (Losartan) ACE inhib blocker.

[randian]

Ask him to put you on Cozar (Losartan) ACE inhib blocker.

As a replacement for which drug?

When I mentioned I was taking lisinopril for kidney protection my pharmacist mentioned Cozar, but only as a replacement for lisinopril. So far the coughing hasn't been too bad.