# Who here is an expert on mature onset diabetes?



## hambone (Mar 30, 2013)

My wife went for fasting blood work and her blood sugar was 208. She had not been previously diagnosed as having mature onset diabetes. She is scheduled to go back for a Hemoglobin A1C test...



Last night... at bedtime.. I took her blood sugar and got 154. This was probably 2 hours after her last meal, red beans and rice.

This morning, at 6:30... I took her blood sugar and it was 205.


Why would her blood sugar rise so much over night?


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## BeachGuy (Jul 6, 2011)

Well I'm certainly no expert but....

The body stores glucose and releases it 24 hours a day, even when you sleep. With diabetes, the pancreas either isn't producing enough insulin or it is and her endocrine system isn't using it properly. Carbs cause high blood sugar. Try eating a low-carb meal and see how it affects her fasting glucose in the morning. I bet it'll be lower.

There is a wealth of information on the internet. I recommend you join and read Diabetes Forums - What's New

Best of luck.


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## hambone (Mar 30, 2013)

BeachGuy said:


> Well I'm certainly no expert but....
> 
> The body stores glucose and releases it 24 hours a day, even when you sleep. With diabetes, the pancreas either isn't producing enough insulin or it is and her endocrine system isn't using it properly. Carbs cause high blood sugar. Try eating a low-carb meal and see how it affects her fasting glucose in the morning. I bet it'll be lower.
> 
> ...


 I'm pretty good with diabetes. I understand that if you don't eat anything for breakfast... at some point, your liver will start dumping glucose into your blood...and drive blood sugar way up... and those with mature onset diabetes, the liver tends to be a little hyper about that..

Seems like two hours would have been long enough for her to have reached peak blood sugar and for it to start falling.

I'm worried that we have something going on here... more than just mature onset diabetes.


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## BeachGuy (Jul 6, 2011)

hambone said:


> I'm pretty good with diabetes. I understand that if you don't eat anything for breakfast... at some point, your liver will start dumping glucose into your blood...and drive blood sugar way up... and those with mature onset diabetes, the liver tends to be a little hyper about that..
> 
> Seems like two hours would have been long enough for her to have reached peak blood sugar and for it to start falling.
> 
> I'm worried that we have something going on here... more than just mature onset diabetes.


It would be long enough for a non-diabetic.

Why do you think there's something more? Sounds like basic diabetes to me so far. I can almost predict my morning glucose within 10 based on my previous evenings diet.

The a1c will be the key since it reflects the previous 3 months and not just one day.


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## hambone (Mar 30, 2013)

BeachGuy said:


> It would be long enough for a non-diabetic.
> 
> Why do you think there's something more? Sounds like basic diabetes to me so far. I can almost predict my morning glucose within 10 based on my previous evenings diet.
> 
> The a1c will be the key since it reflects the previous 3 months and not just one day.


My understanding of diabetes is that once you hit the peak blood sugar after a meal... blood sugar should continue to fall..

With the exception being that if you miss a meal... and blood sugar drops too low...your liver will start pumping glucose into your blood.

Last night, 2 hours post prandial, her blood sugar was 128. I had her eat a teaspoon of peanut butter as a snack about 11 pm. This morning, her blood sugar was 177 at 6:30.


You think that is normal... for a mature onset diabetic?


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## BeachGuy (Jul 6, 2011)

I'm going on the assumption that she is on no meds yet for the diabetes. So no, I wouldn't be surprised by the high reading in the morning. Here's the thing...diabetes keeps your glucose too high, all the time (without meds). So if you have the disease, you can't really expect normal non-diabetic readings at any time, no matter what you have eaten.

I'm also assuming (and I have no idea if this is right) that mature onset diabetes is pretty much the same as type 2 diabetes, which is what I have.


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## hambone (Mar 30, 2013)

BeachGuy said:


> I'm going on the assumption that she is on no meds yet for the diabetes. So no, I wouldn't be surprised by the high reading in the morning. Here's the thing...diabetes keeps your glucose too high, all the time (without meds). So if you have the disease, you can't really expect normal non-diabetic readings at any time, no matter what you have eaten.
> 
> I'm also assuming (and I have no idea if this is right) that mature onset diabetes is pretty much the same as type 2 diabetes, which is what I have.


Type 1 diabetes is juvenile diabetes. It occurs when the pancrease totally shuts down producing insulin.

Type 2 diabetes is mature onset diabetes. When the pancrease just can't keep up... can't produce enough insulin.


The only to treat type 1 is with insulin. Type 2 you can treat with oral medications, diet and exercise.... unless insulin production is so low that you have to supplement with insulin.


Yeah, she just got her fasting blood work done Monday. 


On the plus side, she hasn't been drinking a lot of water, urinating frequently, blurred vision... none of the common symptoms of diabetes. 

I'm ready to get that A1c done and see what it says.

But, just from the BG readings I'm getting... we're going to have to lose weight and star exercising.


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## COGypsy (Aug 12, 2010)

This is what the Google said about high morning glucose readings. The source material is _Diabetes Forecast_ and it's the magazine from the American Diabetes Association.

_I am puzzled by my blood sugar pattern. I am not on any medications. My morning fasting blood sugar is always the highest of the day—between 120 and 140 mg/dl. The rest of
the day it is in the normal range. Why does this occur?
Ruth Reynolds, Elk Grove, Calif.

Christy Parkin, MSN, RN, CDE, responds: In the early morning hours, hormonal changes in your body will naturally cause blood glucose to rise. For people who don't have diabetes, the increase in blood glucose is offset by increased insulin production. For people with diabetes, this can be a problem.

There are a couple of things going on that make your glucose rise in the morning. One of these is insulin resistance—a condition that means your body's muscle and fat cells are
unable to use insulin effectively to lower blood glucose. However, insulin resistance also affects how your liver processes, stores, and releases sugar, particularly at night. The liver is supposed to release small amounts of glucose when you're not eating. But in type 2 diabetes, the liver dumps more glucose than is needed into the bloodstream, especially at night. So, while your hormones are causing a natural rise in blood glucose, your liver is releasing even more sugar into your system. And because your insulin resistance prevents your muscle and fat cells from using the sugar, your blood glucose level rises. 

Unlike mealtime blood glucose, which can be somewhat controlled by diet and exercise, high fasting blood glucose usually needs to be treated with medication. You should talk to your doctor about medications that can help you obtain good control. You may also want to read our September 2008 story "Rocky Morning Highs." _


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## BeachGuy (Jul 6, 2011)

hambone said:


> Type 1 diabetes is juvenile diabetes. It occurs when the pancrease totally shuts down producing insulin.


You can become a type 1 diabetic at any age.



> Type 2 diabetes is mature onset diabetes. When the pancrease just can't keep up... can't produce enough insulin.


I was diagnosed with type 2 at 38 years old. Can happen at any age. I think "mature onset" refers to people retirement age and older.



> The only to treat type 1 is with insulin. Type 2 you can treat with oral medications, diet and exercise.... unless insulin production is so low that you have to supplement with insulin.


My insulin production is not low. On the contrary. My pancreas is dumping insulin in my body (weight gain is a result). The problem is my body is not processing the insulin efficiently.



> On the plus side, she hasn't been drinking a lot of water, urinating frequently, blurred vision... none of the common symptoms of diabetes.


Not to be negative but I never had ANY symptoms. In fact after 13 years I STILL don't have any major symptoms. I think this is one reason a lot of people with type 2 go undiagnosed for so long. I went to see a doctor because I was having stomach issues and they did a routine blood workup. When I went back the doc walked in and said "You're a diabetic! Did you know that?"



> But, just from the BG readings I'm getting... we're going to have to lose weight and star exercising.


PERFECT plan! After I was diagnosed, I lost 30 pounds, exercised, ate better.. My glucose readings became normal with no meds. Doc told me there was nothing else he could tell me to do and to keep doing what I was doing. Then I got older. Gained the weight back, etc. Now I'm on meds and insulin.

After many years of trial and error I know the things that make my sugar go up. Milk, bread (any white flour products), rice, fruits, soft drinks, juices. And the things that don't cause it to go up are low carb foods. Meats, cheese, salads, some vegetables, eggs, etc. It's a struggle, no doubt. One I'm not doing as well at as I should. With all the reading I've done and talking to doctors, I'm convinced low carb is the best diet for diabetics.


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## hambone (Mar 30, 2013)

BeachGuy said:


> You can become a type 1 diabetic at any age.
> 
> I was diagnosed with type 2 at 38 years old. Can happen at any age. I think "mature onset" refers to people retirement age and older.
> 
> ...


Juvenile diabetes is a medical term that was used when I was in school. You are correct in that it can occur at any age but it most commonly occurs in juveniles. It is the result of your Islet's of Langerhans dying. That event frequently occurs after having the flu. They think it might be an auto-immune problem. The term Type 1 came into use about the time I finished school.

Same with Type II, it can occur at any time but most commonly occurs in adults as opposed to juveniles.

If your body isn't using the insulin properly... you most likely have what is know as insulin resistance. It means that the portals through which the insulin drags the glucose are in some way impaired or not as plentiful as they should be. I forget the technical term for those portals. They have oral medications that lower insulin resistance. 

In the old days, when people were on insulin from porcine and bovine sources, they would occasionally develop allergies. But, now days, with Humulin, that's a thing of the past. 

Thanks for your input.. I'll continue to monitor her blood glucose levels and see what the A1c test shows.


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## hambone (Mar 30, 2013)

COGypsy said:


> This is what the Google said about high morning glucose readings. The source material is _Diabetes Forecast_ and it's the magazine from the American Diabetes Association.
> 
> _I am puzzled by my blood sugar pattern. I am not on any medications. My morning fasting blood sugar is always the highest of the day—between 120 and 140 mg/dl. The rest of
> the day it is in the normal range. Why does this occur?
> ...


Thanks... So, it sounds like it's related to insulin resistance.


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## hambone (Mar 30, 2013)

When I was in school, the concept of insulin resistance was brand new. It was mentioned to us along the lines of, "A theory is being advanced that some diabetics produce enough insulin but for some reason... the body is not able to utilize it." And then he shakes his head back and forth as if, "Maybe it's true... maybe not".


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## 827Aug (Apr 27, 2008)

Did your wife have gestational diabetes when pregnant? If so, you are definitely dealing with an insulin resistance problem. At least that's what one endocrinologist told me.


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## hambone (Mar 30, 2013)

827Aug said:


> Did your wife have gestational diabetes when pregnant? If so, you are definitely dealing with an insulin resistance problem. At least that's what one endocrinologist told me.


She flunked the quick and dirty test with her last 2 pregnancies. Then, she passed the test where they made her drink the glucose and have her blood drawn every 30 minutes by the skin of her teeth.

So, she passed by the thinnest of margins.


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## Ikaika (Apr 23, 2012)

hambone said:


> My wife went for fasting blood work and her blood sugar was 208. She had not been previously diagnosed as having mature onset diabetes. She is scheduled to go back for a Hemoglobin A1C test...
> 
> 
> 
> ...


Not to be too personal but between the time you checked it (154) and the next morning how many times if any did she pee?


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## Ikaika (Apr 23, 2012)

Am, there is a rush of cortisol through the system. Cortisol is a glucocorticoid, causing increases in blood sugar from stored sources.


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## hambone (Mar 30, 2013)

drerio said:


> Not to be too personal but between the time you checked it (154) and the next morning how many times if any did she pee?


She says once.


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## Ikaika (Apr 23, 2012)

Insulin is a relatively short-lived hormone that responds through few sources. Raising blood sugar levels after a fast is the job of glucagon, cortisol and epinephrine. 

All three can work in symphony to raise blood sugar levels far above what they can do alone. 

It is not unusual to have spikes in blood sugar in the morning due to the symphonic affects of both glucagon and cortisol (the latter hormone is a rhythmic, diurnally released hormone but can increase with certain stress input). 

However, 205 is typically higher than most morning spikes. If she had very few picturitions (urinating events) after you took her evening 154 test, this would have meant she probably had a higher number than normal if insulin were doing what we think it should do (express Glut-4 carriers to take up glucose). 

AM, fasting Serum glucose levels of 200 - 220 are often looked at as borderline numbers. I normally hate that diagnosis as if to suggest you are "broken" but not really. 

This sounds like an opportunity to try self intervention practices of diet and exercise. I would hate to hear her on the medication cycle. of life.


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