re: Insatiable thirst, more than just summer heat UPDATE 12/29

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My labs have been totally normal for years and out of nowhere these last few weeks, it just popped up.

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I've told my story before. In December of 2020 I had my annual labs done. A1C and fasting glucose normal. Caught covid in March. In May I had the same symptoms as you. Insatiable thirst, frequent urination and lost 20lbs without trying and blurry vision.

Went to the doctor. My fasting glucose was 385 and my A1C was 12.4. Diagnosis T2D. He pushed insulin and ozempic but I said let's try something else. He gave me Metformin, I was taking 2 pills twice a day. I went on a strict Keto diet (30 carbs/day). 3 months later I had lost weight and my A1C was 6.3 glucose under 100. 3 more months and my A1C was 5.1 and glucose stays in the 80s most days unless measured right after a meal. Even then it's gradual changes and no more large spikes.

So here I am years later 80 lbs lighter and don't eat any visible carbs/starchs. I take 1 metformin every morning. Doctor told me I can stop that whenever I want. A1C is consistently 5.3 and glucose stays in range.

The blurry vision was from the glucose in my eyes. I had to go to my eye doctor and he also found diabetic retinopathy. That has cleared up along with all the other symptoms.

I stay on the metformin because some studies suggest it helps with longevity. Other studies say it doesn't 1 pill a day seems to be a compromise. I still don't eat visible carbs. Meat and green vegetables for me. Exercise 6 days a week. 3 days lifting, 3 days cardio/walking/rucking. I've developed a new lifestyle and I have found something that works for me.

Good luck on your journey and ask if you need anything else. I've done it the old fashioned way without the shot. Diet is everything.

Well, I've spent the weekend flipping between pissed off and scared. I know people live with it but I never thought I'd have to. My glucose seems to hover around 220 when fasted and goes into the mid 300s after I eat. My PCP started me on 100mg of Januvia and said I can just keep doing what I was doing until I see the endocrinologist. That sounded wild to me so I've already started low carb, low sugar meals and no snacks. I don't know how that's going to jive with running but until I see the specialist it'll have to work.

I'm aggravated about how insulin management is going to affect my running in the long term. I know lots of people compete at a high level with T1 but I'd be lying if I said I'm confident about being my best while juggling that. I've started reading some books and watching videos on it to prepare.

The medical people I've talked to (besides my doctor) seem to think my training kept things in check and I've probably had it longer than I realize. Thinking back, they're probably right. Some fatigue that I chalked up to running in the heat and having a toddler, feeling tired in the afternoons at my desk, but nothing that really indicated diabetes.

I'll probably keep updating this thread as my own little outlet for coping if anyone is interested. I'm going to let the endo know that I don't plan on dropping running or cycling, so I want my treatment to align with that.

Thanks for everyone who gave input and got me to the doctor!

Hey man just seeing this.

My DIL went T1D about a year ago. Good health overall, no family history.

We have learned a lot in a year and happy to share.

Haven't gotten the results back on type yet, but it's presumed to be T1D or "1.5" since it came on in adulthood. I guess LADA, latent autoimmune diabetes in adults, is the technical name, if that's what it ends up being. He put me on Januvia to try and rein in the blood sugar until I can see the endo. I assume it works because the type I have is sort of a middle ground between 1 and 2

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Haven't gotten the results back on type yet, but it's presumed to be T1D or "1.5" since it came on in adulthood. I guess LADA, latent autoimmune diabetes in adults, is the technical name, if that's what it ends up being. He put me on Januvia to try and rein in the blood sugar until I can see the endo.

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I would really push to get to an endo, asap. A lot of GPs are pretty ignorant when it comes to type 1. Your history screams type 1 to me, but I’m just a guy on the internet. While it is more common for type 1 to appear in childhood or early teen years, it isn’t exceptionally rare that it shows up in adulthood.

There are many people, even in the medical community, that automatically assume type 2 if diabetes showed up in adulthood. Type 1 and Type 2 are pretty different diseases in both causation and treatment that maybe shouldn’t share a name. Januvia is not approved for type 1.

If it is, 1.5 and your pancreas is still producing some insulin, then the medication prescribed might be appropriate. However, if you are eating no/very low carb and running a lot and your blood glucose remains elevated, my instinct is that you are demonstrating signs of Type 1.

My assumptions, from what I remember of your post history, is that you have been a distance runner for most of your life, never been obese, and eat a relatively healthy diet. If I’m confusing you with another poster, then maybe I’m off base.

But don’t trust me…get to an Endo ASAP.

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I'm aggravated about how insulin management is going to affect my running in the long term. I know lots of people compete at a high level with T1 but I'd be lying if I said I'm confident about being my best while juggling that. I've started reading some books and watching videos on it to prepare.

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totally natural fear and concern. I feel very confident you will be able to manage it and run with little effect (eventually) from your insulin management. It will take some trial and error and there will times you are affected while figuring out the plan that works for your body.

He is in a different situation, but my son plays multiple sports (basketball, football, and baseball). He has considerations with respect to managing his diabetes that others don’t, but it hasn’t slowed him down or stopped him from competing at a pretty high level for his age. These sports are different than endurance sports, so I don’t have a lot of experience with specific strategies, but I know there are plenty out there that will be able to give you advice on that. A running specific message board would be a great place to start.

Yep, I just got the A1c back and I'm embarrassed to even post it. Right over 13. My running has definitely been masking this. MyChart message from my GP has me starting insulin and getting into the endo ASAP

Here is the link to a website for a podcast we found helpful in the first year of helping manage my son’s diabetes.

The link is to a page where the host has categorized episodes into helpful series.

I would recommend listening to the Bold Beginnings and Pro Tips episodes over time at a minimum. This will fill in a lot of the gaps in information and management strategies that your Endo appointments will leave.

LINK

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to my wife's dismay; she had to lie down when I first told her my diagnosis and gets spooked listening to all the medical talk) so I'm deep diving into any info I can get.

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I recommend the podcast for her as well. I think it’s something that explains things she will need and want to know through a medium that is very approachable.

It is pretty scary until you have knowledge and tools. Once you have the knowledge and tools, it’s just something you manage as part of normal life.

Been listening to the Juice Box podcast for a few days. It's helpful to hear the stories line up with mine. Especially to set expectations for honeymoon period, exercising, etc.

I saw my GP again today just to go over everything. Still no word on type but he's considering it that 1.5 or whatever you want to call it and will let endo sort it out. For now I'm on 30u of Lantus and on a sliding scale of Humalog before meals depending on my glucose. Just injected my first dose of Lantus and it wasn't bad, so we'll see how things go!

Also I have a Dexcom on the way because he said pricking my finger is no way to go through life. He said he wouldn't be surprised if endo offers me a pump too since I want to keep running and biking.

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When are you able to see the Endo? Your GP seems to be just winging it a bit.

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You're right, and he admitted as much. He (and the juice box episode I listened to) said that the GP basically gets you on a dose of insulin that won't kill you until you can see the endo. I have an endo appointment this Friday.

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This is a faster acting insulin designed to bolus before ingesting carbs. Over time you will develop an insulin to carb ratio that will dial in how much insulin to bolus before a meal based on the amount of carbs in the meal. The faster acting insulin will likely start to work in your body anywhere from 5 minutes after injection to 25 minutes after injection. You will learn over time how your body works.

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This is the one that spooks me a little more regarding hypoglycemia. I have the chart from my GP with dosing depending on my blood sugar before a meal. Obviously it's not the end of the world if I get a little high or low but I'm going to do my best to keep it in range. I'll be much more comfortable after my endo appointment to really nail it down.

In the meantime, I have a bottle of honey near me in case I start getting dangerously low