Why does higher blood sugar feel more healthy?It's been 2 years since it got stabilized.
February 24, 2012 12:44 PM   Subscribe

Why would my dad feel worse after getting his Type II diabetes elevated blood sugar under control? It doesn't seem to be an adjustment-period thing - he's been in the proper range for almost two years and still feels far worse than he did with high sugar.

He takes metformin and something else, I don't remember, but I'll check with him and come back and tell.
He was fairly slim/active/healthy diet before his diagnosis (and is still all of these things) - Type II is just a genetic tendency in my family - and was a bundle of energy. He only found out because of a workplace health screening.

He has been treated successfully and has had stabilized levels for the better part of 2 years now, and he still finds that when he is within "normal" levels (below 100) he needs to nap frequently, aches all over, is cranky and foggy, just feels wiped out. When he is out of range slightly (generally 100-120 or so) he feels energetic, clear-headed, and healthy. Changing his meds to different ones or different combinations has had no effect. He was also on cholesterol lowering medications - tried both statins and something else - but I believe stopped those at least 6 months ago.

What could be causing this? The internet only tells me that people feel like this in the first month or so of treatment as their bodies adjust to the new levels, but this has been 2 years! Is there something he can ask his doctor about? Could this be a sign of something else wrong? Could it just be that his body runs better on a different "norm" than textbook? (If so, can you link me some science on that so he can take it to his doctor?)

I know YANMDDD (you are not my dad's doctor), but I would really like to help him find something he can ask his doctor about and get better.
posted by dust.wind.dude to Health & Fitness (18 answers total) 2 users marked this as a favorite
(Out of curiosity and interest - the numbers you're giving, they're mg/dL, right? So he feels good at 100-120 mg/dL?)
posted by krilli at 12:46 PM on February 24, 2012

Response by poster: I think so - it's whatever the standard American meter-measurements are in.
posted by dust.wind.dude at 12:48 PM on February 24, 2012

How does he seem to you? More or less energetic, clear-headed, ect?

Also, has he had his overall health checked in the last year or so?
posted by Lesser Shrew at 12:49 PM on February 24, 2012

Response by poster: He has had a full checkup regularly, and goes in for monitoring/additional testing every few months or so.
He objectively seems worse. He sleeps all the time and is perpetually sluggish and in a foul mood, and it's not the kind of foul mood I'm used to seeing from him. I don't feel like it's depression (or at least, not only depression) because some days he falls asleep whenever he sits down. He's just not himself, and it's not the kind of "not himself" I'm used to seeing when he gets depressed or frustrated, either.
Then some days he is very much his old self, sharpwitted, energetic, cheerful - and inevitably, he checks and his sugar is high (only slightly though.)

(Also, pre-emptive "no history of bipolar in the family" statement.)
posted by dust.wind.dude at 12:57 PM on February 24, 2012

He should talk to his Endocrinologist (and if he is just seeing a primary care doctor and not an Endocrinologist, that's the first thing to fix), most would consider a number of 100-120 to be "tight control". The Type1 diabetics that I know (my wife, my daughter, relatives, etc) tend to feel not so good as they approach 100, and definitely the worse for wear below 100. Here's what the American Diabetic Association has to say:

Tight control means getting as close to a normal (nondiabetic) blood glucose level as you safely can. Ideally, this means levels between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin (A1C) level less than 7 percent. The target number for glycated hemoglobin will vary depending on the type of test your doctor's laboratory uses.
posted by machinecraig at 1:14 PM on February 24, 2012

My linking skills obviously need help... here's that link.
posted by machinecraig at 1:16 PM on February 24, 2012

This seems unlikely, but is it possible the glucose meter he's using isn't calibrated correctly? Does his doctor test his blood sugar at all or are all of the numbers above based on results from just one machine? I believe I've read that home meters aren't always that accurate.
posted by needs more cowbell at 1:20 PM on February 24, 2012

He objectively seems worse. He sleeps all the time and is perpetually sluggish

Wow. That is frightening. Do you know if this was discussed during a check-up? Is there any chance you or another family memeber could accompany him next time?

My advice would to push for more medical - but as a daughter I'm not sure how much power you have.

There's an outside possibility that he secretly using something, but medical attention would ferret that out.

Does he see someone specifically for diabetes management? Or is all the care from a primary care or internist?
posted by Lesser Shrew at 1:21 PM on February 24, 2012

IANAD. So because of insulin resistance, if his blood sugar is "normal," he's not getting enough glucose to his brain, etc.? Perhaps? What about other sources of energy? Monounsaturated and saturated fat? Dairy? Coconut oil? Fatty meat? Maybe alternative fuel sources will help a bit.
posted by zeek321 at 1:23 PM on February 24, 2012

re: Does his doctor test his blood sugar at all or are all of the numbers above based on results from just one machine?, I know you mentioned that he gets regular tests, but not sure what those include--something like an A1C test wouldn't provide any evidence here.
posted by needs more cowbell at 1:24 PM on February 24, 2012

Check your Dad's symptoms against Hypoglycemia (low blood sugar), they fit pretty well. If your Dad is dipping below 100 frequently, that's almost certainly the cause. If your doctor said 100-120 is "out of range", he needs a new doctor asap.
posted by machinecraig at 1:25 PM on February 24, 2012

Response by poster: Just checked with my mom. There is a distinct possibility that my dad was too stubborn to read the pamphlets he was given and misheard the proper range. Plus his original doctor was horrible - he has since switched to an endocrinologist, but he is not so good at communicating with doctors because he is still SUPER PISSED about this whole business and complains about how he felt fine before and now feels like crap.

We may have found the answer - thank you everyone! - but I would still love to hear more info from everyone, just in case!
posted by dust.wind.dude at 1:45 PM on February 24, 2012

My Dad is likewise Type II (and is in generally good health, not overweight, etc -- it's a genetic thing as well) and has found that his cholesterol meds tend to interact w. his diabetes meds to make him SPACED OUT. Like, so spaced out they were going to test him for Alzheimer's until he pointed out that all his symptoms went away when he stopped taking said drug. So also make sure someone checks his drug interactions VERY carefully.
posted by Countess Sandwich at 2:04 PM on February 24, 2012

One other thing to think about is his carb intake - I am type II as well, and my nutritionist told me that you can't cut out carbs completely because you need them for energy. Whole grains of course, but you have to have some.
posted by InfidelZombie at 2:34 PM on February 24, 2012

I am not a doctor, but it seems to me that your dad is exhibiting signs of Hypoglycemia as stated above.

I know the standard medical practice is that if your above so and so or below so and so that you have a medical problem and maybe they are right.

But what if some people were just meant to run "hotter" than others? If you dad is better without the medication then why not just not use the medication? Quality of life seems to play an issue here.
posted by Takeyourtime at 3:11 PM on February 24, 2012

A lot of my family are type 2 diabetic, most recently diagnosed is my husband. He was told to his target glucose levels were 100-120. He was told he would feel like he was 'crashing' [dizziness, tiredness, lightheadedness, etc.] under 90, and that it was emergency-level dangerous under 70.

I think he needs to go back to his doctor, possibly with another person in tow to help, and clarify whether he is really supposed to be sub-100 as his target. He needs to assert that his state is unacceptable and they need to work with him to improve his quality of life.
posted by asciident at 3:43 PM on February 24, 2012 [2 favorites]

Type II here. It sounds to me like he's running perpetually low. Have him write down his questions AND take a second person with him (you or your mum). Having the second person there (I usually take my husband) can really help.

Good luck!
posted by deborah at 6:33 PM on February 24, 2012

I periodically monitor my blood sugar with an at-home kit. A few months ago, I spent an irate thirty minutes on the phone with tech support when I discovered that those meters are only accurate to +-20%. Or maybe it was 25%. 30%? I can't quite remember, but I did a series of tests one after another, and they varied by at least 35 points, from almost low to higher-than-desired fasting numbers. Maybe 90-120? Something like that. On the phone, they told me that results will vary based on stuff like how you squeeze out the blood, if you accidentally scrape the blood onto the test strip, if you switch from right to left hands, etc. but even without all that, it was only guaranteed at 20% variance. Basically, they told me that the meters are good to make sure your blood sugar isn't twice what it should be, but that they weren't designed to help people whose blood sugar was just a bit on the high side. Or, I suppose, well controlled by meds. I was pretty chagrined to realize that. In other words, if he is testing at 110, it's certainly possible that the true reading is under 90.
posted by instamatic at 7:12 PM on February 24, 2012

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