I’ve mentioned in another blog post that I asked my doctor to prescribe Metformin for me when my a1C creeped over the edge to 6.3%, and so he gave me 500 mg of the “poor man’s Ozempic” (about $4 a month), which among other things, is supposed to help manage glucose levels (aka, 'insulin sensitivity'). I had been taking the drug for about 6 months this past year, when I noticed I was starting to lose some weight, about 10 pounds in a couple of months, despite not altering my eating habits or exercise levels much at all. “Finally,” I told people, “the weight loss benefits of Metformin must be kicking in!” That summer, we vacationed at the family lakehouse in Michigan, where we took advantage of the many paved biking trails, going on 20-30 mile rides. And I also loaded up on a local favorite ice cream, Sherman’s, in big scoops several times a week as well. By the end of the summer, I had lost ANOTHER ten pounds, and now I thought this was strange, but decided I must be biking more than I realized. In addition to weight loss, the extended bicycling seemed to be giving me cramps at night, when I would flex my foot in any direction. Must be the lack of post-workout stretching. I also noticed I would feel extra thirsty at bedtime, guessing it must be because I was dehydrated from biking the extra miles. Finally, we were on our 30th wedding anniversary trip in Europe, where I lost another 5 pounds. And strangely, I had an unusual lack of desire to finish eating the perfectly prepared, Michelin-star-restaurant meals we treated ourselves to. In addition, my left foot was starting to feel numbness and I found myself tripping up stairs when my foot didn’t flex far enough to clear each stair as it normally did. Doing some googling about Metformin and its side effects, I found a strong match between what I was feeling and what some people reported experiencing on the drug. So I stopped taking it, because I couldn’t imagine anything else could be responsible. That seemed to help a little, and by the time we got home I was feeling closer to normal. Diabetes-knowledgeable readers may be finding it hard to stop from shouting, “YOU HAVE DIABETES YOU IDIOT.” But before you judge me too much and jump ahead in the story, it must be shared that my internist, who had been seeing me once a year for the past 13 years for my wellness checkup and had NEVER gotten an email from me during those years, now received 3 from me in the course of a couple of weeks in October when we returned home, telling him of my symptoms and how serious they felt and that I wondered if they were caused by the Metformin. I also asked if I should/could come in to be examined earlier than usual. My doctor was very adamant that these symptoms weren’t being caused by the Metformin, but appeared to show no concern or curiosity about my symptoms, and only half-heartedly (through the physician’s assistant) acknowledged that I could come in “if I wanted to.” My friends and family to had had enough. They saw a near-skeletal friend and father and said I looked terrible. Perhaps a “fresh perspective” from a new doctor would help. So I scheduled an appointment with my friend’s family internist, got a blood test, and (cue the Chorus), my glucose levels were triple the level (300) they were less than a year ago and my a1C was over 19% glucose levels in my blood sugar. They used to by just over 6%. I sent the blood test results to my former doctor and now his tune changed quickly. He insisted I get on basel insulin immediately and said that “this was a failure to control glucose levels.” WHOSE failure he was thinking, we’ll never know. Because I never replied to his email. The point of this cathartic (for me) story is that diabetes, whether Type 1 or Type 2, can sneak up on you. For me, who is very attuned to how my mind and body feel at any time, it was the slow accumulation of factors that I was attributing to various things like medication, exercise, diet or different habits that were not obvious TO ME, but to the informed and attentive professional the accumulating symptoms, even just a couple of them (weight loss, thirst, food aversion, cramping), easily point to diabetes being a leading suspect for further investigation. In retrospect, I was most likely experiencing ketoacidosis, with my rapid loss of 27 pounds in the course of a few months, and I’m lucky I didn’t end up in a French emergency room. LESSON: If you or anyone’s glucose tests are consistently above normal, seek further testing, or at the least be ready to assume that any sudden body changes are a sign of sudden progression of the disease. For me, my pancreas must have suddenly shut down or fallen behind, but because I was “skinny,” ate well and worked out a lot, I didn’t suspect diabetes was the cause.
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