Category Archives: Insulin Resistance

I guess this is good news?

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A nurse called from my doctor’s office today, and my A1C was actually excellent.  On the one hand, I’m thrilled by this news.  As I said earlier, I was worried I might actually have become diabetic, rather than just insulin resistant (IR), which is essentially pre-diabetic.  An A1C of over 7 is considered diabetic, and 6.5 to 7 (or sometimes 6 to 7) is considered prediabetic.  4.5 to 6 is normal.  I was a 4.8!  And since the test measures my average blood sugar for the last 3 months, and I’d only been dieting for about 6 weeks, that wouldn’t have affected the result.

But the fact remains: I’m not losing weight like I have in the past.  If insulin isn’t causing me to hold onto my weight, what the heck is?  Unfortunately, my doctor did not run a thyroid test with the other blood work, so it’s possible that my thyroid is the cause.  Thyroid issues run in my family, although I’ve always tested well in the past.  (However, I’ve also read that the current test is notoriously inaccurate.)

So unfortunately, I’m probably going to have to go back to the doctor to try to figure out what the next step should be, medically – or if there is one at all other than trudging along on my own.  That’s mostly unfortunate b/c it means another $25 copay.  But I guess if that’s what I need to do to get on track, that’s what I need to do.

I am really scratching my head, though, b/c I was SURE my insulin was the culprit.  Since additional weight usually intensifies insulin resistance and I was at my highest weight ever, it made logical sense.  I’m just trying to be happy I’m actually healthier than I thought…

Back from the doctor

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As I wrote about on Monday, I finally quit delaying and made an appointment to see my doctor today about getting back on Metformin for my insulin resistance (IR).  I was first diagnosed back in 2001 when I was having trouble getting pregnant.  I was on Avandia for a little while, then taken off when I got pregnant.  When Maggie was about 9 months old, they put me on Metformin, and I stayed on that all through Gus’s pregnancy and for a couple years after.  Then we moved here, and I didn’t have a doctor, and I didn’t have time to find one, and I’ve been off for 2 years.  I suspect that’s part of the reason why the weight is being so much more stubborn this time.

Anyway, one of my big fears was that I would be subjected to the 3-hour glucose test again, which is absolutely miserable.  Because my body builds up so much extra insulin waiting for my body to respond, once it does respond, my blood sugar crashes to a ridiculously low level, which makes me feel very, very ill, and it takes a couple of hours to recover from it.

So when I went in today, I hoped that once I told her my history, she’d just write me the script.  She was very understanding as I told her everything, taking notes, and then she said, “Yes, we should definitely get you tested and get you back on Met.”  I immediately cringed and said, “Am I going to have to take the 3-hour glucose test?”  And she said, “Oh no, definitely not!”

*whew*

She told me that she was never a fan of that test and that clinical recommendations have changed in recent years anyway.  So instead of the 3-hour test, all she needed to do was an A1C test, which gives a snapshot of what my blood sugar has been for the past 3 months.  The results will either show normal (unlikely), pre-diabetic (the same thing as IR) or diabetic.  I sure hope I have not managed to eat myself into the latter category.

She also gave me the names of some of her own favorite apps for diet and exercise tracking.  I really need to upgrade my 1st generation iPod touch so I can access the app store!

Overall, I was very pleased with the visit.  Not only do I feel like she’s totally on board with helping me move forward (that has not always been my experience), she didn’t make me feel judged at all.  In fact, she complimented me at one point, saying that I was obviously knowledgeable about what IR meant and how I needed to handle it.  And when I made a self-deprecating joke, she countered it by saying that good diet and exercise are a struggle for most people, implicitly telling me to go easier on myself.  Having an understanding doctor makes such a tremendous difference, because it’s just one less barrier to me seeking out the medical assistance that I need.

Here’s to better health!

Tweaking the plan

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On some level, I’ve known for awhile what is most likely the cause of my frustratingly slow weight loss of late, and what I need to do about it.  But I’ve been avoiding it because it costs money, and that’s not something we’re flush with right now.  However, a wonderful friend (I’m so lucky to have so many of those, aren’t I?) encouraged me this morning to take the plunge, and even though Nate has been doing the same for the last couple of weeks, I realized as I talked to her today that I really have to do it.  And that step is:

Go to the doctor.

Background: I have PCOS, and it’s one of the reasons why I’ve gained so much weight over the years.  (It was diagnosed when I struggled with infertility while trying to get pregnant.)  Without denying my own responsibility for my weight gain (and I certainly have plenty), the insulin resistance (IR) that virtually always goes hand in hand with PCOS makes it easy to gain weight (by increasing cravings) and difficult to lose.  Because insulin is at the heart of the issue, low carb diets usually work best for PCOS patients, and they’ve always worked well for me.  But for some people, PCOS makes it very difficult to lose at all.

In the past, I’ve always lost just fine on low carb diets.  That’s why the past few weeks have been so puzzling for me.  However, being that I started at my highest weight ever, it’s a logical guess to make that my IR is also at its worst.  (One of the great – and most frustrating – ironies of IR is that it often leads to weight gain, and then when you gain weight, the IR gets worse, and then you gain more weight and so on.)  There are medications that help to reduce IR (the same ones that Type II diabetics take, actually, as they are related conditions – only my blood sugar doesn’t get out of control, my body just has to produce way too much insulin to keep it there, and I end up with extra insulin floating around my body, wreaking havoc), and I have taken some in the past, but I’ve been off them for a couple of years.

There’s no good reason for that other than when I first moved here, I had NO time for a doctor’s appointment (I was working 50+ hours per week and doing the single mom thing while Nate was still in Detroit) to get my prescription refilled.  And also, I was still coasting along on the euphoria of having moved there and had this bizarre optimism that everything in my life would somehow just sort itself out.

And then?  Once Nate was here and the euphoria had rubbed off?  Well, I just kind of forgot.  Or when I did think about it, I rationalized that I was doing OK, and I shouldn’t waste our money on an expensive doctor’s visit and prescription copays.  Or when I was feeling dark, I did my favorite thing and told myself that being fat was my own damn fault and that if I were just a better person, I could get healthy on my own.  It’s amazing the ways I find to sabotage myself.

Anyway, it’s all very stupid, and I know that, but there’s nothing I can do to change the past.  What I can change is NOW.  So after my friend’s urging, I picked up the phone and made myself an appointment with my doctor for Thursday morning.  I’m hoping she’ll just give me a new prescription without making me go through the miserable 3-hour glucose test which proves that I’m IR again.  That test makes me SO sick.  But if that’s what I have to do, I’ll do it.

And then my plan is to continue to low carb for a month or two and see what happens once the medication kick in.  If my weight loss becomes more normal, then I’ll have a good answer, and I’ll continue low carbing.  If it doesn’t? Well, then I’ll head back to the doctor to figure out what’s going on and what the next step should be.

But I feel better already simply knowing that I have a plan.  Without a plan, I tend to wallow.  This gives me something to focus on and gives me back a sense of hope that this is the time when I will finally successfully lose weight.  I haven’t given up yet, and that’s a bit of a victory in and of itself!