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the mystery: dumping syndrome vs. insulinoma vs. insulin resistance?
by reagan0, Jul 25, 2009 10:28PM
Greetings All,
Here's one for ya:
I'm a 24 yr old female who had surgery for pyloric stenosis as an infant. Within the past 4 years, I have had nasty headaches with mood changes and the inability to "think". I could not put sentences and thoughts together.
I went to doctor number 1, who took my blood work once, and the glucose was at 70mg/dL. She changed my birthcontrol and thought I was fine. I disagreed.
I went to doctor number 2, who ordered a glucose tolerance test using the nasty syrup stuff. My sugar at rest was 70mg/dL. One hour after, it was at about 100. Hour 2 was at 70, and hour 3 was at 20mg/dL. At this point, I could not lift a glass to drink and I had uncontrollable tremors. My insulin was in the 300s in hour 3. She diagnosed me with Insulin Resistance and put me on Metformin. Every thing was dandy, but I still had shakey moments and headaches from time to time. I also put on some weight and could not get it off.
I moved and went to doctor number 3, who works with diabetics (related, right?). I told him my story and he thought that I might have an insulinoma. I went off of Metformin,and promptly started losing weight. He referred me to surgeon number 1.
Surgeon ordered 72 hour fast and endoscopy exam. My sugar held at 70, sometimes going up into 84 (according to the accucheck). The lowest it reached was 61mg/dL as taken from veinous blood. I don't know my insulin levels yet (finished exams two days ago). I thought for certain that my sugar would have tanked within the first 16 hours. We did a follow up glucose tolerance test using food (1 egg, 2 strips of bacon, 4 oz of OJ, 8 oz of 2% milk which was FANTASTIC after 86 hours of no food), and the glucose went to 112 to 96 to 84 to 77 within the following 4 hours. Once again, don't know the insulin levels yet.
I've noticed that I typically tank at 9:30-10:30 after I eat breakfast at 5:30 am. Not entirely predictable as I have some symptoms on some days and not on others. Sometimes I make it to lunch just fine. Some days, the shakes start happening at 9:45 ish and I go on a hunt for a snack.
Endoscopic exam showed no tumors on the pancreas. Current prevailing theory is "dumping syndrome". I'm starting to feel like we are hearding cats here. I will have a follow-up appointment within the next 2-3 weeks, but I figured I'd float this out there for input.
My work health place told me I was obese at 166 at 5'4". I've since decreased my weight to about 150. I exercise at least 3x a week.
Here's one for ya:
I'm a 24 yr old female who had surgery for pyloric stenosis as an infant. Within the past 4 years, I have had nasty headaches with mood changes and the inability to "think". I could not put sentences and thoughts together.
I went to doctor number 1, who took my blood work once, and the glucose was at 70mg/dL. She changed my birthcontrol and thought I was fine. I disagreed.
I went to doctor number 2, who ordered a glucose tolerance test using the nasty syrup stuff. My sugar at rest was 70mg/dL. One hour after, it was at about 100. Hour 2 was at 70, and hour 3 was at 20mg/dL. At this point, I could not lift a glass to drink and I had uncontrollable tremors. My insulin was in the 300s in hour 3. She diagnosed me with Insulin Resistance and put me on Metformin. Every thing was dandy, but I still had shakey moments and headaches from time to time. I also put on some weight and could not get it off.
I moved and went to doctor number 3, who works with diabetics (related, right?). I told him my story and he thought that I might have an insulinoma. I went off of Metformin,and promptly started losing weight. He referred me to surgeon number 1.
Surgeon ordered 72 hour fast and endoscopy exam. My sugar held at 70, sometimes going up into 84 (according to the accucheck). The lowest it reached was 61mg/dL as taken from veinous blood. I don't know my insulin levels yet (finished exams two days ago). I thought for certain that my sugar would have tanked within the first 16 hours. We did a follow up glucose tolerance test using food (1 egg, 2 strips of bacon, 4 oz of OJ, 8 oz of 2% milk which was FANTASTIC after 86 hours of no food), and the glucose went to 112 to 96 to 84 to 77 within the following 4 hours. Once again, don't know the insulin levels yet.
I've noticed that I typically tank at 9:30-10:30 after I eat breakfast at 5:30 am. Not entirely predictable as I have some symptoms on some days and not on others. Sometimes I make it to lunch just fine. Some days, the shakes start happening at 9:45 ish and I go on a hunt for a snack.
Endoscopic exam showed no tumors on the pancreas. Current prevailing theory is "dumping syndrome". I'm starting to feel like we are hearding cats here. I will have a follow-up appointment within the next 2-3 weeks, but I figured I'd float this out there for input.
My work health place told me I was obese at 166 at 5'4". I've since decreased my weight to about 150. I exercise at least 3x a week.
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Unfortunately, doctors, at times, get stuck in a singular world, meaning if they verbally consult with your previous doctors, or follow the path of previous doctors inputs from your medical records as they continue chasing after the same cat on a dead end road. Going by your rapid glucose decline you may be experiencing Latent Autoimmune Diabetes in Adults [LADA] aka diabetes type 1.5. Read this thread on LADA, very informative. http://tudiabetes.com/forum/topics/583967:Topic:133728 Another forum member, Zoelula, is well versed in LADA and may chirp in as she fought thru the same doctor fumbling around misdiagnosed testing as you.
Several tests you should ask for:
1. GAD: Not depression associated, but "glutamic acid decarboxylase" an antibody against insulin production
2. C-peptide: Helps determine how much insulin the pancreas is producing. (your insulin test?)
3. Thyroid: [hyper and hypothyroidism]. Women are 7 times at risk then men at getting this disease. Whacky Thyroid T3 & T4 cell production will affect your pancreas insulin production.
I am type II diabetic, with high glucose and other problems. Glucose below 40 mg/DL
is death dangerous.
Her webpage is www.schwarzbeinprinciple.com
I have no interest in her practice.