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Diabetes - Type 2 Community
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Avatar universal

DM 1, 2, Insipidus, or something else? Confused...

Hello all! This is my first post here and I really appreciate any clarification that can be provided for me, as the last month has been very stressful and is on the brink of ruining my relationship with my girlfriend.

Before I get into my DM concerns, I wanted to provide some observations I've had: I am a 29 year old 6 foot male who was (until recently) fit, somewhat-muscular, and generally in good shape. I was 178 lean lbs. at the beginning of August, and I am now 163---all with a slightly but not greatly reduced caloric intake. Lately, I have noticed LOWER vitals in terms of my blood pressure (usually 130-140 / 75, lately it's been 110-115 / 60-65), resting heart rate (48-55, usually 60-70), and body temperature (96.2 to 97.5 degrees throughout the day). For many people, this would be a welcome change; but I have felt weak, a little shaky, and perpetually cold. I also have started getting light-headed quite easily whereas before that was a very infrequent observation. I have been largely sedentary but have lifted weights approximately 5 or 6 times over the last month, yet I am more vascular and lean in appearance, have lost significant strength, and again, my heart rate is markedly slower than it was prior to all of this. I also noticed this while exercising, where my heart rate was about 13 beats slower at the same power walking speed than it was a month ago. In general, I'm just experiencing a general malaise lately that is permeating all facets of my life.

Now, most of my bloodwork came back fine, but my Hemoglobin A1C was 5.8 and my random bloodwork glucose readings (all taken around 3-4 hours after eating) have been 102, 103, and 109. I bought a home glucose monitor and tested my level recently and conducted a test following one of my typical breakfasts (which included 20g fat, 75g carbohydrates, and 50g protein. I measured a fasting blood glucose of 97, 104 1hr. postprandial, 124 3 hours postprandial, and 102 4.5 hours after the meal. I assume the blood sugar spike was delayed due to the fat and protein content of my meal, but I'm not sure. Regardless, my Hemoglobin A1C and fasting glucose around 100 tell me I am prediabetic, depite my lack of obesity and no family history of type 1 (type 2 in several grandparents).

The most concerning symptom that I've had over the last 2 weeks is polyuria and nocturia. I have measured urine output between 5-6 liters a day, and my water consumption is nowhere near that high. My understanding is that polyuria is comorbid with diabetes, but I don't believe that my modest blood glucose readings would lead to this much urination. I am literally peeing full bladders (16-24 oz.) 10 or more times a day, and 3-4 times at night alone ( I wake up to pee every few hours). I've also noticed some circulation and issues with skin sensitivity, for whatever that's worth, along with decreased wound healing expediency. I shake uncontrollably in the middle of the night also, but I am thinking that that has more to do with my withdrawal from Ativan (a benzodiazepene) that anything else. Is it possible for this kind of polyuria to accompany prediabetes, or is that more of an advanced symptom? I am losing water weight quickly and becoming dehydrated, and I don't have much more water to spare, so I want to figure this out quickly.

Thanks in advance for everyone's help, it is much appreciated!
22 Responses
4851940 tn?1515698193
Polyuria can happen from different problems other than diabetes.

Are you drinking too much coffee, too much alcohol - these drinks will dehydrate you.  

In diabetes, if you your sugar levels are too high, you will want to urinate more often.  This is the kidneys trying to rid the excess glucose in the body.

Having a urinary infection can also cause frequent urination.

You should make an appointment to see your doctor.  Take a morning mid stream urine sample to be tested.  The doctor can do this at the surgery with the dip stick and also send it to the laboratory for analysis.  

Tell our doctor the symptoms that you have noticed and ask for him to refer you for a fasting glucose test.  The results would show whether you have a glucose intolerance, diabetes or diabetes.

If the results come back fine, you may need further investigation and a referral to a urologist.  Get your prostate checked too.

Stop stressing and getting anxious to the point of it marring your relationship with your girlfriend. If you have a problem, the doctor is there to help you find it and to provide any treatment that is required.

Stop trying to self diagnose yourself and obsess about what you may or may not have.  Make an appointment to see your doctor with your symptoms.

Let me know how you get on.
Avatar universal
Hey Austin, welcome aboard!  I've misplaced my glasses so I only really scanned your post.  Excuse me for that but I will try to offer a few suggestions.  Jemma gave you some good ones as far as I can tell.

First off, please, please, please seek professional help.  Places like this are wonderful for pointers but I'm pretty sure nobody he is a doctor and can give medical advice legally.

You sound really obsessive about this.  let me offer you this.  If you do indeed have diabetes, there is help out there and diabetics lead healthy normal long lives when they stick to their programs and listen to their medical advice.  Your glucose levels to me would be a blessing!  I eat 20g of carbs a day or less and struggle to keep levels below 130.  

Please speak to a health care professional.  Its not worth losing sleep or a good relationship over.  Relax...  You don't even have a diagnosis so you're worked up over things you might not even have!

Talk to a doc.
Avatar universal
Jemma,

I know I didn't mention this initially, but I have seen plenty of doctors already following a hospitalization for Pneumomediastinum and a subsequent infection that ensued in my chest & throat about a month ago. They prescribed me penicillin which did not knock it out after a one-week course, so my primary later prescribed me 875 /125 Augmentin (amoxicillin) to finish it off. The Augmentin certainly knocked the infection out of my throat, but since that time I have noticed unexplained weight loss, low body temps, bradycardia, and lower blood pressure than I'm accustomed to, with occasional blurry vision and increasingly frequent lightheadedness.

Now, I didn't mention this initially because my CBC with differential came back with vastly improved WBC, neutrophils, and lymphocytes following the antibiotic treatment and I recently had my CRP, ESR, and Procalcitonin levels checked via blood work, all of which came back clean---indicating no systemic infection. I was more concerned with my recent polyuria, increased wound susceptibility (I cut my hands and bruise all over my body much easier now), and my vitals continuing to be way off. It is really affecting all aspects of my life right now, and I just want to get things normalized by any means necessary.

Again, I know my blood sugar indicates prediabetes, but is 97 (fasted), 104 (1 hr), 124 (3 hours), and 102 after almost 5 hours following a high carb, high protein, moderate fat meal really going to cause my kidneys to dump glucose from my body at all times of the day---including all throughout the night? This just seems like it was too sudden to induce such a volume of urine (5-6 liters measured and confirmed everyday...normal is 1.5-2.5). By my understanding, UTIs could induce more frequent urination, but not polyuria to this degree.

I'm seeing my doctor Thursday regardless, I just wanted some feedback on my glucose measurements and whether such modest numbers could induce this kind of excessive urination. I figured the body only started excreting excess glucose once you got into the 140+ range, not with a fasted glucose right around 100...but I don't have a lot of expertise here, so I was hoping someone could help clarify whether it sounded like DM1, DM2, DI, or none of them. The urine appears foamy and varying degrees of yellow to amber when peeing into a bottle, but less dark and foamy when peeing into a toilet bowl.

Also, I recently (2 weeks ago) had a urinalysis done which came back clean, and a metabolic panel which also looked clean, with an eGFR of 102, BUN of 19 mg/dL, Creatinine of 0.99 mg/dL---all within reference range.

Thanks again for everyone's help!
Avatar universal
I apologize for trying to self-diagnose and I am trying not to obsess about this, but I have lost 15 pounds while eating 2000 calories a day over the last month and while my circulation numbers appear healthy, they are very low for me and have been causing me a myriad of problems---from lightheadedness, to numbness in my extremities, and numerous myalgias throughout my body that plague me on a daily basis. My heart rate drops into the mid 40s while I'm in bed now and my blood pressure is 95 /60 in the mornings now, and beyond it being disconcerting, I can feel these effects throughout my body and I notice the difference from when I had a bp of 135 /75; blood just isn't circulating like it used to.

The polyuria is only the most recent symptom, but I figured since my hemoglobin A1C was in prediabetic range and my blood glucose was a little high, that maybe diabetes was a good place to start.

And listen, I know I probably seem crazy, but as someone who is very in-tune with their body (I exercise frequently, eat right, and have always maintained a healthy physique and body), I know that something is awry; all the measurements provided earlier were not estimates, they were confirmed via multiple instruments and measurements prior to the infection. When my body temperature stays in the 96 degree range (confirmed with multiple thermometers), trust me when I tell you that I can FEEL that temperature permeating through my hands, feet, and entire body---even while wearing a jacket and pants in a 77 degree room. This is all new to me, so I feel compelled to figure out what's causing it.

My faith in the medical industry has been eroded by several misdiagnoses over the last month alone, so forgive me if I appear paranoid or anxious, but I have to be my own advocate and try to figure out what's going on inside my body right now.
231441 tn?1333896366
COMMUNITY LEADER
Hello,

hba1c of 5.8 could get you diagnosed with diabetes as it is an average blood sugar higher than 125.  You should be eating a lower carb, higher healthy fat diet.  Diabetes is certainly a valid concern.  And type 1 diabetes can be triggered by a recent illness, particularly if you were already predisposed / prediabetic.    This an develop very quickly (over a period od days to weeks).  I think you need a new Hba1c and you should also request a glucose tolerance test.  Has there been any new changes in your fasting blood sugar or post eating blood sugars (do you have a home meter?  If not, you should, and you should be using this to determine which foods are ok).

I think you need to have a thorough work up for thryroid disease.  At least this should include FT3, FT4 and TSH.  FT3 and FT4 should be at least middle of the range.  If they are in range, but at the bottom, then it indicates a problem (you can go across to the thyroid forum for more information when you have test results - and make sure you give the test range).

Yes absolutely we must be responsible for own health.  And for anything chronic we must know as much or more than our doctors, particularly as it relates to ourselves.

Please come back and let us know.
Avatar universal
Thanks for your response, Sally! I eat about 200-250 carbs a day, but I may have to lower that number. I already eat plenty of healthy fats and proteins. I already had some thyroid work done but I am certainly open to speaking to an endocrinologist about getting a more thorough workup done, as free T3 and T4 were not included on the last one. My results were as follows:

TSH:                              0.75 (ref. range: 0.40-4.50)
T4 Thyroxine total:          6.60 (ref. range: 4.5-12.0)
T3 total:                         81    (ref. range: 76-181)

I've been told TSH under 1 combined with a lower T3 could signal pituitary issues, but I'm not sure about that. Does age influence where I should fall within that range? I'm 29.
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