Do I have Diabetes - Diabetic Nephropathy

[AlanPi]

Hi I am 35/male with diabetic symptoms
a.Wakeup twice at night, thirst–occasional bouts for 5 yrs, current episode since 2/08
b.Postural hypotention
c.Frequent thirst/urination after meal–5 yrs
d.Gustatory sweating when eating greasy food–5 yrs
e.Back bone pain spine mid-section–current episode
f.Diarrhea/Steatorrhea
g.Frequent fatigue if without multivitamins
h.Elevated blood pressure Dia 85~100 since Feb 08 Now Normal
i.Low heart rate ~ 60 and heart/chest pain
Most started 5 yrs ago due to stress and worsened after prescribed TamiFlu at the time
Glucose tolerance 3/08
Fasting 92
1hr 170
2hr 131
Glycohemoglobin 5.8
Home glucose fasting range: 85~103. I wake up during sleep and performed tests or when I feel ill. I have no family history of diabetics and gallbladder issues
I lost 15 lbs since Feb 08 and now have a normal weight. I am eating healthy and exercised regularly, and able to maintain but still gradually losing weight
Recently discovered low function gallbladder 7% HIDA no stones/no pain. Removable recommended but not performed
Recently had CT:bilateral pars interarticularis defects at L5 with no spondylolisthesis. Blood tests OK except high T. Bilirubin 1.7~2.0. TSH: 0.57~1.28
Q:
1.Am I diabetic/ Pre? Could symptoms caused by others? What disease?
2.Are those Autonomic Symptoms? Diabetic Nephropathy DN?
3.What medication/health supplement can reduce diabetic damage?
4.Do I go see a Specialist? My doctor says I am not diabetic?
5.Could my gallbladder caused by bladder paresis DN? Should I have Cholecystectomy?
6.Sleepless is annoying. Can I prevent it other than sleeping pills?
7.If I do not drink water during sleep I feel extremely tired in the morning. I drink Gatorade/apple juices. Are they OK to consume for a diabetic?
8.Will frequent urination cause renal damage? I urinate small amounts often, should I try urinate less?
9.What is the life expectancy for someone with diabetics and my symptoms/age? I understand I am experiencing serious complications

[Anita Ramsetty, MD]

Hi,
Your glucose numbers suggest you have some impaired glucose tolerance and that is considered pre-diabetes. Some of your symptoms, for example the frequent urination and orthostatic hypotension, are not commonly associated with pre-diabetes so they should be further evaluated as well. Given some of your symptoms, I think you should have a full endocrine evaluation for pituitary function as well as adrenal function, and possible malabsorptive diseases(like Celiac disease). I strongly suggest you have a consultation with an Endocrinologist to have this evaluation done.

There is not currently fully accepted supplement thought to reduce diabetes complications. Cinnamon supplementation has shown some promise but is still being further investigated, and there are various herbs that have some effect but are not proven in large studies.

I cannot comment on the gallbladder issue, this is best discussed with a gastroenterologist.

You can drink juice even if you are a diabetic but they should be dilute and true fruit juice without added sugar. Ideally, stay with water, it is best.

Frequent urination itself is not thought to cause renal damage unless the CAUSE of the urination has caused kidney damage for example a bad kidney infection.

Life expectancy for people with diabetes(true diabetes, not prediabetes) is reduced mainly because of possible complications . But these can largely be prevented with good care. I do not know if all of your concerning symptoms stem from your pre-diabetic stage.

Take care and certainly seek out the opinion and guidance of a specialist. If you do not have one in your area and live in CA,FL or SC, you can visit our practice website at www.endocrinehelp.com for a consultation.

[AlanPi]

Just saw a very nice HMO MD for my symptoms and referral to an Endocrinologist.  The referral was refused but I got:

Test: ESR, Folate, B12

Drug:
  Librax for IBS / diarrhea
  Citalopram Hydrobromide (Celexa) for depression
  Zolpidem Tartrate (Ambien) for sleep

Although I consider myself to be fairly positive and upbeat, I do understand they have to rule out "stress" first...