Diabetic Again - How can this be?

I've been away from these boards for awhile - but always come back when I have issues or questions...

I'd been sick with a terrible cold recently, didn't go to the doctor...until my ankle blew up and I realized it was cellulitis (again).  I got myself treated with antibiotics, and they did some blood work.  Things were fine, I was improving...until I got a call from the doctor last night with the results.

Seems as though I am diabetic again.  I am almost three years out from my DS surgery, and up until recently they have classified me as "Joe Shmo Average" with my A1C numbers.  The doctor wants to see me for an appointment on Monday to discuss everything.

This doctor is relatively new for me, only having gone to their office in the past five or six months.  They are not really familiar with the DS surgery.  My questions to all of you - what should I be talking about on Monday?  What questions should I ask?  How will any diabetic medication (he mentioned metformin, which I'd been on years ago) affect me now?

I'm just blown away by this - my husband is very upset, and my sister (also a DS patient) is in kind of shock - we never thought we'd be bothered by the diabetes bug again.

Any help you could send my way would be greatly appreciated.
Lisa in PA

Sometimes the physical stress of infection can cause your glucose levels to increase temporarily.  You didn't get steroids did you?  Was this a spot glucose test (random non-fasting)?  Was your hemoglobin A1C elevated? Did they do a 2-hour glucose tolerance test (GTT)?  If they are referencing a random glucose test only and you haven't had a repeat A1C or GTT, I wouldn't get too bent out of shape yet.  You want to get tested completely when you're feeling completely better. 

You want your A1C to certainly be less than 6.5%.  For the GTT you have your glucose level checked fasting, then drink a 75 gram glucose drink.  They then check your glucose 1- and 2-hours afterwards.  Your fasting glucose should be 70-110.  Your 1-hour glucose should be less than 151 (higher than that is a 13-fold increase in developing diabetes even if your 2-hour glucose is normal).  Your 2-hour glucose should be less than 140 (over 140 is pre-diabetes and over 200 is diabetes). 

I was thinking that being sick could have affected the result.

It was not a fasting test...in fact, they'd done the test about 5 pm.

My A1C was at 7.  So I guess it wasn't terribly high, but it wasn't as good as it had recently been.  My Vitamin D was low, too - at 18.  That is much better than it was in March, when I was at a 4.  I can't believe how lousy I felt with that number - heart palpitations, body aches.  It was rough.
 
What do you know about Injectible Vitamin D?  That's been a very recent topic on a Yahoo group I'm involved with.  Not too much information there - yet.

Lisa

Yes, your blood sugar is usually higher when you are sick, so that could be it. Dehydration can also play a factor. But I know the A1C tracks a longer period of time. I wouldn't get too worried yet. They need to follow up.

How much dry D are you taking daily?

Unfortunately, the A1c does indicate that you have a longer term glucose issue. But it might not be permanent. Maybe you just were sick long enough to mess it up. But do not delay or put off followup on this.

The DS stats show a 98% cure rate for type II diabetes. I'm sorry if you wind up being in the 2% :-(.

Here's a good reference on injectable vitamin D.  One of my DS friends who was low normal preop had it and his D level shot up to 164 afterwards at 3 months postop (I'm sure it will spike then normalize):

http://www.obesityhelp.com/forums/DS/4221103/FYI-Once-yearly -cholecalciferol-D3-injection-article/

Thank you for the link to the Injectible Vitamin D - right now, there seems to be a problem with me getting to it (probably my computer) but I will read it, print it and take it with me to my appointment on Monday.

It's amazing to me that within minutes of posting stuff here on OH, I get answers and help - best site out there!  Thanks!

Lisa

Oh man..I'm so sorry!!!  That scares me too...  one of the biggest reasons I had this surgery was to get rid of the diabetes that EVERYONE in my family has or dies from.  :(

I am sorry and I hope you get your answers from your doctor soon.

I'm reading what others here are saying, but I must say that I absolutely would be concerned with an A1C of 7 (honestly, I would be concerned with anything over 6.0), unless you've been sick for all of the past 3 months! A single non-fasting glucose reading is one thing and relatively easy to shrug off, but a high A1C is a better indication of a problem.

How long had you been diabetic pre-op? Was it well controlled? Were you on insulin? How is your current diet as far as carbs go?

Unfortunately, there is NO 100% guaranteed cure, not even the DS. I do not consider myself cured even though my A1Cs post-op have all been below 6.0, and even all below 5.5 since about 6 months out, even dipping below 5.0. I know from testing myself that if I have something like, say, a milkshake, my glucose levels will be through the roof at one hour post-prandial (welll into the 200s). Even though they don't stay that high for very long, and that doesn't happen often enough to shoot my A1C up, it's not normal, and I'm not cured, even if a doctor tries to tell me I am.

yes...ditto what I was going to say... with an a1c of 7... it doesnt matter if it's elevated from your being sick... that's your average for 3 months.   I suspect mine would come back if I got into eating sugar again.... I just suspect it would. 

I know it sucks but jsut work with your doctor to do whatever it is you need to do and it'll be alright. 7 isnt super high, but it IS diabetic so you might need a daily med again :(