Insulin Resistance
In early January 2022, I knew that something was wrong. I was exhausted, pale, having continual ulcerative colitis flares and feeling generally unwell. It was a lot like liver failure, and it scared me to death. Fortunately for me, I have a great sense of smell which lead to my diagnosis. One night after a particularly carbohydrate intensive day, I noticed my urine smelled like Cheerios cereal. Initially I thought I was imagining this, but the following day when I awoke and used the restroom, I smelled it again.
I Googled potential causes of sweet-smelling urine, and everything pointed to diabetes. I called my husband and asked him to bring a glucometer home from his office so I could test my blood. The test revealed a fasting blood sugar of 138 and I promptly freaked out. I made an appointment with an Endocrinologist and alerted my transplant team. I was told hyperglycemia is a known side effect of Tacrolimus and that roughly 33% of all transplant patients go on to develop diabetes.
My first appointment with the endocrinologist revealed slightly elevated blood glucose. The doctor wasn’t alarmed or particularly impressed with my blood sugar reading (I wasn’t fasting), so she called up the results of my 90-day lab draws and looked back over a few years to see the trend. Thanks to the amazing Epic Portal, the results of all my lab draws are on record dating back pre-transplant. The doctor noticed my glucose had been steadily rising and was now hovering on the high end of normal (99) or slightly elevated at each draw. My A1C has always been normal, so she wasn’t alarmed. The doctor ordered a glucose tolerance test, and I was off on a new adventure.
The test revealed I was insulin resistant and pre-diabetic, so we discussed strategies to lower my blood sugar before resorting to medication. The drug commonly prescribed to treat pre-diabetes is hard on the liver and can cause damage. If there is one thing I’m not willing to do, it’s damage Grace. She and I are crushing it – she’s pretty amazing. I’ve done liver failure and do not recommend it to any of my readers. Just say no.
I met with a diabetes educator and began a highly regimented diet. Over time, I’ve discovered exactly how many carbs I can consume in a day whilst maintaining normal glucose levels. I quickly realized my daily eating habits/preferences were the “Diabetes Hell” diet, although at the time I thought it was a healthful one. I ate vegetarian 5 days per week, eating mostly carbs, vegetables & fruits. Overnight, I switched to high protein, vegetables, nuts, seeds and dairy, consuming more meat and eggs than I ever thought possible. I cut my carb consumption by 75% and eliminated all refined/added sugar.
It was BRUTAL! The first three weeks I thought I was going to die (and wanted to) because I wasn’t able to eat anything I wanted. For the first time ever, I was afraid of food after loving it all my life. My whole life was planned around food consumption for the delight of the senses. To shift to a style where I ate to live, was a huge challenge. There wasn’t much joy in any meal I ate. Food used to be my hobby and now it was poison. Within 40 days, I lost fifteen pounds and my clothes were hanging off me.
I was taking my wardrobe in batches to be altered. It wasn’t so much the weight I lost, because 15 pounds isn’t a huge amount, but I leaned out in a way I didn’t anticipate. A modified keto diet will strip every last bit of your girly curves away. I now jokingly refer to this time as the “Assless Existence” period of my life. Any hope of recovering my pre-transplant, honky-tonk badonkadonk is gone for good.
But alas, there was a silver lining: my blood sugar can be maintained with diet and at this juncture, a year and half later, I am not on Metformin and my liver enzymes are normal again.
As always, thanks for walking this journey with me.
All Hail the Queen –