Question:
I,ve been diagnosed with type 2{Felt strange after my last
race} Since then my performance is lousy,elevated heartbeat about
20 bpm above normal, burning thighs, and just lowered stamina. My race
events are usually about 60-70 km. with 6000 ft. elevation gain. If I
cant regain my stamina I'll have to drop out, something I dont want to
do. Im not on any medication at the moment and my doc doesnt understand
my need for endurance sport. Does anyone have suggestions?
Answer:
I would question whether you have been properly diagnosed.
I'm not saying you weren't, but I see good reason to
question. Some of the questions used to determine risk of
type 2 diabetes are
Are you sedentary?
Are you overweight?
How old are you?
Do you have a family history of type 2 diabetes?
Obviously you are not sedentary. Based on your race
descriptions, I suspect the next two answers are "no" and
"young". Not that old codgers like me never race, but most
racers are young. And slim.
So the only question I haven't a clue on is family history.
On the rest, you rate a very low risk of type 2 diabetes.
Do not assume that a physician, even an endocrinologist, can
accurately differentially diagnose type 1 vs type 2
diabetes, especially at the onset. There are still far too
many doctors who assume that if you are over 20 years old
and are not in DKA, then you are obviously type 2. They are
wrong.
And it's VERY important, especially for you, to get the
diagnosis correct. Since the doctor assumes you are type 2,
and you say you are on no meds, the doc is treating you
with diet and exercise. Yeah, like you need more exercise
-- you are already doing as much in a day as most manage in
a week or a month. And if you cut back on your dietary
calories, especially carbs, you won't have enough energy to
race. None of this makes sense. If the type 2 diagnosis is
correct, then you have been doing the exercise part
already, and if you are not overweight then you've probably
been doing the diet part already. If the doc understood
type 2 diabetes and was certain of the diagnosis, he/she
would have put you on meds immediately. Ergo, the doctor
fails to understand either the diagnosis or the treatment,
or both.
If in fact you have type 1 diabetes -- which quite commonly
develops in adults of all ages despite the preconceptions
of many doctors -- then only insulin is going to allow you
to regain your energy. The progression will be thus:
treating you as a type 2 will continue to sap your energy,
until you can barely stand up. The doctors will add drugs,
perhaps sulfonylureas or metformin or troglitazone. They
won't help and you'll feel worse. In a few months or years
it will get so bad that the doctor will put you on insulin.
This will quickly normalize your bg and you will regain
your energy, which the doctor will regard as a miracle
since type 2s never do that well on insulin (another
incorrect dogma, though based on a grain of truth). You'll
need about 30 units/day, about average for a very active
type 1.
Can you consult a sports physician? Such a doctor isn't an
expert in differential diagnosis of diabetes, but unlike a
GP probably sees far more type 1s than type 2s and so
wouldn't be biased in favor of a type 2 diagnosis.
Or an endocrinologist. I've heard tales here of endos who
aren't any better at differential diagnosis than a GP, but
on the average an endo will do much better.
I MIGHT BE WRONG. You didn't give enough history to say for
sure. And in any case, differential diagnosis can be
difficult in the early stages. However, in your situation
it's very important to get the right diagnosis, and I don't
think you've had an adequate workup.
