Undiagnosed diabetes

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Unregistered

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Hello all. Maybe this is just the normal pre-medical paranoia attack, but I could use some advice. I have not renewed my medical in almost five years, and in that five years, I've gained quite a bit of weight. Upwards of 50+ pounds. What happens if the urinalysis detects sugar? I don't have any symptoms of diabetes, I don't think so at least, but I am concerned because I know I am high risk because of the weight gain.
Or, do I just let it expire, work on losing the weight in the hopes I caught anything early enough, and THEN go in?
 
Why not just go to your regular doc for a physical first? You might find something else you have a problem with, like high blood pressure.

At you'll know.
 
See your regular doctor for a physical. He or she will do urine and blood tests as a routine part of that exam.

If you've got diabetes, you really want to know about it and start treating it right away. That's much more important than your FAA medical status.
 
that large weight gain may also be associated with sleep apnea as well. Ask me how I know...

Ask the questions with your regular doc.. Look after your health first and formost, and worry about recreational flying second.
 
I don't have a regular doctor and am not really interesting in finding one.
No sleep apnea according to my spouse and no high blood pressure or cholesterol either (I donate platelets regularly).
 
Unregistered said:
Also, this is not recreational flying, so there's a bit more at stake.
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Unregistered said:
I don't have a regular doctor and am not really interesting in finding one.
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Yeah - there is more at stake. That's why you need a regular doctor. Find out if you have problems, and get them fixed, BEFORE you see the AME. Why use the AME as a screener?
 
Matthew said:
Yeah - there is more at stake. That's why you need a regular doctor. Find out if you have problems, and get them fixed, BEFORE you see the AME. Why use the AME as a screener?
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Sigh. Because I don't have a regular doctor.
Thanks anyway, everyone.
 
Unregistered said:
Sigh. Because I don't have a regular doctor.
Thanks anyway, everyone.
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The point is - the AME isn't working for you, and what he finds doesn't stay between you and him. Make sure you can pass before you see the AME.

Ask around, someone you know has a doctor he/she can recommend. Getting a physical shouldn't be too much trouble, or expensive. And blood and urinalysis tests are pretty comprehensive.
 
To answer the OP's specific question, what happens if the AME detects too much sugar is your medical application is denied for failing to meet the FAA's medical standards for that certificate. If you're concerned about that, get a diabetes screening test -- the American Diabetes Association can help you find somewhere to have that done, often free. It is far better to know ahead of time that you are "over the limit," as it's a lot easier to fix the problem and then apply than to reapply after denial.
 
By the time sugar is spilling into the urine diabetes is well advanced and has likely done some damage. If you have concerns go see a physician.
 
Gary F said:
By the time sugar is spilling into the urine diabetes is well advanced and has likely done some damage. If you have concerns go see a physician.
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I have an airman here locally who operates a C310. At least he did. He is not now.

When he came in for his flight physical I had a PDF of his 8500 and so I had not downloaded it; it was not "live". Urine dipstick was quite positive.

Hemoglobin A1c was 10.8. Diabetes.

He got to see his doc the next day, got put on metformin, we're waiting for the six week mark to see if the rate of decay of HbA1c is going to be adequate or if his treatment is enough. He has hit the gym and is losing the weight in ernest.

This is what you get if you have a "thinking in advance" AME. If you just get an exam, you will be deferred, eventually denied. He has no application nor denial on his record.

We will inform the agency of this airman's situation when he has:

(1)a letter indicating that he has again, good control,
(2)that he has no endorgan complications of diabetes
(3)And his Hb A1c is less than 8.0, 9 is the statutory limit but there isn't an examiner at the agency who's wanting to permit that.

The Special Issuance will be issued in the office on the day I have these items.

Go see a family doctor. All of this heartache could have been prevented if he's just done the same thing. See, you're immortal, so you think- until you are not.
 
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I think I'll let it expire while I lose weight and then reevaluate.

I had a pretty traumatic pregnancy/delivery within the last year and am not wanting to go off finding another doctor/getting lots more medical tests at this point in time. Even if it means I can't fly for a while.
 
As someone with DM2, let me say this:

Get your overweight behind to a doctor if you even think you may have diabetes. If you do, and you don't get it treated, then your FAA medical will be the last thing you're worried about.

You won't be doing much flying once retinopathy claims your eyesight and your feet are gone, my friend, both of which are common results of untreated DM.

So please, friend, go see a doc. Diabetes is very treatable these days, and someone like Dr. Bruce can help with the FAA medical if need be. But if you don't treat it, well... like I said, your medical will be the last thing on your mind.

-Rich
 
I don't know what led you to think you might be diabetic, so maybe you aren't, but if you are...

Do you know what untreated diabetes can do to you? Do you want to see your newborn kid graduate from high school and college? Get screened (see my link above on how to do that without "going off to find another doctor," and if it's positive, get yourself to a doctor ASAP unless you want a lot more medical trauma. Like if you were flying along and the weather seemed to be changing, wouldn't you call Flight Watch and ask about how your destination weather was holding, or would you just keep motoring on in the hopes that it was still OK?
 
Ok, but if the first thing they are going to do is say, "watch you diet, exercise more, and lose weight" especially in the case of prediabetes, what is the benefit of having a doctor say that vs. doing it on my own? Isn't it easier to lose the weight and then see if anything's sitll wrong?
I really have no symptoms, just the weight gain has scared me because I know I'm at a higher risk.
 
The benefit is that a doctor will be able to tell you right away not just that you have a problem, but how bad that problem is. If you have an issue you may want medication, like Bruce's patient, to avoid damage to your body while you lose the weight.

If you're on meds, and then get the weight lost and other improvments so you don't need meds, no issue.

But every day you're living with untreated diabetes you're putting yourself at risk. Don't do it.

Oh. You can go to the store and get Diastix to look for sugar in the urine. If you have it, even more reason to go to the doc. It is possible to spill sugar while still having an A1C that's "not too bad" yet.
 
TMetzinger said:
The benefit is that a doctor will be able to tell you right away not just that you have a problem, but how bad that problem is. If you have an issue you may want medication, like Bruce's patient, to avoid damage to your body while you lose the weight.

If you're on meds, and then get the weight lost and other improvments so you don't need meds, no issue.

But every day you're living with untreated diabetes you're putting yourself at risk. Don't do it.

Oh. You can go to the store and get Diastix to look for sugar in the urine. If you have it, even more reason to go to the doc. It is possible to spill sugar while still having an A1C that's "not too bad" yet.
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I wouldn't stake my life on it, though, nor my eyesight, limbs, kidneys, etc. The absence of glycosuria doesn't rule out diabetes.

If the OP simply insists on being his (or her) own MD, then I'd suggest a trip to Wal-Mart to buy one of these and some test strips. That particular model and its strips are very cheap, but surprisingly accurate, as tested by the various outfits that test these things (including Consumer Reports, which ranked it way above many more expensive meters).

Then do an FBS and a postprandial or two, on each of three separate days during a week. If all is well, then just do an FBS once or twice a month thereafter to keep an eye on things.

This, by the way, is pretty much what I did (except I did talk to the doctor about it first). I have a family history on both sides, so when I hit 35 I started monitoring. I became prediabetic when I was 42, but was able to control it with diet and exercise until I was 48, at which time I had to be put on metformin.

Diabetes is nothing to play around with. By the time you start showing symptoms, more than likely some damage has been done. If OP has a reason to believe he (or she) is at risk, then at least splurge on a meter and do some self-monitoring.

But seeing a doc would still be much better.

-Rich
 
yes, I wasn't suggesting using the diastix for diagnosis, but at least if they're consistently negative you shouldn't test positive on the FAA exam.
 
Undiagnosed- the trouble with diabetes is we know it has existed a mean of four years before it comes to medical attention.

Damage to the various organs is a time-under-the excess-glucose-curve phenomenon. The higher and longer you go, the more damage to heart, kidneys, capillaries, retina, and nerves.

Urine only shows if the blood glucose happens to be 170 or more. I really needs to be 100 or lower betwen meals.....
 
Risking your health and stressing out because you dont want to hear the 'too fat' lecture from a doctor:nono: stop being a child and get a proper check up.
 
Agree with others that, as a diabetic Type 2 that was dx'd immediately prior to my flight training, it is extremely important to find out if you have or not and seek treatment now.

I have 2 employees with type 2, one suffered a heart attack at work 6 weeks ago and has not fully recovered yet (has less stamina) and another one recently had to schedule surgery to get another toe surgically removed, and he has 7 left and is in severe danger of losing the foot. Oh, and he has already had 3 major cardiac episodes.... And he's just age 37. He was in major denial for too long and only recently did I ask bout his last A1c. 12.6. And hem is in stage 2 renal failure. He has two kids in 4th and 3rd grade and I'm really concerned he might not see them graduate. I'm encouraging him to improve various lifestyle habits by motivating him, and he is sorta motivating me because I never want to reach his stage of the disease.

Someone mentioned home testing kits. Bayer puts out a home hemoglobin A1c kit ($29-$39 depending on the store you find it at) that is reasonably accurate when compared to the actual blood lab testing. The past three doctor visits I did the home test ahead and it was within 0.2 +/- of the actual.

http://www.drugstore.com/bayer-self-check-at-home-a1c-system-a1cnow/qxp228355?catid=185976

It's an alternative to the real doc to start. But if you get any reading above the 6.0, don't hesitate to get hooked up with a doctor and get your treatment started. Diabetes is a sneaky and dangerous disease because you will feel perfectly fine.... all the while irreversible damage is happening to major organs like eyes, heart, kidneys, and peripheral nerves.

There are many pilots here who are diabetic and one good AME who all can be a good support crew. But you need to want to address this disease and gain the upper hand. and NOW.
 
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The OP obviously wants to be proactive, or she wouldn't have posted here. I would just point out that any doctor is going to be on her side. They aren't there to sit in judgement, but rather to help her succeed.
 
Unregistered said:
I think I'll let it expire while I lose weight and then reevaluate.

I had a pretty traumatic pregnancy/delivery within the last year and am not wanting to go off finding another doctor/getting lots more medical tests at this point in time. Even if it means I can't fly for a while.
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If you have untreated and undiagnosed diabetes, how exactly do you see it as appropriate to not want to know? What are the benefits to your health to delay screening? Its pretty straight forward. Blood draw and if the results are high, lifestyle modification, dietary consult and MAYBE medication, maybe not. There aren't any million dollar workups involved. Most of the medications that may be considered are generic rather than brand name.

By the time you are spilling sugar and protein in your urine, thats not catching it early. Thats catching it late.

I'm not an active pilot at the moment, but I AM a prediabetic. I'm very involved with the local chapter of the American Diabetes Association. This is personal subject for me, and I have many good friends with the disease. At the rate we are going in the US, 1 in every 3 children will eventually become a diabetic during their lifetime if trends dont change.

There is a value called a Hemoglobin A1C that acts as a long term average indicator of ones blood sugar. Mine had been creeping up for about 2 years. 3 months ago I started metformin and I've lost 20lbs since then. The A1C is coming down. It was never above 7. Nip it in the bud early and avoid the problems.

If you "become" diabetic, you will always BE a diabetic in all but the rarest of circumstances, so rather than running from the diagnosis, be smart, get informed by getting your numbers, and from there take steps to avoid, or manage, the diagnosis.

Doc Bruce is telling you what you need to maintain or obtain a medical. I'm more interested in directions to maintain your health.

Sorry if I misspoke about your type of flying. A valid medical approaching 5 years old is clearly a 3rd class, and for the vast majority of pilots thats non-commercial flying... what I mistakenly deemed recreational.
 
Doggtyred said:
If you have untreated and undiagnosed diabetes, how exactly do you see it as appropriate to not want to know? What are the benefits to your health to delay screening? Its pretty straight forward. Blood draw and if the results are high, lifestyle modification, dietary consult and MAYBE medication, maybe not. There aren't any million dollar workups involved. Most of the medications that may be considered are generic rather than brand name.

By the time you are spilling sugar and protein in your urine, thats not catching it early. Thats catching it late.

I'm not an active pilot at the moment, but I AM a prediabetic. I'm very involved with the local chapter of the American Diabetes Association. This is personal subject for me, and I have many good friends with the disease. At the rate we are going in the US, 1 in every 3 children will eventually become a diabetic during their lifetime if trends dont change.

There is a value called a Hemoglobin A1C that acts as a long term average indicator of ones blood sugar. Mine had been creeping up for about 2 years. 3 months ago I started metformin and I've lost 20lbs since then. The A1C is coming down. It was never above 7. Nip it in the bud early and avoid the problems.

If you "become" diabetic, you will always BE a diabetic in all but the rarest of circumstances, so rather than running from the diagnosis, be smart, get informed by getting your numbers, and from there take steps to avoid, or manage, the diagnosis.

Doc Bruce is telling you what you need to maintain or obtain a medical. I'm more interested in directions to maintain your health.

Sorry if I misspoke about your type of flying. A valid medical approaching 5 years old is clearly a 3rd class, and for the vast majority of pilots thats non-commercial flying... what I mistakenly deemed recreational.
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I agree with most everything here but if you are obese, significant weight loss and change in diet may allow someone to get off diabetic meds completely.
 
Gary F said:
I agree with most everything here but if you are obese, significant weight loss and change in diet may allow someone to get off diabetic meds completely.
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I was diagnosed a few years ago with type 2, I ignored it, :dunno:it didn't go away.:mad2: anyway my A1c was around 6.0 and I just let it ride until almost three years ago, it ballooned up 8.0 :eek: I was put on metformin and I took it for about a week and decided I could solve this on my own, so I put the pills in a drawer and never opened them again!:D I started walking everyday, I mean everyday, went on a fairly strict low carb diet, quit all alcohol, and I lost a significant amount of weight. My last A1c was 5.6 and even though I have slipped a bit lately and gained a couple pounds back, I am much better shape, feel better than I have in many years! You don't have to train for a marathon, just get off your rear end and move, eat a little better and you'll be surprised at the results.:D
 
N747JB said:
I was diagnosed a few years ago with type 2, I ignored it, :dunno:it didn't go away.:mad2: anyway my A1c was around 6.0 and I just let it ride until almost three years ago, it ballooned up 8.0 :eek: I was put on metformin and I took it for about a week and decided I could solve this on my own, so I put the pills in a drawer and never opened them again!:D I started walking everyday, I mean everyday, went on a fairly strict low carb diet, quit all alcohol, and I lost a significant amount of weight. My last A1c was 5.6 and even though I have slipped a bit lately and gained a couple pounds back, I am much better shape, feel better than I have in many years! You don't have to train for a marathon, just get off your rear end and move, eat a little better and you'll be surprised at the results.:D
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.......beware...that works for a while, John, but it comes back....you need both your regimen, and eventualy you will need the guy's care again.
 
I think I can put this simply. There have been several deaths in my family in the past three years, some within weeks of each other.

My Dad died of cancer, but at least he'd lived a mostly happy and healthy life.
One of my brothers shot himself, at the age of 22.
One of my brothers-in-law was Diabetic, and one night forgot his meds because he had been drinking alone, and he simply died. He was 38.

For me, a complete layman, of the above three deaths, at least two were easily avoidable.

If the OP is one of my family (I suppose not likely), I'd be incredibly upset if you didn't get checked out. And since you ARE part of someone's family, I'm sure they feel that way.
 
N747JB said:
I was diagnosed a few years ago with type 2, I ignored it, :dunno:it didn't go away.:mad2: anyway my A1c was around 6.0 and I just let it ride until almost three years ago, it ballooned up 8.0 :eek: I was put on metformin and I took it for about a week and decided I could solve this on my own, so I put the pills in a drawer and never opened them again!:D I started walking everyday, I mean everyday, went on a fairly strict low carb diet, quit all alcohol, and I lost a significant amount of weight. My last A1c was 5.6 and even though I have slipped a bit lately and gained a couple pounds back, I am much better shape, feel better than I have in many years! You don't have to train for a marathon, just get off your rear end and move, eat a little better and you'll be surprised at the results.:D
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Exercise is vital, especially the large muscles, and especially the legs.

My doc told me that walking is crucial, especially after meals, because the leg muscles absorb a lot of glucose and convert it to something else for storage (glycogen, I think?), and exercise apparently facilitates this.

What I usually do is some chore or another. I'll mow the lawn, blow the leaves, or whatever; or just walk to the top of the hill and back down again (maybe a mile or so total, but steep on the way up) if there are no chores that need done.

-Rich
 
Gary F said:
I agree with most everything here but if you are obese, significant weight loss and change in diet may allow someone to get off diabetic meds completely.
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You are absolutely correct. Yet except in the most exceptional of circumstances (and there are studies looking at those circumstances right now) you will still "be" a diabetic and have to eat right to maintain that med free situation. If you eat a bunch of sugar and simple carbs for a meal even after the weight loss, a diabetic would spike their sugar where a nondiabetic would not. The insulin resistance persists.

Being "cured" of diabetes is not simply a matter of losing weight and stopping pills. Thats the point I was trying to make.

Early detection and management, however, can help you choose the lifestyle changes that help prevent the long term, gradually occurring sequalae of unmanaged diabetes.
 
Having seen a family member poorly manage his diabetes I can say that untreated diabetes is more troublesome than some on here are explaining. The short version is that untreated it can lead to other disqualifying issues such as partial vision loss, high blood pressure, reduced mental capacity days after events (my non-medical opinion based on observations), renal failure, a variety of (temporary?) nerve issues that pretty much suck and make even walking difficult for weeks, and $900+ ambulance rides.

My non-medical advice is if you don't have a doc and won't visit one then buy a cheap glucose monitor from WalMart and check your fasting glucose and also test regularly. I'm not a doc of any sort. I'm just a guy that's seen what it can do if poorly managed.
 
I had a postprandial of 148 a little over two hours after lunch today. That's higher than I want, and was probably because I was stuck at my desk for the two hours right after lunch.

So I went outside and grabbed my trusty electric leaf blower and 150 feet of cord, and moved all the leaves around. I came back in and re-tested: 107.

Don't underestimate the importance of exercise, especially the leg muscles, in managing diabetes.

-Rich
 
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