glycemic problem?

[bigrobbierob]

I have developed a new problem the past year or so....if I eat carbs it will just about knock me out about an hour later. Seriously, I just slept 9 hours last night, woke up,ate, and feel about ready to go back to sleep to the point I am sitting here swaying.

I never had a problem with insulin spikes and crashes before. I definitely never had carbs effect me like this before.

I always get hypoglycemia and hyperglycemia confused....which does this sound more like?

Type 2 diabetes does run in the family (mom and brother) but I have no other symptoms (thirst, frequent urination, healing problems, ect). I just get really tired and need a nap after I eat.

I guess maybe I'll try keto a while to see if I feel better.

 

[TheDarkHalf]

Maybe you have developed Celiac disease? See your doctor.

 

[bigrobbierob]

Maybe you have developed Celiac disease? See your doctor.

I don't get diarrhea or anything, just really really sleepy. Almost like being drunk. I'm pretty sure my blood sugar is being messed up somehow, just not sure how.

I'd love to see my doctor, but currently unemployed and my extension just ran out. I'm broker than broke atm, so I'm looking at altering my diet.

 

[crazyfool405]

sounds like HYPO glycemia with concurrent HYPER insulinemia, which the high amount of insulin you secrete, causes your sugars to drop abnormally low,

id stick to a lower carb higher protein and fat diet.

also if you can get a blood sugar monitor, and do readings for 3 days in a row after each meal to see how your body reacts, especially on those days your super tired.

Maybe adrenal fatigue, you a heavy stim user?

 

[bigrobbierob]

Maybe adrenal fatigue, you a heavy stim user?

Not really. Maybe a cup of morning coffee, but that's it.

Yeah, I really want to give a keto type diet a try just to see how I do. My biggest issue is on Keto I will do fine all day, but about 6 pm I will CRAVE carbs. The evil little bastards!

I may see if my mom has any old blood sugar testing kits she doesn't use anymore laying around.

 

[Nitrox]

I have developed a new problem the past year or so....if I eat carbs it will just about knock me out about an hour later. Seriously, I just slept 9 hours last night, woke up,ate, and feel about ready to go back to sleep to the point I am sitting here swaying.

I never had a problem with insulin spikes and crashes before. I definitely never had carbs effect me like this before.

I always get hypoglycemia and hyperglycemia confused....which does this sound more like?

Type 2 diabetes does run in the family (mom and brother) but I have no other symptoms (thirst, frequent urination, healing problems, ect). I just get really tired and need a nap after I eat.

I guess maybe I'll try keto a while to see if I feel better.

At any point do you have an elevated heartbeat, feel anxious, jittery, feel irritable, or have cold sweats? These are symptoms of HYPOglycemia. If you don't and and your sleepiness is to the point of passing out standing up then I think that you are experiencing HYPERglycemia.

I had these same symptoms in my 20's. If I had pancakes for breakfast I would be back in bed 45 minutes later. Basically I was 'pre-diabetic. I learned to avoid high GI/high carb meals and I was able to manage it - however I eventually developed diabetes by the time I was 30. Your family history is also a strong indicator of the same.

Personally I would not go to a full keto diet. I had tried it and the cravings were awful and my energy levels tanked. Instead I would just go to a low carb diet (~20% carbs) and stick mostly to fruit and dairy (low GI).

Also total calorie intake plays a big role. The more calories you consume relative to what you expend, the more insulin resistance increases. Consequently, if you do indeed have pre-diabetes, your bulking/strength potential at the gym will be limited.

If you can get that glucose meter you can do your own glucose tolerance test. Have a high GI carb meal and then test yourself at 20 minute intervals after. If your levels are going well into the 200's then you're probably looking at impaired insulin function as the culprit.

Good luck.

 

[crazyfool405]

At any point do you have an elevated heartbeat, feel anxious, jittery, feel irritable, or have cold sweats? These are symptoms of HYPOglycemia. If you don't and and your sleepiness is to the point of passing out standing up then I think that you are experiencing HYPERglycemia.

I had these same symptoms in my 20's. If I had pancakes for breakfast I would be back in bed 45 minutes later. Basically I was 'pre-diabetic. I learned to avoid high GI/high carb meals and I was able to manage it - however I eventually developed diabetes by the time I was 30. Your family history is also a strong indicator of the same.

Personally I would not go to a full keto diet. I had tried it and the cravings were awful and my energy levels tanked. Instead I would just go to a low carb diet (~20% carbs) and stick mostly to fruit and dairy (low GI).

Also total calorie intake plays a big role. The more calories you consume relative to what you expend, the more insulin resistance increases. Consequently, if you do indeed have pre-diabetes, your bulking/strength potential at the gym will be limited.

If you can get that glucose meter you can do your own glucose tolerance test. Have a high GI carb meal and then test yourself at 20 minute intervals after. If your levels are going well into the 200's then you're probably looking at impaired insulin function as the culprit.

Good luck.

or OGTT with 75 g dextrose.

to me it sounds like hypoglycemia from hyperinsulinemia,

whats your body fat, weight loss/gain history.

 

[bigrobbierob]

I finally ate lunch and then had to take a 45 minute nap.

At any point do you have an elevated heartbeat, feel anxious, jittery, feel irritable, or have cold sweats? These are symptoms of HYPOglycemia. If you don't and and your sleepiness is to the point of passing out standing up then I think that you are experiencing HYPERglycemia.

Not from eating that I can tell. I am being treated for anxiety and depression anyway (like I said, unemployed for quite a while and emotionally stressed atm) so it's hard to differentiate what you describe from the panic attacks, other than I don't have to eat to have a panic attack.

About the only thing that accompanies the tiredness is sometimes a shortness of breath.

or OGTT with 75 g dextrose.

to me it sounds like hypoglycemia from hyperinsulinemia,

whats your body fat, weight loss/gain history.

Bodyfat, I don't know at the moment. I actually went through a period of weight gain over the past year or so drastic that when I went to the Dr last time she commented on it. I have gained 30 lbs in just over a year...I wish I could say it was all muscle mass, but I can't. :shame: anyway she looked back on my records and decided that I fluctuate a great deal anyway (I guess leaning and bulking cycles) and decided it was fine.

OGTT?

 

[Nitrox]

OGTT?

Oral Glucose Tolerance Test.

 

[Nitrox]

Bodyfat, I don't know at the moment. I actually went through a period of weight gain over the past year or so drastic that when I went to the Dr last time she commented on it. I have gained 30 lbs in just over a year...I wish I could say it was all muscle mass, but I can't. :shame: anyway she looked back on my records and decided that I fluctuate a great deal anyway (I guess leaning and bulking cycles) and decided it was fine.

Since you have some other issues going on a as well, an objective approach is needed. When I was diagnosed I was already pretty lean and very active - I did not have much room for lifestyle changes. On the other hand if you say that you have put on some fat recently (are you still 220lbs @ 5'10"?) then I suggest taking the opportunity to go on a low carb cutting diet and see how you feel in a couple weeks.

Otherwise you really need to get some testing done because at best we here are just making educated guesses.

 

[bigrobbierob]

are you still 220lbs @ 5'10"?

I'm closer to 245 plus or minus 5 lbs right now.

Oral Glucose Tolerance Test.

Ok, thanks

 

[triton185]

The weight gain......from meds you were put on?

Also, I have blood sugar issues......was dismetabolic. Mine will crash but not usually like a rebound effect....mine just bottoms out some days if I go over 3 or 4 hours without food. I pretty much eat thoughout the day. BUT before I changed my diet and the way that I ate, I did have that type of rebound effect at times.

My symptoms are: shaky, irritable (freakin mean), some confusion, some dizziness, extreme weakness.....to the point where I cannot move well at all and slurry speech...you would think I was drunk. It will mess me up for hours if I let it go too far. I carry food with me for emergencies.

I have just started to use a meter.

The reason why I am saying all this is because with your other issues, you are going to have doctors tell you different things. My suggestion is that you go to an endocrinologist. I wasted a lot of years going to doctors who put me on all kinds of sh*t and telling me that I was having panic attacks etc. The very day that I went to an endo and listened to what she was saying and DID what she was saying, I quit having any of those episodes. I know what to do now and I do it everyday because I felt like crap for years before I made the changes that I made.

One other thing that is ridiculous is that one of the meds that my previous doctors put me on made me crave sugar like CRAZY. This is going to sound stupid as hell but all I wanted to eat was fruity pebbles.....and I mean every freakin meal!! Now, just think about what kind of hell that was doing to my body with a blood sugar issue. I told my doctor that I thought it may be a sugar problem......he said no way and sent me for the 4 hour test. I fell asleep in the middle of it and got sick.....he who was a neurologist, told me it was just fine. I finally said screw him, after years, and went to an endo....took the test again (did not even get sick during this one) and she said told me that I absolutely has blood sugar issues.

Sorry to have rambled but listen, go to an endo and tell them ALL your symptoms. When Years ago when I was taking all this bullsh*t for neuro and other issues, I still felt like crap, did not feel any better at all.....and got so freaking FAT that I was depressed as hell and could not lose it taking the stuff I was on. My life literally changed the moment I began to manage my blood sugar. It has been years now and I don't take any of the junk that I used to and I feel great. Keep taking whatever you are taking and go get checked out.......

I turned this post into an "All about me" post but that is not my intention.....just giving you an example of what getting checked out can do for you.

Good Luck!!

 

[bigrobbierob]

Thanks for all the replies and help guys.

I wiki'ed hyperinsulinemia and the list of symptoms sound alot like what I feel. The fatigue, mental fog, and shakiness especially.

I was unaware headaches was a symptom, I get at least one a week.

The inability to concentrate, I thought was my ADD acting up.

Blurred vision....I just got new contacts a month or two ago and my prescription changed, I thought it was that.

That's definitely something I will bring up tom my Dr whenever I can afford to go again.

 

[crazyfool405]

Thought it sounded like that. You are insulin resistant on the verge of metabolic syndrome. I HIGHLY recommend recompadrol (low dose) while on a low carb diet to help correct insulin resistance leading to hyperinsulinemia

 

[bigrobbierob]

Being dirt poor atm, I may have to just take some cinnamon whenever I eat on top of a lower carb diet.

 

[crazyfool405]

I never seen any effect with cinnamon, however its worth a shot!

Let us know how it goes

 

[bigrobbierob]

I had actually stopped working out for most of this year thus far because I have felt so lousy. I just started up again about a month ago with bodyweight exercises.

Today I failed waaaay to early. I didn't even complete the full cycle. I forced myself to finish push ups (had to cheat by using my knees at the end) and then couldn't complete my hindu squats....I only did 3 of the 5 sets. My heart was pounding, I was out of breath, and just has to sit for about 10 minutes. I decided to call it a day and hit the shower, and my muscles were all quivering. The program I'm doing is progressive so I shouldn't have been doing too much too soon.

Could all this be a result of my blood sugar issue?

Should I maybe consume something along the lines of oats 1/2 hour or so pre-workout to fuel the workout?

Should I still look to spike my insulin with a post workout shake?

And a final question about my apparent insulin resistance in general....it seems everything I look up says "rapid weight loss", but I did the opposite...a rapid weight gain. As I have said, I have put on 30lbs of fat in just over a year. Why would I gain fat? Especially since I don't eat sugar and eat mainly whole wheat anyway.

 

[triton185]

I had actually stopped working out for most of this year thus far because I have felt so lousy. I just started up again about a month ago with bodyweight exercises.

Today I failed waaaay to early. I didn't even complete the full cycle. I forced myself to finish push ups (had to cheat by using my knees at the end) and then couldn't complete my hindu squats....I only did 3 of the 5 sets. My heart was pounding, I was out of breath, and just has to sit for about 10 minutes. I decided to call it a day and hit the shower, and my muscles were all quivering. The program I'm doing is progressive so I shouldn't have been doing too much too soon.

Could all this be a result of my blood sugar issue?

Should I maybe consume something along the lines of oats 1/2 hour or so pre-workout to fuel the workout?

Should I still look to spike my insulin with a post workout shake?

And a final question about my apparent insulin resistance in general....it seems everything I look up says "rapid weight loss", but I did the opposite...a rapid weight gain. As I have said, I have put on 30lbs of fat in just over a year. Why would I gain fat? Especially since I don't eat sugar and eat mainly whole wheat anyway.

You taking any meds that cause weight gain?

 

[bigrobbierob]

You taking any meds that cause weight gain?

My meds were just changed in April and I had just started the previous scripts in November of last year.

Current meds are: Celexa (depression), Metropolol (BP), Buspirone (anxiety), Trazodone (sleep)


Hmmm....I think I need to talk to my Dr...... according to wikipedia on Metroprolol "This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests"

 

[Nitrox]

I had actually stopped working out for most of this year thus far because I have felt so lousy. I just started up again about a month ago with bodyweight exercises.

Today I failed waaaay to early. I didn't even complete the full cycle. I forced myself to finish push ups (had to cheat by using my knees at the end) and then couldn't complete my hindu squats....I only did 3 of the 5 sets. My heart was pounding, I was out of breath, and just has to sit for about 10 minutes. I decided to call it a day and hit the shower, and my muscles were all quivering. The program I'm doing is progressive so I shouldn't have been doing too much too soon.

Could all this be a result of my blood sugar issue?

It is possible that it is part of the problem. I know that when I was being diagnosed, exercise is discouraged UNTIL blood glucose levels are brought under control through diet and/or medication. This has to do with the potential of exercise induced catabolism can make the problem worse (and you cant just take carbs to combat it.)

However it may just have been that because of your situation you were motivated 110% and trained too hard considering your time off. Maybe try again but take it easier. Remember this is a marathon not a sprint.

Should I maybe consume something along the lines of oats 1/2 hour or so pre-workout to fuel the workout?

Remember, your current goal should be to get your problem under control. You should be on a calorie and carb reduced diet. Just try to have one of your planned meals somewhat close to your workout.

Should I still look to spike my insulin with a post workout shake?

No. In fact I don't recommend that any one do this. 'Spiking' insulin as defined in the BB community is not the greatest idea IMO but especially so for those with blood glucose issues.

And a final question about my apparent insulin resistance in general....it seems everything I look up says "rapid weight loss", but I did the opposite...a rapid weight gain. As I have said, I have put on 30lbs of fat in just over a year. Why would I gain fat? Especially since I don't eat sugar and eat mainly whole wheat anyway.

Ok firstly, you gained weight (fat) because of the QUANTITY of food you ate. Even 'healthy' food will put on weight if you eat enough of it. This is why most people who are serious about managing their weight, plan and measure what they eat. Yes this is a pain, especially at first, but IMO there is no better way.

As for your reading about insulin resistance causing rapid weight loss, it depends on the progression of the condition. Think of it this way, everyone's insulin function has a limit to how much food it can metabolize. Once you reach that limit it goes into overdrive and then starts to burn out. As it decreases, it can no longer maintain that body weight.

So what probably happened is that your insulin function was ok at maintaining your 215ish lbs. Then as you ate more and hit 245 and it reached its limit. If you don't make adjustments eventually your function will drop further and you would begin to lose weight. Your blood glucose levels will skyrocket and you would start to see the symptoms of excessive thirst/urination, blurry vision, etc. If you were to get on a diet and exercise plan that got you to say, 180 lbs, you might find that all symptoms disappear.

Hmmm....I think I need to talk to my Dr...... according to wikipedia on Metroprolol "This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests"

This medication may well be making your situation worse. However I would be hesitant to place all the blame on it and expect that if it were discontinued that you could continue with your existing diet.

 

[bigrobbierob]

I was flipping channels the other day and of all things stopped on Oprah...it happened she was doing a show on diabetes warning signs and things you can do to get better. A weird coincidence that I stopped there while I attended to my cat and they were taking about my current worry.

She had Dr Oz and Bob Greene on, they made me aware that Apple Cider Vinegar taken before a meal can lower the GI and help regulate blood sugar. Of all the things claimed about ACV, this seems to be one that could possibly be truest. As I researched more I found numerous people that tested their blood sugar regularly and claimed to have dropped 10-20 points overnight by just adding ACV.

So this morning I went to the store and bought a bottle of Braggs Organic ACV. Man, the stuff is strong!!! I watered it down and it still made me make an ugly face!

I then ate breakfast and ended with 1/4 tsp cinnamon, thus far, an hour and 1/2 later I'm not tired like I have been. I wonder if it's placebo or if there's something to this?

 

[bigrobbierob]

My step-daughter brought me her blood sugar testing kit and I've checked myself the past few days.

What is the best time to test?

I have been doing morning (before consuming anything), an hour after eating breakfast (an hour after eating is when I feel worst), and two hours after eating (per kit instructions).

So far, I am confused as my blood sugar does not appear to be bad.

Sunday wake up= 80, 1 hr after breakfast= 135, 2 hrs after= 121

Monday wake up= 110, Monday 1 hr=138, 2 hrs after= 119

Both time when I did the 1 hour check I did so because I was feeling rough...tired and sweaty.

I am open to suggestions and theories. I plan on keeping an eye on things for a week.

 

[bigrobbierob]

I finished checking my blood sugar and nothing ever came up abnormal...even if I checked it when I was feeling really really bad.

Is it possible my blood sugar checks OK but something is still wrong with my insulin itself?

 

[Nitrox]

I finished checking my blood sugar and nothing ever came up abnormal...even if I checked it when I was feeling really really bad.

Is it possible my blood sugar checks OK but something is still wrong with my insulin itself?

Yes. Because blood glucose readings do not really say anything about insulin levels, especially in a non-diabetic. AFAIK you have two options. You can either make the lifestyle changes (diet and exercise) and see if the problem goes away - if it doesn't then it is probably something else altogether. Or you can get a C-peptide blood test done to test your insulin levels which will explicitly tell you if you are running high or not.

 

[crazyfool405]

My step-daughter brought me her blood sugar testing kit and I've checked myself the past few days.

What is the best time to test?

I have been doing morning (before consuming anything), an hour after eating breakfast (an hour after eating is when I feel worst), and two hours after eating (per kit instructions).

So far, I am confused as my blood sugar does not appear to be bad.

Sunday wake up= 80, 1 hr after breakfast= 135, 2 hrs after= 121

Monday wake up= 110, Monday 1 hr=138, 2 hrs after= 119

Both time when I did the 1 hour check I did so because I was feeling rough...tired and sweaty.

I am open to suggestions and theories. I plan on keeping an eye on things for a week.

thats a prediabetic reading (although HbA1C is better for diabetic readings.

honestly it looks as though your insulin resistant sugars should go back to basically normal by 2 hours post meal. this means you have problems with your glut4 comin to the surface and thus you have higher circulating levels of insulin.

 

[bigrobbierob]

thats a prediabetic reading (although HbA1C is better for diabetic readings.

honestly it looks as though your insulin resistant sugars should go back to basically normal by 2 hours post meal. this means you have problems with your glut4 comin to the surface and thus you have higher circulating levels of insulin.

The kit only had 10 strips, and I goofed my first test up, so I had to budget the last 3 tests I could do.

I had a wake up result of 103 and a 2 hours after eating result of 116. The final strip I used a few days later. I waited until I had ate and felt really really bad....so bad I had laid down for a nap...but decided to test first, it was 105.

I really think I may have the hyperinsulinemia, the more I read on it the more it sound like me atm. Now that unemployment checks are flowing again I just ordered some Recompadrol after seeing it mentioned several times and researching it....apparently it was originally designed for just this problem. Hopefully it does the job and I can get to feeling better.

 

[bigrobbierob]

My Recompadrol arrived yesterday. How should I take it for my problem? Should I continue my low carb diet? Should I contimue the 6 meals a day, but have the 3 main meals "normal" and the other 3 low carb, with the Recompadrol taken 1/2 hour before the main meals? I need a general idea for the best results.

I tried a cap last night before eating some Chicken Tikka Masala and Basmati rice (which is supposed to be low GI). I felt a bit of a "whoosh" through my body about 20 minutes after taking it, is that normal? I still got tired after eating that, if the Recompadrol works for hyperinsulinemia, how long until I notice I feel better?

 

[crazyfool405]

Whooosh? You mean like a warming sensation.

Start of with 1 cap 3x a day. If you can try and keep it low carb (for not just to try n increase insulin sensitivity a little more). Then add carbs as you see fit.

It should greatly help with your blood glucose. There's a thread on BB specifically for diabetics and the supplement.

Your pre diabetic it looks like from your readings as well. so start off how I said and eventually get up to full servings. And when you can test your sugars again

 

[crazyfool405]

Basmati rice I believe is high GI along with jasmine rice.

 

[southpaw23]

I have developed a new problem the past year or so....if I eat carbs it will just about knock me out about an hour later. Seriously, I just slept 9 hours last night, woke up,ate, and feel about ready to go back to sleep to the point I am sitting here swaying.

I never had a problem with insulin spikes and crashes before. I definitely never had carbs effect me like this before.

I always get hypoglycemia and hyperglycemia confused....which does this sound more like?

Type 2 diabetes does run in the family (mom and brother) but I have no other symptoms (thirst, frequent urination, healing problems, ect). I just get really tired and need a nap after I eat.

I guess maybe I'll try keto a while to see if I feel better.

Wow your description of your own symptoms really resonates with me, as I share the same exact symptoms. My family also has a history of Type II diabetes. I have to be very careful with my post work out drinks, as some that have sugar cause me to crash and crash hard and even harder to concentrate while at work. It's also difficult putting on size when you can't take advantage of insulin spikes, without suffering through feeling like you're comatose for hours on end.

 

[southpaw23]

Not really. Maybe a cup of morning coffee, but that's it.

Yeah, I really want to give a keto type diet a try just to see how I do. My biggest issue is on Keto I will do fine all day, but about 6 pm I will CRAVE carbs. The evil little bastards!

I may see if my mom has any old blood sugar testing kits she doesn't use anymore laying around.

I think we may be half brothers, but all kidding aside I suffer from the same issues, come evening time...crave, crave and more cravings for sweets.

This is a serious quality of life issue and I've yet to find something that works, tried Chromium and not sure if it's all that effective.

Recompadrol and Vinegar both appear to be popular, as forms of treatment, has anyone experienced success with either of these products?

 

[andrewcb]

how are you getting your carbs? get some organic blue agave, its low in glycemic and its real sweet

 

[Nitrox]

I think we may be half brothers, but all kidding aside I suffer from the same issues, come evening time...crave, crave and more cravings for sweets.

This is a serious quality of life issue and I've yet to find something that works, tried Chromium and not sure if it's all that effective.

Recompadrol and Vinegar both appear to be popular, as forms of treatment, has anyone experienced success with either of these products?

:frustrate Neither Recompadrol nor vinegar are approved medical treatments.

Look, if you are really suffering from insulin resistance/early stage diabetes you are simply not going to find a solution in a bottle unless it comes with a prescription. I know this is likely to be disregarded because people just want a solution that is convenient for them but there isn't one.

Anyways, good luck.

 

[bigrobbierob]

:frustrate Neither Recompadrol nor vinegar are approved medical treatments.

The Apple cider vinegar was approved by Dr. Oz and Bob Greene. I saw that on TV a few weeks ago and it's why I started taking it.

 

[Nitrox]

The Apple cider vinegar was approved by Dr. Oz and Bob Greene. I saw that on TV a few weeks ago and it's why I started taking it.

Ok I know all this gets complicated but bear with me.

At best, vinegar slows (not stops) the digestion of carbs. That means that ultimately, your body must at some point, still process them. Therefore it is no better than a band-aid.

Also the media loves to jump on any studies that suggest even the slightest potential for any 'natural' products to have therapeutic applications. This makes for interesting news/TV but is rarely of any practical value. I can guarantee that no endocrinologist is going to advise acetic acid as a first line treatment for diabetes.

 

[southpaw23]

:frustrate Neither Recompadrol nor vinegar are approved medical treatments.

Look, if you are really suffering from insulin resistance/early stage diabetes you are simply not going to find a solution in a bottle unless it comes with a prescription. I know this is likely to be disregarded because people just want a solution that is convenient for them but there isn't one.

Anyways, good luck.

Thanks and I understand that. I was more hopeful than anything, for a natural alternative as opposed to an RX. I've been to an endo and educated myself extensively on the issue of insulin resistance, as type II diabetes is prevalent in my family. My endo didn't seem to think that I needed treatment for insulin resistance, which isn't viewed by medical community the same way as a diabetes is , an almost passive approach towards offering the patient any type of treatment.

 

[pcproffy]

At 5'10 / 245, plus a family history of diabetes and hitting middle age, its a safe guess that he is having insulin resistance / metabolic syndrome. Top priority is to get diet under control and lower body fat ASAP.

Get down to 180-200 and you can likely manage it without needing drugs. With the internet you can easily find tons of information on diabetes. Get your carbs from low GI foods.

Its really all up to you at this point.