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42 diabetic, wake up early in the morning with internal

42 diabetic, wake up...
42 diabetic, wake up early in the morning with internal tremors. they have gotten worse. could it be anxiety or something else. checked heart, brain, bp is a little high around 117/80 in the morning, also feeling of butterflies in stomach. I know generally my sleep has not been the greatest I usually am able to get to bed but wake up at 4 or 5 or 6 and then go back to bed, but dont feel rested when I awake. I am 6'0 280, have lost about 20lbs, exercise in the morning and the night with a 20-30 min walk and also add in weights from time to time. Please help tremors are really affecting my work day. also my score of the thyroid is as follows he TSH was 1.46 (reference range 0.45-4.5) and the Free T4 was 1.03 (0.7-1.5).
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Answered in 5 minutes by:
8/23/2013
Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29,269
Experience: MD
Verified
Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.



Mysticdoc :

What is your blood sugar level when these episodes occur?

Customer:

My level was 157 this morning when I awoke, HR 72 BP 117/80.

Mysticdoc :

and what diabetic medications you are taking?

Customer:

So right now, warm flush feeling in shoulders and face, ringing in the right ear, and tremor. I currently take lantus insulin and that is it. I will be going back on metformin in the next couple of days. my stomach had a reaction to the medicine so my endo told me to stop taking the med and that cured my stomach issues. i was taking 4 500mg extended. I will be starting back with 1 or 2.

Mysticdoc :

ok

Mysticdoc :

when did these tremors start?

Customer:

I started with them about 2 years ago, just a slight anxious feeling like 3 cups of tea or coffee in the early morning, so over the last year and a half i have been checked for everything and it has come up negative, possibly anxiety which is fine i get that and possibly stress but some days i am not worried about anything life is great and i still have them. I am a worrier and just want to have my life back.

Customer:

Also I take 2 GNC Mega Men multivitamins

Mysticdoc :

ok

Mysticdoc :

yes anxiety and caffeine can cause them

Mysticdoc :

However, our blood sugar is also running little high.

Mysticdoc :

That also should be addressed.

Mysticdoc :

metformin should help.

Mysticdoc :

parkinson's or neurologial disorder is unlikely since you do not have any other symptoms over 2 yrs.

Mysticdoc :

Peripheral neuropathy also worsens over time --not the case with you.

Mysticdoc :

But possible in mild degree with diabetes.

Customer:

I have cut out caffeine completely as of 6 months ago. I may have a glass of tea or soda once a week maybe, that is it. GP said he didnt think parkinson.

Customer:

can sleep deprivation cause these issues ?

Mysticdoc :

yes sleep deprivation also can cause this.

Customer:

I generally go to bed around 10-1030 listen to a cd fall asleep possibly take a melatonin and then wake up in the middle of the night, i generally can get back to sleep but when i awake i am not rested. right now i know i am tired from last night. got to bed at 10:30 and woke up around 4, went back to sleep and then awoke at 630

Mysticdoc :

ok

Mysticdoc :

disruptive sleep pattern can cause tremors as well.

Customer:

I have thought this for awhile, but asked GP about it took the sleep test and i was right on the border of being a candidate. I have only had one night actually april 14 2012 that I slept all the way through and felt refreshed. nothing for about 9 months before that and nothing since then,

Mysticdoc :

Ok

Mysticdoc :

you should consider a sleep study.

Mysticdoc :

losing weight does help.

Customer:

Losing weight is my main priority and the one i have anxiety about. I am really trying hard but weight is being stubborn and i am sure not getting the right amount of sleep aint helping.

Mysticdoc :

yes correct

Mysticdoc :

stress causes excess cortisol in the body and that can make losing weight difficult.

Customer:

any way to reduce the cortisol level?

Customer:

other than getting rid of the stress?

Mysticdoc :

unfortunately not.

Mysticdoc :

watch your diet.

Mysticdoc :

Vegetarian diet helps.

Customer:

got to have my chicken breasts, i could cut out the steak, i have cut down on my dairy, need more veggies i am sure typical day is breakfast oatmeal or scrambled eggs with grits, 6oz oj, 20oz water, lunch is usually a ham and cheese lettuce, tomato, mustard 6 inch sub, water throughout the day, approx 80oz, and then dinner is usually vegetable, chicken breast or half a piece of steak.

Mysticdoc :

yes you can cut down the steak and ham.

Mysticdoc :

chicken should be ok.

Mysticdoc :

and lot of veggies

Customer:

Ok thanks for the help, Enjoy your Weekend!

Mysticdoc :

very welcome

Mysticdoc :

you too

Mysticdoc :

It was my pleasure to help you today.


Best wishes,


Please rate the chat Good or Excellent, if you are satisfied with our conversation and do not have any further question, so that I get rewarded for my time & effort. Thank you!




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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29,269
Experience: MD
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Customer reply replied 3 years ago

still having issues, discomfort in upper right chest and burning in throat. can any lung issues cause this. gets worse throughout the day. I wake up in the morning fine but after breakfast it starts. After lunch really got worse with pressure prilosec and zantac doesnt even touch it. any clues, one other thing, is that my heart rate is fine but my BP will jump up to the 145-150/83-92 range. will get warm flushing feeling inside my face. could i have an infection in the gut causing this? last thing i have my right nostril that i have not been able to breathe freely from several months. occasionally it will be clear but not often. I also have a tooth that will be removed shortly, just thinking could it be an issue with nasal back of throat to stomach issue? Let me know thoughts. Thanks.

Lung problem should cause cough and shortness of breath by now.
Being said that, a chest xray should be considered.
Infection is unlikely since you do not have any nausea, vomiting, diarrhea.
Nasal polyp is a possibility causing blocked right nostril.
THis can be checked out by the ENT specialist.
Flushing is commonly caused by the anxiety related issues.
The burning feeling also can be related to the anxiety issues.
One rare condition can be serotonin secreting tumor in the gut causing all these symptoms.
Carcinoid syndrome is the another name.
THis is a rare condition, but can be checked by the 24 hour urine HIAA levels which will be very high.
Best wishes
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Customer reply replied 3 years ago

okay don't think it is the cs. no shortness of breath, just lump like in back of my throat feeling, internal tremors, pain/discomfort in right chest, slight burning feeling in throat. I wake up fine, and I know there is anxiety there but that shouldn't be causing everything. any other thoughts. sometimes a little nausea/dizziness, but no vomiting or diarrhea. can anxiety raise the the BP that much?

Anxiety can cause all these symptoms.
The best differentiating point will be lack of significant worsening or additional symptoms over time usually associated with serious conditions.
However, since you have diabetes, diabetic neuropathy can affect the nerves resulting in these symptoms.
Another rare condition can be multiple sclerosis.
Gallbladder disorder or pancreatitis are other less likely possibilities.
Best wishes
Ask Your Own Medical Question
Customer reply replied 3 years ago

my ct came back fine last year for ms. i know the diabetic neurapathy can cause some of the symptoms. I do know the tremor and discomfort has become more evident. So being a diabetic and when neuropathy is concerned can the symptoms be worse in regards ***** ***** Basically could the symptoms be worse being a diabetic due to anxiety. If Gall bladder disorder i don't have jaundice, any other symptoms fit the disorder?

Diabetic neuropathy can worsen your symptoms.
Anxiety does play a vital role.
You seem to have good work up so far.
I do not see any serious condition at this point.
Best wishes
Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29,269
Experience: MD
Verified
Dr Basu and 87 other Medical Specialists are ready to help you
Ask your own question now
Customer reply replied 3 years ago

Trying to figure out why my sugar level is not going dow. 141 this morning, took my 3 metformin, and lantus 30units. at 12:30 down to 103, went to lunch at 1:10 ate a 1/2 sub, chips, and soda, level was 213 at 3:30, 205 4:00, 191 at 4:30. Can stress keep those levels up? should have gone down by then. let me know.

stress can keep the levels up.
Another thing I am noticing, the blood sugar level does not go down fast enough rate later on the day.
So, it is better to take lantus an hour before lunch.
Best wishes
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