I suggest you get your A1C result and keep track of that.

Here is a link with a chart, showing the relationship to A1C value to average daily blood glucose:

http://healthy-ojas.com/diabetes/a1c-glucose-chart.html

A level of 7.0 and above is typically used to start medications or insulin. But some some doctors use a cut off of 6.5.
There are new studies out, showing that with age, some patients normally show higher A1Cs...and this is racially happening too. With Caucasians having slightly higher normal A1Cs than Hispanics and Blacks. The suggestion therefore is to be more aggressive with the latter, and not to overmedicate the Caucasians. But don't expect all doctors to know this yet.

In drug induced elevations, like from steroids, metformin is typically tried first. This is because it helps block glucose stimulation of the liver by the drug. There are some newer ones too in this category, but they bring more serious potential side effects. Metformin can cause diarrhea, and this is because of its stimulation of serotonin release in the GI tract.

Your doctor may order a glucose tolerance test, and if that happens ask for the 4 or 5 hr one (the two hour is not very useful). The values of acceptability are based on pure glucose consumption, and not food. So the levels --cut off are not really comparable to food.

A 1 hr postprandial when high at every meal, will raise the A1C. As will an all day high in the ranges shown on the chart. High one hour readings after eating are 140-200 typically after a non sugar meal. Fructose from fruit is slower in raising glucose than sucrose. But it will raise, only much slower.

So you should check with your doctor about your readings on fasting in the 140 range, get that A1C value, and start reading up on the topic. It is very complicated however, and doctors do vary in how they manage patients taking prednisone in high doses.

And remember eating huge portions of protein, will have the same effect on blood sugar as carbs--only the timing is slower to measure. So watch your portion sizes. Eating whole fruit and veggies, slows the absorption of their carb content because of the fiber present. Juicing, removes the fiber, and the carbs then get absorbed faster. Also having some good fats present slows the stomach emptying and then evens out the carb factor in raising blood sugar. But this does not have a bearing on steroid users where the excess glucose is coming from the liver and not food.

Here are the test my new PCP ordered. I will see him on December 16th. I will see my neurologist on December 9th. My IVIG was moved to December 2nd and 3rd.

Here are the test my PCP ordered:

• TSH - measures the amount of thyroid stimulating hormone
• PSA - measures the blood level of PSA, a protein that is produced by the prostate gland
• B12 Hemoglobin A1C - diagnose type 1 and type 2 diabetes
• Complete Metabolic Panel (CMP) - overall picture of the body's chemical balance and metabolism
• Lipid Panel - check cholesterol levels
• Vitamin D

I could do the test now, instead of waiting. At this point, would another two weeks make a big difference? I had planned to have the blood test a week before my December 9th appointment with my neurologist.

-Mark-

I had the two hour test earlier in the year. I had to stay at the testing area for the two hours. If you do the longer test, do they make you stay there the whole time?

-Mark-

Yes. You stay the whole time. Moving around physically skews the insulin and glucose readings. Activity tends to raise glucose levels, especially in those with pre-diabetic or diabetic syndromes. The longer test shows more, also.

This link shows examples of various responses to the long test.
There used to be university sponsored sites, but they tend to change their addresses or disappear. This person copied some of that to his own site.
http://www.rajeun.net/gtt.html

These graphs and tables show only response to pure glucose after a long fast. The numbers are not really applicable to food.(which takes more time to break down and enter the blood).

Also, home monitors are not 100% reliable. Then tend to report + and -10% .. so they cannot be compared to actual blood drawn in larger quantities like in the GTT.

Dear Mark,

The blood tests ordered are pretty standard and will give your physician a good overall picture and will be useful in deciding if and what other testing might be needed.

Hi Mark,

I have only read this thread so I may be missing a lot of other pertinent info but I think having a lengthy glucose tolerance test at this point in time is premature. Personally, I would wait and see the results from the basic testing you are to have done and then maybe consider some additional testing if the results indicate the need.

Your blood sugar levels are not normal but they are certainly not outrageous either. BUT, the sooner you get the abnormal variations under control, the better off you will be. Waiting until they are BAD is not in your best interest. Damage can be done to body systems even at levels that are not terrifically above normal.

It has already been mentioned that steroids raise blood sugar levels. This may be the entire cause of your abnormal levels OR it may be more complicated. It is not uncommon for people needing steroids to take a medicine to control the effects on the blood sugar levels.

I started to suspect the accuracy of my inexpensive CVS glucose tester. Last night I had a 159 reading when I would have expected a lower figure. I did another test and got 132, and then 136, one and two minutes later. I did notice that the sample did not fully fill the window on the high figure, but not enough to produce an error message.

Are the more expensive testers more reliable?

Here is my typical daily intake of food and drink:

4:00 to 5:00 p.m -- First meal around -- 16 ounces of smoothie, 1/2 cup oats with tbsp brown sugar and cinnamon, and a cup of kefir (your suggesting from earlier this year).

I take five thermos bottles with me to work, one large one with 4 cups of home made chicken soup, one with 16 ounces of smoothie, and three with green and herbal tea.

I also take 1 1/2 cup of meat (roasted chicken, smoked salmon or tuna, or smoked meatloaf). I also have 2 cups of vegetables from the Dutch oven, carrots, onions, cabbage, or broccoli (the heavy stocks).

I have a 3/4 cup garnish with salsa, avocado, and Philadelphia cheese. I sometime I have a 1/2 cup of baked beans, potatoes, or hummus.

I usually have the above in to or more settings through the night. If I eat late I may have it in one setting, but this does not happen very often. I often graze on my working days.

After work I will have the reaming smoothie, and sometimes similar food mentioned above. My appetite is very strong right now.

I also have canned fish and other snacks on hand, sardines, boneless herring fillets, Vienna sausages, and Bumble Bee Snacks (tuna and chicken). I only have a few of these a week.

-Mark-

All home monitors may have drawbacks:

This link I give some information on the two major chemical systems used in common monitors:

http://neurotalk.psychcentral.com/post754069-38.html

The One Touch system is chemically the most accurate, unless something new has come along. I believe they have new strips out today, which I am not yet familiar with.

The link on the post I am quoting is very helpful, so do check it out.

I edited the broken link out of that link above and added another.
You can Google for more-- keyword : "Most accurate blood glucose meters"

This field continues to change and more and more meter types appear yearly.

Also do not consume high dose Vit C before glucose testing. It affects certain chemical systems some of the hospitals use and some home meters.

I wonder if the longer test can be done at the same time that I am being infused. I will be there for 7 hours each day.

-Mark-

You should ask... I have no idea about the parameters of IVIG infusions, and the food allowances during them, etc.