Idiopathic,

I hope your doctor helps you. They typically are useless until it is too late. If he is not concerned then don't give up.

Synnove,

The dr pointed it out because it's BAD. A reading of 200 is bad but doctors simply don't like to do anything UNTIL your fasting number reaches about 100 and/or your 2 hour numbers get bad...at which point...it's REALLY bad. So, it is "normal" for the dr to tell you that your fine at this point? yes. Because as I just said, he will wait until it really bad watching those other stupid numbers to get bad before he gets concerned.

It really is like thyroid results, doctors were trained to look at the TSH numbers and only progressive doctors are accepting that those old guidlines are outdated and wrong, just like these blood gluclose numbers are wrong now. It takes forever to get doctors to change their ways. Looking at A1c, fasting, and 2 hour marks is old school and how they were trained. Research is showing that spikes at ANY time is bad and the numbers they use as guidlines need to be lowered also, to help people PREVENT it before its out of control.

If I had numbers anywhere NEAR 200 at any time I would be freaked out big time. I worry when they go above 150.

" But I also point out that normally, we do not take in that much glucose during a meal as that heavy glucose dring you are given in the lab"

That is kinda wrong. If you ever sit down and eat cake or any high starch it is the same thing. Matter of fact, I was told in order to do that test on yourself at home, eat 1 cup of white rice then check your numbers at 1 hr and 2 hr and it will tell you how your body handles sugar. It's not about numbers and doctors it's about how your body is handling insulin at all times. If your numbers are high, you need to be concerned don't just accept a doctor telling you that you are fine because some test says so.

I understand your reluctance to add even more medications. I do not like to take anything that is not absolutely essential. I totally agree with you on that. I suggest the Metformin partly as a "test" over a 30 day time frame to see if it changes your spikes. If it does, then it would also be beneficial for your nerves and PN. It would treat your PN but it would keep spikes from causing further harm to your nerves.

I would not suggest you continue with the Metformin after 30 days if you do not see improvement in your post-prandial readings.

I totally understand both your concern and your not wanting to take more meds. While "pain" can elevate your blood sugars, it appears that is not what is causing your spikes. It appears your body is not responding in a timely manner to your ingestion of food, even healthy food.

I will mention it to my doctor's visit tomorrow. Thank you Hopeless.

It is hard to find a "progressive" doctor who thinks out of the box. They always follow what is in the books afraid of medical malpractice lawsuits.

Obviously I am replying to make things more confusing, or am I...

The result of the glucose tolerance test is nothing else but a result. It needs to be interpreted while considering other results (blood tests) and clinical symptoms (visible signs of retinopathy for example - these findings are most important). Unfortunately no single test can tell you about the real condition of your body. Why is that so?

Imagine a narrow stream and a wide river. How much water is transported via the stream and via the river?
Does it depend on the level of the water? No, it all depends how fast the water flows. You may imagine that in a rapid stream the water flows very fast and it transport much more water than a slow river.

Same principle applies to these measurements... your glucose blood level doesn't tell (almost) anything about how much glucose goes into your tissues (level doesn't imply how much) after meal or about how much damage your tissues sustained until now. That's why there are so many complications of diabetes - because even doctors do not understand the fact that the tests are often worthless and when they intervene it's often too late.

When you reach 200, this means that you are really really overloaded, and it is too late.

It's a very good idea to try supplements, because at this stage (when the spikes are not that high) they may actually work very well. It's also a very good idea to take Metformin. Off-label use is also pre-diabetes (as far as I remember, but I may be wrong). Plus, Metformin is almost like a supplement, because it is of plant origin (see Wikipedia entry about Metformin).

hi Bigg
Well. since my last post on this issue, I have been doing a lot of thinking. And do not get me wrong, I do understand the "thing " with the numbers etc. Yes, I know the limits. And I actually have been thinking I should get a glucose monitor and monitor my glucose, to see. I was actually at the neurologist's office today, and since it was him that had gotten stuck on this glucose tolerence test result, I asked him for a script for a glucose monitor meter, so that I could get some reimbursement from my insuranse company. But the doctor did not realy want to write me a script, he said because I do not need it, I am not a diabetic. But, as he said, any time you eat over 50 gram of glucose ( which is in that drink in the lab) you will be getting more than your body can tolerate, and it will damage your nerves.
so, perhaps I am " pre diabetic" or just have to be real careful with glucose. I will look for some strict diets.
By the way, I do like sweets, so I am surprised that my HG A1C was not higher
Bigg, what do you mean wit supplements? Can you mention some?
the only treatment I know about is the pills for diabetes( and of course the Insulin)

You can buy cheap monitor and strips at walmart. They are not as accurate but within 7 points either way, so just keep that in mind.

Google supplements for diabetes you will find TONS of info.

I just want to share with you what happened to my doctor's visit yesterday.

1. He discussed with my earlier 2-hour glucose test, which was a spike of 157 (I think) at 30 mins and 72 at 2-hour post prandial -- he said NORMAL.
2. I showed numbers of my home monitoring which are punctuated with spikes at 1 hour and generally normal after 2 hours (except on few occasions).
3. He said accdg to the criteria of the American Diabetes Assoc, my "official" results are not diabetes, not even pre-diabetes. While my home numbers are high, he does not want to recommend medication at this point....
4. I asked if the spikes, even a short while, can damage nerves. His answer, "yes to some, no to some". But since i already have the nerve problems, will it further damage mine, he said "maybe".
5. i mentioned treatment, e.g. ER Metformin.

The doctor was really hesitant to give me treatment but i said to give it try because the numbers are freaking me out. I need to gain some weight but i cant eat because i am scared of elevating the sugar!

So, he gave me a prescription. its not metformin but, Tradjenta. When i went home, i checked on the drug interaction website. It has contraindication with one of my antibiotics. I called the clinic and am waiting for the callback.

Thank you for letting me share.

I do NOT understand his reluctance to prescribe Metformin. Docs do it ALL the time for people with your blood sugars, LONG before they are "official".

Maybe you could/should discuss it with your PCP or even your pulmonologist. I doubt your pulmonologist would prescribe since it is outside his specialty, but PCP's would not have a problem prescribing it. MANY PCP's actually treat diabetics rather than send them to an endocrinologist. Diabetes is well within the scope of a PCP when not contraindicated.

I am not familiar with the drug prescribed but I will look it up.

I realize you are NOT diabetic but I am also darn sure your blood sugars need attention. They are NOT normal. I am not saying you are pre-diabetic, you have something going on that is causing your spikes. Someone needs to find the cause of your spikes. I would keep seeking answers. Do not accept that you do not fall withing the guidelines of the ADA. I know and have heard THAT response. As long as my A1C stays below 7.0 (the ADA guideline for diabetics) my doc is satisfied. I am NOT. When I get post-prandials in the 300's, I am NOT satisfied because it takes dropping into the 50's to get my AlC's below 7.0 Only after explaining to him that I did not want to go blind, lose limbs, have renal failure, etc. because that was OK with the ADA, did I get a different response. I said that the ADA was not the one that was going to suffer the consequences of my spikes and I needed something to deal with them. He then took my swings under consideration and has worked with me to help control them.

OK, I need to retract some of my prior comment. I looked up the drug prescribed which is a DPP-4, one of the newer classes of drugs for diabetes. I also looked up Metformin which is considered first line treatment after diet, BUT, and here is the clincher that would explain your endo....... Metformin has lung disease listed as a contraindication. Ah, that is why I am not a doctor, just an ignorant patient.

When will you see your PCP again?

I am not surprised at all that he didn't want to give you medication.

Like I said earlier, your numbers do not present as a problem to most doctors. And no, you are not diabetic, but your numbers indicate you will be. Keep on trying to find ways to lower it and find a doctor that believes in treating it BEFORE you are a full blown diabetic.

I agree with everything Hopeless said too..there ARE consequences to spikes. Problem is most doctors don't worry til it's too late.

Hope you get it figured out real soon.