How high is considered diabetic?
 

Hi. My Aic on 2 occasions were borderline and normal. My fasting blood sugar is ALMOST always normal. But my post prandial numbers are high. I have been experimenting my food and monitoring my blood sugar at home but it seems that my sugar goes up with every food I eat. I stopped eating rice and bread. Being a rice and bread eater, this is really difficult but I don't mind doing it. I am eating sweet potato as my substitute.

One time, with the same breakfast and quantity, my BS went down to 65 two hours after. I didn't know the first time i experienced it that the strange weird feelings were symptoms of low BS.

Last Monday, my neighbor took me to a new Vietnamese restaurant and I ate a small bowl of chicken noodle soup. After 1 hour, my BS went up to 197 (the highest recorded number, so far). On the 2nd our, it went down to 132 then 84 on the 3rd. I was surprised because it came back to normal on the 3rd hour. Normally, it takes so long before it comes back to normal range.

My endocrinologist does not seem to take me seriously because of my normal Aic.

My questions are:

1. does the blood sugar of a healthy person goes up to 197 after a heavy carb meal?
2. How long does the blood sugar of a healthy go back to normal range?
3. For case like mine, how often should I take the Aic test?

Is there anything I should do to prevent my condition to get worse? I exercise almost everyday. My parents were not diabetic, no uncles and aunties from both sides who were diabetic, except my sister who has been recently diagnosed to be pre diabetic.

Will appreciate comments.

Mary

It is when your blood sugar stays up after the 2 hr mark that is
concerning.

You should get an A1C at least yearly, and if you are worried,
every 6mos. Anything more often than 3-4 months is not accurate, because A1C only shows long term trends.

As people age their insulin response can become strange and blunted and be different from when they were younger.

Thank you so (very) much Mrs.D.

I know now that taking Aic every 3-4 months is not recommended. I think I will ask doctor at least 6 months. I remember your post before that as we aged, our insulin becomes strange but I never thought of the 2-hour mark as the "cut-off". Mine would SOMETIMES go back to normal on the 2nd hour but SOMETIMES not. It depends on the food I eat.
I will stay at home the whole day for the next 2 days to monitor my BS every hour. I have been monitoring it at least 3-4 times but I could not really see the 2-hour mark number because I do it by random.

I will let you know the result of my exercise.

Again, thanks:hug:

Mary

For pre-diabetics, normally at what time should the BS be within normal range? I know we all have different reaction to different food, but is there a "normal time frame" where a pre-diabetics or diabetics should be within normal range?

A little confused
 

Hi Mary,

I am a little confused. You are being followed by an endocrinologist? Are you taking any diabetes meds for pre-diabetes? You never did mention what your A1C's have been. Maybe you have some other threads that I have not read that cover my questions so I apologize if I am not up to speed.

My personal opinion is there is something going on to be causing such volitility to your blood sugar levels. You near 200 post prandial but also drop below 70 at times?

A1C's show the past 2 months. How long have you been tracking your blood sugar levels? How long has your endocrinologist been checking your A1C's?

You may be insulin resistant which is before you become diabetic. Some docs will put a patient on a low dose of Metformin with insulin resistance to ward off becoming diabetic. You are doing the proper things with altering your diet to reduce your carbs and getting exercise. If you are concerned and your doctor is not........ you might want to consider checking your A1C yourself every two months with a home test kit over a 6 month time frame. Bayer puts one out that is pretty accurate. The kit has two tests in it and sells for about $25. One kit would cover you for testing for 4-6 months.

I have used the kit on several occasions. I will test myself and then compare the result with the labs result. They are usually the same. It was off by one decimal once. My home test was 6.1 and the lab was 6.2 Close enough for me to trust the kit.

As long as your A1C is below the American Diabetes guideline of 7.0, most docs consider the diabetic patient to be in control. Of course, this is for a known diabetic. You certainly do not want to be in the 6.0 to 7.0 range and not be monitored closely.

I do not think your "swings" are normal unless you are doing heavy carbs.

Many here might disagree with me but I would seek an explanation for your wide range of BS levels. You may not be diabetic, but you may have some other reason for the variation. I do not know your age and that is a factor. Whether you are pre or post menopausal and if you have any gyn problems is also a factor. Even stress will cause elevated blood sugar levels.

Bottom line........ I would investigate and track your blood sugars. Just my opinion. I recently read my medical records from a few years before I was diagnosed with diabetes and had slightly elevated fasting blood sugars which were never mentioned or followed. It wasn't until I had a very high fasting blood sugar did anyone bother to mention it. My A1C was 10.2 when I was first diagnosed. They only did the A1C after a routine blood draw came back with the very high fasting blood sugar.

I would not "worry" but I do think it is worth a watchful eye if for no other reason but to ease your mind.

Hopeless,
Thank you for your reply.

I am seeing an endocrinologist primarily because of my thyroid problems. However, I found accidentally that my FBS is high but not high enough to be concerned about it (though it never happened to me before). Anyway, during my subsequent bloodworks, I saw that my FBS was getting really --though it was non fasting. I never had such high numbers even at non fasting. So, I mentioned this to my endoc, he gave me the Aic test in December, result was normal. Even the Aic was normal, I started monitoring my sugar at home since March randomly and It was when i got a record high of 197. In April, i had another Aic, the result was normal high (i couldnt find the report for now). between April and now, I had 4x of BG that came crashing to as low as 65. This crash ALWAYS HAPPEN IN THE MORNING AT LEAST 2 HOURS AFTER BREAKFAST. the crash has no trend, same food, same quantity and same activity. My major problem is the 2hr post prandial, it goes down very slowly.

I have no meds as I have not been officially diagnosed. I am post menopausal at 52y.o.

Took too long
 

I just finished a lengthy reply and took too long doing it and it disappeared.
I may try to re-create it. Maybe outside of the forum and then paste it in since I am so slow. Look for my reply soon.

Hopeless

Hi Mary,

If your blood sugar swings are a fluke every now and then I would not be concerned but if you repeatedly go high and low, that is NOT normal. I am basing that opinion on information I have received from physicians and from a lot of research I have done.

It may not be diabetes, but it does appear that there is some metabolic issue or another reason for the swings. Since repeated highs can affect nerves, blood vessels and body systems, I would keep track of your levels. Doctors see a lot worse but you do not want to be over looked just because your situation is not BAD at this time. If left undetected and untreated, it could put you at risk for problems down the road and then it will be “noticed”.

My prior lost post was much better than this one is turning out to be so I apologize.

I was diagnosed with diabetes at the age of 56 and had an A1C of 10.2 at that time. For several years prior to that, I had elevated blood sugars on routine lab tests but was not informed of them by my physician. I feel that I was entitled to know even if he did not feel it was significant.

I won’t go into all the drama and details but I changed doctors and began seeing my current endocrinologist. I see him every 90 days.

I would suggest that you continue monitoring your blood sugar levels with your meter and also use the Bayer at home A1C test kit every 8-12 weeks. I would also keep a log to show your endocrinologist on your next visit. My A1C’s are considered “good” or “controlled” for being diabetic but they do not show the fluctuations, only the average for the prior 2 months.

I keep a loose leaf binder on my kitchen counter with a daily log sheet. I record my fasting blood sugar first thing every morning. I record everything and anything that goes into my mouth and the time of day, including medications. I test at least two additional times a day unless I am above 200 or below 65. If those situations arise, I do additional testing to see if they are moving in the proper direction. I will also do additional testing if I am symptomatic.

My fasting blood sugars usually hoover around 100 but have occasions of fasting blood sugar of 156 for no apparent reason. My post prandial sugar levels range from 180 to 300 on medications. My lows are usually in the 50's and 60's and happen several hours after eating or during the night. I am glad I usually wake up and can take action with a low of 50 and dropping. The point here is that my A1C is OK for a diabetic because it averages the highs and lows. It does not show the wide swings that are so hard on my body. That is also why my doctor wants to know what my highs and lows were and the frequency each 90 days, not just the A1C he gets every 90 days from the lab. Sometimes he adds medications or changes them to see if we can level things out.

I am extremely compliant with my diet. I keep my carbs below 15 grams. I can eat the exact same thing and portion size and have a very different blood sugar reaction so I do understand what you are going through. I can eat a small piece of baked fish and a spoon of steamed broccoli and have a post prandial blood sugar above 200. There is nothing, absolutely nothing on the fish or broc..... no salt, butter, sauce, etc. Absolutely plain. The only beverages I drink is water and coffee. I cut out milk for several years and never did drink soda or anything alcoholic. I have since put milk back in my diet but limit it. Rice is totally taboo. That will shoot me sky high, even one teaspoon.

I really wish I had not lost my prior post. It was much better and not so rambling.

A low dose of Metformin might help level out your blood sugars. Metformin will not make you go low but will help to lower the post prandial highs. Of course, that would depend on the reason your blood sugar is volatile. I think a good log will go a long way in getting some answers from your endocrinologist. I do think further investigation is warranted in your situation.

Hopeless

Hi Mary,

I am sorry I seem to have repeated myself a lot with my last two posts but I actually wrote it outside of Neuro to be sure I had enough time. Please forgive my repetition. Too much blood sugar on the brain. (Smile)

Wishing you levelized BS, that is blood sugars, not bull blank.

OK, my very short response.

65 not terribly low
197 not terribly high

Normal ??? NO

Diabetic? Not necessarily.

Should you worry? NO

Should you monitor? YES

Hopeless,

Thank you so much for your time and efforts of answering my post. I also made a long and detailed reply to your first reply but for whatever reason, It didnt not get through. I dont do well in front of the screen for a long time, plus my neuropathy is bothering me a lot. So, i just wrote an abbreviated reply which what you read last night.

I am very concerned about the highs and the lows because I already have a neuropathy, a painful and creeping progressively. I am not sure if the elevation is due to my age or my post menopausal or both. Having BS normal and with no family history, the numbers are high for me.

Well, i received a call from the endoc's nurse, my AIC is within normal. It really makes so much sense when you said that AIC is normal when you have swings of highs and lows. I try to walk regularly but with the neuropathy, it restricts me in doing so as often as i should.

is the reason for extreme numbers ONLY insulin resistance? I had a complete thyroidectomy and currently being treated for Mycobacterium Avium with 3 strong antibiotics. I am not sure if this can be a reason. though, my pulmonologist/infectious disease said that my pulmonary infection is stable that it could not be the reason for my elevated sugars. But you know these doctors, with my personal experience with a lot of them, and with lack of awareness of the infection, Im not sure....:confused:

I totally agree with you doctors will not take you seriously, unless you are really sick.

Mary

Hopeless,

Can it be considered as pre-diabetes?

thanks.

Mary

This may be in parts
 

I run out of time and get logged out while I am responding if I take too long. I may respond in bits and pieces to avoid losing the post as I did last night. This has happened to me before and I was told that I might try clicking on the Remember Me when I sign in to prevent being timed out.

I did not mean to ramble so much when I tried to re-create my lost post. Sorry about that. I have had peripheral neuropathy for many many years, long before I was diabetic. Now, docs want to blame everything on my diabetes. Yes, the diabetes is creating some of its own problems and exacerbating others but it is not the cause of everything that is wrong with me. I get really annoyed with the constant blame on my diabetes for conditions I had 20 years and more before I was diabetic.

Oops, better stop here and submit. I will continue under a separate response.

If you check the "remember me" box when you log
In... You will not be logged out ( timed out).;)

Hi Mrs D,

I thought I remembered you telling me about the remember me but I keep forgetting to do it.

Thanks for the reminder. It will help IdiopathicPN, too.

Hi Mary,

I am back. The reason I had previously asked about your age and/or post menopausal was because there is a relationship of PCOS, polycystic ovarian syndrome and metabolic syndrome including insulin resistance. There are a lot of other contributors to blood sugar changes, including high blood pressure, high triglycerides, low HDL cholesterol, stress, arteriosclerosis, fatty liver, PVD, liver disease, certain medications, alcohol, etc. Cushing's and Addison's can alter blood sugar. Possible signs of insulin resistance can be skin tags and acanthoses nigrican, (spelling??) big word for darkened skin.

There is an interesting article about "normal" blood sugars at www.phlaunt.com/diabetes/16422495.php I do not know how to post a link so I hope you can get to it by typing it in. I think you would like reading it. Most blood sugar articles are geared to diabetics.

I did see that hyperthyroidism will cause changes in blood sugar levels and since you said that you had thyroid issues, maybe that is a reason for your swings. I would ask your endocrinologist about it. Maybe that is why he is not concerned about your swings. He surely knows a few thousand tons more than I will ever know.

Hi Mary,

Me again. I am guessing you are on thyroid medication. Maybe your meds are causing your swings.

No matter what the cause, I do think you should seek advice from your doc as to the best method for leveling out your blood sugars. The swings are hard on your body and organs, not to mention adding to your PN.

I have seen some articles claiming post prandials up to 180 OK, but I think that is pushing the envelope. Normal should not go above 140. Normal should not go below 70. I have always been fearful of losing my sight since early childhood. I won't risk my eyesight to what some piece of paper says is OK. I already have cataracts, narrow angle glaucoma, and episodic blurrs, and despise seeing my eye doctor. A lot of people hate going to the dentist but I hate going to the eye doctor.

Hope some of this helps. Oh, I see that the typed link did turn into a hyperlink when I clicked on the submit post.

Hope you can find the link and enjoy reading it.

Keep in touch.

Possibly
 

Yes, it could be pre-diabetes but I would not jump to that conclusion. I would monitor daily for several weeks and take the log to your endocrinologist. A BMP blood draw, (basic metabolic panel which includes a blood glucose) is just one point in time. An A1C is an average of your sugars, both highs and lows, over about 2 months time. The BEST diagnostic tool is your daily log combined with the lab tests.

Hopeless,

My case is hypothyroidism. My endocrinologist didnt seem to relate my blood sugar complaint on my thyroid. The thyroid function is relatively stable. I said "relatively" because sometimes its normal and sometimes its high normal, sometimes its way off. But most of the times, its normal.

Among the causes you mentioned, the possible that i can point at : medications, stress and the PCOS and age. When i was younger, I was diagnosed to have endometriosis (not sure if PCOS and endometriosis are the same - i will google it after i submit this post). I am taking combination of strong antibiotics for a lung infection, and yes a lot of stress because of the PN pain and the uncertainty of my lung infection.

I dont know what to believe now. My pulmo said that my lung infection is stable. But I remember this elevated sugar started around the same time that i was doagnosed with the lung infection. Maybe its just a coincidence.

Im not sure if i mentioned it (my memory is so bad because of the gabapentin) but the endoc called me informing me that my recent AIC was normal. I asked that the report be mailed to me. So now, I should be more vigilang with my home test monitoring.

Your link is very helpful and informative. It was written in a way that easy to understand. I read from top to bottom.

thank you so much for your time.

P.s. After my eye check up today, I ate a Whopper (hamburger) and skip the fries. Unfortunately, I could not be home in time for the 2hr mark test. I tested once i home and it was 114 after 3.5 hours.

Hi Mary,

I think if you want to see your peak highest level post prandial, you might want to check about 45 minutes after eating to see just how high it gets, and then a second time to see the direction. If I eat something out of the ordinary, I test about 45 minutes to an hour and then again about a half hour later to see if I am climbing or coming back down. I don't do that often, only when I eat something different which is rare. The problem is the only time I usually eat something different is when I eat at someone else's house or in a restaurant and I have to remember to bring my meter with me. That only happens a very few times per year. The reason I test so quickly is because I may have consumed "fast" carbs, rather than "slow" carbs.

Maybe you could send me PM's to keep me posted on how it is going. I would love to keep in touch. I think you have been very smart to keep track of your blood sugars without being diagnosed with a problem. There are a lot of people walking around with pre-diabetes and diabetes and have no idea. Even when people feel fine, have an annual check-up and routine blood work, they usually do not know their lab results. The doc says everything is within normal range and it ends there.

I was at a meeting a few years ago and sat next to a lady that happened to mention that she was diabetic. We actually have the same endocrinologist. She told me that she tests a few times per week and had no idea what her A1C is on any occasion. I was shocked that she did not keep track of her levels. (She also has VERY serious lung conditon and cardiac issues.) She is not well at all.

You may not be pre-diabetic but you have taken the right steps to stay as healthy as possible and correct a potential problem. I applaud you for taking control and keeping a watchful eye on your levels. Again, I would not worry but I would keep track and discuss it with your endocrinologist at your next visit.

Eye doctor today? Glad it was you and not me. I freak out every time I have to go. I had a great opthomologist from childhood until my forties. We actually crossed paths outside of his practice and I became friends with his family. I even babysat for his kids. I ran into his oldest daughter and learned he had passed away. I haven't found anyone I trust near my eyes ever since then. My newest optho and I did not hit it off on the very first visit. I asked my endo for another reference and he asked why I did not like her. I gave her a second chance thinking maybe she was just having a bad day. NOPE, she was even worse the second time. That is a long story which I won't go into tonight but maybe another time. I am thinking I will see one of the other docs in the practice next time because I never want to see her again.

I am really particular with the people (doctors) that I trust with my life, my eyes, etc.

I worked with too many docs and know that just because they made it through med school does not make them good. Their certificates do not say whether they were at the top or the bottom of the class. I also make sure they are board certified. She may be a good optho but we do not get along at all. And if I don't like her, it affects the trust.

There I go again, rambling. It must be my meds. (Smile) Not really but that sounds better than I am just off my rocker.

Hopeless

Keep in mind that high dose vitC may
Be causing inaccurate test results.

Often vitC is withheld when having blood
work at labs and hospitals.

There are now about 30 drugs in papers
Listed as affecting blood testing for glucose.
Not all strips and meters use the same
Chemical technology.

When I return next week I'll put some
Links up.

Also what you read "today" about A1C
And other suggestions may change
with time. Already there is a complex
Paper out there explaining A1C differences
By age and race and in certain populations
not to over medicate or treat these
Patients .

I just bumped up a thread that pertains
To this subject. So today it is at the
top of this forum. ;)

i think a lot about the article you posted a while back about age affecting the sugar and I always think that it might be.... but, with all my condiitions, I'd like to be pro-active in dealing with my health.

as far as the vitamin c., i started cutting it back to 500mg. As you may know, i need my immune system to be working well. The major side effects of the medicines to me is the abnormally low WBC and Neutrophils. To start with, my immune system may have been low thats why i acquired the infection so now with low Wbc,etc i have virtually no defense for regular bugs, I am really prone to other infections.

thank you.

Mary

Hopeless,

I used to take my BG 1, 2, and 3 hrs after meals but then i read that the critical number is the 2 hour mark. So, I am now just taking the early morning and 2 hours after each meal because my fingers have become really sore due to the pricks. there is one thing though that I think my monitoring is not as effective as it may sound. You see, I have some unresolved stomach acid that makes me feel hungry. I eat in between meals. The effect of these snacks are not recorded because I thought it may not be significant BUT it may not. One time, i ate one cheese stick (i normally eat cheese as it has no carbs and sugar content) and the Premier Protein drink which has 5 carbs and 1 sugar but my sugar shoot up to more than 130 after 2hours! It seems the spike is not commensurate to the food intake.

I will do as much testing as possible. Oh, i read somewhere (maybe in one of the links you gave me) that if one FBS is somewhere in between 92-100, you will be likely diabetic in 10 years. Its still a long way but if i dont watch what i eat now, the 10 yrs may be reduced to half :)

Since Dec 2012, i have been steady losing weight unintentionally. My pulmo said its not my lungs, my endoc said, its not my thryoid, the GI dr said, its not in my stomach. but i need gain more weight. the pulmo warned me that with my built, just one exacerbation, i will be left with nothing to fight any bugs because i dont have "buffer" in my muscles mass. So you see my predicament, i need to eat more but when i eat more, my sugar shoots up!!!!!

Mary

Hi Mary,

Can I donate some of my "extra" weight to you? I need to get rid of some and you could use some so lets transfer some. I have become so sedentary due to health issues that no matter how much I watch my calories, I do not lose any weight. I am one that definitely believes that weight loss MUST be attacked on BOTH dietary restrictions and exercise. Either one alone does not work.

My WBC is always Above normal as I stay in a constant "inflammatory" state. Years and years. I could donate some of those too.

You have a lot more serious issues to be concerned with than your volatile blood sugars. In your situation, I would not test quite so often. Yes, it does make your fingers sore. The two hour mark??? Well, different foods metabolize at different rates and the two hour mark is not always the best time. It is the one that has most consensus but not necessarily the one that will give YOU the information you need.

If I had your situation, I might test first thing in the morning "fasting" maybe every other day or less. I would test 45 minutes after a FULL meal and repeat at 2 hours later a few times a week. NOT daily unless you see BAD numbers. Example, test after breakfast on Monday, after lunch on Wednesday, and after dinner on Friday or the weekend.

The "snacks" are actually good for your blood sugar as they help to balance it. Diabetics do better with several small meals a day rather than the traditional 3 meals. Diabetics are encouraged to eat healthy snacks.

Are you able to supplement your diet with a nutritional drink like Boost or Ensure? That might help with your attempts to maintain or increase your weight. Boost makes shakes that are designed for diabetics, providing nutrients, without throwing blood sugars into chaos.

Keep snacking and test on occasion. Give your fingers a break. The week before your next appointment, then you could test more frequently to have a lot of good data for your doctor. You are doing more for yourself than most diabetics. Keep up the great work on helping yourself.

With your efforts, you may just avoid joining the group, the diabetic group.

Hi Mary,

I wish I knew how to quote portions like I see others do. Maybe someday I will learn the ropes here. You said you shoot up to 130 after the nutritional drink. That falls within the NORMAL range for NON-diabetics. It is when you go above 140 that you begin to look at it. Because you are post age 50, I would not worry about anything under 150 unless it is truly fasting. Any food or beverages that result in less than 150 would be of no concern. When you go above 180, that is reason to watch it. Above 200 is time to have a discussion with your doctor regardless of your A1C results.

Blood sugar is a little bit like blood pressure as they are both measured at a single point in time. Both are constantly changing in NORMAL people. The degree of variation is what matters and even then, a drastic change attributal to a specific event is not indicative of diabetes or of hypertension depending on whether we are talking about BS or BP.

When I was in my early 20's and VERY healthy, I had broken a bone and went to the ER. They treated me and then would not let me leave because my blood pressure was sky high. Not really but way above normal. At that time I was NOT hypertensive. It was nothing more than my body's reaction to the pain. Once the pain meds kicked in, my BP immediately went back down to normal.

NORMAL people can have an "odd" blood sugar due to some momentary situation. The body will usually remedy the situation in short order if there is no disease process.

My point is I do not think you should get alarmed with some BS readings unless they are persistently low or high. You should be very proud of yourself for your efforts.

It seems the spike is not commensurate to the food intake.

Hi Mary,

I can certainly understand THAT statement. That happens to me, too. It all depends on what your liver and pancreas are doing sometimes and not your intake. Those are the readings that baffle me and make me a little crazy. I can have a FBS of 88 one day and a FBS of 157 the next. Then, everyday for the next several weeks, my FBS will hover around 100. If I am "fasting", it certainly is NOT food related. There are also times, like you stated, the levels are not commensurate with your intake. I can eat the EXACT same thing and amount at lunch and at dinner and get VERY different results.

Do not obsess about it. That will only cause you stress and stress WILL elevate your blood sugar. I get dis-heartened sometimes when I work so hard to control my diabetes and have wide swings. Then I see someone else that does nothing to control their levels, eat anything they want, etc. and get better results. Or at least that is what they say. Maybe their results are not what they claim. Well, they are the excuse I make to have a very small piece of cake on my birthday each year (no icing) and one spoon of dressing at Thanksgiving.

Hi Hopeless,

Not that i dont want to join a group, but with all my health issues, even with a gold invite and walk down a red carpet, i definitely will refuse to join the group (no offense meant):D .

I try to walk as often as my feet and legs allow. if i dont exercise, my shortness of breath is more pronounced. So you see I am into a lot of predicament: my lungs need exercise but my legs and feet are not cooperative; i want to gain weight (by eating more) but my sugar goes up. Sometimes life is full of contradictions.

I take the protein drink called Premier Protein because it has only 5 grams of carbs and 1 gram of sugar. I am not, at this point, very particular of the calories because i need more calories. Premier Protein has the highest protein, lowest carbs and sugar i have seen and it tastes food too. I dont like the taste of ensure, glucerna and boost.

I make oatmeat raisin cookies using an artificial sweetener and i only use half of the. flour that is required and I fill the other half with the ground flaxseed. I eat this with 1 cheese stick for my snack. but believe me, its so hard to have a snack so little as this, it does not fill me up :). i normally eat my dinner before 6pm. i read that to have a good numbers in the morning, you have to have dinner not later than 6pm. the problem with this, i get hungry by 8pm especially that i dont eat much at night. i always have this idea to eat less at night because you dont need much energy at night. do you snack before bedtime?

Mary

Hi Mary,

I will send you a Private Message.

Hopeless