Another 2-hour glucose test!!!
 

I had another 2-hour glucose test last month. the results are as follows:

Glucose, fasting 79
glucose, 1/2 hour 154
glucose, 1 hour 136
glucose, 2 hour 72

The results look the same as my first one last year. As expected, my endocrinologist has declared me to be "essentially normal". I would have been happy with these numbers. But my problem is the post-prandial numbers. I take my home testing seriously. I eat breakfast exactly the same thing, same measurements and alternate it with and without exercise. One morning, everything was normal, the 1 hour post prandial went up to only 136 and on the 2nd hour went down to 91. Another morning, the 1 hour post prandial was 192 and the 2nd hour was 126. This trend goes on several days. I take down everything that I eat, calories and carbs., time and medicines/supplements, activities.

In the morning, my sugar goes down as quickly as it goes down but at dinner time, the numbers are up until the 3rd hour. I am still in the process of experimenting my lunch and dinner foods finding the kind of food that spikes my sugar most.

What makes this whole thing frustrating is I am steadily losing weight. My pulmonologist strongly suggested that i should gain weight but how can I gain weight if whatever i put in my mouth spikes my sugar? I dont want this blood sugar to get out of hand because I already have Neuropathy. My appetite is good, in fact, I want to eat more but I control it. I am obsessed that I measure all my food to be balanced and yet diabetic friendly. Sometimes, i think maybe, I am too uptight in observing my food intake but when I become less vigilant, my sugar goes even higher. I am confused and becoming frustrated.

Mary

Are you eating fats? Using good fats (fatty fish, olive oil, flax), will slow the stomach emptying, and even out some of the highs.

Try eating a larger protein filled meal at lunch... say at 1pm... and a smaller dinner. A protein filled breakfast with lean meat and eggs, will help too.

The liver has a big job in controlling blood sugar. It may be a factor for you, with the medications you take.

If you are not overly thirsty, or urinating alot, I wouldn't worry too much. Alot of factors go into becoming type II diabetes, and if your pancreas is giving up, nothing you can do about that.
Just keep an eye on things.

And--
 

--to really get a look at your patterns and see what stage of metabolic dysfunction you may or may not be at, you might want to try a longer glucose tolerance test, with draws of both glucose and insulin every half hour through four hours.

This is the way I get it done, to monitor the reactive hypoglycemia I tend to get due to insulin resistance. In the insulin resistant/pre-diabetic, often the pancreas can produce enough insulin to keep blood sugar relatively in check, but often, due to resistance of the cells, it has to overproduce to do so, and so there is a big insulin spike in the first to second hour, followed by a considerable dip in blood sugar in the third to fourth hour, often down to hypoglycemic levels, then a re-normalization. But these patters are often missed unless one takes more frequent measurements and includes both a a fasting insulin level pre-drink, and insulin levels with the other draws for glucose levels.

Admittedly, sitting for four to five hours to do this is boring--and one cannot exercise, even walk much, during the process or the results get skewed. Bring a good book or an ipod.

Yes Mrs.D, i eat at least 3x a week of salmon. I could eat more of it but I try to minimize it -- I buy the farmed raised salmon -- trying to temper the overly hormones and antibiotics fed fish but on the other hand, I dont want to eat the wild caught either because of the mercury laden salmon. tks! tsk! I dont know which is the lesser evil. I use olive oil in my cooking but admittedly, I use my ground flaxseed rarely.

Okay, i eat same breakfast: oatmeal with blueberries and a 1/2 banana and I alternate this with egg omelet (2 white eggs with some veggies and cheese). I sometimes put a ham, but i think I should add this on a regular basis. we eat breakfast out at least 2x a week.

I am not thirsty, in fact i have to force myself to drink. BUT, I pee A LOT! I attribute this to a dignosis of overactive bladder years back. Though, it has been corrected but I guess not completely. :) But who knows Mrs.D, my body is tooo busy.

How do i know that the pancreas giving up? Is there a test to determine that or we know it when when its showing on the BS?

Thank you Mrs.D:hug:

Mary

Yikes, I brisk-walked after The first hour. I was bored with no wi-fi at the Lab-Corp. The book brought by my hubby was not of my interest. :) I asked the technician if I can walk and she said "no problem".

My endoc thinks that a 2-hour glucose test is sufficient in my case considering the normal numbers from the last 2 Aic's. In lieu of the 4-hour glucose, I am trying to get my numbers until the 3rd hour at home. Will this at least serve the purpose of trending (but accurate too)? My fingertips are becoming so sore!!!!

I know that the FBS is not a very good basis of monitoring, but I will mention it just the same, I always have normal results ranging from 81-98.

Thank you glenntaj.

Mrs.D,

I hope that this elevation is just due to aging or due to the medication.

talking about medications, other than the heavy antibiotics I am on, is there a chance that all my supplementations may have some impact on the pancreas? As you know, my body prior to PN, is not used to all the supplements. All i was taking was Multivitamin, calcium, vit c and Vit.E. I am thinking of stopping them but with the PN, I could not!

I hope you dont mind, are you on meds for the BS?

Mary

Not likely that supplements will affect the pancreas. Some drugs do however... some used for diabetes cause pancreatitis.

I couldn't do anything when I had my long test. After the 2nd hour I crashed, ended up sweating and crying and trembling most of the time. They had trouble finding my veins so that was very painful for me. I can't imagine reading a book under the circumstances I had to go thru. (reactive hypoglycemia etc).

To get less painful fingers, try lancing with a very fine point ( I use Delica lancets with the Delica tool)..and do the upper sides of the fingers. I usually do the middle or ring finger on the left hand. Squeeze the blood down, by shaking your hand and then squeeze the finger near the palm and push the blood to the tip...it should get dark red. (if cold, warm them up in warm water). You'll get a good drop from the side of the finger and it hurts less and won't leave pain in the tips when you use the finger later in the day. The tips of the finger have more nerve endings and are more problematic for discomfort.

When?
 

Hi Mary,

When did you have the test? Since we talked? I still believe that a 192 is NOT normal if everything, pancreas and liver, etc. are working perfectly.

If you only have one reading above 160 post prandial, that could be a fluke or a heavy carb but "normal" does not usually produce a 192. I am no doctor but I have personally seen doctor's ignore signs of insulin resistance until patient's hit the magic numbers outlined by the American Diabetes Association.

How often are you getting readings above 160? Your glucose test does look OK but again it is a point in time or rather just two hours of time. What is going on the other 22 hours in your day with your levels?

Hopeless

You can request a fasting INSULIN level test next time you get tests run. This will show if your insulin levels are above normal.

Do not exercise before this test, as it can skew the results.

Its nice to know I can continue my supplements.

I am sorry that you had difficulty during your test. I did not feel "weird" during my test. However, on some occasions, I knew when my sugar dips down to the range of 65 because i would feel "strange" -- lightheadedness and slight trembling. the doctor said that 65 is not really dangerously hypo. But I think the reason I feel different on that number because I am not used to this low.

I use the sides of my fingers and use Lancets Ultra Thin with Freestyle Freedom-Lite tool. I will continue to be vigilant watching my BS.

I wonder how bad (and how long) is the elevated sugar that could further my nerves. This really concerns me because my nerves are painful as it is.

Thank you.

Mary

Hopeless,

Yes, the incidents happened after we talked.

Since September 1, there were 2x incidences where my sugar went up to 192 and 187 on the 1st hour post-prandial. Take note that on both occasions, I ate exactly the same breakfast: 1/4 oatmeal with 1/4 blueberries and 1/2 banana and 2 white eggs.

One dinner of 1 cup of bitter melon, 2 pcs of chicken nuggets, 1 slice of beef and a medium boiled sweet potato, after 1 hour my sugar was 179, 2nd hour was 139 and 3rd hour was 102.

All meals from same period were either normal or above 150 but less than 160.

thank you.

Mary

Thank you for this suggestion. I will try to request for it. I need a good argument so he will approve.

May I ask, if my insular shows above normal, does that mean that I am insulin resistance?

Mary

Since September 1, there were 2x incidences where my sugar went up to 192 and 187 on the 1st hour post-prandial. Take note that on both occasions, I ate exactly the same breakfast: 1/4 oatmeal with 1/4 blueberries and 1/2 banana and 2 white eggs.

One dinner of 1 cup of bitter melon, 2 pcs of chicken nuggets, 1 slice of beef and a medium boiled sweet potato, after 1 hour my sugar was 179, 2nd hour was 139 and 3rd hour was 102.

All meals from same period were either normal or above 150 but less than 160.

thank you.

Mary

Hi Mary,

It appears your body is making corrections in a relatively short amount of time and that is very good news. The question is why are you going out of normal range in the first place to make your body work at correcting? Something is going on and I would suggest that you keep an eye on your blood sugars occasionally. This is a long shot but at least worth mentioning...... have you calibrated your meter? I feel confident that your meter is giving you appropriate results but just wanted to mention that meters can be "off".

You are correct to have "some" concern as elevated blood sugar levels WILL affect your nerves. Even if your body is correcting and bringing them down, the fact that you reached higher levels than normal means your bodily systems are all dealing with the elevation even if just for short bouts.

According to the ADA, diabetics are considered "under control" if their A1C levels are below 7.0 BUT that does not mean that damage to body systems is not happening. That simply means that the diabetic has a "lower" risk of complications. I have never gone over 7.0 since I was diagnosed at 10.2 but I do have complications from my diabetes. If my blood sugar goes up, my ability to focus my eyesight goes out the window. My PN gets more severe. And I am "under control" according to the ADA. My docs are happy with my lab results. Am I happy with my highs and lows? Not at all. I strive to get them leveled out to no avail. My medications bring my highs down but I want to halt them from happening. My doc is afraid I will have too many BAD lows in order to prevent the highs from occurring at least for now.

I do suspect--
 

--that, given the reports of what you said you've consumed, some of those half-hour and 1-hour readings are concerningly high. But it is true that people can have occasional high spikes like that, due to supplements, medications, activity level, content of meal, or even stress (which certainly raises blood glucose levels temporarily) without being diabetic.

I do agree, though, that a longer (and stationary!) glucose tolerance test with 1/2 hour spaced draws and insulin levels done concurrently may give you more insight into what's going on. Yes, it's boring, and yes, it makes you feel like a pincushion (it helps to alternate arms and fingers during the draws), but the patterns of results are often helpful to see whether insulin resistance is suspected and how severe it may be.

Some strips read other sugars as "glucose". They all have different chemical systems.

FreeStyle is one that will register mannose/mannitol, and other -ol sugar alcohols.

One Touch as a rule is better IMO.
Also the strips may be off, 10 pts either way, as a rule.
And calibrating with a test solution to see if the meter is off.

This thread discusses glucometer systems and gives links to details.
http://neurotalk.psychcentral.com/sh...ght=glucometer

I will continue to watch out for my BS, hopefully to prevent either further damage to the nerves or graduated to become pre-diabetic.

Btw, the meter has been calibrated and its doing fine.

Thank you.

Mary

Thank you for this heads-up. I will take if i take anything with sugar alcohols in the food.

The reason why i want my glucometer is even a small amount of blood can be read. And it looks like the results are close to the range of LABCORP.

Thank you Mrs.D.

I wish my endoc will agree to give me the insulin test. I don't know yet how to convince him though. Definitely, he will not another glucose test. You know how doctors now are too cautious in giving tests, for economical reasons.

The "diabetes digest" site could not be opened anymore but i could still open the other site. One of the medicines in the that may cause elevated sugar is RIFAMPIN!!! I mentioned this to my pulmo during my visit today, as expected he is not aware that Rifampin can elevate BS. No one among his patients has mentioned anything about it. I guess, no one has maybe ever mentioned to him because no one has ever made the connection.

I will take note on which days do the numbers elevate more than normal, if this happens on "medication days" or not. I take the antibiotics every M-W-F.

Thank you Mrs.D.

Just a thought
 

I did not think it was your meter but it is always something to consider. I had one go haywire after a few years. It was extremely accurate and then all of a sudden went crazy. I had two other meters handy so I just switched to a new one. Same brand.

I really would not "worry" but I would keep checking every so often. Diabetes can sneak up on people.

I agree, i should look at every possible sources for being "off". I appreciate you mentioning it because I never actually considered it because well, the unit is new. But, i checked it just the same :-) (by using the solution -- is that the correct way to do it???). I have an extra unused unit of the same brand, as a stand by.....

I will continue to be vigilant with my blood sugar. Mrs.D and Glenntaj suggested the insulin test. I would want to have the test but I am thinking of a good argument to convince my doctor. some doctors no are so careful i. giving out laboratory tests.

Thank you.

Mary

All home glucometers are considered only approximations for testing.

Here is a link explaining:
http://forecast.diabetes.org/meters-jan2013
Even in this article the explanation of "accuracy" is difficult to grasp IMO. So getting really picky about various readings that vary from day to day...may just be a function of the strip that day and/or the meter itself.

I do know that very low levels are not accurate. Most glucometers explain that.

So keeping any log or track of levels...is quite fluid...don't get overly concerned about slight changes up or down.

Keep in mind your pancreas can change too...many type II diabetics eventually tire out their pancreas and may need a basal injectable insulin.