For a Friend - High Post Meal Sugars?

[Diamattic]

So I went out for dinner with an old friend on the weekend and got to talking about my new diagnosis of T1D, and he was saying he just had some tests done for his liver, i guess Simple Fatty Liver (disease?) is in his family and he likely has that.

He was saying he is always thirsty and peeing a lot, and i brought up that was a symptom I had as well. He asked if he could check his blood sugar (kinda jokingly...) and i said "Sure, its been just about 2 hours after we had dinner i should check too"

So i busted out my glucometer, and did mine first (it was 8.2mmol/L - I had a salad, but i guess the dressing had some sugar in it :/ oh well..) then i changed everything out and we did his. His was 9.2mmol/L just a bit longer then 2 hours after eating.

My question is - What does this mean?

He gave me that look and asked "Is that good?" and i just kinda said "umm, well, you should probably see a doctor..." It kinda put a damper on the evening, and his wife was not to impressed.

He said he had recently done blood work and doctors never mentioned his blood sugar at all, but the blood work was after 8 hours of fasting.

I don't know much about T2D but do BS drop back to normal after fasting ? or would they remain elevated until corrected somehow?

and, is this typical T2D straight away?, or just the Pre-diabetic stages?

My friend is 29, and overweight as well..

Whats up here?

 

[Bluetit1802]

Hi,

That single reading could indicate Type 2. Non-diabetics normally spike at about an hour after a carby meal, which can be as high as 8 's or 9's but usually in the 7's or lower. However, with correctly working pancreas they should be back down to base at about 2 hours. The timing is all very vague because it depends on the amount of carbs and fat (and alcohol) in the meal. Type 2's not controlled will spike and will stay up there a lot longer than a non-diabetic would because their natural insulin doesn't work properly.

He needs to see a GP and ask for the diagnostic tests. Better safe than sorry.

 

[Diamattic]

I cannot recall what he had for dinner, but he certainly had a couple drinks.

I knew normal people spike, but i always thought it would stay under 8, and that damage starts to occur over 7.8mmol/L..

Does anyone know if Liver issues can cause poorly controlled blood sugars like this?

 

[Bluetit1802]

I cannot recall what he had for dinner, but he certainly had a couple drinks.

I knew normal people spike, but i always thought it would stay under 8, and that damage starts to occur over 7.8mmol/L..

Does anyone know if Liver issues can cause poorly controlled blood sugars like this?

Fatty livers can cause insulin resistance, which in turn leads to type 2.

Most non-diabetics probably do stay under 8 most of the time, but they can go higher as evidenced by friends and family on this forum when tested by their diabetic partners. The NICE guidelines say under 7.8 at 2 hours for non diabetics and under 8.5 for type 2's, but so much depends on what they ate. The trick is to drop right back down again quickly, which an uncontrolled type 2 will not do.

The drinks can also have an effect, as you probably know. Beer will raise the levels initially, then will lower them after a period of time. Wine and spirits (no sugary mixers) won't raise levels but will lower them.

I suggest you advise him to visit his GP and ask for an HbA1c test.

 

[Diamattic]

Thanks guys,

Would a glucose tolerance test be of any help for diagnosing T2D ? In addition to an HbA1c ? and at what reading does an HbA1c become 'diabetes' ?

 

[Bluetit1802]

It's unusual for a GP to arrange a GTT, but some do. The HbA1c is normally the diagnostic test.. HbA1c of 48 or over is diabetic. (42 to 47 is pre-diabetic)

 

[Brunneria]

It's unusual for a GP to arrange a GTT, but some do.

I've seen you write that several times. And I am certainly not disagreeing.

But my experience at two different doctors surgeries, with 2 docs and at least 3 different nurses, is that ALL they were interested in was the fasting BG and the OGTT (for diagnosis). Only if they were in the diabetic range do they offer an hba1c to monitor control and to see if the drug regime is working.

Maybe I have just had 2 unusual doctor's practices...

 

[Bluetit1802]

I've seen you write that several times. And I am certainly not disagreeing.

But my experience at two different doctors surgeries, with 2 docs and at least 3 different nurses, is that ALL they were interested in was the fasting BG and the OGTT.

Maybe I have just had 2 unusual doctor's practices...

I don't really know to be honest. I can only speak for what I see here on the forum when newly diagnosed come along. Very few (in fact, hardly any) seem to have had this test. I did ask my own nurse about it recently. She said they only do the HbA1c and mine is a very large practice in a health centre.

 

[Brunneria]

I don't really know to be honest. I can only speak for what I see here on the forum when newly diagnosed come along. Very few (in fact, hardly any) seem to have had this test. I did ask my own nurse about it recently. She said they only do the HbA1c and mine is a very large practice in a health centre.

Maybe it depends on budgets. An OGTT is more expensive in staff time.
I suppose it all depends whether they run the a1c test from a kit in the back office, or send it off to a lab (which is more expensive and more accurate.

Sorry @Diamattic , that was off topic.

I agree that your friend should have an hba1c and/or an OGTT.
But Jenny Ruhl points out that people can be prediabetic for years/decades but then slide into type 2 within a matter of weeks, so even if he gets the 'all clear', I would encourage him to keep a very close eye on things, and have regular tests in the future.

 

[NoCrbs4Me]

Tell your friend to join our forum. The more the merrier!

 

[AndBreathe]

Maybe it depends on budgets. An OGTT is more expensive in staff time.
I suppose it all depends whether they run the test from a kit in the back office, or send it off to a lab (which is more expensive and more accurate.

Sorry @Diamattic , that was off topic.

I agree that your friend should have an hba1c and/or an OGTT.
But Jenny Ruhl points out that people can be prediabetic for years/decades but then slide into type 2 within a matter of weeks, so even if he gets the 'all clear', I would encourage him to keep a very close eye on things, and have regular tests in the future.

At diagnosis, when I saw the Doc (summoned, post fasting test), I had done some research (Erm,.......... as you might expect), and I asked if I should be having an OGTT, but was told that these days, the HbA1c is the "Gold Standard diagnostic test, in UK". That seemed like a long way to say, "No".

I think he knew I was trouble, at that point.

Edit: Sorry, that was off-topic too!

 

[Diamattic]

No Worries on the off topic stuff team, its the internet, i rarely expect a group of my friends discussing one thing to stay on topic very long let alone the internet lol

Thanks all!

 

[Lamont D]

An OGTT is a diagnostic tool to see how your system copes with high content of glucose. They take a fasting reading and then monitor readings and take blood samples for which ever reading they believe is causing symptoms. They would do blood plasma, c peptide and like me if you hypo. There are probably many more.
They use the test to help them with what meds are the best for you.
They also show insulin resistance or lack thereof!

GPs would not do this any more, only specialists with clinical equipment and trained staff.

I have to spend the day in hospital. Because mine is over 5 hours long, I am due one now within the next few weeks.