My fasting BS is rising nearly daily despite diet and exercise

[MissGiggles]

Hi,

After reading about an increase in diabetes diagnoses after Covid infection I decided to just check my glucose levels. They were all in the normal range but were high for me, so I decided to start monitoring them daily. They actually started rising almost daily.

From when i started recording them

4.8
5.5
5.8
7.1 (started steroids in the afternoon before)
5.1
5.4
6.2
6.7
6.9 (steroid dose reduced day before, but did have a croissant at lunch day before)

I know steroids increase BS but I have always monitored this when I go on them, and previously they only affected postprandial levels, not fasting levels. My postprandial readings were increasing (up to 8.5 before steroids, then 10 when i initially started steroids) but they have since dropped down to generally below 7.2

I switched to a low carb diet (<50g carbs) on the 4th day and I have been doing a lot of exercise and/or walking.

Is it nornal for fasting levels to keep rising even on a low carb diet?

 

[MissGiggles]

Hello,

I was wondering how long it took people after commencing a low carb diet to see any improvement on their fasting glucose levels.

I have been eating 30g - 50g carbs for 8 days now, postprandial readings are fine but my fasting glucose levels are continuing to rise almost daily.

Is this normal? How long before i can expect them to start decreasing?

I am panicking because 11 days ago my fasting glucose level was 4.8, now its 6.9.

 

[bulkbiker]

For me FBG readings were the last to "normalise" after about 6 months.
I'll hazard a guess that your body is "de-toxing" the excess sugar that it has been storing away so taking advantage of an overnight fast to purge itself of sugar.
Hence your FBG will be higher until your sugar stores have reduced.
Have you thought of throwing a bit of time restricted eating into the mix to speed this process up a bit more?
You might also find that 30-50g of carbs may still be too many.. depends on how long you have been producing excess insulin.

 

[MissGiggles]

For me FBG readings were the last to "normalise" after about 6 months.
I'll hazard a guess that your body is "de-toxing" the excess sugar that it has been storing away so taking advantage of an overnight first to purge itself of sugar.
Hence your FBG will be higher until your sugar stores have reduced.
Have you thought of throwing a bit of time restricted eating into the mix to speed this process up a bit more?
You might also find that 30-50g of carbs may still be too many.. depends on how long you have been producing excess insulin.

I have to eat at roughly set times because of taking medications with food. Although i am going to try and make my dinner the lowest carb content meal.

Gosh, less than 30g seems like a serious challenge. I will give it a go, need to do something.

 

[Jaylee]

Hi,

After reading about an increase in diabetes diagnoses after Covid infection I decided to just check my glucose levels. They were all in the normal range but were high for me, so I decided to start monitoring them daily. They actually started rising almost daily.

From when i started recording them

4.8
5.5
5.8
7.1 (started steroids in the afternoon before)
5.1
5.4
6.2
6.7
6.9 (steroid dose reduced day before, but did have a croissant at lunch day before)

I know steroids increase BS but I have always monitored this when I go on them, and previously they only affected postprandial levels, not fasting levels. My postprandial readings were increasing (up to 8.5 before steroids, then 10 when i initially started steroids) but they have since dropped down to generally below 7.2

I switched to a low carb diet (<50g carbs) on the 4th day and I have been doing a lot of exercise and/or walking.

Is it nornal for fasting levels to keep rising even on a low carb diet?

Hi @MissGiggles ,

Welcome to the forum.

Can I ask when do you have a formal diagnosis of diabetes? (If so.) When we’re you diagnosed?

It’s great you have access to a meter..

 

[MissGiggles]

No formal diagnosis. I purchased a blood glucose monitor the first time I went on steroids just to make sure I was maintaining good levels and check my levels sporadically.

I just happened to check my glucose levels almost 2 weeks ago, it was at the high end of normal which is high for me. So I decided to keep checking them daily after that and noticed they mostly kept rising daily.

None of my healthcare providers are helping. I was told that my glucose readings don't mean anything and its about the HbA1c, which came back as 5.5% so they wouldn't help. Although the HbA1c doesn't reflect the trend that is happening right now.

 

[Jaylee]

No formal diagnosis. I purchased a blood glucose monitor the first time I went on steroids just to make sure I was maintaining good levels and check my levels sporadically.

I just happened to check my glucose levels almost 2 weeks ago, it was at the high end of normal which is high for me. So I decided to keep checking them daily after that and noticed they mostly kept rising daily.

None of my healthcare providers are helping. I was told that my glucose readings don't mean anything and its about the HbA1c, which came back as 5.5% so they wouldn't help. Although the HbA1c doesn't reflect the trend that is happening right now.

When was your last HbA1c check?

 

[MissGiggles]

When was your last HbA1c check?

It was done on Monday.

 

[Jaylee]

It was done on Monday.

How long have you been prescribed the steroids?

 

[Antje77]

I purchased a blood glucose monitor the first time I went on steroids

Are the steroids a temporary thing?

 

[Oldvatr]

We like to think our meters are accurate, but they have an allowed error band which is defined in document ISO 15197(2016) revised. Meters now must be within +/- 0.83 mmol/l for readings of 5.6 and below, or _+/- 15% of reading above 5.6 mmol/l.

What this means is that two different meters reading the same drop of blood can disagree by up to 1.66 mmol/l below 5.6 mmol/l or by (for example ) 3 mmol./l if the sample is actually 10 mmol/l For the same meter one could expect the error between readings on different days or samples to be better than this, but it remains statistically possible to still get a worst case event. So I normally allow a margin of 1.5 mmol/l before I panic.

The coments regarding the fasting level falling last of all happened to me, and it tool me a couple of months to clear the backlog of stored sugar from my liver. But I went gently into Low Carb, and that was because in my case I was on maxed out medications for reducing blood sugar, so I had to reduce doses as I went. Your 8 days reported in your Op is perhaps wishful thinking since you are trying to undo months and years of harm from an unrestricted diet. Remember that every carb you eat is charging up the liver battery again.

 

[MissGiggles]

How long have you been prescribed the steroids?

I started the steroids 5 days after noticing my glucose levels going up. Steroids have never affected my fasting levels before, only my postprandial. However this time despite taking steroids my postprandial levels are generally in the normal range now, but my fasting levels prior to taking my steroids are the issue.

I would be far less panicked if i wasn't on medication that can in very rare circumstances cause type 1 diabetes. So i am sort of hoping for reassurance that the seemingly continually increasing fasting levels despite switching to a low carb diet are normal. And that going from 4.8 - 6.9 in 11 days is characteristic of prediabetes. I acknowledge I am at risk of type 2 diabetes due to obesity, but that means no doctor will attempt to rule out the medication as the cause. Hence the panic.

I am not expecting miracles overnight by changing my diet, and several people have said fasting levels were the last to come down. Its not so much that they are elevated that is bothering me, its the trend of them continuing to go up that is worrying me. But if that is normal then I will stop panicking.

 

[MissGiggles]

Are the steroids a temporary thing?

I am on long-term low dose hydrocortisone to behave as cortisol. But i am currently on a course of higher dose prednisolone which is a temporary thing.

 

[Antje77]

But i am currently on a course of higher dose prednisolone which is a temporary thing.

Would it be an idea to not draw conclusions until after the prednisolone course?

 

[MissGiggles]

Would it be an idea to not draw conclusions until after the prednisolone course?

I have been on prednisolone a few times, any excessive blood sugar reading was easily remedied by walking it off. It has never affected my fasting levels. Also my glucose readings had started going up a few days before I started taking the prednisolone. And my steroid dose has decreased but the fasting level still went up.

 

[Rachox]

Without prying into the reason why the course of prednisone is needed, could it be the cause of the rising fasting readings? Pain, illness and discomfort can affect readings.

 

[MissGiggles]

Without prying into the reason why the course of prednisone is needed, could it be the cause of the rising fasting readings? Pain, illness and discomfort can affect readings.

Thanks for your message. The reason I am on prednisolone is the reason I am so concerned about my glucose levels rising.

Up until last month I was on immunotherapy, which can trigger auto-immune type side effects, including very rarely type 1 diabetes. I have already developed one permanent endocrine problem, and very recently I developed arthritis in my wrists which is why I am on the steroids to try and get rid of it. This is why I am being perhaps irrationally phobic of these fasting levels continuing to rise. But none of my healthcare team will help rule out that its the treatment, so its presumed type 2 because I am overweight.

 

[chrisjohnh]

I wonder whether a rising profile of 5 successive readings is necessarily significant given the inaccuracy of meters and the variability in metabolic dynamics. I have kept a spreadsheet of readings over 18 months and the wobble about between 4.8 and 6.0 with an overall average of 5.3. But within them I can observe many sub-sequences that could be viewed as “trends” but are truly nothing of the sort. I think it’s because of these potentially alarming short-lived variation that some health professionals tell us that using meters will make us insane. I think one has to examine much longer series, and to do so using sound analysis, to detect real trends and to draw conclusions from them. So I would say don’t worry about these 5 rising numbers, instead wait until you have a much larger sample.

 

[MissGiggles]

I wonder whether a rising profile of 5 successive readings is necessarily significant given the inaccuracy of meters and the variability in metabolic dynamics. I have kept a spreadsheet of readings over 18 months and the wobble about between 4.8 and 6.0 with an overall average of 5.3. But within them I can observe many sub-sequences that could be viewed as “trends” but are truly nothing of the sort. I think it’s because of these potentially alarming short-lived variation that some health professionals tell us that using meters will make us insane. I think one has to examine much longer series, and to do so using sound analysis, to detect real trends and to draw conclusions from them. So I would say don’t worry about these 5 rising numbers, instead wait until you have a much larger sample.

Hi, thank you for your message. The real reason I was panicking is because I am on medication which can lead to type 1 diabetes (rarely), due to inflammation, but people don't realise until they are admitted to hospital experiencing DKA because most people don't check their sugar levels unless they have a reason to. At which point no intervention can undo the damage. It requires early steroid intervention to stop it.

What unnerved me was there appeared to be improvement and stabilisation after starting steroids for a different reason, although of course I had switched to a low carb diet as well. My glucose levels started rising again after dropping a dose of steroids, however stabilised after a few days. So I was scared that my treatment was involved.

I absolutely agree with your point about a few days isn't really enough data, I just went into panic mode! However I have had a few successive days of all normal readings, and have been able to increase my carb content to include more veg, so I am feeling so much calmer. Although I did just try porridge and that went up to 8.1.

If my glucose levels go up again after I reduce my steroids I will get back in touch with the endocrine team but for now I am feeling optimistic that it will be fine.

Thank you for your reply, it is good to know that people do get such variability.