Normal Range Fasting but high 1-2 hour after food

[Blondie2]

Hi there,

I am new to the forum, a 48 year old female 170 cm tall 82kg (BMI = overweight) carrying fat around my middle section. I have put on 16 kg over the last 15 years and have trouble losing weight. My father and older brother are both Type 2. I have had digestive issues in the past and found cutting out bread helps. I recently got a BG meter and found that my fasting BG is around 5.6 - 5.9 however after eating a meal (fish and chips or something with potatoes or bread) I am getting up to 9-10.3 one hour after the meal. Two hours after I am only down to 8 or 7. Not falling back to around 6 until 3 hours later. I went to the doctors and they did the hBA1c test and it came back normal - I am assuming this is the average BG over three months. The doctor told me to stop testing and that I could eat what I liked just make sure I exercise. I am testing myself daily of course and can control my BG by very low carbs (have got lots of good advice reading this forum). I have added a Les Mills Pump Class (Weights for 50 minutes, group class) 3 times a week and interestingly enough my BG goes up even if I am fasting (5.3 fasting today went up to 6.4 after 1 hour exercise). I got my teenage daughter and husband to both test themselves 1 hour after we all ate an identical meal, I was 10.3, daughter 5.5, husband 6.8.
I know that I should be aiming to lose weight and also get my fasting BG down, I guess I need to stay low carb, just not sure what I should aim for in terms of fasting BG? Also, could a glass of wine with a meal be used to counteract carbohydrate in a meal at my stage? Your comments greatly appreciated - I really don't think I can approach my doctor given my test results are normal.

 

[KevinPotts]

Welcome and well done on adding the exercise and the self-education, it could really help you

You have the solution from what you've already described:

1. You are not diabetic T2 yet

2. Keep occasionally testing

3. Keep up the exercise, but do remember that can help your cardio vascular fitness and strength if you also include resistance (weights), BUT you cannot outrun a Bad Diet (Aseem Amalhotra, UK cardiologist).

4. Seriously explore Low Carb lifestyle to drop some weight and BMI. We have a gentle free 10 weeks LC Programme on this site

Good luck



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[Blondie2]

Thanks KevinPotts, that is great advice. I have done Low Carb very loosely in the past, but after seeing my BG with things like potatoes, bread have just reinforced that I need to go off these things. I will look at the 10 week low carb diet and see how I go - I am greatly impressed with your stats. Ironically my doctor told me I should not be eating bacon and eggs for breakfast and suggested I eat porridge - this has always made me feel terrible several hours later, so now I know!


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[sud5nala]

my fasting BG is around 5.6 - 5.9 however after eating a meal

I am getting up to 9-10.3 one hour after the meal. Two hours after I am only down to 8 or 7. Not falling back to around 6 until 3 hours later. I went to the doctors and they did the hBA1c test and it came back normal - I am assuming this is the average BG over three months. The doctor told me to stop testing and that I could eat what I liked just make sure I exercise.

I got my teenage daughter and husband to both test themselves 1 hour after we all ate an identical meal, I was 10.3, daughter 5.5, husband 6.8.

I really don't think I can approach my doctor given my test results are normal.

I support your intuition: these numbers are not good. However, there should be plenty of time to get it sorted. Have you looked at the Success Stories forum at this Website? I give the doctor credit for recognizing that exercise alone can lower the numbers by a lot.

Here are some postmeal values from clinical studies. When nonprediabetic people take the maximally aggressive glucose challenge test, the OGTT (drinking nothing but glucose), their blood glucose does not peak above approx. 7.8. In my reasoning, to exceed that number when eating food is unhealthy. On average, 7.8 is the value at which the great majority of testees peak. The humans of 5,000 years ago, eating low carb, must have peaked lower. In another study, the researchers concluded that the criterion of 8.6 at 60 minutes was statistically superior to 7.8 at 120 minutes as a predictor of progression to diabetes. Admittedly, this other finding is still a paragraph in a journal article. But it reinforces the belief that exceeding 7.8 at any time is a sign of worsening health.

The susceptibility to Type 2 is highly inherited -- this is stated everywhere. You mentioned family history.

There is so much individual variation in postmeal levels, and in the duration of the postmeal rise, as you have seen in your family. Down to age, genetics, and how many years we've been eating the Western diet with all its white flour and sugar. In my opinion, when I eat a meal, the maximum peak that can be considered healthy is around 7.0 -- unless the "meal" were to consist of four cans of fizzy drink, in which case the peak may be 7.8.

When blood glucose reaches around 10.0, the kidneys spill glucose into the urine. This is a backup mechanism, hence a sign that the blood glucose is quite excessive.

Three hours to return to fasting is too long. I mean: for this to be happening over years and years. However, if the peak value is low (6.0 or 7.0), that reduces risk of progression. There are images on the Web of glucose response curves. I was inactive for two decades. For a few years now, I have been active, and this shortened my regain time from 3 hours to 2 hours. If I were a young person and curtailing sugar intake, the regain time should be 1 hour or 1/2 hour.

 

[Blondie2]

I support your intuition: these numbers are not good. However, there should be plenty of time to get it sorted. Have you looked at the Success Stories forum at this Website? I give the doctor credit for recognizing that exercise alone can lower the numbers by a lot.

Here are some postmeal values from clinical studies. When nonprediabetic people take the maximally aggressive glucose challenge test, the OGTT (drinking nothing but glucose), their blood glucose does not peak above approx. 7.8. In my reasoning, to exceed that number when eating food is unhealthy. On average, 7.8 is the value at which the great majority of testees peak. The humans of 5,000 years ago, eating low carb, must have peaked lower. In another study, the researchers concluded that the criterion of 8.6 at 60 minutes was statistically superior to 7.8 at 120 minutes as a predictor of progression to diabetes. Admittedly, this other finding is still a paragraph in a journal article. But it reinforces the belief that exceeding 7.8 at any time is a sign of worsening health.

The susceptibility to Type 2 is highly inherited -- this is stated everywhere. You mentioned family history.

There is so much individual variation in postmeal levels, and in the duration of the postmeal rise, as you have seen in your family. Down to age, genetics, and how many years we've been eating the Western diet with all its white flour and sugar. In my opinion, when I eat a meal, the maximum peak that can be considered healthy is around 7.0 -- unless the "meal" were to consist of four cans of fizzy drink, in which case the peak may be 7.8.

When blood glucose reaches around 10.0, the kidneys spill glucose into the urine. This is a backup mechanism, hence a sign that the blood glucose is quite excessive.

Three hours to return to fasting is too long. I mean: for this to be happening over years and years. However, if the peak value is low (6.0 or 7.0), that reduces risk of progression. There are images on the Web of glucose response curves. I was inactive for two decades. For a few years now, I have been active, and this shortened my regain time from 3 hours to 2 hours. If I were a young person and curtailing sugar intake, the regain time should be 1 hour or 1/2 hour.

Thanks sud5nala,
I think I may have had the glucose challenge test with each of my 3 pregnancies, passed each one but each baby weighed over 10lb and they were all tested in hospital for diabetes (all clear). How would you know if your kidneys were 'spilling glucose into the urine'?
I agree with the genetics, my fathers family also have high incident of heart attacks at an early age, and diet favouring baking (Grandmother was a cake maker by trade!)
When I initially started testing my BG with a monitor I used the Diabetes Daily chart which plotted diabetic and non-diabetic response post meal - this showed me clearly that my post-meal readings were much higher and not coming down anywhere near quickly enough compared to the normal chart https://www.diabetesdaily.com/learn...anding-blood-sugars/is-my-blood-sugar-normal/

I have not been able to find the Success Stories on this website, is it a thread on the forum somewhere?

 

[sud5nala]

Thanks sud5nala,
How would you know if your kidneys were 'spilling glucose into the urine'?

this showed me clearly that my post-meal readings were much higher and not coming down anywhere near quickly enough compared to the normal chart https://www.diabetesdaily.com/learn...anding-blood-sugars/is-my-blood-sugar-normal/

I have not been able to find the Success Stories on this website, is it a thread on the forum somewhere?

To navigate to Success Stories and Testimonials, first go higher in the menu path, clicking on Forums.

Glucose in the urine ("glycosuria") can be found by testing a urine sample. A few times I have had a "urine panel", a test battery. I've never tested for glucose alone. It occurred to me that it should be cheap to test for just glucose, if only I knew what materials to use. I imagine glucometers are optimized for blood and urine would foul them. I read that urine is not supposed to have any glucose. Glycosuria may not be a medical emergency, but it shows that the loss of BG control is getting serious.

Figure 1 in this study published here, shows multiple glucose response curves. The only way to graph your curve is to take readings at least every half hour. The area under the curve is a contribution to that day's average daily glucose. To reduce average glucose, arithmetically we need to shorten the top to bottom dimension or the left to right dimension.

 

[Lamont D]

If I suggested a similar meal for yourself and you tested every half hour for up to four hours, then give us the results, we would have a clearer idea of what is going on.
Having normal range fasting and then having high readings and not returning to normal for more than two hours would be something more than prediabetes.Having normal hba1c, suggests other things are going on.
Do you have other symptoms? Or other medical issues? On any meds?
The weight increase is probably due to either high glucose or high insulin and because of insulin resistance, the unused insulin is being stored in your endocrine system.
Exercise is good for getting rid of the unwanted weight and a few months of low carbing would really help with the weight. Also try smaller meal sizes and stay away from what is causing the spikes, which is spuds and grains.
I myself cannot eat spuds or grains as they have a similar effect on my bloods.
You do need to sort these things out and not get fobbed off by your GP!
You already have family members with T2, it is more likely if you don't do something about it, that it will happen to you.
If you have questions, please ask.
There are more conditions than just T2 and prediabetes, that affect people.
Most doctors wouldn't recognise them!

 

[sud5nala]

This PowerPoint, slides 20 and 25, gives numbers and sources that pertain to the renal threshold. This doctor says that actually, there could be a tiny amount of glucose in urine at lower blood glucose levels, less than 1% of all the glucose that passes through the kidneys in 24 hours.

NovoNordisk sponsored this brief lecture by Dr. DeFronzo on the eight organs and tissues that contribute to taking a person from normal to diabetic.

 

[Kristin251]

When I eat a meal high in fat, moderate protein and very very low carb ( which are most of my meals) I will be highest at 2 hours but it's a slow low rise. I really never spike anymore but I am always highest at 2 hours. I come down very slowly as well. I eat at 8 and its avocado and celery. Then not again until 3 and then dinner 6:30 ish. I rarely spike at lunch or dinner but only BF. I don't tolerate carbs are much protein at BF hence the fatty avocado.

 

[Blondie2]

If I suggested a similar meal for yourself and you tested every half hour for up to four hours, then give us the results, we would have a clearer idea of what is going on.
Having normal range fasting and then having high readings and not returning to normal for more than two hours would be something more than prediabetes.Having normal hba1c, suggests other things are going on.
Do you have other symptoms? Or other medical issues? On any meds?
The weight increase is probably due to either high glucose or high insulin and because of insulin resistance, the unused insulin is being stored in your endocrine system.
Exercise is good for getting rid of the unwanted weight and a few months of low carbing would really help with the weight. Also try smaller meal sizes and stay away from what is causing the spikes, which is spuds and grains.
I myself cannot eat spuds or grains as they have a similar effect on my bloods.
You do need to sort these things out and not get fobbed off by your GP!
You already have family members with T2, it is more likely if you don't do something about it, that it will happen to you.
If you have questions, please ask.
There are more conditions than just T2 and prediabetes, that affect people.
Most doctors wouldn't recognise them!

Thanks Nosher8355, that would be good if you could suggest something I could test - also what time (eg; first thing in the morning). My hbAlc is 35 (range is 20-40 mmol/mol) so can't understand my high range post meals. Would being on a relatively low carb diet and doing intermittent fasting prior to the test cause the level to be lower? I don't suppose BG rises as an inflammatory response? My sister has developed an allergic response to wheat over time. Have been checked out for coeliacs all clear. Never been on any medication, had IBS symptoms for many years which pretty much cleared up once I stopped eating bread, pasta - wheat. Greatly reduced potatoes in recent months too. Maybe I am spuds and grains too.

 

[Blondie2]

When I eat a meal high in fat, moderate protein and very very low carb ( which are most of my meals) I will be highest at 2 hours but it's a slow low rise. I really never spike anymore but I am always highest at 2 hours. I come down very slowly as well. I eat at 8 and its avocado and celery. Then not again until 3 and then dinner 6:30 ish. I rarely spike at lunch or dinner but only BF. I don't tolerate carbs are much protein at BF hence the fatty avocado.

Hi Kristin251, could you let me know what your BG rises to at 2 hours after the high fat/mod protein/low carb? Do you find any change if you have exercised/tired/stressed? I guess you would have to test the same meal with each different situation!

 

[Lamont D]

Hi @Blondie2
You could always do a fasting trial with any of those you suspect send you high.
For example, bread, potatoes, glucose drink.
You may wish to look up, oral glucose tolerance test.
This will give you a better idea how to do a home test and what to look out for.
Usually testing for more than the two hours up to four hours taking your reading every half hour.
It is advised to be with someone during this test.
If any reading is below 3.7 then eat something as soon as possible.
If you do, let us know how you do!

If because you can't tolerate certain foods, it is best to avoid them.

I am allergic to many foods, so I have changed my eating habits to make certain that I don't become ill! Because that is what happens to me.
And I certainly don't want to be ill again!

 

[Brunneria]

Hi @Blondie2

Can I suggest that you have a good rummage around www.bloodsugar101.com
It is a great website, giving masses of info that is very useful to prediabetics and Type 2 diabetics.
One of the pages is a fascinating discussion on how our glucose tolerance deteriorates before our HbA1c shows it, and you may find the info particularly illuminating.

Hope that helps.

 

[KevinPotts]

Thanks KevinPotts, that is great advice. I have done Low Carb very loosely in the past, but after seeing my BG with things like potatoes, bread have just reinforced that I need to go off these things. I will look at the 10 week low carb diet and see how I go - I am greatly impressed with your stats. Ironically my doctor told me I should not be eating bacon and eggs for breakfast and suggested I eat porridge - this has always made me feel terrible several hours later, so now I know!


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[/QUOTE]

My doc said the same thing just prior to my diagnosis. Once I was diagnosed, he changed his advice as oats/porridge in the first week would spike me to 12+ 2 hours after brekkie. So I would knock it on the head and stick to your be on and eggs... Just try to purchase the best quality you can afford


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[KevinPotts]

This PowerPoint, slides 20 and 25, gives numbers and sources that pertain to the renal threshold. This doctor says that actually, there could be a tiny amount of glucose in urine at lower blood glucose levels, less than 1% of all the glucose that passes through the kidneys in 24 hours.

NovoNordisk sponsored this brief lecture by Dr. DeFronzo on the eight organs and tissues that contribute to taking a person from normal to diabetic.

Thanks for providing both links to these extremely interesting resources


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[KevinPotts]

Hi @Blondie2

Can I suggest that you have a good rummage around www.bloodsugar101.com
It is a great website, giving masses of info that is very useful to prediabetics and Type 2 diabetics.
One of the pages is a fascinating discussion on how our glucose tolerance deteriorates before our HbA1c shows it, and you may find the info particularly illuminating.

Hope that helps.

Thanks Brunneria, seems very helpful, so I've bought the book version of the site

Look forward to reading it and what new stuff I can absorb!


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[Kristin251]

Hi Kristin251, could you let me know what your BG rises to at 2 hours after the high fat/mod protein/low carb? Do you find any change if you have exercised/tired/stressed? I guess you would have to test the same meal with each different situation!

My biggest rise is always breakfast. I need a high fat, low carb and protein BF. I either have half an avocado with celery or 1/4 avocado with a piece of deli turkey on a lettuce wrap with mustard and mayo. I generally start around 80-85 and go up to about 100 2 hours later , then start coming back down
For lunch and dinner I have 1/3 more avocado, two ounces of protein with either mayo or olive oil with a few chopped onions scallions radish and celery on a lettuce wrap. Avocado has been my magical fruit, it slows and lowers any rise. I have some with every meal. I eat one large one a day.
Lunch and dinner I start around the same but rarely reach 100. I like to be in the 90's before bed but sometimes I need a snack to get there. Lunch and dinner I basically stay flat.

I do t find any difference if stressed or tired but definitely exercise. Since the weather has been great lately I try to take a slow walk 30 min after eating. Strenuous exercise sends me through the roof. I also need to walk while insulin is on board and active or I will go up and not come down unless i inject again. I don't want to do that so I just keep my walks slow. It's relaxing and reduces stress so not useless.

Are you on meds?

 

[sud5nala]

Thanks for providing both links to these extremely interesting resources

And here (this link) is a 2015 slide show from the RCGP that shows how the "ominous octet" model is at the basis of the conventional wisdom on medical management. It's sort of the NHS playbook for glucose lowering agents (doesn't address blood pressure agents, etc.). It represents a joint statement by the European and American diabetes establishments. I mention it now because it gives the context of the use of Forxiga and other meds that make the kidney excrete glucose.

 

[sud5nala]

My biggest rise is always breakfast.

I generally start around 80-85 and go up to about 100 2 hours later , then start coming back down

Lunch and dinner I start around the same but rarely reach 100.

Those are really low numbers! (4.7 mmol/l to 5.5). Is it that if control that tight is not maintained, then the numbers soar? Middle ground not possible?

 

[Kristin251]

Those are really low numbers! (4.7 mmol/l to 5.5). Is it that if control that tight is not maintained, then the numbers soar? Middle ground not possible?

Not sure. I almost always eat at home and am fairly good at judging portions out if I stick to salads. I will say if I overindulge without enough insulin it takes awhile to get back to normal. My mantra is o e bad meal equals three bad days. And I don't mean bad food, just not dosing enough. Over the 4 th of July I had some really great chicken legs ( without skin and sauce ) and over ate but corrected. It took three full days for fast to come under 100. There is no forgiveness.....diabetes never cheats or takes vacations in my world