My theory on blood sugar and developing T2

[New2T1D]

I do not have diabetes; my son sadly has T1. He uses Freestyle Libre and I ordered a box of 10 of the sensors a few months ago. As he progressed through them, I soon realised that they'd expired, though they still seemed to work. Abbot sent me 10 sensors to use within 2 months and I didn't notice the expiry date until too late. I couldn't return then: after 28 days. I ordered some more, as I didn't want to take the risk of him using inaccurate ones, and decided to try to do something useful with a few obsolete sensors and gave them to a couple of people to look at and try applying, because they were nervous of it. I then experimented on myself and used a sensor for 2 weeks myself. I was surprised at what I discovered.

I often feel shaky and extremely hungry, as well as light headed; always have done.When I do, I eat and it resolves for a while and then it happens again. I will feel sick if I don't eat. This has been the case all my life. When I was young, I managed to resist eating quite so much as I do now and I'm overweight - have been for 20 years now, having been thin when younger.

The Libre showed me that I have a tendency towards running very low blood sugar - between 3.8 and 4.2 for most of the time, unless directly after eating. When I eat, I go into the 5's. Only once did I hit a high 6: after eating 200g of high GI carbs. That was my highest point in the two week period. I seem to deal with carbs/ sugar very quickly and return to my low level again.

Oddly, my husband has always obsessed that I am a prime candidate for T2 because I have been overweight for years.

So I have a theory to share: I wonder if some people who run low blood sugars and process carbs really fast end up eating more because they genuinely feel hunger that goes with being "hypo," a lot of the time. The advantage of low bs would be lower blood pressure and a healthier heart but the disadvantage would be weight gain, which could eventually work against the natural advantages and cause T2 to develop. So could it be that people who develop T2 (ironically) started off with a high propensity towards running LOW bs? My suggestion is also because my older sister has just been diagnosed as T2 and used to have the same symptoms as me re low bs. [It's made me decide to lose weight, btw.]

I wonder what research Abbot/ anyone else have done with people who don't have diabetes, if any. I'd be so interested to know how many other people are in a similar range to me - I'm assuming my levels are low, since I seem to spend so much time technically in hypo. When I've been low a lot in my sleep, I wake feeling "not right." This has been so enlightening. My research suggests that 4.4 to 5.6 is the usual "between eating" range for people who don't have diabetes.

Anyway, thought I'd share this notion

 

[andcol]

Your numbers are all perfectly normal and 3.8 to 4.2 is not a hypo it is baseline- in fact they are great and I would say you are one of those that have no insulin resistance.

There are lots of causes of two and a lot of ways to progress into them. but generally it is: Insulin resistance -> more insulin required -> more hunger -> drives weight gain -> drives insulin resistance ---eventually--> pancreas cannot provide enough insulin.

To break the cycle you can reduce the carbs and replace with fats or proteins or try to improve your insulin resistance or realise that the increased insulin is driving the demand to eat and never being told that you are full and exercise strict portion controls

Insulin resistance is genetic and probably is a survival strategy during lean times and ice ages. By the way T2 rarely existed before the 80s and the push to high carb processed foods to feed the masses.

 

[Brunneria]

I would agree with @andcol

Something else that you may like to bear in mind is that for some of us, the Libre reads a bit low.
This happens to me.
The majority of my Libre sensors read lower than comparable prick tests using a glucometer, so that it looks as if I am running lower than I really am. The difference is usually 0.2-0.7 mmol/l lower than the prick tests, but it varies a little with each sensor.
Fortunately, I don't need the Libre for calculating insulin doses (cos I don't use insulin) so these discrepencies don't matter. Instead, I use the Libre for tracking trends, and for the arrows showing how fast my bg is rising and falling.

Unfortunately, this means that the Libre habitually tells me that my averages and predicted HbA1c are significantly lower than they actually are.

 

[Fleegle]

I would agree with @andcol

Something else that you may like to bear in mind is that for some of us, the Libre reads a bit low.
This happens to me.
The majority of my Libre sensors read lower than comparable prick tests using a glucometer, so that it looks as if I am running lower than I really am. The difference is usually 0.2-0.7 mmol/l lower than the prick tests, but it varies a little with each sensor.
Fortunately, I don't need the Libre for calculating insulin doses (cos I don't use insulin) so these discrepencies don't matter. Instead, I use the Libre for tracking trends, and for the arrows showing how fast my bg is rising and falling.

Unfortunately, this means that the Libre habitually tells me that my averages and predicted HbA1c are significantly lower than they actually are.

Mine reads a little lower too - and like you I use it for trends. I am probably more like .2-.5mmol different but the point is still well made.

 

[New2T1D]

Yeah, now you mention it, my son reads about 10% lower on average than when finger pricking. Thanks to everyone for engaging with my little blurb! What a friendly place this is

 

[kokhongw]

I often feel shaky and extremely hungry, as well as light headed; always have done.When I do, I eat and it resolves for a while and then it happens again. I will feel sick if I don't eat. This has been the case all my life.

Oddly, my husband has always obsessed that I am a prime candidate for T2 because I have been overweight for years.

This is the 2 clues in your narrative.

I believe what you have just described is a fairly common experience for many of us who eventually progressed to a T2D diagnosis later in life.

This chart regarding T2D progression provides some perspective, see the bottom chart.

What typically happens is that for many years, we are experiencing the effects of excessive insulin secretion to high carbs meals. This is quickly driving down and maintaining the glucose level. But as time goes on...it becomes more and more like driving with a loose steering wheel. The body tends to over steer and over corrects. This results in the jittery hunger that requires immediate attention/feeding. The frenzied hunger that many of us are familiar with.

Some often ask "Does insulin make us fat?", another way to consider the question is "Can we become fat without insulin?"

I believe the answer is actually that the excessive insulin response drives the hunger that leads to over consumption of food that makes us fat. It is a vicious cycle.

Once we are aware of food that tends to elicit excessive insulin response and switch them for less insulinogenic food, eg fats and proteins...then we find that we are able to put a stop to this cycle and starts to turn things around...

 

[kokhongw]

It may also be interesting to note that ADA is well aware of this phase of the condition's progression...but has been unsuccessful in providing the guidance needed to achieve broad base success in averting the current crisis...

 

[Lamont D]

Through my research and scanning for why I am weird.
There is a condition called 'Post Prandial Syndrome '
What it is. You have all the symptoms of hypoglycaemia in normal levels but don't have the hypos.

 

[Lamont D]

I also agree with @kokhongw that high insulin is a precursor first to weight gain then diabetes.
Hyperinsulinaemia is not tested, when symptoms like yours show.

It should be!

Adjusting your carb and sugar intake will help regardless of condition.

 

[New2T1D]

Oh my gosh, this is a wake up call. I only tried the libre because my son has recently acquired T1 and we had those out of date sensors. It seems I've discovered that I'm potentially at risk of T2. I will do something about it immediately, like NOW. Thanks everyone.

 

[Lamont D]

Dear Lamont,

Which are the proper tests for hyperinsulemia for which the majority of us are not being tested?

The main test for hyperinsulinaemia is a simple blood test concentrated on serum insulin levels. But I'm lead to believe that it is expensive.
There is also c-peptide and GAD test.

 

[CherryAA]

Oh my gosh, this is a wake up call. I only tried the libre because my son has recently acquired T1 and we had those out of date sensors. It seems I've discovered that I'm potentially at risk of T2. I will do something about it immediately, like NOW. Thanks everyone.

One way you can test this out is to ask for a fasting insulin blood test- if everything is in balance the number should be between 2-6. if it higher than that, it means your pancreas is starting to have to work harder to keep your blood sugars low . There was a lot of research done on this by a guy ( name escapes me for the moment ) that showed that by using this test almost 60% of the entire population is now prediabetic as their average insulin levels are rising.

Knowing what I know now, I would say that when people first start to put on weight , its not necessarily because they overeat, its because their system has stopped working quite correctly and that lack of balance gradually grows and causes the hunger pangs created by the lows caused by your body pumping out too much insulin. If corrected quickly enough weight will return to the right range for many of us, if not then it gets harder and harder to lose it.

 

[Lamont D]

I wonder if you had one or another of these tests, say, a decade ago, is it appropriate to redo the tests a decade later if there are changing problems

Do you mean like an MOT test for cars in the U.K.?
I agree we should have a blood panel done every five years.

I had my insulin plasma done on my last eOGTT and it was within normal.
However, I still went hypo.

 

[New2T1D]

One way you can test this out is to ask for a fasting insulin blood test- if everything is in balance the number should be between 2-6. if it higher than that, it means your pancreas is starting to have to work harder to keep your blood sugars low . There was a lot of research done on this by a guy ( name escapes me for the moment ) that showed that by using this test almost 60% of the entire population is now prediabetic as their average insulin levels are rising.

Knowing what I know now, I would say that when people first start to put on weight , its not necessarily because they overeat, its because their system has stopped working quite correctly and that lack of balance gradually grows and causes the hunger pangs created by the lows caused by your body pumping out too much insulin. If corrected quickly enough weight will return to the right range for many of us, if not then it gets harder and harder to lose it.

Thanks for this. It's 3.8

 

[CherryAA]

that's great.

Other things to keep an eye on

Ask your doctor for a 2-Hour Insulin Glucose Challenge Test. This should be done when fasting, with blood sugar and insulin levels checked at fasting, then again at one- and two-hour intervals.

Your blood sugar levels should be less than 80 mg/dl fasting and never rise above 110 or 120 mg/dl after one and two hour checks.

Your insulin should be less than 5 mg/dl fasting and should never rise above 30 mg/dl after one and two hour checks.