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Dawn phenomenon disappeared, now FBG maybe too low

Ronancastled

Ronancastled

Well-Known Member
Messages
1,234
Type of diabetes
Type 2
Treatment type
Diet only
I'm exactly a year post diagnosis.
As per my sig my FBG was 7.5 around this day last year.
I copped on & hit low carb & exercise straight away & my follow up bloods 3 weeks later had me down to 5.1.
I took my FBG religiously during the first 3 months.
What I noticed was the rise between 2am of low 5's to 8am when I'd be in the low 6's.
Then about 6 months post diagnosis it started to nosedive suddenly into the high 4's.
This was backed up by lab bloods last June that recorded a FBG of 4.7.

Now some mornings I'm in the low 4's, one morning I got a 3.9 that came back as 3.8 on a retest.
Does this stop & level off or am I gushing insulin which cant be a good thing long term ?

I've documented a few successful home tests on this forum & seem to be getting away with more & more carbs.
Last week I had a McDonalds & was 4.8 at 1 hour which freaked me out.
Tonight after curry, rice, naan bread, peanuts & 3 pints of Guinness I was 5.0 about 3 hour post first bite.

I'm worried my body is back over producing insulin & may eventually give out earlier.
I'm slipping back into old habits that would have been no go 6 months ago.
Am I in some magical honeymoon that will crash drastically.

I don't know & there's not enough info online about post-diabetics & their experiences.
I could do with feedback & a bit of cop on.
 
Maybe you’re cured! I read it’s possible in about 5% of us. You do know where the “old ways” lead , so don’t go there
 
Ronancastled said:
Now some mornings I'm in the low 4's, one morning I got a 3.9 that came back as 3.8 on a retest.
Does this stop & level off or am I gushing insulin which cant be a good thing long term ?
Click to expand...

These are normal levels for non diabetics. The reason that diabetics panic about levels under 4 is that if you are on insulin (or drugs that increase your insulin production) you can go lower....

Congrats on your turn around. If you keep testing occasionally you'll find out what your body can now tolerate and hopefully turn things round if your levels start going back up.
 
LaoDan said:
Maybe you’re cured! I read it’s possible in about 5% of us. You do know where the “old ways” lead , so don’t go there
Click to expand...
I have lost 5 stone so perhaps ectopic fat was my issue & not genetic insulin resistance.
Also my first phase insulin response has kicked in again in the past 3 months, my homemade OGTT had me at 6.4 at 1 hour from memory.
I'd previously seen a 13.3 in the early months with the same meal.
 
Perfectly normal numbers. But be warned going forward - if you can get it once you can certainly get it again, but probably much quicker.
 
Jim Lahey said:
Perfectly normal numbers. But be warned going forward - if you can get it once you can certainly get it again, but probably much quicker.
Click to expand...
Thanks to your response Jim, I've noticed the quality of your posts on this forum, you are an inspiration.
The damage already done is unequivocal, the potential for organ repair is such a grey zone that science & Pharma won't touch it.
The first search result we see when we Google type 2 is a "Progressive chronic condition with no cure".
This forum & others like it are at the hope that the medical profession don't seem onboard with yet.
 
They are great numbers- congratulations!

I would also recommend that you are careful about going back to the old ways- however it may be possible for you to have a more 'normal' diet or to occasionally have something with more carbs- just keep checking your levels.

My personal thoughts are that you may be able to sustain a higher level of carbs either permanently or for a while but unless you monitor carefully and don't go overboard you will end up back with diabetes. Maybe a very occasional treat will be okay. For me- I am a carboholic and I think I would find moderate carbs actually harder than very low carbs.
 
Those FBG levels you have now are great. If in your shoes I wouldn't want to change that, so eating more and more carbs is a bit like poking the bear with a stick... you might get away with it for a while, but at some point the bear is not going to tolerate it .
 
Well done @Ronancastled. Well done indeed.

If the sick fat cell theory is indeed the case, or at least a decent part of the picture re the development of T2D, then your fat cells are shrunken and looking nice and healthy, and you need to keep them that way.

What role carbs play in that for you, in relation to the fat you are eating, is anybody's guess. You have a pretty good idea though? As you know what you were eating before diagnosis, and when you started to get better, and a LOT better.

You can easily keep a track of your body's production of insulin by getting a C-peptide test as part of your blood panel. This is what I do. Get to know healthy/normal/unhealthily high levels of C-peptide/insulin. (Different countries measure it differently? Or it might just be the ol' US versus the rest of the world on numbers and tests thing.)

"Genetic insulin resistance"? Hmmm.
 
VashtiB said:
but unless you monitor carefully and don't go overboard you will end up back with diabetes.
Click to expand...

I would add to this - relying solely on blood glucose readings is a dangerous game because you don't know whether or not insulin levels are rising in order to maintain glucose homeostasis. @Ronancastled if you intend to keep eating carbohydrate in meaningful quantities then you may wish to consider periodic insulin testing. Fasting insulin or C-peptide. This way you would be able to see if you are developing insulin resistance again long before any issues manifest in glucose.

Up to you of course. Just my opinion.

EDIT: I missed the post above from @AloeSvea
 
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Jim Lahey said:
I if you intend to keep eating carbohydrate in meaningful quantities then you may wish to consider periodic insulin testing. Fasting insulin or C-peptide. This way you would be able to see if you are developing insulin resistance again long before any issues manifest in glucose.

@AloeSvea
Click to expand...

That test would have really helped so many of us years out from diagnosis. Pity it's not included on the standard blood panel. I would love to take an extended OGTT with insulin and at least 6 draws but do not know anyone who does them.
 
There's another relatively straight forward possible option to track your, in your case you lucky thing you :), your non-diabetic status non-insulin resistant cells - and that is by your fasting tryglyceride/HDL ratio, worked out by yourself from your usual blood lipid tests. In that this ratio be a low one.

This does not work for everyone though, in my case I don't think it does, re insulin sensitivity, but I definitely use it to keep a track of my heart-health regarding LDL particle number and size, which is the chief reason to track your tryg/hdl ratio. But it is explained in this webpage (plus the all important numbers of the world versus USA numbers thing!) (Scroll down towards the end for the ratio and insulin resistance paragraph):

https://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/
 
Ronancastled said:
That test would have really helped so many of us years out from diagnosis. Pity it's not included on the standard blood panel. I would love to take an extended OGTT with insulin and at least 6 draws but do not know anyone who does them.
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I totally agree, I would have been diagnosed at least ten years earlier.
Full blood panel tests should have a c-peptide and fasting insulin tests.
Many T2s have what is known as hyperinsulinaemia, which because of insulin resistance causes a cycle of having hyperglycaemia as well because insulin resistance won't get rid of the glucose derived. There will be circulating insulin in your bloodstream that won't help and the amounts of carbs and sugar in the average diet, will exacerbate the cycle of more useless insulin and higher glucose levels, when it should have been back to normal levels.
An eOGTT is a diagnostic tool to eliminate other conditions depending on results.
I have had a few glucose tolerance tests, and because I went hypo, even though I'm not T1 or a T2 on meds, I needed further tests to diagnose my condition.
So a tolerance test will help but unless you have other tests, it might be a waste of time.
As someone has already said, your readings are fine, normal and as long as you maintain them in and around normal, you should be okay.
Keep testing and unless you see something that concerns you, behave yourself.
It's your health, look after it!

Keep safe
 
AloeSvea said:
There's another relatively straight forward possible option to track your, in your case you lucky thing you :), your non-diabetic status non-insulin resistant cells - and that is by your fasting tryglyceride/HDL ratio, worked out by yourself from your usual blood lipid tests. In that this ratio be a low one.
Click to expand...

So far I've only received short phone consults from either the nurse or doctor.
I've asked for my full blood results in writing but they say they are currently busy with Covid test referrals & will get around to it post Covid.
I don't have a breakdown but I do know my Cholesterol on diagnosis was 8.5 & it's now 4 on my most recent panel. The nurse told me I'm high in the "good one" & low in the "bad one" if that makes sense.
As I hadn't cut fat from my diet I have to put that succes down to low carbing & exercise.
 
Ronancastled said:
So far I've only received short phone consults from either the nurse or doctor.
I've asked for my full blood results in writing but they say they are currently busy with Covid test referrals & will get around to it post Covid.
I don't have a breakdown but I do know my Cholesterol on diagnosis was 8.5 & it's now 4 on my most recent panel. The nurse told me I'm high in the "good one" & low in the "bad one" if that makes sense.
As I hadn't cut fat from my diet I have to put that succes down to low carbing & exercise.
Click to expand...

Yeah I hadn't asked for my last two or so tests and have struggled to get anything out of them since... keep trying - I was supposed to go pick up the forms and head to the walk-in (now by appointment) clinic at the local hospital and have been told not to bother until Londinium gets itself out of the Tier-whatever-it-is-right-now clag...

But do stick at it - it is your blood test numbers and they do have a copy so politely keep nagging them!
 
Ronancastled said:
I have lost 5 stone so perhaps ectopic fat was my issue & not genetic insulin resistance.
Also my first phase insulin response has kicked in again in the past 3 months, my homemade OGTT had me at 6.4 at 1 hour from memory.
I'd previously seen a 13.3 in the early months with the same meal.
Click to expand...
Could have been excess fat around your visceral organs was hampering the effectiveness of your insulin response.
The weight loss which will have no doubt included some of this fat will have helped enormously in starting to restore "normal" insulin function.
Re your medical records.. have you tried to register to get them online?
Makes life far easier.. no bargaining with the incompetent receptionists.
 
bulkbiker said:
Could have been excess fat around your visceral organs was hampering the effectiveness of your insulin response.
The weight loss which will have no doubt included some of this fat will have helped enormously in starting to restore "normal" insulin function.
Click to expand...

I took great inspiration in the early days post diagnosis from the 2 year follow up to Direct
https://eprints.gla.ac.uk/211019/7/211019.pdf

So those who'd gained remission had a completely normal insulin secretion rate which I take to be the 2nd phase maximal response.
Their first phase insulin response however remained blunted at about 50% of the control group.
This explains the spike we still see in T2's in remission, their first phase is taking that bit longer to kick in.
Of course there are outliers in the both groups with the high responders after one year not being far off the lower end of the control, 201 vs 226.
Remember too that his in remission group still only averaged a HbA1c of 6.0% which some would say puts them in a pre-diabetic range where Beta Cell damage could still be occurring.

findings.PNG

In my own case I seem to have recovered most of my first phase response but that has been my latest development, only truely kicking in since around July when I re-ran a home test with a bowl of cereal.
https://www.diabetes.co.uk/forum/threads/fbg-4-1-hba1c-33-and-passed-ogtt.175834/#post-2301412

Now my job is to not **** it up again.
 
Ronancastled said:
I took great inspiration in the early days post diagnosis from the 2 year follow up to Direct
https://eprints.gla.ac.uk/211019/7/211019.pdf

So those who'd gained remission had a completely normal insulin secretion rate which I take to be the 2nd phase maximal response.
Their first phase insulin response however remained blunted at about 50% of the control group.
This explains the spike we still see in T2's in remission, their first phase is taking that bit longer to kick in.
Of course there are outliers in the both groups with the high responders after one year not being far off the lower end of the control, 201 vs 226.
Remember too that his in remission group still only averaged a HbA1c of 6.0% which some would say puts them in a pre-diabetic range where Beta Cell damage could still be occurring.

View attachment 44721

In my own case I seem to have recovered most of my first phase response but that has been my latest development, only truely kicking in since around July when I re-ran a home test with a bowl of cereal.
https://www.diabetes.co.uk/forum/threads/fbg-4-1-hba1c-33-and-passed-ogtt.175834/#post-2301412

Now my job is to not **** it up again.
Click to expand...

Just goes to show that starvation might not be the best policy..

But indeed your main job is to not **** it up again so watch out for too many carbs.
 
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