Has anyone ever done a DIY glucose tolerance test and is it possible to do so?

[Tannith]

Prof Taylor measured maximal insulin secretion rates back to normal at 12 months post remission in the follow up to his Direct Study.
In his previous smaller study, Counterweight, he subjected his 11 "successsful" candidates to a 75g OGTT at 12 weeks & the results were pretty dismal.
Recommendation is to eat 150g of carbs per day for 3 days prior to test.
One off spikes, as you'll experience perparing & conducting this test, are unlikely to contribute to complications.
The advantage is that it establishes a baseline for your insulin sectretion/sensitivity for you to track your progress in the future.

I do them every 3 weeks or so, though it varies. I use pure glucose powder. I think this is the only test you can do at home which gives a realistic assessment of how fit/unfit your beta cells are. HBA1C test results can be distorted by simple eating low carb, therefore not challenging your beta cells to deal with a normal amount of carbs. Low carb is a bit like putting one spoon of sugar in a cup of tea, rather than two. OF COURSE the resulting tea is less sweet. So is your blood if you don't eat many carbs (sugars). A low HBA1C is just about meaningless in the context of judging whether your Beta cell function has improved or not.

 

[Brunneria]

I have refused to submit to glucose tolerance tests when offered by my doctor, and have no intention of ever subjecting my body to that amount of carbs in one hit, without any fat, protein or fibre to mitigate the impact.

As far as I am concerned, that amount of sugar is bad for anyone, and taking that amount regularly, for someone (such as a diagnosed T2) with an already established glucose dysregulation, must be harmful. Perhaps as a once a year monitor of long term progress, it might have value. But every few weeks? No. I consider that to be detrimental, and likely to be undoing any benefits achieved by other diet and lifestyle changes.

 

[bulkbiker]

a normal amount of carbs.

How do you define this please?

 

[Mike d]

That's like opening a healing wound because you crave more sutures ....

 

[Tannith]

I have refused to submit to glucose tolerance tests when offered by my doctor, and have no intention of ever subjecting my body to that amount of carbs in one hit, without any fat, protein or fibre to mitigate the impact.

As far as I am concerned, that amount of sugar is bad for anyone, and taking that amount regularly, for someone (such as a diagnosed T2) with an already established glucose dysregulation, must be harmful. Perhaps as a once a year monitor of long term progress, it might have value. But every few weeks? No. I consider that to be detrimental, and likely to be undoing any benefits achieved by other diet and lifestyle changes.

I need to know when I can stop my 1000 cal per day diet, and that's obviously not until my beta cells are restored to normal function. Last time I did a low cal diet I had an HBA1C which the NHS claimed was "normal" simply because it was under 42. I was later told by someone on here that it was actually at the bottom of the diabetic range on some scales and definitely at the top of the prediabetic range by most of them. Absolutely far too soon to stop. But I was fooled into stopping. I am not going to make that mistake again.

 

[Tannith]

Prof Taylor measured maximal insulin secretion rates back to normal at 12 months post remission in the follow up to his Direct Study.
In his previous smaller study, Counterweight, he subjected his 11 "successsful" candidates to a 75g OGTT at 12 weeks & the results were pretty dismal.
Recommendation is to eat 150g of carbs per day for 3 days prior to test.
One off spikes, as you'll experience perparing & conducting this test, are unlikely to contribute to complications.
The advantage is that it establishes a baseline for your insulin sectretion/sensitivity for you to track your progress in the future.

Thank you for your useful post. I think you meant to say "counterbalance"?

 

[Brunneria]

I need to know when I can stop my 1000 cal per day diet, and that's obviously not until my beta cells are restored to normal function. Last time I did a low cal diet I had an HBA1C which the NHS claimed was "normal" simply because it was under 42. I was later told by someone on here that it was actually at the bottom of the diabetic range on some scales and definitely at the top of the prediabetic range by most of them. Absolutely far too soon to stop. But I was fooled into stopping. I am not going to make that mistake again.

You can stop your 1000 calorie diet at any time, if you wish.
There is no guarantee that your beta cells will ever be restored to normal function, especially if you stress them regularly with glucose tolerance tests.

Just because 'reversal' happened to a % of people in the controlled environment of a clinical study does not mean that it will happen to you, repeatedly, after recurring bouts of very low calorie eating - especially after you have added time, weight, blood glucose fluctuations, a continued carb intake, as well as the repeated stress of glucose tolerance tests since your first attempt to reverse your diabetes. You say you are still T2. So each of those stressors has an added impact on your pancreas, which is obviously struggling to cope with the amount of carbs you are currently eating.

From what I have seen when you post the results of your home glucose tolerance tests, the differences between test results are so small they are within the +/- tolerance of your meter. Spreading those tests out by months rather than weeks, or doing the test annually would place far less stress on your body.

The glucose tolerance test is intended to be used in specific medical need, and is no longer supported by the NHS as a diagnostic tool (except in during pregnancy). Repeated home tests, out of personal curiosity, would definitely not be supported by the NHS.

Ed to add the blue text.

 

[bulkbiker]

Thank you for your useful post. I think you meant to say "counterbalance"?

The initial study in 2011 was in fact called Counterpoint.

 

[HSSS]

I do them every 3 weeks or so, though it varies. I use pure glucose powder. I think this is the only test you can do at home which gives a realistic assessment of how fit/unfit your beta cells are. HBA1C test results can be distorted by simple eating low carb, therefore not challenging your beta cells to deal with a normal amount of carbs. Low carb is a bit like putting one spoon of sugar in a cup of tea, rather than two. OF COURSE the resulting tea is less sweet. So is your blood if you don't eat many carbs (sugars). A low HBA1C is just about meaningless in the context of judging whether your Beta cell function has improved or not.

Can I clarify your definition of “normal amount of carbs”? According to who, where and when?

As far as I can see it’s a very variable amount. Even in this country, taking out geographical and many cultural disparities, over the last 50 or 60 years the “typical” amount has changed enormously, as has the frequency of metabolic, diabetic and obesity related diagnoses. Is “normal” not a societal term with regards to food rather than a scientific or nutritional one?

I don’t agree the hb1ac is distorted by low carb. The test measures average glucose levels over 3 months and it continues to do just that whatever way you eat. What it does not do, nor claims to do, is measure beta cell function - as you yourself say later - there it is not distorted in the way you imply .

 

[HSSS]

I need to know when I can stop my 1000 cal per day diet, and that's obviously not until my beta cells are restored to normal function. Last time I did a low cal diet I had an HBA1C which the NHS claimed was "normal" simply because it was under 42. I was later told by someone on here that it was actually at the bottom of the diabetic range on some scales and definitely at the top of the prediabetic range by most of them. Absolutely far too soon to stop. But I was fooled into stopping. I am not going to make that mistake again.

What is the plan after the 1000 cal/day diet resuscitates your beta cells (assuming it ever does)? How do you plan to stop them being damaged again?
Nhs levels do specify that an hb1ac under 42 is normal. 42 -48 is prediabetic and over 48 diabetic. This is easily accessed information. No one has tricked you about that.

Whoever told you it was diabetic or high prediabetic was simply wrong if they and you were both discussing hb1ac. I seem to recall you having a fair bit of confusion over conversions and what the different tests represent so perhaps there is some misunderstanding in this claim.

 

[Tannith]

The initial study in 2011 was in fact called Counterpoint.

Correct.Thank you.

 

[Tannith]

What is the plan after the 1000 cal/day diet resuscitates your beta cells (assuming it ever does)? How do you plan to stop them being damaged again?
Nhs levels do specify that an hb1ac under 42 is normal. 42 -48 is prediabetic and over 48 diabetic. This is easily accessed information. No one has tricked you about that.

Whoever told you it was diabetic or high prediabetic was simply wrong if they and you were both discussing hb1ac. I seem to recall you having a fair bit of confusion over conversions and what the different tests represent so perhaps there is some misunderstanding in this claim.

This is what I am going by:
On average, normal HbA1c for non-diabetics is < 36 mmol/mol (5.5%). For people with diabetes, an ideal HbA1c level should be 48 mmol/mol (6.5%) or lower. A HbA1c measurement of between 36 and 48 mmol/mol means that the individual it at a very high risk of developing Type 2 diabetes, termed ‘pre-diabetes’.@ jimlahey pointed out that mine was too high and by some scales actually in the diabetic range, though I think in others (they do vary) just at the top of prediabetic. As I have said before I think the NHS sets the bar too high at 42 mmol/mmol which it calls "normal". Jim pointed out that many scales would call that prediabetic and some even diabetic. I should like to be safely within the normal range. No I did not suggest "tricked", just fooled, as in being foolish enough myself to take them at their word instead of looking up the scales myself and finding what was a sensible measure. Health services often set the bar too high to avoid having to treat as many people. I think the American scales are the worst for this. Jim also kindly pointed out the conversion charts between the old and the new numbering of HBA1C, and also how it converted into average blood sugar

https://www.news-medical.net/health/What-is-HbA1c.aspx

 

[Tannith]

Can I clarify your definition of “normal amount of carbs”? According to who, where and when?

As far as I can see it’s a very variable amount. Even in this country, taking out geographical and many cultural disparities, over the last 50 or 60 years the “typical” amount has changed enormously, as has the frequency of metabolic, diabetic and obesity related diagnoses. Is “normal” not a societal term with regards to food rather than a scientific or nutritional one?

I don’t agree the hb1ac is distorted by low carb. The test measures average glucose levels over 3 months and it continues to do just that whatever way you eat. What it does not do, nor claims to do, is measure beta cell function - as you yourself say later - there it is not distorted in the way you imply .

"What it does not do, nor claims to do, is measure beta cell function - as you yourself say later -"
Exactly! That is why I use the OGT, which measures the beta cell's reaction to a specific amount of carbs in a specific time. That is why I can't understand why people on here seem to use HBA1C as anything but a measure of how many carbs they are eating, which they could do by weighing them. As to carbs BNF says the ideal is 50% of cals, which for a person eating 2000 cal per day is 1000 cals or 333g carbs cals AT EACH OF THEIR 3 MEALS. So why you consider a 75 g carb drink (300 cals) every 3 weeks or so, to be damaging is odd, when compared to the average person eating more than 3 times that daily, even if they are not diabetic.

Nutrition Requirements © British Nutrition Foundation 2015 Carbohydrate and Fat · Dietary reference values (DRVs) have been set for fat and carbohydrates (including sugars and dietary fibre) for the population. · DRVs for total fat, saturated fat, total carbohydrates and sugars are given as a percentage of daily energy intake. DRVs for carbohydrate and fat as a percentage of energy intake % Daily Food Energy Total Carbohydrate* 50% of which free sugars* Not more than 5% :Total Fatⱡ Not more than 35%: of which Saturated Fatⱡ Not more than 11%.

*based on SACN 2015 recommendations for population aged 2 years and above ⱡ based on COMA 1991 recommendations for population aged 5 years and above https://www.nutrition.org.uk/attachments/article/234/BNF_Nutrition Requirements_October 2015.pdf


(Mod edit for clarity)

 

[lucylocket61]

1000 cals or 333g carbs cals AT EACH OF THEIR 3 MEALS.

there are 4 calories per gram of carbs, so the daily amount of carbs, based on 1000 cals, is 250g A DAY.

 

[lucylocket61]

So why you consider a 75 g carb drink (300 cals) every 3 weeks or so, to be damaging is odd,

because of the spike it causes, and how long that spike lasts. 75g of carbs spread over 24 hours is not as damaging as 75g of carbs in one hit, as our bodies have time to deal with the small chunks of carbs at a time. The spikes are the problem, as has been explained previously, along with the relevant links to research backing up the danger of spikes.

 

[Tannith]

You can stop your 1000 calorie diet at any time, if you wish.
There is no guarantee that your beta cells will ever be restored to normal function, especially if you stress them regularly with glucose tolerance tests.

Just because 'reversal' happened to a % of people in the controlled environment of a clinical study does not mean that it will happen to you, repeatedly, after recurring bouts of very low calorie eating - especially after you have added time, weight, blood glucose fluctuations, a continued carb intake, as well as the repeated stress of glucose tolerance tests since your first attempt to reverse your diabetes. You say you are still T2. So each of those stressors has an added impact on your pancreas, which is obviously struggling to cope with the amount of carbs you are currently eating.

From what I have seen when you post the results of your home glucose tolerance tests, the differences between test results are so small they are within the +/- tolerance of your meter. Spreading those tests out by months rather than weeks, or doing the test annually would place far less stress on your body.

The glucose tolerance test is intended to be used in specific medical need, and is no longer supported by the NHS as a diagnostic tool (except in during pregnancy). Repeated home tests, out of personal curiosity, would definitely not be supported by the NHS.

Ed to add the blue text.

I am doing my second bout of low cal eating, because I stopped my first too early in the mistaken belief that an HBA1C was "normal" ie normaoglycaemic, when actually I needed to be aiming for 36. I am only too well aware that the diet might not work for me now that I know I have been T2 for at least 4 years, and that, I believe is the cut off point for more or less certain success in the low cal diet. But it certainly won't work if I stop it before I have reached normoglycemic levels, which is the mistake I made last time. A low cal diet is a marathon not a sprint. A lot of anti weight loss people seem to think if it doesn't work in days then I should give it up without giving it a fair trial. Once I have done that - and it took many of Dr Taylor's subjects 5 months - and/or got to my personal fat threshold, if it still hasn't worked, I shall of course try metformin etc, to keep my BG's down low enough to avoid complications.

 

[lucylocket61]

Nutrition Requirements © British Nutrition Foundation 2015 Carbohydrate and Fat · Dietary reference values (DRVs) have been set for fat and carbohydrates (including sugars and dietary fibre) for the population. · DRVs for total fat, saturated fat, total carbohydrates and sugars are given as a percentage of daily energy intake. DRVs for carbohydrate and fat as a percentage of energy intake % Daily Food Energy Total Carbohydrate* 50% of which free sugars* Not more than 5% :Total Fatⱡ Not more than 35%: of which Saturated Fatⱡ Not more than 11%.

You may not have realised this, but our ability to process carbs is impaired, hence the advice from even anti-low carb diabetic medics is to lower our carb intake to under 150g of carbs a day. Its the first thing they say when someone is diagnosed, at leat, round here it is. Controlling our carbs due to our impairment is fundamental.

 

[Tannith]

because of the spike it causes, and how long that spike lasts. 75g of carbs spread over 24 hours is not as damaging as 75g of carbs in one hit, as our bodies have time to deal with the small chunks of carbs at a time. The spikes are the problem, as has been explained previously, along with the relevant links to research backing up the danger of spikes.

My most recent "spike" was 8.3, and was down to 6.6 an hour later. There are plenty of people on here who have FBGs that high or not much lower, (eg 7) every single day.

 

[lucylocket61]

A lot of anti weight loss people seem to think if it doesn't work in days then I should give it up without giving it a fair trial.

Good job we dont have any anti-weight loss people on here then : )

 

[lucylocket61]

My most recent "spike" was 8.3, and was down to 6.6 an hour later. There are plenty of people on here who have FBGs that high or not much lower, (eg 7) every single day.

was that during an OGT? or after a meal consisting of 75g or carbs in one go?