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Query re Blood Glucose fluctuations / swings

A

angusglens

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I am looking for input or suggestions regarding the wild BG fluctuations I am seeing - this can be +10mmol/L over the course of a couple of hours, ordinarily I wake up to BG levels in the high teens and then through the day can fluctuate mid-teens to mid-twenties. I also believe that I am experiencing the effects of hyperglycaemia with BG levels from 13.9 up to 26mmol/L. I can feel it affecting my eyes, I am incredibly sleepy especially in the evenings after dinner, my mood can be temperamental and I pee and drink incessantly to say the least. I’ve also had other small niggly issues which are all likely associated with high BG levels.
When my levels have been particularly high I have tested with Ketostix and there are ketones however traces or small 1.5.
During covid I was diagnosed as pre-diabetic however managed to get my levels down. This week I have conducted a private HbA1c test which has come back at 11.9%. I’m disappointed as previously I had been in the pre-diabetic level 18 months ago, and I’m not consciously eating worse or being particularly unhealthy. Is such an increase normal without any significant dietary / lifestyle changes? The one thing that changed is that I’m not as able to exercise as frequently as I’d like which I blame on a busy and stressful job and busy family life.
As a mum of three, having just turned 40, with two gestational diabetes pregnancy I know the rational answer is to go to see my GP!

HbA1c history:
June 2020 - 6.6%
August 2020 - 6.4%
June 2021 - 6.8%
January 2023 - 12.1%
April 2023 - 11.9%f
 
angusglens said:
I’m not consciously eating worse or being particularly unhealthy
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Can you give us an idea of what your meals are? And are you testing around your meals to discover why your levels are so high
 
ajbod said:
You hit the nail on the head with seeing your GP those numbers are very high. What med's are you on.
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No medication at the moment. Previously I reduced carbs when diagnosed pre-diabetes and increased exercise.
With gestational diabetes I was on metformin and moved onto insulin very quickly, with first GD pregnancy, second GD pregnancy I was on insulin from week 6.
Meals wise, breakfast is boiled eggs, lunches are salads and evening meals are when I permit myself some carbs. All meals are homemade and with an awareness of the affect the carbs can have on my BG .
 
Can't see too much wrong with your diet, you could try testing just before your evening meal when you have carbs, and again 90min or so afterwards, just to see what those carbs do to your levels.
Numbers that high with no obvious reason definitely need looking into, you need to see your Dr.
Let us know how you get on.
 
where did you get the January 2023 test of 12.1% (109mmol/mol)? If it was at the GP I’m shocked no action was taken. The June 2021 test of 6.8% (50mmol) was actually in the diabetic range too, not prediabetic and should have been highlighted by the dr. Is there any reason you tested privately rather than going to your dr?

But you are where you are. The breakfast and lunch sound good (depending what’s in the salad of course) What are the carbs you allow yourself in the evening? What are you drinking? Stress can raise levels too.

Even with your GD history it’s always possible this could be LADA not type 2 because it’s a fairly dramatic rise in a fairly short time. Of course if it was the exercise keeping a lid on a long standing type 2 issue then being unable to do it might have made quite a difference.

Go see your dr and get the appropriate tests done to rule out LADA (type 1) if possible. If it is type 2 you need to find a way to manage these levels as they are way to high (as you already know).
 
Hi @angusglens and welcome to the forums.

As others have already said, with levels like that you need to see your GP urgently. Aside from the long term damage and the short term effect on your ability to function, the small risk that you might have a diabetic type other than T2 is something to be aware of.

Diabetic ketoacidosis (caused by lack of insulin and high blood sugars) can kill quite quickly without hospital treatment so in your position I would keep checking ketones and be prepared to call an ambulance or 111 if they are high.

www.nhs.uk

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.
www.nhs.uk www.nhs.uk

Good luck and once more welcome.
 
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