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Perplexed by the numbers

jim1951

jim1951

Well-Known Member
Messages
562
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone

Officially labelled type 2 three weeks ago but have moved towards it over the last 12 years or so. A routine blood test at that time showed raised glucose levels and I have slowly chugged along with slightly increasing levels every 6 months.

I have gone from 6.5 fasting 12 years ago to 8.4 fasting last month, so it has been very slow. My GP started testing HBA1C a couple of years ago and this has stayed pretty level at 53/54.

Whilst according to NHS guidelines 53/54 is still within pre medication levels, my GP has put me on 500mg Metformin as he thinks as the fasting level is higher than the average I must be having lots of lows as well.

I decided to buy testing monitor and have been testing 3 times a day. I test at approx. 6PM before my evening meal, this averages the mid fives. I test 2 hours after my evening meals and this averages the mid sixes. I understand both these readings could be considered non diabetic.

When I test first thing in the morning it is in the eights. This has obviously pushed the HBA1C results up.

Reading various bits on the site I understand the morning high could either be the morning liver dump, or, it could be "impaired fasting glucose with normal post meal control" ?

How does one differentiate between the two explanations and is it possible to influence the morning high? I go roughly 12 hours from my evening meal until I test in the morning, is this too long? Should I be having an appropriate snack later in the evening and what is the theory of what it would do to the morning number?

Would really be interested in thoughts from members that really understand these areas.

jim
 
Hi Jim, and welcome.

I don't understand why you have only just had an official diagnosis when your HbA1c levels have been 53/54 for 2 years. That is well over the diabetic cut off level of 48.

Perhaps you aren't testing enough. Breakfasts and lunches, plus snacks, are also important to test, and one test at 2 hours post meal often misses the peak. Food, and combinations of food, are all different. Some take longer to get through the system than others so will peak later, even at 3 hours. Others will peak at 1 hour. Protein, especially in large quantities, takes up to 24 hours before it affects anything. You also don't know how long your fasting level is staying at 8 and what your after breakfast level is if it starts at 8. To get any sort of average out of your meter you have to be consistent and test more often. Then you have to remember your meter has a 10 to 20% error rate. (They all have)

Good luck!
 
[QUOTE="Bluetit1802, post: 570110, member: 94045

I don't understand why you have only just had an official diagnosis when your HbA1c levels have been 53/54 for 2 years. That is well over the diabetic cut off level of 48.

[/QUOTE]

Bluetit1802, thanks for your words.

I think because my progress was so slow, my GP wanted to give me a chance to control and reverse with diet/exercise before he gave me an official label. Although I have always taken it seriously, perhaps I should have purchased a meter sooner. I think only by testing can you gain the appropriate control.

What I am interested in is what is the difference between dawn phenomenon and impaired fasting glucose with normal post meal control" ?
 
look up insulin resistance too, which is also what metformin treats, are you told to increase it to 1,500 a day?
IMO find a diabetic Dr for second opinion and ongoing care, he should have treated you earlier
 
jack412 said:
look up insulin resistance too, which is also what metformin treats, are you told to increase it to 1,500 a day?
IMO find a diabetic Dr for second opinion and ongoing care, he should have treated you earlier
Click to expand...

no just 500mg and HBA1C in 3 months to see how I am going.
 
jim1951 said:
[QUOTE="Bluetit1802, post: 570110, member: 94045

I don't understand why you have only just had an official diagnosis when your HbA1c levels have been 53/54 for 2 years. That is well over the diabetic cut off level of 48.
Click to expand...

Bluetit1802, thanks for your words.

I think because my progress was so slow, my GP wanted to give me a chance to control and reverse with diet/exercise before he gave me an official label. Although I have always taken it seriously, perhaps I should have purchased a meter sooner. I think only by testing can you gain the appropriate control.

What I am interested in is what is the difference between dawn phenomenon and impaired fasting glucose with normal post meal control" ?[/QUOTE]



I can't answer your question. I have no idea.
Your progress may have been slow, but for the ;last 2 years you have been a full blown diabetic and you should have been referred for a retinal eye screening test (essential every 12 months) and a foot neuropathy test either by the diabetic nurse or a podiatrist. These 2 screening tests are part of the NHS guidance on diabetes treatment. Whether or not you were given the chance to control it by diet alone, or put on meds is irrelevant. There are many of us on this forum that are not on any meds. I'm one of them. My diagnostic HbA1c was 53, fasting glucose test was 7mmol/l. Meds were not mentioned at the time, and up to now still haven't been, but I am still a diagnosed type 2 and have had my eye test and foot test.
I don't see how you can say you have normal meal control when you only test one meal, before and at 2 hours. You may be right, and I hope you are, but how do you know?
 
Bluetit1802 said:
Bluetit1802, thanks for your words.


I don't see how you can say you have normal meal control when you only test one meal, before and at 2 hours. You may be right, and I hope you are, but how do you know?
Click to expand...

You are right, I don't know!

What I will be doing over the coming weeks is testing at all different times. My diagnosis has come as no surprise, no need for knee jerk reactions by me, I will take my time.

I have a number of other conditions and am well monitored by the NHS. I have gout which is uncontrolled by medication which has required intervention by podiatry. I also have non diabetic eye problems which has led to many tests over recent years. Because of these I have not been worried about the tests you mention, but thanks for mentioning them.

jim
 
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