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To trust or not to trust?

Captain Glucose

Captain Glucose

Active Member
Messages
31
Type of diabetes
Prediabetes
Treatment type
Diet only
Firstly I’d just like to thank you all for your collective knowledge. I have learnt more from you all than I have in dozens of frustrating doctors visits.

I am as yet undiagnosed but have seen 2 or 3 different doctors over the past few years for issues such as tingling and dry feet, lethargy, thrush and headaches. Around 2 years ago, in response to my concerns, they took my fasting blood glucose which was found to be within the non diabetic range (4.5mmol) and told me I was worrying over nothing (ate a full packet of biscuits that night :-)

2 weeks ago in a chance conversation about this subject with a neighbour who is type 1 diabetic, I mentioned feeling under the weather and he took my blood sugar with his meter. He looked slightly surprised as it read 10.2mmol. This was around 1 hour after breakfast which was ½ a bowl of porridge and nuts/seeds.

Suffice it to say I went straight to the doc but he told me this is probably “perfectly normal” but has ordered a HBA1c which I’m awaiting the result of. I’ve also purchased a meter and having spent the last few days monitoring my levels, it’s clear that carbs spike my blood sugar in around 1 hour and it starts moving down in 2 to 3 hours. If I exercise the decrease in blood sugar is dramatic.

What I’d like to ask is this; am I correct in thinking that even if I spend much of the day (between meals) at lower blood sugars, these large spikes occuring after carb rich meals show that I have some degree of insulin resistance/slow or impaired insulin response and am therefore pre diabetic and should be taking affirmative action?

I am 34 years old, 6ft, have a low BMI and very little body fat with reasonable muscular definition. When I asked my doctor about diabetes he pretty much laughed in my face but after everything I’ve read on this site, I’m confident that this is something I should address.

What would be your advice moving forward? Given my age and body type, should I take a Glucose Tolerance Test and GAD/islet test to make sure this isn’t late onset Type 1? Or, as there is family history of type 2 is it a safe bet I’m in the early stages of this and have a chance at controlling/reversing the condition?

Sorry for the long post and thanks in advance,

Mike
 
I think I am with your doctor. 10 an hour after breakfast may just be normal for you (your body always responds least well at breakfast to other meals surprisingly). The HbA1c will hopefully put your mind at rest.

As to the insulin resistance - no I do not believe you can jump to that conclusion. Everyone spikes up at 1 hour some more than others. If you are worried about the breakfast spike have your breakfast meal in the evening and see what happens. May be you shouldnt have a high carb for breakfast.

Wait until you get the blood test results back but I expect you will be clear. It is then your choice as to your future approach
 
I kind of agree with @Andrew Colvin , plus your problem may easily be a food intolerance making you feel grotty - they can cause raised bg too.

Personally, i wouldn't want to have bg that high after breakfast, so i would change to a lower carb one. (Or switch to a different carb food as a trial, to see if its an intolerance) I would also want to use my meter to map out a few things.

Have you checked out the bloodsugar101 website? (Link in my sig). There are studies discussed there which show that bg issues start long before they can be identified by fasting blood tests or hba1cs. If that is your situation, then you are in a great position to make a few changes now and avoid future problems.
 
Hello and welcome,

I am in agreement with the other posters. Everyone will spike at 1 hour after a carb meal. My non-diabetic husband does. The secret is to make sure it returns to base level as quickly as possible. If that is happening, then your pancreas is probably working normally. It is also true that our functions improve as the day progresses, so mornings are not always the best time for carbs.

What other figures have you been seeing throughout the day?
 
It’s good to hear that a spike could be normal; perhaps I’ve read too much about so called normal levels and that non diabetics never spike, which admittedly I do find hard to believe.

I agree that lowering carbs seems to have a positive affect but my numbers seem to be all over the place. For example, yesterday I tried 75g oats with nuts and pumpkin seeds and this gave me a BG of 9.2 at 1 hour and 7 at hour 2. However today it resulted in 10 at 1 hour and still 8.7 at hour 2, dropping off at around 3 hours. Could it be something to do with me being sedentary and stressed out today?

I’ve read plenty on here about not easting too many carbs for breakfast so I’ll experiment with portion size and time of day as you suggest Andrew.

I’ve had good results with eating less carbs and more protein and found that I get less of a spike (around 6.5 ) which lasts longer (around 2 hours, tailing off at 3)

Brunerria, yes I’m hoping that as you suggest, I’ve caught this early and can remedy things through diet and exercise. From what I understand 4.5 fasting is fine but these spikes indicate the beginning of something. I’m crossing my fingers for the HBa1c

Bluetit, Yes I hope the ol’ pancreas is still in a reasonable state! I’m currently trying to figure all this out and have been having some spreadsheet fun in an effort to find patterns. It definitely seems that being sedentary keep my levels higher for longer. Even walking for 5 minutes has a big affect on lowering my levels.

Thanks again to all of you; what a useful resource this site is.
 
Captain Glucose said:
It’s good to hear that a spike could be normal; perhaps I’ve read too much about so called normal levels and that non diabetics never spike, which admittedly I do find hard to believe.

I agree that lowering carbs seems to have a positive affect but my numbers seem to be all over the place. For example, yesterday I tried 75g oats with nuts and pumpkin seeds and this gave me a BG of 9.2 at 1 hour and 7 at hour 2. However today it resulted in 10 at 1 hour and still 8.7 at hour 2, dropping off at around 3 hours. Could it be something to do with me being sedentary and stressed out today?

I’ve read plenty on here about not easting too many carbs for breakfast so I’ll experiment with portion size and time of day as you suggest Andrew.

I’ve had good results with eating less carbs and more protein and found that I get less of a spike (around 6.5 ) which lasts longer (around 2 hours, tailing off at 3)

Brunerria, yes I’m hoping that as you suggest, I’ve caught this early and can remedy things through diet and exercise. From what I understand 4.5 fasting is fine but these spikes indicate the beginning of something. I’m crossing my fingers for the HBa1c

Bluetit, Yes I hope the ol’ pancreas is still in a reasonable state! I’m currently trying to figure all this out and have been having some spreadsheet fun in an effort to find patterns. It definitely seems that being sedentary keep my levels higher for longer. Even walking for 5 minutes has a big affect on lowering my levels.

Thanks again to all of you; what a useful resource this site is.
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Stress can play a part but 75g of oats is a lot. I normally have about 30g so it could just be the portion size. Nuts will tend to slow it down along with the fat quantity in the milk. There are many factors that can effect your bodies response and yes that includes being sedentry (or as I like to think of it sedementary)
 
I'm definitely a sedimentary kind of guy :-)

Funnily enough, I have a big appetite and up until recently I'd been eating nearly 150g of oats for breakfast. I soak them in water rather than milk so perhaps the lack of fat contributes to the rapid absorption of what I now realize is about as healthy as eating a small family car.

It's makes me feel pretty stupid that I've been chugging down that amount of carbs most mornings and then sitting around all day feeling complacent due to my low BMI and all the while my body has been overloaded trying to deal with it.

One thing I'd love to know is would it still be unhealthy to eat large amounts of carbs if I did regular exercise to burn them off until I was down to normal blood sugars, or is the very nature of carbs such that I should limit their intake regardless?
 
Are you testing pre-meal just before eating? This will give you a base level for any spikes.

Non diabetics do actually spike - if you're interested have a bit of a search through the forum - some of our members have tested their non-diabetic partners and found this to be the case. And if I remember correctly some 1 hour spikes were also on the highish side...

If you're really worried, I'm another confirmed believer that reducing carbohydrates is definitely the way to go to improve matters. And I am, as @Andrew Colvin so charmingly puts it, fairly "sedementary" :p:D in my elderly lifestyle. But a low carb higher fat diet has considerably reduced any spikes (or not!) that I now see ...

Robbity
 
Thanks Robbity,

Yes, I've found that there seem to be large jumps when I eat a lot of carbs. I start around 4.7 and jump to around 9 when I eat carb rich foods, however if I eat say 30% carbs, 70% protein/fibre, then I start at 4.7 and end up around 6 at the peak.

When you mention reducing spikes through increasing dietary fat, what sort of fats do you eat in place of carbs and do you still eat a lot of protein? From of I've read many of the people doing this are also on the low side of their BMI so I'm concerned that I need to keep my calories up, lest I waste away to a skeleton!!

Would you be kind enough to give me an idea of your typical breakfast, lunch and dinner?
 
full fat milk, chees, nuts, animal fats, coconut, advocado, not reduce fat products as they take out the fat and replace with sugar. That sort of fat
 
Yes, no low fat products. Eat real dairy (butter, cheese, full fat plain yogurts, cream), olive oil, I cook with rapeseed oil, oily fish such as salmon, mackerel etc. any other sort of fish without the breadcrumbs or batter coating, all meat, high meat content sausages (97%), mayonnaise (Hellmans has virtually no carbs but some brands add sugar), nuts, avocados, and loads of eggs..

Cereals, bread, rice, pasta, potatoes, flour are ones to be very selective portion-size with. Fruit and milk can also cause problems and we need to be careful. Berries are a good choice, but certainly not bananas.

A lovely English fry up is a good meal for diabetics - eggs, bacon, sausage (high meat), tomatoes, mushrooms.
 
I would say the same variety of fats as Andrew and Bluetit - I think most low carb people would show you the same list. I try not to eat too much protein as this can also (in the absence of carbohydrates) be turned into glucose.

I'll eat whatever I fancy that is very low in carbohydrates (not very helpful am I) - but try to include some protein, some (mainly) green veggies, salad, or very low carb fruit, and plenty of fats, in my meals. I also try to eat as great a variety of foods as I can. I don't always eat at the same time of day and don't always eat 3 meals a day. For ideas though, browse through our "What have you eaten today?" and the recipes threads in the low carb section of the forum, and have a look at one of the low carb nutrient calculators, such as this one - Google will find you others - and these will give you recommended proportions of carbs, protein, and fat for you size and lifestyle.

Robbity
 
Thanks to all of you, that's really useful to me.

I'l definitely spend some more time looking on the forums and be mindful of not eating protein to excess.

Thanks again and will keep you posted on my results.
 
Just remember though you arent diabetic so although you won't to reduce your spikes you do not need to go excess and you need to find a balance. If you are doing lots of exercise you need more protein and protein is a slow release so should not impact your spikes. You just need to flatten your spikes so that is more fat with your carbs and you will have done it. Be careful though high insulin levels causes fat storage from excess calories.
 
Thanks Andrew,

Just spoke to the surgery and my HBA1c is apparently normal. I'm not exactly sure what that means so will have to ask the doc on Monday I suppose?

Yes, I'll definitely keep in mind that this is very much the early stages and not full diabetes. I'll keep my calorie intake in line with physical excursion and err on the side of less carbs.

When you mention being careful of insulin levels being high, if I were to eat too much would this also affect my insulin resistance due to those levels being constantly high? It sounds like I basically need to balance the food input with the energy output while leaving enough in reserve for my cells to regenerate and repair but not so much that it gets stored as fat? Is that about right?
 
no insulin levels are rised by high carb meals. Other food types raise them a little but not to the extend of carbs and for many (not all) grains are as bad if not worse than sugar. Maybe you are just intolerant to a certain extent to oats. Do you know what happens if you eat 75g of bread say, or potatoes, rice, pasta. They will all cause a different profile. try them all out - rice you are likely to find you get a long slow rise and fall. Try to replace your carbs you do eat with low GI ones (brown rice, whole meal bread etc and see if that helps. Just a question do you have sugar with your porridge?
 
Your body produces insulin as a response to rising blood glucose. It takes the glucose and tucks it into muscle cells (where it will be used to fuel movement) and fat cells where any excess glucose is converted to fat and stored for later use. This explanation is very simplified)
- and the more carbs you eat, the more this happens.

Type 2 diabetes develops when our bodies have been exposed to so much insulin that our cells become resistant to that insulin. The body has to work harder and harder to produce enough insulin to get that glucose to where it will be needed.

This is why type 2s often put on weight. They have enough glucose but the insulin resistance means that the glucose isnt getting to where it can be used. Fat cells become insulin resistance more slowly than other cells. So the excess glucose goes there, rather than the rest of the cells which want and need the glucose.

The result is a person who eats, gets raised bg, releases insulin (which cant do its job properly) the energy is tucked into fat cells instead of where it is really needed. And the body is smart enough to realise this. It still needs that energy. So it stimulates the appetite, the person craves carbs, and the cycle begins again.

Type 2s are often fat, ravenously hungry, with bodies that are effectively starving.

So from your perspective, you can at this point, head all of that off at the pass by nipping 2 things in the bud:
Avoid excess carbs which produce excess insulin which produce insulin resistance.
Keep your weight to a normal bmi (being fat increases insulin resistance)

Hope that helps. :)
 
Captain Glucose said:
Up until recently I'd been eating nearly 150g of oats for breakfast. I soak them in water rather than milk so perhaps the lack of fat contributes to the rapid absorption of what I now realize is about as healthy as eating a small family car.
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Hiya. At the risk of boring everyone AGAIN with my breakfast, 2 or 3 times a week I soak about 50grams of wholegrain oats in a thermos of hot water overnight and warm it up in the morning with berries, butter, coconut oil, chia seeds, yoghurt, double cream & nuts. My BS is the same 2 hours after as before (my base level is 5.2-5.3).
I'm a great believer in offsetting carbs with fat, eg 2-3 new potatoes and butter in a meal with other fat. In fact I've just had that so I'll know in a couple of hours.
*EDIT* 6.7, a rise of 1.4, so I'm happy with that.
Yep, it's good here, innit?
 
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Thanks to you both, that's really insightful. I really appreciate that everyone has taken the time to provide such detailed reponses to my questions.

Andrew, I'll definitely test out different carbs and give some brown rice a go. I feel a bit like a mad scientist experimenting on myself at the moment but it really is fascinating to understand the mechanics of how food is affecting my body. Brunella also mentioned about food intolerance potentially affecting things; do you know if that would have a significant impact on blood sugar levels in your experience?

Brunella, could I ask a couple of quick questions regarding what you've mentioned; when you say that type 2s often carry more weight, is it possible that I may be what I believe is termed "skinny fat" where much of my fat is visceral and distributed around my organs rather than my stomach/legs etc. Basically if I am this body type, I'd love to know how to loose this inner fat without dropping too much weight; I'm guessing a gradual increase in exercise and reduction in carbs will go some way to helping though.

Finally, I wonder if either of you or anyone else knows about whether having a fatty liver may be of significance in regards to how well the body utilities insulin? Several of my family members on my mums side have suffered from that and I have wondered whether the past few years of me gorging myself on huge amounts of carbs may have aided in the development of such an issue, contributing to how quickly my body uses the insulin that is released? Not sure if I have that right or not though?
 
DeejayR said:
Hiya. At the risk of boring everyone AGAIN with my breakfast, 2 or 3 times a week I soak about 50grams of wholegrain oats in a thermos of hot water overnight and warm it up in the morning with berries, butter, coconut oil, chia seeds, yoghurt, double cream & nuts. My BS is the same 2 hours after as before (my base level is 5.2-5.3).
I'm a great believer in offsetting carbs with fat, eg 2-3 new potatoes and butter in a meal with other fat. In fact I've just had that so I'll know in a couple of hours.
Yep, it's good here, innit?
Click to expand...
Thanks Deejay,

Even in the short amount of time I've been here, I'm already aware of your breakfast!

I'll definitely try it and check the difference in my levels.

To me, although it makes total sense about offsetting the carbs with fat to slow the release, why are some people anti fat and carbs together, because I couldn't quite understand the logic behind why that would be in any way bad?
 
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