Why is 11mmol the cut off?

[Lavender100]

Why is this the point at which diabetes is diagnosed? why not 10 or 12? Is there any science behind it?

 

[andcol]

I think it is 11.4

If your body is working perfectly then the enzymes from your liver and pancreas will stop further glucose being released into your blood stream at the point. So yes there is science

 

[MikeTurin]

Why is this the point at which diabetes is diagnosed? why not 10 or 12? Is there any science behind it?

I suppose that is the rounded to a nice number mean obtained from medical surveys... Nobody talks about χ2 test, Fisher test, and other nicieties, because statistics is a niche subject so a simple number is thrown.

 

[catapillar]

Here is some information on the WHO diagnostic criteria for diabetes:- https://www.diabetes.org.uk/Profess...itoring/New_diagnostic_criteria_for_diabetes/

Do you have a diagnosis @Lavender100 ? You previously posted you had had spikes <11 and had been diagnosed type 1 and were awaiting results of antibody tests, have you had those results and an answer on what type of diabetes you have now? Your most recent question, querying the diagnostic criteria, does suggest that you haven't been diagnosed with diabetes... if that's the case, you will receive appropriate screening under follow from your gestational diabetes and be able to raise any concerns to your health team.

 

[azure]

Why is this the point at which diabetes is diagnosed? why not 10 or 12? Is there any science behind it?

The diagnostic guidelines have been very carefully set by WHO so yes, there is science behind it.

I believe you were waiting for your 13 week screen after having had GD? Have you had that yet?

 

[Lavender100]

My HBA1C was normal at 33mmol but I've not been eating as I normally would for most of the three period - low carbing during pregnancy because of my 'GD'. Having a GTT next week. My fasting was also normal - 3.7. I'm still testing and getting these high 1 hour spikes (10), even with relatively low carb meals so who knows. Doctor won't do antibody test yet. Going to see what the GTT says then ask her again. I'm still breastfeeding and wonder if that will skew the results of the GTT as you're supposed to be less insulin resistant when doing so. Also wondering about the safety of the test when breastfeeding...Wonder how much of thwhat glucose will pass through my milk

 

[Lavender100]

That should say three month period

 

[catapillar]

So you've not been diagnosed with diabetes @Lavender100 ?

The post prandial spikes should be tested 2hrs after eating, not 1hr, for the purpose of diagnosis. Ifs perfectly common for non diabetics to spike after eating.

 

[Lavender100]

I'm due to get my GTT next week. Trust me, I don't want diabetes.

My doctor said I should not be spiking to 10 and I know from research that, whilst non diabetics can spike high after a carby meal, they generally don't exceed 7.8. I spike above 10 all the time.

I did have gestational diabetes so this isn't something I've made up. I went back to my normal diet again after pregnancy and started to get really thirsty again which is why I started testing and noticing the spikes.

This has certainly been a wake up call to eat better. My old diet was apalling.

Oh I had a liver function test too - all results but bilirubin were the highest they could be without being abnormal. Not sure what to make of that.

 

[Freema]

That should say three month period

well if you do have diabetes, it will certainly not run away easily, so even when or if the breastfeeding could take a lot of the sugars and use it into producing human milk, which is indeed filled with sugars..., even then you will either have diabetes or not...if breastfeeding can delay the full blown diabetes type 2, which i dont think it can , then you just get the diagnosis later on, if you have diabetes type 1, I don´t think breastfeeding will be able to have much of an effect at all, but that I think a breastfeeding type 1 person would be able to tell you much more of.. hormons do a lot of stuff in peoples bodies , but never heard that they could cure diabetes ..
I think your worrying is not helping you much and that it is waste of time speculating so much, but I know it can be really hard not to if one is scared... but if you are type 2 diabetic your effort in the log run is what matters , not usually what you do in a few month unless it was totally out of controll which seem not to be the case at all your numbers are so perfect and low, that it would be unlikely that you have diabetes as I see your numbers... so try to think of something else instead...
you would be more likely in the pre-dabetes kategory

 

[Lavender100]

I agree Freema. I think it will be prediabetes if anything. I'm fully expecting my 2 hour GTT to come back high and be diagnosed with impaired glucose tolerance. We shall see. I wish I never knew about it. It's all I think about (other than my baby). I'm still very much enjoying my baby

 

[Freema]

take care not to get your iron levels higher than in the normal range as too high iron also seems to maybe promote diabetes type 2.. so no more supplementation than actually is recomended..according to iron that is..

 

[Juicyj]

Trust me, I don't want diabetes.

Sadly non of us do either

I really do think you're making yourself anxious over this, unless you have a confirmed diagnosis then there is nothing to worry about and any worry you have will transfer over to your baby.

You are a new mum, please focus on your baby, this is your number one priority not beating yourself up over whether you could of couldn't have diabetes, as you are breast feeding you should avoid eating a low carbohydrate diet as this will affect your milk production, speak to your doctor and tell them your worries but do not keep worrying it's negative energy that's not good for you or baby

 

[Freema]

I agree Freema. I think it will be prediabetes if anything. I'm fully expecting my 2 hour GTT to come back high and be diagnosed with impaired glucose tolerance. We shall see. I wish I never knew about it. It's all I think about (other than my baby). I'm still very much enjoying my baby

It is sad you can lot let your worry leave you right now when you should honeymoon with your baby instead... try to focus on your little wonderfull baby instead... and there is not much we can do about diabetes diagnosis that you are not already doing.. so find Peace in that...your at least know what to do..!!!

 

[azure]

My HBA1C was normal at 33mmol but I've not been eating as I normally would for most of the three period - low carbing during pregnancy because of my 'GD'. Having a GTT next week. My fasting was also normal - 3.7. I'm still testing and getting these high 1 hour spikes (10), even with relatively low carb meals so who knows. Doctor won't do antibody test yet. Going to see what the GTT says then ask her again. I'm still breastfeeding and wonder if that will skew the results of the GTT as you're supposed to be less insulin resistant when doing so. Also wondering about the safety of the test when breastfeeding...Wonder how much of thwhat glucose will pass through my milk

Thank you for responding That HbA1C is very normal

I know you're concerned about the spikes, but many of the 'spikes' you reported weren't spikes in a diabetic sense. The reason people are advised to test at two hours is that that's the point at which your blood sugar should be back to normal. you're hypersensitive to your blood sugar testing because you've had the worry of GD - I understand that. But you would get a better picture if you tested at two hours.

You should also bear in mind that blood sugar can remain erratic up to approximately 13 weeks after delivery.

One thing that can cause higher than usual blood sugar readings is stress. It's possible that your worry is pushing your blood sugar higher than it would be, and that could create a vicious circle.

I would repeat my advice in a previous thread to put it out of your mind until there actually is a diagnosed problem. Concentrate on eating well for your baby. As long as you rceive the normal follow up tests as every woman should after GD, then that should put your mind at rest.

If your GD did show a propensity to tending towards prediabetes, then regular tests should pick that up.

 

[Lavender100]

Thank you all. I definitely do plan on worrying less. 4 squares of dark chocolate and no spike! Yum! No testing now at least until I've had my GTT and have had a proper diagnosis. I suppose my only concern is not wanting to make my insulin resistance worse . ..I.e usually I love indulging on Christmas food this time of year and have a lovely big dinner, but this year I'm too scared to. I guess there's more to life than food

 

[alaska]

Why is this the point at which diabetes is diagnosed? why not 10 or 12? Is there any science behind it?

Note that 11 mmol/l is a rough translation of 200 mg/dl (the blood glucose level units used by countries like the US)

11 is quite high and so it sets a border that says, if you're this high on a random glucose test, then we can be 90-something % sure you have diabetes.

It's less an exact science and I believe it being 11 mmol/l has a lot to do with it being a nice round number (200 mg/dl) that experts were happy to agree was a good sign of certainty that somebody showing a figure this high can be reliably regarded as having diabetes.

Ed

PS convert mmol/l to mg/dl by multiplying by 18. So, 11.1 x 18 = 199.8

 

[asparagusp]

Just a thought - Everybody is different so what is to say that your body is not functioning well and continue to into the distant future on (slightly) higher than average sugar levels? ie you are more tolerant .....

 

[Lavender100]

Asparagus - I love that thought! I do hope that's true my paternal grandmother is diabetic but I suppose that doesn't mean I'm destined to get it.

P.S I'm not neglecting my baby to post on here. Baby is currently fast asleep

 

[catapillar]

Trust me, I don't want diabetes.

Yeah, Id really rather not have it too.

So, when you posted on 28 and 29 October that you had been told you have type 1 diabetes, was that a misunderstanding on your part? As it sounds like your still being investigated with glucose tolerance tests (a test that is not conducted on people with a type 1 diagnosis, because obviously people who don't produce insulin don't tolerate glucose) to determine whether you have diabetes I assume you haven't been told you have any kind of diabetes?

As has been said several times, allow a few months from birth to get back to normal after gestational diabetes. Have your gd follow up.

FYI:-

• "Normal"/non-diabetic does include post prandial spikes up to 10
• Type 1 diabetes is not a condition of insulin resistance, it's an autoimmune disease that destroys insulin production
• If you've not been diagnosed with diabetes there's no clinical reason for a gad test - a test that does have a significant wait for those who have been diagnosed with diabetes and are trying to determine what type of diabetes they have, because all gad test are carried out at the same lab.
• If you have had GD that increases the risk of developing type 2 diabetes. That's what the GD follow up is for. You can take steps to reduce your risk of type 2 by looking at your diet-exercise, once your back on your feet after the baby.