Second OGTT after 5 years

AnnInDenmark

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You say you want to fail the test. No-one can say if you will fail or pass the test, but if you stick to your very low carb and do not carb up, you have more chance of failing it. Why not have a go at home with 75mg of glucose rather than a higher carb meal?

In the UK, even if we have been taken off the register, we still get our annual retinal screening. (These are the instructions given to GPs) I don't know how it works in your country, but when I was nagged about coming off the register my nurse assured me I would still have annual HbA1c and foot checks because of being deemed to be "at risk". Perhaps it is worth investigating?

By the way, I declined the offer to come off the register because currently I have 6 monthly blood checks and I would be moved to annual if I came off it, so I do understand your thinking.

I don't know why I didn't think of drinking some glucose instead of eating carbs. It sounds like a more reliable test. Lucozade isn't sold here, but I am sure I can find something similar. Thanks for the idea. I will try it out.

My GP told me that I can't have the tests anymore if I'm not registered as diabetic. I have no saying in that.
 
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AnnInDenmark

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Hi @AnnInDenmark, I'm in a similar situation with a HbA1c of 33 and a very stupid diabetes nurse. I haven't made my mind up yet but will discuss it with my GP. I was diagnosed a few years ago with an OGTT of 13.8 at two hours (20.6 at one hour) and am not very keen to go through that experience again.

As far as I can understand there are problems with the HbA1c test as the amount of Hb can differ as can the actual type of Hb and both will affect the result, whereas the OGTT is fairly reliable.

If my GP is very insistent I might go ahead and have the test, provided I can get some further tests done at the same time, like C-peptid for example.

What if they took a more scientific approach to blood glucose levels and asked us how we have managed to achieve this level of control? They might even learn a thing or two.

Hello @Totto
I believe that our two countries are very similar in how things are handled, somewhat different than in Britain.
I have not seen anyone specialized in diabetes, just a practice nurse who weighs, measure height and blood pressure, takes blood sample and ECG, and ticks off a list.
She is a youngish, very chatty woman. When I first saw her, she was overweight after having a couple of children, talking about going to lose weight, which she actually did very fast. Because of that I thought she knew something about nutrition, and mentioned in passing that I had stopped eating potatoes (back then). Her face got an interesting blue colour, and she said something about it beeing wrong of me. That's all. I never mentioned food again.

My GP tells me the results of the bloods a week later, and do the foot tickling procedure. As she is older than the nurse, and never once mentioned diet, I never had the urge to talk about it, as I would expect the same reaction from her.
I do not expect a GP to know everything about every disease on earth. They work long hours and spend most of their time with patients. How can they possibly keep up with all the new science? Think of how much time we spend reading about just one disease. It's impossible.
 

Totto

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I think it differs a lot depending where you are, a sort of post code lottery regardless if you are in Scandinavia, the UK or somewhere else. I live on an island and there aren't a wide range of practices to choose from. There is one diabetes nurse covering the south part of the island and as she is unbelievably stupid, in my opinion, she also is causing quite a lot of damage while complaining about how bad her patients are doing, bloodsugarwise. You would have thought she'd jump with joy when she saw my tests regularly coming back at around 33 but no, not she.

A neighbour reduced his HbA1c to 54 and she was over the moon and told him how very good he had been. He is a good diabetic and eats bread with every meal.
 
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AnnInDenmark

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I think it differs a lot depending where you are, a sort of post code lottery regardless if you are in Scandinavia, the UK or somewhere else. I live on an island and there aren't a wide range of practices to choose from. There is one diabetes nurse covering the south part of the island and as she is unbelievably stupid, in my opinion, she also is causing quite a lot of damage while complaining about how bad her patients are doing, bloodsugarwise. You would have thought she'd jump with joy when she saw my tests regularly coming back at around 33 but no, not she.

A neighbour reduced his HbA1c to 54 and she was over the moon and told him how very good he had been. He is a good diabetic and eats bread with every meal.

At my last meeting with the nurse, as she was ticking off her list of questions, one of them was: "You test as home, don't you?"
Me: "Yes, but not as much as I once did, now that I have good control". (It is self-funded)
Nurse: "Good, good". Check mark on computer.
Me: "Do many of your T2 patients self test?"
Nurse with a happy smile: "Yes, almost all of them. Once a month or so, that is enough".
I believe I blinked a lot, trying to keep a straight face. I was afraid that I would have had to pick her up from the floor, had I told her that I test 3-4 times a day, down from 10.

I never heard a "well done" either, only a baffled "I have never seen that before".
GP told me a couple of times that a HbA1c of 48 is a very good level, so I expect that most of the once-a-month testers are higher than that. I am the only one in the practice of 5 GPs who got down to none-diabetic levels, so I was once told. I suspect that that is the reason why my GP now doubt my diagnosis.
 
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Mbaker

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Your "tough as nails" made me chuckle. I take it as a compliment. Thank you.
When I first started reading this forum, I didn't understand what people meant by "craving carbs". I never craved a certain kind of food. Lucky for me I guess, as I don't need as much discipline as many others.
There is no doubt in my mind that I will have no trouble at all going back to eating LCHF after the test.
Completely a compliment, it is not easy achieving non diabetic levels, it takes a heap of commitment and strength.
 

AnnInDenmark

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This morning I tested myself at home.
I did everything as if I was going to have the test at the lab, but did not have a high carb meal yesterday. Total for the day was 10g carbs. Fasted for 10 hours, did the routine as if I was going to get out, even pretended to drive a car for half an hour.:wacky:

Liver gave me a boost, so before the test bs was 5.4
Drank an energy drink containing 75g sugar within the required 5 minutes.
Then sat down, as the lab will tell me to do, and hardly moved for the rest of the time.

30 minutes: 11.8
60 minutes: 12.6
90 minutes: 14.3
120 minutes: 10.1

I felt increasingly hungry during all this time, which might, or might not, have been the reason I could not concentrate after an hour, and felt a bit shaky after two hours. I then immediately had my usual breakfast of bacon, eggs and a small tomato, which stopped both brain fog and shakiness quite fast.
I am not bouncing with energy, but feel okay.

Any thoughts?
 

Bluetit1802

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That would just about pass the OGGT but only just.

Was the sugar just 75g of refined sugar?
 

AnnInDenmark

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That would just about pass the OGGT but only just.

Was the sugar just 75g of refined sugar?

According to the lab, anything above 11 is positive.

80g carbs of which 75g sugar.
I can't find anything sweet but refined sugar on the ingredients list.
 

Bluetit1802

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According to the lab, anything above 11 is positive.

80g carbs of which 75g sugar.
I can't find anything sweet but refined sugar on the ingredients list.

I understand the criteria for a diabetes diagnosis is above 11 at 2 hours.

http://www.diabetes.co.uk/oral-glucose-tolerance-test.html

What should the OGTT results be?
People without diabetes
  • Fasting value (before test): under 6 mmol/L
  • At 2 hours: under 7.8 mmol/L
People with impaired glucose tolerance (IGT)
  • Fasting value (before test): 6.0 to 7.0 mmol/L
  • At 2 hours: 7.9 to 11.0 mmol/L
Diabetic levels
  • Fasting value (before test): over 7.0 mmol/L
  • At 2 hours: over 11.0 mmol/L

I wonder if you would be better finding some pure glucose to drink rather than a mix of different sugars (fructose, dextrose and sucrose) I am just guessing here!
 

AnnInDenmark

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I understand the criteria for a diabetes diagnosis is above 11 at 2 hours.

http://www.diabetes.co.uk/oral-glucose-tolerance-test.html

What should the OGTT results be?
People without diabetes
  • Fasting value (before test): under 6 mmol/L
  • At 2 hours: under 7.8 mmol/L
People with impaired glucose tolerance (IGT)
  • Fasting value (before test): 6.0 to 7.0 mmol/L
  • At 2 hours: 7.9 to 11.0 mmol/L
Diabetic levels
  • Fasting value (before test): over 7.0 mmol/L
  • At 2 hours: over 11.0 mmol/L

I wonder if you would be better finding some pure glucose to drink rather than a mix of different sugars (fructose, dextrose and sucrose) I am just guessing here!

Yes, and my fbg now is much lower than when I was diagnosed. I found my notes from when I started testing six months later, and they were 7.5-8.5 at that time after cutting out a lot of sugary stuff. That is a whole different starting point for an OGTT test.
 
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Bluetit1802

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I just found out that you were talking about the number after two hours.
The lab does a 120 minute test,


Yes, and my fbg now is much lower than when I was diagnosed. I found my notes from when I started testing six months later, and they were 7.5-8.5 at that time after cutting out a lot of sugary stuff. That is a whole different starting point for an OGTT test.

Yes, with your low fasting numbers you are going to struggle to fail this test. I don't know what else to suggest other than a pure glucose drink, similar to the one the doctor will use.
 
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Ann1982

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In the cause of scientific research, you must understand, I had a white pudding supper last night. Thought I had bolused enough (30 units Humalog) but sadly no. I was still at 14.2, after 4 hours. My BS was still 7.7 at 6.20am. Ugh! And I feel awful. We had just come back from holiday and a very long drive and was so exhausted I just couldn't be bothered to cook. I promise I won't do that again!
 

AnnInDenmark

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In the cause of scientific research, you must understand, I had a white pudding supper last night. Thought I had bolused enough (30 units Humalog) but sadly no. I was still at 14.2, after 4 hours. My BS was still 7.7 at 6.20am. Ugh! And I feel awful. We had just come back from holiday and a very long drive and was so exhausted I just couldn't be bothered to cook. I promise I won't do that again!

Sorry you had to go through this.
I think it is worth trying, having a high carb meal, as I am supposed to the evening before my test, and see what my fbg will be. If it is still lowish, I could try a high carb day.
Funny, I can't think of anything to eat. :banghead:
 

Bluetit1802

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Sorry you had to go through this.
I think it is worth trying, having a high carb meal, as I am supposed to the evening before my test, and see what my fbg will be. If it is still lowish, I could try a high carb day.
Funny, I can't think of anything to eat. :banghead:

Lol. In my case I would have a sugary breakfast cereal, baked beans on 2 slices of white toast with chips or a huge baguette followed by a massive piece of cake with a jam filling and icing!! Oh and some chocolate biscuits!

Excess protein one day can sometimes cause havoc the following morning with FBG. It takes a while for excess protein to convert to glucose, and I know if I eat more protein than I normally do, it makes a difference the next morning.

How different to see someone deliberately trying to raise FBG and deliberately fail an OGGT. ;)
 
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AnnInDenmark

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Lol. In my case I would have a sugary breakfast cereal, baked beans on 2 slices of white toast with chips or a huge baguette followed by a massive piece of cake with a jam filling and icing!! Oh and some chocolate biscuits!

Excess protein one day can sometimes cause havoc the following morning with FBG. It takes a while for excess protein to convert to glucose, and I know if I eat more protein than I normally do, it makes a difference the next morning.

How different to see someone deliberately trying to raise FBG and deliberately fail an OGGT. ;)

It feels weird too, believe me. :)
Your wish list rang a few bells with me. I would most likely react to bread and potatoes in som form .... and white or milk chocolate. Excess protein? Never thought of that, but worth a try. I wonder if I would have room for a biscuit.
Great ideas, thanks. :)
 
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Bluetit1802

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It feels weird too, believe me. :)
Your wish list rang a few bells with me. I would most likely react to bread and potatoes in som form .... and white or milk chocolate. Excess protein? Never thought of that, but worth a try. I wonder if I would have room for a biscuit.
Great ideas, thanks. :)

Please keep us posted!
 

Totto

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This morning I tested myself at home.
I did everything as if I was going to have the test at the lab, but did not have a high carb meal yesterday. Total for the day was 10g carbs. Fasted for 10 hours, did the routine as if I was going to get out, even pretended to drive a car for half an hour.:wacky:

Liver gave me a boost, so before the test bs was 5.4
Drank an energy drink containing 75g sugar within the required 5 minutes.
Then sat down, as the lab will tell me to do, and hardly moved for the rest of the time.

30 minutes: 11.8
60 minutes: 12.6
90 minutes: 14.3
120 minutes: 10.1

I felt increasingly hungry during all this time, which might, or might not, have been the reason I could not concentrate after an hour, and felt a bit shaky after two hours. I then immediately had my usual breakfast of bacon, eggs and a small tomato, which stopped both brain fog and shakiness quite fast.
I am not bouncing with energy, but feel okay.

Any thoughts?
My thoughts are that if you had 75 grams of sugar, not 75 grams of glucose, you can't compare it with an OGTT. Sugar is sucrose and once inside you it turns into half fructose, half glucose. The OGTT test is done with pure glucose.
 

AnnInDenmark

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My thoughts are that if you had 75 grams of sugar, not 75 grams of glucose, you can't compare it with an OGTT. Sugar is sucrose and once inside you it turns into half fructose, half glucose. The OGTT test is done with pure glucose.

I think you are right, but am not sure I will test at home with glucose.
I had potatoes with my chicken this evening to see if it will have any impact on my fbg tomorrow. Things happened so forgot to test before the meal, but after 90 minutes I was 17.3.
Strange how my sense of taste has changed. The potatoes were well salted, but tasted sweet. I liked the smell better.
 

Bluetit1802

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I think you are right, but am not sure I will test at home with glucose.
I had potatoes with my chicken this evening to see if it will have any impact on my fbg tomorrow. Things happened so forgot to test before the meal, but after 90 minutes I was 17.3.
Strange how my sense of taste has changed. The potatoes were well salted, but tasted sweet. I liked the smell better.

Well that 17.3 will have told you something :) Maybe something to tell the doctor.
 
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AnnInDenmark

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Sooo, after my high number last night I woke up with a fbg of 7.1, so decided to go for it, and went to the lab as soon as it opened. The nice young man checked my details on the computer and asked why I was having another test after so many years.
I told him my story in short, LCHF, normal numbers and so on. He nodded all the way through, and crossed his eyes when I mentioned GP's doubt. :hilarious:
He said that I was not the first one this has happened to, and that the test would be inacurrate if we did it now. I should eat a normal diet for three days, longer if possible.
Before I left I thanked him for understandig, and he said: "I'm T1".