HBa1c normal but fasting still too high.

[toryroo]

Hi from a long time lurker! I've had 3 gestational diabetic pregnancies (eldest is 16 youngest is 3 - last one I was on insulin) and have probably been prediabetic for years. I spent a long time playing with lowering my carbs a bit and burying my head in the sand I'm embarrassed to say! After visiting my new doctor (we've moved from Oz to France) back in June something just clicked after explaining to her I was well overdue some bloods doing and she was so concerned about the possible damage I was doing to myself running around with too high BS! It shouldn't have come to that, I should have taken control a long time ago - I'm a nurse and midwife I really should know better! I decided not to get the test done straight away but to go LCHF for a few weeks before testing and see what happened.

Within the first week my fastings went from mid to high 6's into the 5's - I was hooked sadly my machine then packed it in so I've not tested for the last 2 months! I lost over 8kg since June (although I've put on half a kg and it is not budging in the last month or so - not sure what is going on!). Summer visitors got in the way and the couple of weeks became a couple of months and I only got my bloods done this week. I was thrilled with my Hba1c -
5,4 %
35,5 mmol/mol
Fasting blood not so much: 6.44mmol/l
Is this dawn phenomon, stress or what? I'm so sad that my great efforts seem to have not paid off! Any ideas / thoughts welcome please!
Thanks in advance!

 

[ringi]

Your effects had paid off your Hbac1 is now very good. Fasting BG often takes longer to respond to "low carb" than other measures.

One option is to try eating as early in the evening as possible or even skipping dinner, this should give your body a long time overnight with low BG and insulin to use up some of the fat on your liver.

Resistance training also helps as it results in more demand for glucose when you are at rest.

 

[Alison Campbell]

Hi well done on taking control and the excellent HBA1C. I know my results are better when I'm home testing. So my suggestion is get yourself sorted with a new meter pronto.

 

[toryroo]

Thanks @ringi - a couple of good points that I haven't thought over too much- we often eat too late although getting better as the nights draw in. And the really big point is the exercise - I'm just not doing any other than running after a toddler, tween and teen, renovating an old french barn and trying to grow our in veg! I've just found out my iron is crazy low which will explain why I have been so exhausted - am on tablets so hopefully as I feel better I can think about adding some moving!

Thanks @Alison Campbell I'm heading back to Oz in 9 days for work so will pick up my other monitor while I'm there and get testing. Interesting that you do better when you are testing at home.

I'm so thrilled about the HBa1C but feeling a bit deflated by the FBG so was also good to hear that it can take longer to sort out as well. I think I need to do more reading about the dawn phenomonon.

 

[ringi]

Testing 2hr after eating a meal is the most useful test, as it is the only result you can quickly change. Get the post-meal result great (ideally always under 6) and everything else will sort itself out.

 

[toryroo]

Little update. I went to see my GP and she was thrilled with my weight loss and the Hba1c result and told me she wasn't bothered at all about my fasting being (in my mind) so high hmmm ok I thought! Anyone shed any light on that theory??????
She also said she thought I should let my body get used to the weight I've lost before trying to loose more - around 6 months - really??? Does anyone think that is a good idea? My body seems to naturally be doing it (also stopped smoking a few weeks back which will have slowed my metabolism a bit) as been sat on around 77kg (so 7kg loss) for probably 2 months now. So I guess with that and a month in Oz then Christmas maybe that will be OK and I can just relax a little!
The other thing she said was that she was worried about me not having 'carbs' and being tired when I go back to work next week (been on mat leave for 3 years but heading back to Oz to do a months work). I'm wondering if LCHF exists in France or if she is just a bit dubious! I think I feel less tired (other than the iron in my boots issue) that I did before going low carb but hard to know for sure with the iron issue!

Testing 2hr after eating a meal is the most useful test, as it is the only result you can quickly change. Get the post-meal result great (ideally always under 6) and everything else will sort itself out.

Hmmm OK, only remembered to test a couple of times since my meter working and not always under 6. Need to get in the habit of doing it while I sort out what is going on with my reaction to carbs so I know what I can and can't have.

 

[caroline_92]

Testing 2hr after eating a meal is the most useful test, as it is the only result you can quickly change. Get the post-meal result great (ideally always under 6) and everything else will sort itself out.

I agree that the post meal test is the best measure to focus on, to work out how to avoid high blood sugar spikes and get good long term control which can be measured by the HbA1c. If you get your diet sorted so your after meal readings are normal (I aim for below 6.7) your weight will adjust to a normal level.
Your story is eerily similar to mine - although I only have 2 children! My youngest is now nearly 17 and I have been low carb, and non-diabetic, for 6 years now. Take a look at my blog if you want to read my story!
I really, really wish I had known about a low carb diet and this forum, when my youngest was born, as I think my glucose intolerance/prediabetes would never have developed into full blown diabetes if I had. At least I know now & have stopped type 2 in its tracks...
Well done on what you have achieved & don't let poor advice (or seductive French bread!) derail you

 

[caroline_92]

I agree that the post meal test is the best measure to focus on, to work out how to avoid high blood sugar spikes and get good long term control which can be measured by the HbA1c. If you get your diet sorted so your after meal readings are normal (I aim for below 6.7) your weight will adjust to a normal level.
Your story is eerily similar to mine - although I only have 2 children! My youngest is now nearly 17 and I have been low carb, and non-diabetic, for 6 years now. Take a look at my blog if you want to read my story!
I really, really wish I had known about a low carb diet and this forum, when my youngest was born, as I think my glucose intolerance/prediabetes would never have developed into full blown diabetes if I had. At least I know now & have stopped type 2 in its tracks...
Well done on what you have achieved & don't let poor advice (or seductive French bread!) derail you

P.s I forgot to say that the advice from drs to test fasting blood sugar levels stems from the need to adjust basal insulin, which lowers fasting levels, and is the most common insulin prescribed to type 2 diabetics. But if you aren't on insulin it really isn't a good measure!

 

[ringi]

She also said she thought I should let my body get used to the weight I've lost before trying to loose more - around 6 months - really??? Does anyone think that is a good idea? My body seems to naturally be doing it (also stopped smoking a few weeks back which will have slowed my metabolism a bit) as been sat on around 77kg (so 7kg loss) for probably 2 months now. So I guess with that and a month in Oz then Christmas maybe that will be OK and I can just relax a little!

Just keep doing what you have been doing but if your weight loss slows down or stops that's OK provided your BG remains under control.

The other thing she said was that she was worried about me not having 'carbs' and being tired when I go back to work next week (been on mat leave for 3 years but heading back to Oz to do a months work).

Unlikely to be an issue as your body is now used to burning fat. When people stop eating carbs they can feel tired for a week or two and as most research studies are only a few days long, they mislead doctors.

 

[Resurgam]

Due to advice from doctors I have stopped low carbing from time to time over the past several decades. I always feel that I have more aches and pains and less energy, I see my weight increase, I even get more colds and sore throats - I am determined to stick to low carbing - in my case that means less than 60 gm of carbs most days. The longer I stick to low carb the lower my blood glucose levels are going, my weight is reducing slowly and I am able to go our for walks without taking tablets to ease the pain in my knees, as it seems to have gone away. I have the carbs as I like the fresh crisp salads and tasty veges, and the berries - but it isn't 'for energy' - I notice that I am often the one still working when younger people have fed themselves with sandwiches and chocolate, fizzy drinks and fruit having flagged several times - something which doesn't happen to me. I have a protein and fat packed breakfast, they usually admit to cereal or toast.

 

[toryroo]

I finally made it to Oz (on my own with a toddler ) and got my machine that works from mums. I arrived after 40 hours of travelling last night and we just had cheese on toast for dinner so I was expecting a really bad reading this morning (I also ate carbs on the journey as it was just easier and I wasn't going to add more stress to myself!) but no it was 5.2 . I wanted to test last night to see what the 2hr pp reading was but I was in bed alseep by then so I decided to have toast for brekkie this morning to see what would happen. These were big grainy bits of toast and 2 peices was 48 grams of carbs (made me wince - this is what I have been eating for a whole day!) and I was expecting at least mid to high 6s but probably higher but now the reading was 5.2 I'm so pleased but also really, really confused. Could loosing 10% of my body weight and 3 months of low carbing given my body a chance to heal and is now able to deal with carbs? It just seems a bit extreme that I'm coping that well with such a big hit of carbs! What do you guys think?

I think I'm going to do lots more testing to see what works and what doesn't for me but I think for weight management I'm going to stick with low(ish) carbing but stop being quite so strict and see how that works in terms of weight and BS levels.

 

[toryroo]

Just thinking but in my mind mid 6 fasting readings aren't 'normal' and are too high, that is what I was pre low carbing and then again last week but am now in the 5's - I wonder if the pre low carbing BS's were down to insulin resistance but last weeks was reflecting me not feeling great (rest of the family had a fluey thing) and I was fighting it off plus the stress pre travel? Will be interesting to see what happens in the coming weeks!

 

[Grateful]

I'm wondering if LCHF exists in France or if she is just a bit dubious

I'm a Brit, but was brought up in France and now live in America. When I was diagnosed with Type 2 diabetes I checked around to see what the various national diabetes associations recommend.

• UK: I am a bit baffled, but it sounds like the NHS does not officially advocate LCHF but rather, the "Eatwell" balanced diet. This, even though many diabetes nurses seem to be supporting patients who make the choice to try LCHF.
• USA: The American Diabetes Association (ADA) largely favors a "balanced" approach that includes a considerable amount of carbs, but the ADA does not "shun" the low-carb route altogether. Indeed, a few months ago their magazine had a cover story about low-carbing, presenting it as a fringe treatment but one that works well for some people.
• France: The Fédération Française des Diabétiques advocates a "balanced" diet and says there is no such thing as a special diet for diabetes. It says each food group should be properly represented. Their website presents this as the "modern" point of view. If you can read French, here is a summary: Y a-t-il un régime pour les personnes diabétiques ? Aujourd’hui, on ne parle plus de régime pour personnes diabétiques mais d’une alimentation équilibrée, dans laquelle chacun des groupes alimentaires aura sa propre importance. Pour équilibrer ses repas, il va alors falloir respecter certains principes diététiques simples, acquérir quelques connaissances sur les aliments et connaître leurs intérêts nutritionnels. Their website is here: https://www.federationdesdiabetiques.org/information/alimentation-diabete/equilibre-alimentaire.

If the FFD's recommendations reflect general medical thinking in France, then you may be are out of luck if you want support "official" for your decision to go LCHF. That is not to say you won't find a sympathetic doctor. In France, many doctors are in the "profession libérale" i.e. they run a private practice, but get reimbursed by the government for most of the care that they provide.

Quite a lot of French food is already LCHF as long as you are careful about the sauces (sauces, as you know, are at the core of French cooking).

Edited to add: My mother is Australian by the way, but has lived in Paris since the 1950s and now has French nationality.

Good luck.

 

[toryroo]

Interesting comparison @Grateful thank you! I'll have a closer look at the FFds site (yes I do read and speak French) I think there are doctors (thinking of my endocronologist I was seeing during pregnancy) and DNs here in Oz that are advocates of LCHF (thinking of what they said to me without saying it outright in hidsight!) but perhaps working in a system that is still based on the 'eat a set number of carbs at each meal'. Luckily my GP is absolutely lovely and supportive of my choices so no issue there and has been great about giving me prescriptions for strips and needle cartridges as she is happy I'm being proactive and taking control of my own health. Even not being diabetic she is allowed to prescribe them for me for monitoring purposes and I'm allowed 200 strips a year covered which I think is pretty cool compared to what I've read on here about the UK for example - I only had to pay a bit of a gap (maybe €7 for 100).

I agree about the French food too - so much is meat / veg and sauce based! Although when I first moved to France nearly 20 years ago often the menu du jour would be meat and green beans as the main where now everything seems to be served with les frites!I dont' worry about any carbs in the sauces though, I would tend to choose a cream based usually which I would imagine would not have any thickners or anything added and even 'jus' served on roasted meat is generally unthickened unlike anglo gravy!

Edited to add: My mother is Australian by the way, but has lived in Paris since the 1950s and now has French nationality.

It sounds like you have a interesting complicated life background like mine! I was born in the UK to a Aussie mum and Pommy dad, was totally brought up by mum in Oz from about 18 months, married to a 1/2 French (mum) 1/2 English guy brought up in UK but we've lived most of the last 20 years in France with a 7 year gap back in Oz until 2.5 years ago and now I'm trying to do fly in fly out to Oz so I can keep up my midwifery hours in Oz so I dont' loose my registration while I work out if it is possible to eventually practice in France!

The plot thickens - after 3 months of barely allowing myself a single frite to pass my mouth I've eaten more carbs in the last 5 days than I have probably the whole time and this morning my reading was 5.0 dont' get me wrong I'm thrilled but confused - I dont' remember having a reading that low since I was on insulin when pregnant - although hard as I wasnt' able to test until last week so not really sure what was happening since low carbing maybe I have been doing this all along and the 6.4 from the lab and the days after were the freak readings! Yesterday I had the 2 bits of toast I tested with for breakfast, salad with salmon for lunch, chicken pieces (with a light breadcrumb) beans and brocolli for dinner with some dip, smoked oysters and about 3 crackers for a snack earlier in the evening. Could it be I was actually not eating enough carbs (or fats maybe or something) before?

 

[Grateful]

The plot thickens - after 3 months of barely allowing myself a single frite to pass my mouth I've eaten more carbs in the last 5 days than I have probably the whole time and this morning my reading was 5.0 dont' get me wrong I'm thrilled but confused - I dont' remember having a reading that low since I was on insulin when pregnant - although hard as I wasnt' able to test until last week so not really sure what was happening since low carbing maybe I have been doing this all along and the 6.4 from the lab and the days after were the freak readings! Yesterday I had the 2 bits of toast I tested with for breakfast, salad with salmon for lunch, chicken pieces (with a light breadcrumb) beans and brocolli for dinner with some dip, smoked oysters and about 3 crackers for a snack earlier in the evening. Could it be I was actually not eating enough carbs (or fats maybe or something) before?

I'm lucky that I have found, so far, no need for self-testing. I tend to be fussy/obsessive about things and unless absolutely necessary, would prefer not to feed that personality trait by constantly reading a meter. But I do understand the benefits of "eating to the meter" and all that, who knows, it may well come to that anyway.

You have a fun life!

 

[AloeSvea]

@toryroo - if I had an HBA1c of 5.4%/36 like you have achieved, I would be swinging from the rafters, and me and my family would be celebrating for weeks! (Celebrating on low carbs of course!)

My non-diabetic normal partner has an HBA1c of 36. It is getting into the higher range of normal, but it is in the non-BG dysregulated range.

Keep up the good lower carbing work! And may your BGs be in the normal range forever now.

 

[ringi]

I'm lucky that I have found, so far, no need for self-testing. I tend to be fussy/obsessive about things and unless absolutely necessary, would prefer not to feed that personality trait by constantly reading a meter. But I do understand the benefits of "eating to the meter" and all that, who knows, it may well come to that anyway.

It much better to be obsessive about avoiding processed carbs (and most other carbs) even if a meter says they are OK.

 

[Grateful]

@toryroo - if I had an HBA1c of 5.4%/36 like you have achieved, I would be swinging from the rafters, and me and my family would be celebrating for weeks! (Celebrating on low carbs of course!)

My non-diabetic normal partner has an HBA1c of 36. It is getting into the higher range of normal, but it is in the non-BG dysregulated range.

Keep up the good lower carbing work! And may your BGs be in the normal range forever now.

Thank you for your kind comments. However, now that I know that I have diabetes, I think that if I can achieve not only normal, but better-than-normal (low-normal) A1C that could be an advantage.

Why? Because diabetes is not the whole enchilada. Sooner or later, we get ill with other stuff, especially as we age. At that point we might end up in a hospital, being fed standardized "balanced" diets and (if our illness is serious enough) putting BG management on the back burner. Under those circumstances, being able to start from an initial floor of a low A1C is pretty attractive to me -- enough to make me work not just for non-diabetic, but low-non-diabetic readings now.

Does that make sense? I feel almost sheepish talking about it, given how lucky I have been so far in lowering my A1c (albeit with a lot of work involved).

There is also a diabetes angle to this. If I end up (as many people do) experiencing T2 as a "progressive" disease then things will get worse. If they get worse from a very low A1C level, it will take longer before things get hairy. I want to see my (future) grandchildren grow up.

 

[AloeSvea]

Yes, @Grateful with an HBA1c of 30 I can well see that you are grateful to the wonders of low-carbing!

These kinds of success stories are wonderfully inspirational indeed.

And very interesting regarding your body type comment in your signature. It's the 'tofi' thing? (thin on the outside and fat on the inside).

 

[Grateful]

These kinds of success stories are wonderfully inspirational indeed.

A word of caution. I am only nine months since diagnosis. Diabetes is a very long slog. I would say, if you check in with me 10 years from now and things are still hunky-dory, that proves something. Nine months, not so much -- although it is enough to justify a certain amount of optimism.

And very interesting regarding your body type comment in your signature. It's the 'tofi' thing? (thin on the outside and fat on the inside).

I have never heard of "tofi." To be blunt, my body now looks pretty stick-like in the mirror: an apparent rib-cage, with a rather unattractive small paunch which I have been told cannot be eliminated without years of "resistance" exercises (even though my BMI is on the edge of "underweight").

A while back I started a thread about a measurement called the "hip to waist ratio." Under that metric, I was classified as "obese" at diagnosis (I am 6-foot-4, male, and had a 40-inch waist with 39-inch hips). This "waist-to-hip ratio" is not a metric that makes sense for a lot of people, but in my case I think it might have encapsulated a weird truth about my lack of health at the time (years of sedentary work and lots of carbs). After nine months on the low-carb diet, I still have the 39-inch hips but the waist is down to 35 inches (it was 34 inches at age 35, I am now 60 years old).

Bleaaargh. Too much information, huh? Nasty disease, but great community here.