Lab results and home testing at odds- scared and confused...

[JonMarq3]

Greetings, guys and gals. I am a 32 year old male living in the US and was about 2 stone over my current weight back in January . I apologize for not converting but I weigh about 78.6 kilograms and 1.78 meters tall. Before my weight loss, I had a fasting BG of 5.78 mmol/L, which is considered “prediabetic” in the US. I started testing my BG since then and figured that with weight loss I’d see changes but if anything it seems to be my system is deteriorating. In April, I decided to go for an oral glucose tolerance test, have my HgA1C checked, fasting insulin, etc. My fasting glucose was 5.05 mmol and 2 hours after the 75 grams glucose drink, I was down to 6 mmol, which is considered to be normal glucose tolerance since I was below 7.78 mmol at the 2 hour mark . My A1C was 5.4%. Last week I decided to do another OGTT but with a 1 hour blood draw as well as the 2 hour. At 1 hour, I was at 10.4 mmol. At 2 hours, I was down to 6.94 mmol and once again considered normal glucose tolerance. Fasting this time was 5.44 mmol. A1C again 5.4%. Everything seems normal except when I test at home with my glucometer, I get high peaks at 1 hour of up to 9.44 mmol after moderate to high carb meals and at 2 hours, I don’t seem to come down below 7.78 mmol. My glucose seems to linger there for a while and may take up to 3 hours before I go below 7.78 mmol. In other words, the lab tests using a glucola drink indicate I have no issues with glucose tolerance but with normal meals, it seems to be I am “prediabetic” if not diabetic. I am so confused and lost. Even my A1C is considered normal. How can labs tell me one thing and the reality of after meal testing be different? I am so anxious and afraid I am becoming diabetic and the labs don’t catch anything abnormal with me . I know how to properly use a glucometer, wash my hands before testing, etc . The readings on the glucometers are all over the place. So I am “normal” on labs, prediabetic on home testing after meals. What do you guys think about all this? I am going to see an endocrinologist soon to figure out what’s wrong with me. I’m sorry for the long rant but I am quite stressed. Thank you.

 

[Rachox]

Hi Jon and welcome to the Forum. As this is your first post I’ll tag in @daisy1 for her useful welcome info post.
It’s past midnight in the U.K. now so you may not get many responses til morning. However in preparation for more people being on line in the morning it would be helpful to post your pre-meal glucose readings as the difference between them and your post meal readings are as relevant as the readings themselves. Also some details on the meals you’ve tested would be useful, as it’s not just the carb count that’s relevant but fat content can affect the time of the rise in sugar level and also eating too much protein can affect levels. Hopefully you’ll get some replies soon.
Well done on your weight loss btw!

 

[JonMarq3]

Hi Jon and welcome to the Forum. As this is your first post I’ll tag in @daisy1 for her useful welcome info post.
It’s past midnight in the U.K. now so you may not get many responses til morning. However in preparation for more people being on line in the morning it would be helpful to post your pre-meal glucose readings as the difference between them and your post meal readings are as relevant as the readings themselves. Also some details on the meals you’ve tested would be useful, as it’s not just the carb count that’s relevant but fat content can affect the time of the rise in sugar level and also eating too much protein can affect levels. Hopefully you’ll get some replies soon.
Well done on your weight loss btw!

 

[JonMarq3]

Thanks for the reply, Rachox. Typically, a premeal /fasting level for me might be around 5.27 mmol. None of my readings after meals make sense. One example is a banana- I’ve tested after eating just 1 and it raises my BG up to 8.88 mmol 1 hour after eating. If I have a ham and cheese sandwich with mayonnaise with a large cup of coffee with milk and a little sugar, it drives me up to 8.88 mmol as well. Today, I had a honey glazed turkey and cheese sandwich with mayo, a large cup of coffee with some sugar, and a banana and at 1 hour it went up to 9.3 mmol. A minute later I tested again and got a much lower reading. By 2 hours, I was at 7.72. I measured at 2 hours 30 minutes, and it was still more or less around 7.72 as if the glucose just hangs out in my blood and doesn’t drop. Perhaps at 3 hours it was much better but I didn’t test at 3 hours. With the above “experiments”, I figured if I was hitting high 100s with simple sandwiches, coffee, and bananas, I figured I’d probably go well over 11.1 after eating hundreds of grams of carbs in one meal. So I carried out a test: I ate fried rice, two spring rolls with sweet and sour sauce, a small Coca Cola, orange chicken, and Shanghai angus steak. Total carb content is in the range of 275-300 grams- a ridiculous amount of carbs and I imagined I’d be at 12 or more 1 hour later. But no. Despite all that food for the test, at 1 hour, I was between 10 mmol to 11.1 mmol. Let’s say average was 10 mmol. I did not understand how that many carbs did not get me much higher than a sandwich and banana . Makes no sense to me. Anyway, at 2 hours, I tested around 7.5 mmol on 2 different fingers. I felt a bit relieved but of course it didn’t last. At 3 hours, I tested again and instead of being even lower, it went up slightly to around 8.3 mmol. In essence, I appear to have a big problem despite my lab results indicating otherwise. High peaks, impaired first phase insulin response, and readings that don’t make sense. I am aware this awful meal of 275 grams of carbs also contained a lot of fat but they say normal people would be at 5.5 by 2 or 3 hours after any meal, no matter how large etc. Maybe lab results are wrong ? I am clueless.

 

[daisy1]

@JonMarq3

Hello Jon and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you want and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[JonMarq3]

Anyone have any feedback?

 

[Rachox]

I’m sorry no one has responded. My comment will bump it up the list to make it more visible for a while. Rather than generalising about your pre meal figure being “around 5.27” can you measure one meal today. First measure at first bite, then at the two hour post first bite mark. Let us know what you’ve eaten. Don’t modify your meal to sway the results either way, just eat what you’d have for a normal mid week lunch. Here are the numbers we aim for here in the U.K.:
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

 

[xfieldok]

I have only been doing this for 6 months so if I say anything wrong feel free to shoot me down in flames.

First you need to stop stressing about this, stress can raise BG.

You should be reassured that your lab results are good.

Bananas. Tennis players eat bananas between games to get the fastest possible hit of energy. Diabetics generally give them a wide berth.

It seems to me that you are cramming loads of carbs every meal in order to check your numbers. That's how many of us got here in the first place.

Do as @Rachox asked, eat your normal meal and post here.

If you are worried about developing prediabetes or full blown Diabetes, you should be looking to restrict your carbs.

 

[Bluetit1802]

I can't explain your OGTT results, but can say the HbA1c is not always as reliable as doctors believe. It is an average over 2 to 3 months - it does not catch any high peaks. You may be high post meal for 3 hours or so, but you are probably low right through the night while fasting. All those lows will negate the relatively short lived highs. Additionally, if you have certain red blood cell issues such as anaemia, or thyroid issues, the HbA1c can be falsely low. This would also apply if your red blood cells die earlier than the standard 120 days - as they die, new ones are made, and they have hardly any glucose attached to them, so when you have a blood test much of the haemoglobin will be new and with very little glycation. (There are people with the opposite problem - they have long lived red blood cells and so have very few new ones. Their HbA1c will be falsely high)

My advice is to stop all this experimenting and cut out these carbs. If you are on the cusp of diabetes, eating bananas, putting sugar in your coffee, and eating all those carbs will get you there quicker.

 

[Phoenix55]

I really don't understand. All your results show that your body is working within the bounds of 'normal' even though you try to put it out of kilter by eating carb heavy meals and repeatedly testing. Is there a link in the family, someone who had type 2 and did not take care of themselves? If you think you are borderline diabetic please stop trying to push your results artificially high. Cut down on the carbs you are eating, balance it with more fat so that you control your weight loss. If all the results come back negative then heave a sigh of relief. You have been spared for now, get on with your life but remember this feeling so that you can empathise with those who have just had a life-changing diagnosis.

 

[flexi06]

I can't explain your OGTT results, but can say the HbA1c is not always as reliable as doctors believe. It is an average over 2 to 3 months - it does not catch any high peaks. You may be high post meal for 3 hours or so, but you are probably low right through the night while fasting. All those lows will negate the relatively short lived highs. Additionally, if you have certain red blood cell issues such as anaemia, or thyroid issues, the HbA1c can be falsely low. This would also apply if your red blood cells die earlier than the standard 120 days - as they die, new ones are made, and they have hardly any glucose attached to them, so when you have a blood test much of the haemoglobin will be new and with very little glycation. (There are people with the opposite problem - they have long lived red blood cells and so have very few new ones. Their HbA1c will be falsely high)

My advice is to stop all this experimenting and cut out these carbs. If you are on the cusp of diabetes, eating bananas, putting sugar in your coffee, and eating all those carbs will get you there quicker.

@Bluetit1802 I am always a bit in awe of your knowledge, I hope you don’t mind me asking but are you in the medical profession or an academic of some sort? I am very grateful to you and others like you for your advice on this forum

 

[Deleted Account]

How are you testing?
This may seem like an odd question but your readings seem to be incredibly precise. I am not aware of a meter that provides a reading to two decimal points which is reasonable as meters only need to be accurate within +/-15%.

 

[andcol]

@flexi06 Normal non-Ds quite often get 8s/9s/10s at the one hour. Your body has to have some time to notice the rise in glucose and then release insulin to get it back down. The time to worry is if you go over 11 or stay raise for a long period of time.

By the way just because the US decided to put more people into the medication lifestyle by lowering their standard doesnt mean you have to worry - call me cynical but I think this is a money grab by the drugs industry.

 

[Bluetit1802]

@Bluetit1802 I am always a bit in awe of your knowledge, I hope you don’t mind me asking but are you in the medical profession or an academic of some sort? I am very grateful to you and others like you for your advice on this forum

Thank you for those kind words. I am flattered, but no, I am not in the medical profession and nor am I an academic. Far from it. Any knowledge I have about diabetes and related issues has come entirely from this forum plus plenty of research over the past 4 plus years. There are far more knowledgeable people on this forum and I have learnt from them, which is a good reason for me to stick around because I learn something new every day. This is a great corner of the internet.

 

[JonMarq3]

Andcol: The reason I’m worried sick is because everything I have read on the internet about “normal, nondiabetics” is that no matter what they eat, they typically never go above 6.9 and only rarely do they go up to 7.77. Everyone says normal, metabolically competent people never go up to 9 or 10 after meals because they have a functional first phase insulin response which prevents such dramatic spikes. Honestly, it is all very confusing and controversial. Some say one thing, another group says nondiabetics do spike high etc. I don’t even know what to believe anymore. The more I read studies, research, investigate, etc the more lost I feel. It just seems absurd that I can be around 6.9 or even 6 two hours after two different ogtts and yet it takes much longer for my numbers to be under 7.8 after a meal that may break down into less than 75 grams of glucose after digestion. I had the second ogtt only a week ago and with the readings on the meter and how long it takes for my glucose to drop it almost gives me the impression that my pancreas has deteriorated or become impaired .

 

[Ambersilva]

@JonMarq3

Despite your carbfest experiments your body seems to be handling the punishment you are presenting it with. As others have suggested above cut the carbs. Give your body a chance instead of trying to induce results above normal range.

Diabetes is confirmed by having blood sugar results that stay consistently well above the normal range and often above the scope of the meter. But your body is coping by bringing blood sugar back to a normal range

If I ate what you ate during your carbfest experiments (without injecting insulin to cover the carbs) I would be feeling quite unwell and sleepy with a dry mouth and frequent passing of glucose laden urine.

BTW, which meter do you have that gives such detailed readings?

 

[xfieldok]

Do you need to lose weight? Is your waistline larger than it should be?

There. Is a lot of rubbish on the internet. Diet and Diabetes is a hugely complex subject. If you want to read up about it get The Diabetes Code by Jason Fung.

 

[Rachox]

How are you testing?
This may seem like an odd question but your readings seem to be incredibly precise. I am not aware of a meter that provides a reading to two decimal points which is reasonable as meters only need to be accurate within +/-15%.

BTW, which meter do you have that gives such detailed readings?

As the OP is in the USA I’m thinking he’s converted his figures to U.K. numbers and quoted them to two decimal points, as at one point he mentions readings in the 100s?

 

[JonMarq3]

@JonMarq3

Despite your carbfest experiments your body seems to be handling the punishment you are presenting it with. As others have suggested above cut the carbs. Give your body a chance instead of trying to induce results above normal range.

Diabetes is confirmed by having blood sugar results that stay consistently well above the normal range and often above the scope of the meter. But your body is coping by bringing blood sugar back to a normal range

If I ate what you ate during your carbfest experiments (without injecting insulin to cover the carbs) I would be feeling quite unwell and sleepy with a dry mouth and frequent passing of glucose laden urine.

BTW, which meter do you have that gives such detailed readings?

I’ve been using the Freestyle precision neo. It’s not as detailed as 2 decimal points. Not at all. That’s just me converting from mg/dL, which is the system we use here in the US, to mmol and sometimes I’ll say it’s 7.33 or just round to 7.3 or whatever. But it’s a standard meter, no more accurate than any other.

 

[Ambersilva]

As the OP is in the USA I’m thinking he’s converted his figures to U.K. numbers and quoted them to two decimal points, as at one point he mentions readings in the 100s?

@Rachox I realise that OP is in USA but was thinking that he did in fact have a meter with such fine readings. If only we in UK could measure to two decimal points or even with the USA system.