5.5 to 5.9 mmol/L Oddity

[Bluetit1802]

This is true, and also a real fasting test should be taken after sleeping so that it includes the early morning glucose release. How the body handles this morning rise is a very telling measure of insulin resistance.

Then, of course, there are many folk (I am one) that see no rise at all after sleeping. Flat all night in fact. My rise never began until I had been up and about for a period of time.

 

[Member496333]

Then, of course, there are many folk (I am one) that see no rise at all after sleeping. Flat all night in fact. My rise never began until I had been up and about for a period of time.

This indicates that you have a good level of insulin sensitivity

EDIT: misread the past tense of the last part of your post...

 

[Jaylee]

This indicates that you have a good level of insulin sensitivity

EDIT: misread the past tense of the last part of your post...

Or the liver has dumped glycogen as a response to running about like a "headless chicken" getting one's act together in the routine (including a dog walk.) before setting off to work?

Yarp, I know I'm T1.
Similar to @Bluetit1802 though, I can have a steady nights sleep, wake testing in the good zone. Then 1.5 hours later before I've touched a cup of coffee (don't do breakfast.) just to make sure before starting the van. I can get a rise of upto 2.0Mmol.

 

[Brunneria]

Yes, I would agree that insulin resistance is just one factor amongst several, that affect fasting and morning blood glucose readings.

 

[HSSS]

I’ve no idea what I do overnight never having tried a libre and unwillingness to wake myself just to test. But my waking figure is always less than an hour later but before any food or drink. Like me my liver is not a “lark”, both perform better as “owls”

 

[Jaylee]

I’ve no idea what I do overnight never having tried a libre and unwillingness to wake myself just to test. But my waking figure is always less than an hour later but before any food or drink. Like me my liver is not a “lark”, both perform better as “owls”

I'd be more inclined to investigate nocturnal BGs using a CGM or flash monitor sytem than needlessly setting an alarm & disturbing a sleep pattern. Which in turn could throw out the personal metabolic cycle of things?

 

[HSSS]

I'd be more inclined to investigate nocturnal BGs using a CGM or flash monitor sytem than needlessly setting an alarm & disturbing a sleep pattern. Which in turn could throw out the personal metabolic cycle of things?

I keep promising myself a gift of at least one sensor to do just that but then read about issues with them and am put off by an expensive failure possility. There’s no danger of repeated alarms all through the night for curiosity sake. Love my sleep too much for that.

 

[Bluetit1802]

This indicates that you have a good level of insulin sensitivity

EDIT: misread the past tense of the last part of your post...

I put my morning rise, which isn't particularly significant, down to activity, even a small amount. I am one of those unlucky ones that doesn't respond too well to exercise blood sugar-wise.

 

[Member496333]

Everyone has a different experience for sure. My glucose was always slightly elevated on waking and would continue to rise until I ate. Now I get neither effect no matter what. But then I recently “scored” a HOMA-IR of 0.3, so I would expect my insulin to quickly take care of any increases in blood glucose concentration that would otherwise be measurable.

EDIT: In T1 I would expect a rise, because the pancreas isn’t trying to keep up with the normal morning function of the liver to secrete glucose. In T2 I would expect to see a rise if insulin sensitivity is poor, which it invariably would be. It’s all sliding scales of course, and very few of us will have an identical experience or even perception of what is happening.

 

[Jaylee]

EDIT: In T1 I would expect a rise, because the pancreas isn’t trying to keep up with the normal morning function of the liver to secrete glucose. In T2 I would expect to see a rise if insulin sensitivity is poor, which it invariably would be. It’s all sliding scales of course, and very few of us will have an identical experience or even perception of what is happening.

As T1 I expect everything and anything in any direction where exogenous insulin working profile is used. Pending on variants sutch as how fresh was the cartridge opened. Did I drink alcohol the night before..(not on a school night.) To name a few. Even a good hot shower could increase insulin sensitivity.

I mentioned waking at that "good zone" & testing aproximately "1.5" hours later on my first coffee before starting the van?
If there was a liver dump? It can also be overwhelmed by the basal... That 6.5 or 7mmol can sometimes throw up as sub 5.

Hey, don't get me mentioning what could happen at the end of a "gig day" as the basal tails off during 12 hours of fasting.. (I don't eat prior to a show.) You would probably expect a rise with a T1? I can hover in the late 4s. (Providing no one has inadvertently laced my drink with sugar..)

 

[Member496333]

I think my only point was that as the T1 pancreas [effectively] isn’t trying to keep up with morning liver secretion in ‘real time’ then a rise wouldn’t at all be a surprise. I’m very sure it can also drop depending on many factors. Which was kind of my point - ie. I was originally talking about endogenous insulin resistance, not exogenous insulin dosing and any associated factors.

Anyway I think this is now probably going slightly off track.

 

[JohnEGreen]

John, you may like to check your figures.
HbA1c under 42 is non-diabetic
42 to 47 is pre-diabetic
48 and above is diabetic.

https://www.diabetes.co.uk/images/article_images/DiagnosticCriteriaPrediabetes.png

All right call me a fibber for 1 mmol/mol

But you are correct I did know just hit the wrong key thanks for the correction.

 

[Emile_the_rat]

Right, but you could also do it normally, take readings before your meals and two hours after your meals. If you eat for example 4 times per day then you will have 8 measurements per day. This will result in your glucometer to collect all the data needed to show you correct monthly averages. If you take your readings once a week at random times and just out of the blue then of course your meter will never have any accurate monthly figures.

I agree that the HbA1c tests are more accurate, but you do not do them every day at home, therefore I am trying to make the most of my glucometer and to use it / understand its readings to the best of my ability. I also think that an idea of approximate values and figures is not quite right here.

Hi

I think you kind of mix up before meal reading and fasting blood glucose.

A fasting blood test has to be done 8 hours after last meal, were 4.0-5.9 are non-diabetic, 6.0-6.9 mmol are pre-diabetic, and any fasting reading over 7.0 mmol are considered diabetic.

Before meal reading can vary by how often and how much you eat. So pre-meal reading do not tell much unless you have really high blood sugar.

Also 5.5 to 5.9 mmol are not of any concern as I see it, really. Sounds perfectly normal to me
Of course it might be different guidlines from country to country, but where I live 5.5-5.9 fasting are not considered pre-diabetic, if that’s a relief

 

[Klpville]

Hi

I think you kind of mix up before meal reading and fasting blood glucose.

A fasting blood test has to be done 8 hours after last meal, were 4.0-5.9 are non-diabetic, 6.0-6.9 mmol are pre-diabetic, and any fasting reading over 7.0 mmol are considered diabetic.

Before meal reading can vary by how often and how much you eat. So pre-meal reading do not tell much unless you have really high blood sugar.

Also 5.5 to 5.9 mmol are not of any concern as I see it, really. Sounds perfectly normal to me
Of course it might be different guidlines from country to country, but where I live 5.5-5.9 fasting are not considered pre-diabetic, if that’s a relief

Thank you so much for your input, Emile. I appreciate. It's useful to know but it definitely differs from country to country and possibly from doctor to doctor. All these guides and charts found online have different advices.. each.. some say 5.5 is diabetic, others say 6.0 is completely healthy. That's actually why I asked my initial question in this thread. It would be really weird if some countries said that 2+2=4 and some other countries sticked to the rule that 2+2=5. I believe that all the doctors worldwide should come up with just one exact number, not some approximate values and figures. It just doesn't sound right to me. When a bone is broken it is broken in Australia, Germany, Switzerland, Canada, Great Britain, you name the country, anywhere. It cannot be considered broken in Italy and not broken in the US. Why is it different with diabetes? Hope you see my point.

Does fasting include sleeping? Let's say 10 hours of fasting where 7 out of them would be spent asleep? I can easily stay without any food for a day or two. I basically never feel hungry. All I need is water so I can easily do 8 hours of fasting during the day time.

 

[Member496333]

It just doesn't sound right to me. When a bone is broken it is broken in Australia, Germany, Switzerland, Canada, Great Britain, you name the country, anywhere. It cannot be considered broken in Italy and not broken in the US. Why is it different with diabetes? Hope you see my point.

Insulin resistance is a spectrum rather than a binary, which is probably why there’s disparity in what suddenly constitutes diabetes today that wasn’t diabetes yesterday. We even have a made-up name of prediabetes to help rationalise it. The problem really is that very few seem to realise that insulin is the key to it all. Everyone is focused on blood glucose. If insulin were measured routinely then we could prevent millions of cases of diabetes and have a much more universal understanding of how to beat it.

 

[Emile_the_rat]

Thank you so much for your input, Emile. I appreciate. It's useful to know but it definitely differs from country to country and possibly from doctor to doctor. All these guides and charts found online have different advices.. each.. some say 5.5 is diabetic, others say 6.0 is completely healthy. That's actually why I asked my initial question in this thread. It would be really weird if some countries said that 2+2=4 and some other countries sticked to the rule that 2+2=5. I believe that all the doctors worldwide should come up with just one exact number, not some approximate values and figures. It just doesn't sound right to me. When a bone is broken it is broken in Australia, Germany, Switzerland, Canada, Great Britain, you name the country, anywhere. It cannot be considered broken in Italy and not broken in the US. Why is it different with diabetes? Hope you see my point.

Does fasting include sleeping? Let's say 10 hours of fasting where 7 out of them would be spent asleep? I can easily stay without any food for a day or two. I basically never feel hungry. All I need is water so I can easily do 8 hours of fasting during the day time.

Well, the guidelines for pre-diabetic differs from country to country, I think the reason might be because not every country see pre-diabetic as disease, but more like a warning sign.

There is a worldwide consensus that readings above 11.2 mmol are diabetic.

Fasting blood sugar must be taken after sleeping, becuase the liver dump glucagen while you sleep, which are the reason why diabetics tend to have higher fasting blood glucose than the rest

 

[vit90]

I am trying to make sense of waking-up fasting readings which average 5.5 compared to day time (at least 8 hours fasting - only plain water ingested) of around 4.7.

Of course the early morning readings are higher because of the 'dawn effect' but what do I read into it if my day time readings are significantly better?

In the morning I have to get up early as I make my wife her breakfast and she has an early start while I work at home. I average avout 7 hours of sleep and the sleep monitor suggests it's good quality sleep - I sleep easily.

I'm on a very low carb diet and have been for several years. I also walk around 12,000 steps on average daily as well as do some weights (8kg dumbbells).

 

[bulkbiker]

I am trying to make sense of waking-up fasting readings which average 5.5 compared to day time (at least 8 hours fasting - only plain water ingested) of around 4.7.

Of course the early morning readings are higher because of the 'dawn effect' but what do I read into it if my day time readings are significantly better?

In the morning I have to get up early as I make my wife her breakfast and she has an early start while I work at home. I average avout 7 hours of sleep and the sleep monitor suggests it's good quality sleep - I sleep easily.

I'm on a very low carb diet and have been for several years. I also walk around 12,000 steps on average daily as well as do some weights (8kg dumbbells).

I'm guessing that your HbA1c levels are pretty good so what is there to change..?

 

[vit90]

I'm guessing that your HbA1c levels are pretty good so what is there to change..?

HbA1c was 38 last year but at my lowest weight it was 33.

I guess the difference between the morning and day time fasting readings niggles. I was also cross that I allowed my weight to creep back up. Certainly as the weight has come down since New Year, the BG readings have trended down (morning fasting down from 6 to 5.5).

All my Chinese relatives become diabetic in middle age but none of my Anglo Saxon relatives. I know I can benefit from more weight loss and I also wonder if that will sort out the morning discrepancy.

So in answer to your question - what to change? More weight loss!

PS - looked at your figures; impressive A1c, though my lipid profile is better than yours

 

[vit90]

Is there an advised time from waking up in the morning to do a fasting blood test? I generally do one within 20 minutes of getting out of bed. Is that too soon?