Undiagnosed diabetic?

[Rach612]

Hey I wonder if anyone can help me. Long story but I’m 5 months postpartum, I was diagnosed with gestational diabetes in pregnancy. I was put on steroids for my hyperememsis gravidarum and it increased the risk. I was diagnosed with home meter readings (my fasting levels started at 5.7 at 24 weeks) I needed to take insulin as tablets I would have brought back up. My bmi at booking was 30 although I was down to 10 stone 6 after having my daughter. My fasting numbers didn’t settle after the birth for a while until I did an extreme diet, lots of fasting, extremely low carb and got my HBA1c down to 22 at 12 weeks PP with fastings 4.6, 4.9, 5.0. BMI 20.

then I thought perhaps it was gestational and I had some bread paired to slow absorption private dietician was encouraging and my fasting numbers are back up to 5.7-6.9 depending on how I sleep. I have symptoms of diabetes but GP says HBA1c is fine so I’m not diabetic or pre-diabetic even when I say about my fasting numbers. Hubby got me a CGM and one hour after having full fat Greek yogurt, few blueberries and chia seeds I crashed to 3.9. An hour and a half after 2 egg omelette with cheese, no added sugar almond milk and spinach 3.6. My daytime figures normally hover around 5.
Do you think I have diabetes or not?

 

[Rokaab]

I crashed to 3.9. An hour and a half after 2 egg omelette with cheese, no added sugar almond milk and spinach 3.6. My daytime figures normally hover around 5.

Low blood sugar is NOT a sign of undiagnosed diabetes
High blood sugar is a sign of undiagnosed diabetes

Many not diabetic people I believe can quite happily dip into the 3's, so worry about numbers like that. I beeieve fast numbers can be a bit dubious anyway.
Also note, the CGM's like the libre may not be accurate for everyone, so its possible those numbers are lower than you are are or in the case of your fasting ones it possibly shows higher, you'd need blood testing to see how it reacts to you really

 

[In Response]

Whilst we have no medical training and are not able to diagnose, I would agree with @Rokaab - there is nothing in the numbers that you have shared to suggest you have diabetes.
Not only do people without diabetes get blood sugars under 4 but CGMs are notorious for reading incorrectly for low or high numbers.

And congratulations on the birth of your 5 months old. I hope you are having fun.

 

[Rach612]

Thank you both for your replies. I hope you are both keeping well. It’s a Dexcom my hubby trialled. I’m just worried as I have insulin resistance that I’m either a pre-diabetic or a diabetic with my fasting numbers. They are the same on a meter as well. I have blurry eyes sometimes, an itchy groin, marks on my skin that have been there for more than 6 months, my urine smells sweet and my feet and hands sometimes tingle and my hair is falling out in clumps. Hubby thinks I’m not eating enough and a lot of my probs are low blood sugar but I’m not sure. I’m taking Thiamine as hospital put me on it. My last HBA1c a few weeks ago was 28mmol. Also was diagnosed with gingivitis after my first child in 2018.

 

[Brunneria]

Hi and welcome

- and congrats!!!

What levels is your CGM showing?

And are you still on your low carb way of eating?
If so that may have an impact on how you handle a portion of carbs.
If you have been eating very low carb for some time, it can take a few days of consistent carb eating before your pancreas gets back into gear and handles the blood glucose like it did before keto. Think of it as the pancreas having taken a bit of a holiday and needing a few days to get back into the 9-5

You may not want to do this: but if you really want to find out what your blood glucose levels are now, in a way that would be meaningful to a health care professional, you would need to 'carb up' to around 150g carbs a day, for several days before eating something and getting the peak that occurs when your body is used to carbs.
Of course, very few people know this, and if they don't get used to the carbs again first, they can produce some alarming spikes with a surprisingly small amount of carb, leading to a lot of worry.

My suggestion is that you do this. Doesn't have to be high carb, and it doesn't have to be sweet cakes and sugary desserts. Just something like a slice of toast at breakfast, a potato salad at lunch, some fruit, a portion of rice at dinner with some yog or something after. Spread it out, count the carbs, and break your body into carb eating again gently. Then after several days test again and see if you get the same reaction.

Another possibility is that your body is handling carbs differently for other reasons - still not fully recovered from the birth, or maybe you are a step closer to T2, or even another form of diabetes. If that is the case, then a few days of comprehensive testing (your CGM will track this nicely) to see what happens in the hours after carbs could be very informative. Are your readings consistently doing a spike-then-drop to lower than they were before eating a portion of carbs? If so, the Reactive Hypoglycaemia section of the forum may make an interesting read. Or does your graph spike rapidly and high, then go back to normal within the 2 hour period? If so, you may have an impaired first insulin response, but your 2nd insulin response is catching up nicely.

Lots of variables, and having the CGM puts you in an excellent position to work out what is going on.

Hope that helps!

 

[Rach612]

Hi and welcome

- and congrats!!!

What levels is your CGM showing?

And are you still on your low carb way of eating?
If so that may have an impact on how you handle a portion of carbs.
If you have been eating very low carb for some time, it can take a few days of consistent carb eating before your pancreas gets back into gear and handles the blood glucose like it did before keto. Think of it as the pancreas having taken a bit of a holiday and needing a few days to get back into the 9-5

You may not want to do this: but if you really want to find out what your blood glucose levels are now, in a way that would be meaningful to a health care professional, you would need to 'carb up' to around 150g carbs a day, for several days before eating something and getting the peak that occurs when your body is used to carbs.
Of course, very few people know this, and if they don't get used to the carbs again first, they can produce some alarming spikes with a surprisingly small amount of carb, leading to a lot of worry.

My suggestion is that you do this. Doesn't have to be high carb, and it doesn't have to be sweet cakes and sugary desserts. Just something like a slice of toast at breakfast, a potato salad at lunch, some fruit, a portion of rice at dinner with some yog or something after. Spread it out, count the carbs, and break your body into carb eating again gently. Then after several days test again and see if you get the same reaction.

Another possibility is that your body is handling carbs differently for other reasons - still not fully recovered from the birth, or maybe you are a step closer to T2, or even another form of diabetes. If that is the case, then a few days of comprehensive testing (your CGM will track this nicely) to see what happens in the hours after carbs could be very informative. Are your readings consistently doing a spike-then-drop to lower than they were before eating a portion of carbs? If so, the Reactive Hypoglycaemia section of the forum may make an interesting read. Or does your graph spike rapidly and high, then go back to normal within the 2 hour period? If so, you may have an impaired first insulin response, but your 2nd insulin response is catching up nicely.

Lots of variables, and having the CGM puts you in an excellent position to work out what is going on.

Hope that helps!

Brunneria,

thanks very much for your reply. This isn’t a good example as I tend to go higher at night and is so bad but last night my hubby made me beans on toast at approx 9ish it spiked to 7.8 at 11pm crashed to 4.3 at 1.35am but my fasting was 5.5 this am better than some days see attached. Yesterday I had some chocolate (again bad I know especially when I’m worried sick about this diabetes) and crashed after it too. I’ve decided
Low carb for life now for me. It’s not good for my liver/pancreas. Need to get my fasting numbers back down again. Prob is as I had an eating disorder in my 20s my family get worried when I don’t eat/ eat v little as I don’t have anymore weight to loose.

 

[Brunneria]

Ah, thanks for that.

Firstly, I think you may be applying some rather extreme thinking to your situation. Probably because it was impressed upon you throughout your pregnancy that the health of your little one depended on tight glycaemic control. Am I right?

Can I urge you to relax a little. Your passenger has disembarked and it is just you and your body.
A dip in blood glucose down to 4.3 in the middle of the night isn't a 'crash'.
Believe me, it isn't.
It is a perfectly normal dip that many, many people experience in the middle of the night.

Also, a reading of 7.8 after food is not a spike. A spike would be something like 14mmol/l.
If your body is only going to 7.8 after a high carb meal of beans on toast, then I think your pancreas is doing very well indeed!

Please don't think that I am trying to dismiss your concerns. I am not.
But I would encourage you to have a look at these links, which show you the kind of bumpy shenanigans that a perfectly average and non- diabetic person's blood glucose goes through during a day:

https://lilynicholsrdn.com/cgm-experiment-non-diabetic-continuous-glucose-monitor/

https://bionicwookiee.com/2020/02/03/non-diabetic-glucose-levels/

 

[Rach612]

Ah, thanks for that.

Firstly, I think you may be applying some rather extreme thinking to your situation. Probably because it was impressed upon you throughout your pregnancy that the health of your little one depended on tight glycaemic control. Am I right?

Can I urge you to relax a little. Your passenger has disembarked and it is just you and your body.
A dip in blood glucose down to 4.3 in the middle of the night isn't a 'crash'.
Believe me, it isn't.
It is a perfectly normal dip that many, many people experience in the middle of the night.

Also, a reading of 7.8 after food is not a spike. A spike would be something like 14mmol/l.
If your body is only going to 7.8 after a high carb meal of beans on toast, then I think your pancreas is doing very well indeed!

Please don't think that I am trying to dismiss your concerns. I am not.
But I would encourage you to have a look at these links, which show you the kind of bumpy shenanigans that a perfectly average and non- diabetic person's blood glucose goes through during a day:

https://lilynicholsrdn.com/cgm-experiment-non-diabetic-continuous-glucose-monitor/

https://bionicwookiee.com/2020/02/03/non-diabetic-glucose-levels/

Thank you again for your reply Brunneria. I do appreciate it. I’m really just concerned about my numbers not being normal in the morning and now the fact I may have reactive hypoglycemia and be a diabetic. Especially with the symptoms, I need to put it in remission and get my numbers (esp in the am back to low 4’s) like I did before on my starvation diet. Before my dinner at 5.55pm it was 4.3 (I had a v small amount of cooked chicken, slice of bacon, butter with a very small portion of cauliflower rice and a sprout (on a side plate) two hours after was 4.3 I did go for a walk in between. At 6.19pm it dipped to 3.6.