Should I be concerned ?

[Calitriuk]

Hi,
So for a couple of years now I’ve had what I thought where blood sugar issues, before eating I would feel weak and a little bit disoriented mainly in the evening this seemed to be worse if I had higher carb meals in the day, so I thought I would get a CGM and do some tests over a couple of weeks, now I know these are always really accurate but it’s more of some information for my GP if I need it.

I’ve added some of the CGM results from yesterday this is only day 2 but I’m not sure what is good or bad and a lot of information online is conflicting, for example I woke up this morning at 4am needed a wee and just checked my bloods and it was 7.8, I had no snacks before bed the last thing I ate was homemade egg fried rice with veggies, any insights would be really helpful - my A1C was taken ( private blood test ) it was 31.40 mmol/mol so I’m a little confused.

I can’t add photos it won’t let me but here’s some info.

Today -
4am - 7.8
6:30 - 7.1

Yesterday my alarm on the app went off but I know it can take a few days to calibrate.

4:30am - 8.2
7am - 8.6

After eating last night - 7pm 8.5

It doesn’t stay this high all the time it does fluctuate.

 

[boggle]

When you wake, or anyone wakes, we experience the 'dawn phenomenon', although 4am is probably too early. Rice has a lot of carbs but the eggs or any fat in the meal might delay the release of any sugar into the blood, so it might be that you are seeing a delayed response. I think sleep probably slows digestion also.

 

[Mrs HJG]

Good morning @Calitriuk, the figures on this page may help you:
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
I am no way an expert, but rice is high carb, so that is the sort of food that will spike your blood sugars. Obviously don't know how late you ate, so can't say anything more except your HbA1c is totally in the non-diabetic range.

 

[Calitriuk]

When you wake, or anyone wakes, we experience the 'dawn phenomenon', although 4am is probably too early. Rice has a lot of carbs but the eggs or any fat in the meal might delay the release of any sugar into the blood, so it might be that you are seeing a delayed response. I think sleep probably slows digestion also.

Thank you that makes sense, I also had rice the day before aswell, it does seem to be all carbs but I’ll try some others, I ate at 18:30

 

[Calitriuk]

Good morning @Calitriuk, the figures on this page may help you:

I am no way an expert, but rice is high carb, so that is the sort of food that will spike your blood sugars. Obviously don't know how late you ate, so can't say anything more except your HbA1c is totally in the non-diabetic range.

Hi, thanks this is what’s confusing because according to the link I’m pre diabetic but my A1C is fine

 

[catinahat]

Welcome @Calitriuk
Something seems to not quite add up, your private HbA1c puts you firmly in the non diabetic range but your readings from the cgm would indicate otherwise.
The cgm sensors can be faulty any give inaccurate reading's, it's possible you have a duff one.
HbA1c tests can also be wrong, that's why Gp's usually insist on 2 tests done within a few weeks of each other before diagnosing.
We are not doctors and cannot give you a diagnosis. Your best course of action would be to visit your Dr, tell him/her your symptoms and concerns, show your Dr your HbA1c test results and the cgm readings then let your Dr's do their own investigations.
Good luck, hope you get some answers soon.

 

[Calitriuk]

Thank you this is what I thought and why I’m confused.

 

[Mrs HJG]

Hi, thanks this is what’s confusing because according to the link I’m pre diabetic but my A1C is fine

Ah you updated your post after I replied, so I didn't see the extra figures, and thought the 7.8 was a one-off, sorry.
I agree with @catinahat get your GP to do more - The HbA1c will be from the last 2-3 months, if you have only recently started with higher readings and symptoms, from my understanding, these probably won't have increased your HbA1c significantly yet, but you don't say when you had the private test done, so bare this in mind.

 

[Calitriuk]

Ah you updated your post after I replied, so I didn't see the extra figures, and thought the 7.8 was a one-off, sorry.
I agree with @catinahat get your GP to do more - The HbA1c will be from the last 2-3 months, if you have only recently started with higher readings and symptoms, from my understanding, these probably won't have increased your HbA1c significantly yet, but you don't say when you had the private test done, so bare this in mind.

Hi, the HbA1c was taken on the 15th February

 

[In Response]

When you wake, or anyone wakes, we experience the 'dawn phenomenon', although 4am is probably too early.

Someone without diabetes would not see a rise due to Dawn Phenomenon. Most people’s liver will dump glucose to provide energy to start the day. But those without a defective pancreas will release insulin to manage the dump and won’t see a blood sugar rise.

 

[Calitriuk]

Someone without diabetes would not see a rise due to Dawn Phenomenon. Most people’s liver will dump glucose to provide energy to start the day. But those without a defective pancreas will release insulin to manage the dump and won’t see a blood sugar rise.

So you would my results be problematic do you think ? I will be going to my doctors

 

[sgm14]

I don't think you can really come to any conclusions yet.

before eating I would feel weak

That sounds like a low blood sugar issues, but most undiagnosed diabetics don't have that problem, as their blood sugar levels would normally be high all the time.

worse if I had higher carb meals in the day,

That sounds like a high blood sugar issue.

So if you are having issues with low and high blood sugar, then it is possible that your HbA1c would be in normal range as it is an average and the lows could be cancelling out the highs. I think this is one of the reasons the Time in Range values from a CGM are becoming more popular.

I certainly don't want to stop you from talking to your doctor, but at this stage if it was me, I would try to see if it is possible to just give him/her a quick telephone call as opposed to a visit, as I would suspect they may want to wait a while before doing anything as your figures don't suggest anything that requires urgent action.

Also, you don't mention which CGM you have and although I have found my Libre to be very accurate, there are some people who don't, so I would suggest you do a few fingerprick readings to see how accurate your CGM is for you.

 

[Calitriuk]

Thank you, yes it’s the libre that I’m using at the minute i’d need a machine to do finger prick, I’ve just checked my time in target which is really useful thank you, do you know what numbers I should have it set to ? I’ve looked online and it looks like between 4 and 7 before and after eating is normal ? I’d like to at least have some date for the doctor or they will just fob me off saying it’s fine.

 

[boggle]

Someone without diabetes would not see a rise due to Dawn Phenomenon. Most people’s liver will dump glucose to provide energy to start the day. But those without a defective pancreas will release insulin to manage the dump and won’t see a blood sugar rise.

https://pubmed.ncbi.nlm.nih.gov/6389230/

 

[EllieM]

I second the suggestion that you back up your libre readings with a glucometer. Some people find the libre reads low or high, and just a couple of mmol/L difference in readings would completely change the situation.

Do you have any lowish readings (in the 4s or less) before meals?

 

[Calitriuk]

Yes today before dinner 4.8 and 4.9 went to 8 after food then again at 6:30am then 4.9 at 20:45, I’ve got the doctors on Monday so they should hopefully look at it

 

[Calitriuk]

Just an update on this, I’m now waiting to get a GTT I’m not sure how long it will take with the NHS I may need to go private. Today has been lower than normal I was at 6.3 when waking and went to the gym, it had a reading where it just said lo, when I got out of the gym no reading still just lo, after some food it was 2.4 and still only at 2.9 after food and water I thought I may of been dehydrated, at dinner it was still 3.1, I did feel pretty tired during the morning and a bit shaky at some point, I thought maybe the device was a bit inaccurate as others have said so to test I thought I’d eat some sweets ( jelly tots ) and see what happens if it was broken or giving wrong readings then it would stay the same, around 15 minutes later I was at 9.0 another 15 minutes 9.7 and then eventually it got back down to 6.0. My gym workout was not stressful, a strength workout that lasted on 30 minutes, no cardio something I do 3 times a week.

I’m not looking for advice as I need to see what happens with this test and I understand no one on here is a doctor just wondering if anyone knows what could be happening, one good thing is that I’m finally seeing that things are not quite right which I’ve thought for a while but never really been able to prove it,