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Drugs raising BG

Hi @lovinglife

I have now had a response from my Physio to say NO steroid content in massage oil used. So, notionally I am left with your feedback which suggests that you have had similar rises from massage alone perhaps for the moment.

I take your point that you consider the change involved as small (1.5+ on Prick BG) however, my tutor on the NHS sponsored course for pre-diabetics has signalled otherwise, citing such changes as unexpected 'peaks' from my data records. Clearly views differ as to the need to investigate what is going on.

The emphasis on the course is to avoid these peaks. To avoid a peak one has to understand a the mechanism that causes it. Thus, I am inclined to the view that the better we can come to understand what is going on in our bodies (much to discover yet) the better we will be at managing matters in the future with less reliance on drugs. Equally, with a science background if "nobody knows why" crops up, it is like a red rag to a bull to find out if possible or at least add to the data bank in the hope that another may spot what is going on.

I suspect that the multiplicity of variables (not necessarily all identified yet) involved points to some potential use of AI in the future to statistically, analyse the data from a cohort by normalising transit times and the like, progressively focussing on the change agents; no agent identified as a statistically likely cause, would point to something else to be discovered. Sometimes we can characterise the something without knowing what it is exactly and go looking for it, as happened with the neutrino during my life time.

Very closely linked to bowel transit times, which vary from person to person and from food to food there is an overall hysteresis effect (delayed action) which 'writings' seem light on, but for example you mention can result in days of continuing raised BG from some foods in your experience.

Thank you again for sharing. b
 
I’m afraid I have to disagree with your tutor, a 1.5 rise is not a peak, everyone & I mean everyone diabetic or not, gets these rises. What matters is how fast they come down, BG are not flatline they fluctuate from minute to minute, for any amount of reasons. The over worrying and trying to find a reason for every little up or down could, in fact be contributing to what you refer to as a peak. (Stressing about something you have no control over)

As you found yourself even a massage which you would think would reduce your BG as you relax does exactly the opposite, but it’s good for your well being - having a hot shower, stubbing your toe, dropping your cup, I could go on & on - even when you lay still and do what you think is nothing your BG can fluctuate. You are never going to avoid the up & downs of BG
 
Hmmmm. Interesting, @lovinglife. Need to think about that some more perhaps. May be for some people such changes are small in comparison with other peoples' sizes of change and range of day to day readings. However, statistically, if there's a series of readings of mean 5.5 and range + 0.4, -0.3 then a reading of 7.0 pops up and is reproducible, then that is statistically significant, as in my case. However. if the range of your day to day readings is anywhere between say 4 and 7, with a sprinkling of readings across the whole range with the same mean(5.5), then a reading of 7would not be significant, but a reading of 11.4 would be. Overall, I guess it is that some people's readings are noticeably more wide ranging than others. If you fall into this other category with a wider natural range then I suspect you could both be right. Hope that makes sense.
This gets more and more interesting. b
 
Thank you @EllieM - I have seen that report before - it is very interesting. Yes, there is quite a wide range for the data soon after eating. However, the levels 3 hrs or so after have a much tighter range, down around 4.4 with little change for a prick BG equivalent.

So, whilst interesting, and serving to show how overall readings can vary throughout a day with meals, it does not appear to add to the understanding of my excursions several hours after meals. Indeed, in principle, it does not support the proposition that variations of > 20 % several hours after eating are normal and should be accepted and not investigated, be it a very heavy meal, or a massage, hidden sugars in a food or whatever.

If I have mis-interpreted the report and there is another way of viewing it, I have missed, it would be great if someone could enlighten me please. b
 
@bogwort47 do you use a Continuous Glucose Monitoring device (CGM) or do you just finger prick? If you wanted to analyze your blood glucose stats then a CGM would give you an overall better picture. The FreeLibre 2 CGM sensor, for instance, ' takes a reading from your interstitial fluid every minute and automatically records the glucose concentration every 15 minutes, storing that data in a rolling 8- hour log. ' The results if which can be seen on a graph. Apologies if you use a CGM already.

I would think a night time fasting analysis of your blood glucose would have less variables than during the day time. Daytime readings can vary because of food and fluid intake, physical activity, thought stressors, heart rate, daytime exterior and internal temperature fluctuations, human and non human interactions, blood pressure, and circadian rhythm activated hormone releases, to name but a few. At night, these variables would be greatly reduced and limited to the after effects of any food you have consumed in the evening, your body temperature, BP , rem sleep, and circadian rhythm activity around the 3 am mark, where by the body releases cortisol and growth hormones.
Just a few thoughts.

I also forgot to mention fluctuations in insulin sensitivity.

Edited to add Insulin sensitivity.
 
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Thank you @EllieM - I have seen that report before - it is very interesting. Yes, there is quite a wide range for the data soon after eating. However, the levels 3 hrs or so after have a much tighter range, down around 4.4 with little change for a prick BG equivalent.

So, whilst interesting, and serving to show how overall readings can vary throughout a day with meals, it does not appear to add to the understanding of my excursions several hours after meals. Indeed, in principle, it does not support the proposition that variations of > 20 % several hours after eating are normal and should be accepted and not investigated, be it a very heavy meal, or a massage, hidden sugars in a food or whatever.

If I have mis-interpreted the report and there is another way of viewing it, I have missed, it would be great if someone could enlighten me please. b
I think you're reading it correctly. The issue might be that while we can estimate carbs in food, and perhaps guess at a likely BG rise following eating, what we do not really have a grip on is what our livers will be doing about setting and maintaining "baseline" blood glucose levels, or the blood glucose levels the liver estimates we need, in the hours afterwards. That (I would guess) depends a lot on what the individual does in that time, and (for one example) the levels of cortisol, which normally provoke the liver to create and release glucose.

I found a CGM graph (I can't find the original graph, so this is a slide I made earlier) produced by a T2 someone who had a very stressful day, and nothing to eat during it: attaching. The account is that at the first green x the individual was informed her son had been in a (bad) car crash: the second is the point where she visited him in hospital. Huge rises (I would be happy to describe the first as a "spike") in BG, no food involved.

So for me the question here is can we separate the impact of food at (say) >3 hrs from the impact of liver action, on our blood glucose levels?
 

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I think you're reading it correctly. The issue might be that while we can estimate carbs in food, and perhaps guess at a likely BG rise following eating, what we do not really have a grip on is what our livers will be doing about setting and maintaining "baseline" blood glucose levels, or the blood glucose levels the liver estimates we need, in the hours afterwards. That (I would guess) depends a lot on what the individual does in that time, and (for one example) the levels of cortisol, which normally provoke the liver to create and release glucose.

I found a CGM graph (I can't find the original graph, so this is a slide I made earlier) produced by a T2 someone who had a very stressful day, and nothing to eat during it: attaching. The account is that at the first green x the individual was informed her son had been in a (bad) car crash: the second is the point where she visited him in hospital. Huge rises (I would be happy to describe the first as a "spike") in BG, no food involved.

So for me the question here is can we separate the impact of food at (say) >3 hrs from the impact of liver action, on our blood glucose levels?
This looks like what's happening to me, far more influence on BG from non-food factors, given that I usually get my highest results while fasting. Very frustrating as food is the easiest variable to control but it hardly makes a dent.
 
Quite so @EllieM. No I do not have a continuous sensor. I more than take your point about cortisol and other affecting factors outside of food. The data relating to one unusual peaking event is on page 1 of this thread. All the readings have their times recorded and all 1st Pricks are1st thing after waking/rising. Having eliminated steroids, the next most likely contender is cortisol. I have already got a marker down with a consultant to check this as higher than expected BG readings are not unusual for me, beyond the level which one might expect the liver to support the body during fasting. Coupled with this, I also have a lot of pain from a hamstring injury, which new imbalance in my body has set my neck off again, after triple disc surgery, waking me up with bilateral nerve pain in my arms variously, into my hands. Both my knees are arthritic also. Hey Ho what fun. If you check out my previous posts you will see that I have had a high HbA1c since 2020 and 9 months of dietary measures have brought about only 1 point of improvement down to 41. Constant pain will elevate cortisol levels I believe, particularly overnight when it is not possible to focus away from the pain as old gits like me do when we are awake, well try to anyway. Whatever, I am hoping the cause is the pain > cortisol > raised BG. One way or another I will be glad to find out for sure as my Wife died with 2ndary cancer of her adrenal gland.
Thank you for your thoughtful post. b
 
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