Glucose Tolerance Test - Results are in

[sugarmog]

As posted last week, I had a GTT , using my Accu check meter to provide real time updates on my progress. According to my measurements I was 5.3 at the start, 11.6 at 1 hour, and 8.1 after two hours. The official results are back and I was 5.1 at the start and 7.4 after two hours. So based on these results and my recent 5.5% Hb1Ac I am no longer diabetic, in fact I am not even classed as glucose intolerant.

This is all a bit confusing as according to NHS measurements I have "cured" my diabetes. I was first diagnosed as glucose intolerant in 1995 with a two hour result of 8.6, but in 1997 I managed to return this to a "normal" level of 7.2 @ 2 hours. Not sure what happened in the next few years, but things started to change in 2009 when another test had me at 7.6 fasting and 10.2 after two hours. Very definitely glucose intolerant although my Hb1AC was a respectable 5.7. Two months later a further GTT had me at 12.6 ie :- diabetic. However this test somehow got lost in the system and I wasn't aware of it until my 7.2 Hb1AC result of July last year made it clear that I was now considered fully diabetic. I was immediately offered medication but decided against this as I wanted to see how far I could control it with lifestyle changes. Cut down on the carbs (although not low carbing) and gradually reduced my weight from just under 13 stone to an ideal 11 stone.

What this all seems to show is the importance of weight in controlling glucose levels. I've fluctuated between 11 and 14 stone over the past 20 years, usually being somewhere between 12 and 13. Not hugely overweight but not as good as I should have been. My worse GTT results seem to have coincided with my increases in weight. If I keep myself at my ideal weight I appear to have a fairly normal, although not perfect, insulin response, but it doesn't seem to take a huge increase to compromise this.

Looking to the future, given that diabetes is a progressive problem I probably will eventually become a medicated diabetic. However, it seems that my own behaviour will strongly influence exactly how long this takes.

To add a final twist, I woke up in the early hours of yesterday morning feeling rather sweaty and clammy. I tested my blood and it was 7.5 and still at 6.9 when I woke at 9am. 6.1 this morning. However, I've developed a nasty sore throat and cold, so hopefully that is the cause.

 

[Sparklygal]

hiya. yeah it must be that without any/much fat around the pancreas that it's able to work a lot better. well done on getting the weight off! It's great if you can avoid meds for as long as possible.

 

[sugarmog]

Saw my GP to discuss this result. She is also a bit puzzled by the readings. Although she agrees that the weight loss is responsible, she has never previously come across a case where weight loss has reversed fully diabetic measurements to "normal" readings. She was aware that it is possible to reduce Hb1AC readings to a normal level through good diet control, but has never seen GTT results reversed in the same way. She also agrees that high stress levels at the time of the 12.6 GTT result and 7.2 Hb1AC results may have artificially skewed the results higher and possibly given a false fully diabetic diagnosis. She is going to talk to the practice diabetes specialist and see if he has ideas about what is happening. At my request, the surgery is still going to list me as diabetic which means I will still get regular reviews and eye tests etc, just to be on the safe side. She also gave me some more test strips so I can continue to monitor myself and not slip back into bad habits.

How long is it usual for people to be considered glucose intolerant / pre diabetic before progressing to fully diabetic. Checking my medical history I seem to have had an issue with my levels for at least 20 years. I even found a letter from 1994 after I had my tonsils removed where the consultant refers to me as "mildly diabetic". I suspect I have been glucose intolerant related to my weight most of my life, but because most of the time my levels were normal it never really showed up on blood tests for other things. I don't think I had a blood test specifically for sugar levels until I was about 30. When I was in my very early teens (born 1960) I used to suffer from what we called my "Sunday Problem". On Sundays I would always have to visit the loo far more often than any other day of the week. It is only now that I realise that my sugar consumption on a Sunday was far higher than any other day of the week. I would have a bar of chocolate in the morning (at the time a bar chocolate was considered a weekly treat, not a daily dietary requirement) and lunch would involve roast potatoes followed by trifle or pie. However, at my ideal weight I am now registering fasting levels lower than the first tests 20 years ago


However, I find it difficult to believe that I am unique, and was wondering how many diagnosed diabetics actually have follow up GTT tests once they have good control, particularly if weight loss has played a significant role in gaining that control. I requested the follow up test partly because I always had a nagging suspicion that the initial diagnosis might have been wrong (although many people would label that "denial"). Are there many people out there who are unaware that their lifestyle changes have technically reverted their diabetic status to normal? It also raises questions about the validity of using particular numerical cut offs to define "normal" and "diabetic". Are the boundaries actually a lot looser. Are we even looking at a slightly different condition where some people have a compromised insulin response related purely to their weight, something that is only becoming apparent as levels of obesity rise and we hammer our pancreases with a level of sugar and carbs that would have been almost impossible 20-30 years ago. Unlikely, but it still doesn't alter the fact that this time last year certain foods spiked me at nearly 20, now nearly two stone lighter the NHS does not have a test that will label me diabetic.

 

[youngmanfrank]

I am in the same position,although in my case it has happened since I completed the Newcastle University Diet to reverse type 2 diabetes,to give it is full title.This diet is based on the theory that fat accumulated in the pancreas and liver causes insulin insensitivity,with accompanying loss of control over blood sugars and resultant weight gains.The diet de-fats these organs,restoring insulin sensitivity and blood sugar control.I am maintaining my ideal weight of 12 stone or so by exercise and diet (restricting calories not types of food).

There are many conflicting opinions as to what happens next.I have read that by the time you have been diagnosed with diabetes you have lost a significant percentage of your insulin producing cells,and that this will continue.On the other hand a consultant recently told me that she knew of patients maintaining their control five years down the line,but others slipped back into the diabetic condition within a year or two,the difference being whether or not you maintain your new life style.Of the two doctors in my practice,one says I will be back for metformin within a year or two,the other that with care I could remain where I am indefinitely.

Bottom line for me is that nobody really knows,that there are a lot of entrenched opinions,and that the only sensible thing to do is to continue with whatever improved your condition in the first place.