1 hour postprandial readings and a few other questions...

[jenniferocious]

I had gestational diabetes with my daughter who I gave birth to in early May. In September I took a finger prick test one hour afterwards to see how my blood sugar would respond to a pizza (knowing that it would have obviously given me a high reading in pregnancy). I got a high rating of around 10mmol/L. I did some further testing and got pretty high readings one hour eating the usual 'bad for diabetes' foods, i.e. most bread, white pasta, rice etc, and was worried that I had developed type 2 (my husbands was 5.6mmol/L post pizza). I booked an appointment for a OGTT - my HbA1c was 33 which I understand is normal, but my C-Peptide result was 3 which means I may have some degree of insulin resistance.

The nurse told me that, as I am no longer pregnant, I shouldn't worry at all about 1 hour postprandial readings, only 2 hour readings - which are generally fine. I read some research papers, however, that a high 1 hour postprandial reading has shown to be a predictor of prediabetes. So I've been eating a lower carb/low GI diet and I'm the skinniest I've been since I was a teenager (have been around 10 stone at 5'6" since my mid-twenties and am now 9 stone at the age of 37). I've been aiming for a 1 hour postprandial blood sugar reading of below 8mmol/L with the assumption that it will be in range after 2 hours.

Anyway, I have some questions...

Are there any guidelines on what a 1 hour postprandial glucose level should be outside of pregnancy? Am I being overly anxious worrying about the 1 hour number?

My main question is regarding improving/reversing insulin resistance. If I stay slim and generally eat better like I've being doing, does that I mean I may be able to start treating myself to the odd pizza without getting big spikes in my blood sugar? Or are things only improved/reversed when you are constantly eating lower carb/low GI and not giving your blood sugar the chance to spike in the first place?

Is it damaging to allow your blood sugar to spike once in a while? Or is it all about high blood sugar over long periods of time?

I know I'm in a good position compared to others on here trying to control an actual diagnosis, but I find myself getting quite anxious about it at times, mainly because cardiovascular disease runs in the family. I just want to know that I have understood my situation and that I'm doing the right things to prevent problems further down the line.

 

[Ronancastled]

The old paradigm was that non-diabetics would never spike higher than 7.8 then come down to baseline rapidly.
The onset of CGMs has radically changed this belief & there seems to more of a concensus that we fall into a range of glucotypes.
(1) Those who show a flatline response to carbs i.e. your husband.
(2) Those who rise to the expected 7.8 then fall back down.
(3) Those who can spike then rapidly return to normal i.e. your own experience

A good study on the above can ge read here:
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2005143

With your HbA1c being so normal you have very little to worry about.
Chances are you were always thus but before GD you probably never pricked your finger.

 

[jenniferocious]

The old paradigm was that non-diabetics would never spike higher than 7.8 then come down to baseline rapidly.
The onset of CGMs has radically changed this belief & there seems to more of a concensus that we fall into a range of glucotypes.
(1) Those who show a flatline response to carbs i.e. your husband.
(2) Those who rise to the expected 7.8 then fall back down.
(3) Those who can spike then rapidly return to normal i.e. your own experience

A good study on the above can ge read here:

With your HbA1c being so normal you have very little to worry about.
Chances are you were always thus but before GD you probably never pricked your finger.

Thank you for your response! That's a very interesting study that helps clarify my situation.

 

[Tedakos]

The old paradigm was that non-diabetics would never spike higher than 7.8 then come down to baseline rapidly.
The onset of CGMs has radically changed this belief & there seems to more of a concensus that we fall into a range of glucotypes.
(1) Those who show a flatline response to carbs i.e. your husband.
(2) Those who rise to the expected 7.8 then fall back down.
(3) Those who can spike then rapidly return to normal i.e. your own experience

A good study on the above can ge read here:
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2005143

With your HbA1c being so normal you have very little to worry about.
Chances are you were always thus but before GD you probably never pricked your finger.

Sorry for the hijacking here, if HbA1c is 5.3 like mine is also find and nothing to worry about ?

 

[Ronancastled]

Sorry for the hijacking here, if HbA1c is 5.3 like mine is also find and nothing to worry about ?

A HbA1c of 5.3% in old money equates to 34 mmol/mol in new units or an average glucose level of 5.9 mmol/L

As you can see it's considered normal.
A large percentage of the general population would fall inside this normal zone.

 

[Doireallyneedanams]

Interestingly, I had similar concerns for a long time. I fell pregnant last year and had my baby in February this year. When I was 37 weeks pregnant my siblings were both diagnosed with type 2 and when I told the hospital this they suggested I monitor my glucose at home for a week and report back. I had three “high reads” after very carb heavy meals (burger, chips etc) 7.9, 8.2 & 8.6. On this basis they diagnosed me with “ borderline” gestational diabetes. My HBA1c at that point was 33. Crazy that if I’d only had “two” high reads then I would have never been diagnosed. Doesn’t sit well with me.

I was completely beside myself with worry as to whether it was actually undiagnosed type 2, and I immediately switched to a low carb diet. My postpartum hba1c was 30.

Since then I have done a LOT of reading about what actually happens to non diabetics glucose and it would appear that this 7.8 maximum is completely false.

My partner is a slim, active healthy 34 year old and after drinking a Red Bull randomly checked his glucose at 1 hour and it was 8.3. By 2 hours it was 5.3.

There are even threads online from doctors who have checked their glucose and hit 10/11 after certain meals.

I still worry and I am still high risk because of my siblings, but I’m not even sure I had gestational diabetes now which is just really stressful.

 

[jenniferocious]

Interestingly, I had similar concerns for a long time. I fell pregnant last year and had my baby in February this year. When I was 37 weeks pregnant my siblings were both diagnosed with type 2 and when I told the hospital this they suggested I monitor my glucose at home for a week and report back. I had three “high reads” after very carb heavy meals (burger, chips etc) 7.9, 8.2 & 8.6. On this basis they diagnosed me with “ borderline” gestational diabetes. My HBA1c at that point was 33. Crazy that if I’d only had “two” high reads then I would have never been diagnosed. Doesn’t sit well with me.

I was completely beside myself with worry as to whether it was actually undiagnosed type 2, and I immediately switched to a low carb diet. My postpartum hba1c was 30.

Since then I have done a LOT of reading about what actually happens to non diabetics glucose and it would appear that this 7.8 maximum is completely false.

My partner is a slim, active healthy 34 year old and after drinking a Red Bull randomly checked his glucose at 1 hour and it was 8.3. By 2 hours it was 5.3.

There are even threads online from doctors who have checked their glucose and hit 10/11 after certain meals.

I still worry and I am still high risk because of my siblings, but I’m not even sure I had gestational diabetes now which is just really stressful.

Only just seen your reply! Your blood sugar situation sounds similar to mine. I've too been anxious about it. Yes, I've also tried reading about it but I find it all pretty confusing. The diabetes nurse told me that I could eat really well/strict and still get type 2 later in life, or I could eat **** and never get it (it's in the genes after all, but obviously a preventative diet will reduce my risk dramatically). I try to remember this when ever I slip up and eat too many carbs. But I think I'll keep eating preventativly, it's seems like an sensible way of eating for my overall health.