Anyone else with this diabetes pattern?

[Yoggy]

Hello!

I’d love to know if anyone else is in my boat:

I am a mid fifties male. Diabetes was picked up on a health screen with A1C of 56 mmol. After 3 months on a Keto diet it, is back in the pre diabetic range and my weight is pretty much optimal with est. 12% body fat. My fasting glucose via CGM is good but post prandial spikes are sizeable if I try even small amounts of carbs. I am exercising and doing resistance training regularly.

Liver and Pancreas were MRIed and all good. Diabetes screen from the endocrinologist shows no real problems: no markers for type1 and Dr. does not think I am insulin resistant based on that screen.

So, not Type1, or classic Type2 (as far as I can tell) . Fasting glucose and ability to tolerate carbs do appear very sensitive to cortisol levels: much better when relaxed and well rested. I would say I don't generally tolerate stress that well.

I’d love to hear from any one who has experience of this pattern, but also to know if it's unusual or not.

Best Regards, Yoggy.

 

[lovinglife]

Hi @Yoggy & welcome to the forum

Sounds like you’ve got it nailed already, well done on your results, can I ask what you mean by classic T2?

 

[Yoggy]

Hi @Yoggy & welcome to the forum

Sounds like you’ve got it nailed already, well done on your results, can I ask what you mean by classic T2?

Thank you, that’s very kind.

What I mean by ‘Classic T2’ is that, I thought it normally came with Insulin Resistance, which (according to the Dr. I don’t apparently have). Happy to be corrected on that.

Yoggy.

 

[lovinglife]

Thank you, that’s very kind.

What I mean by ‘Classic T2’ is that, I thought it normally came with Insulin Resistance, which (according to the Dr. I don’t apparently have). Happy to be corrected on that.

Yoggy.

Ah I see - thanks for clarifying, hopefully someone on the forum has a similar experience- I’m a bog standard T2

 

[Lamont D]

Hello!

I’d love to know if anyone else is in my boat:

I am a mid fifties male. Diabetes was picked up on a health screen with A1C of 56 mmol. After 3 months on a Keto diet it, is back in the pre diabetic range and my weight is pretty much optimal with est. 12% body fat. My fasting glucose via CGM is good but post prandial spikes are sizeable if I try even small amounts of carbs. I am exercising and doing resistance training regularly.

Liver and Pancreas were MRIed and all good. Diabetes screen from the endocrinologist shows no real problems: no markers for type1 and Dr. does not think I am insulin resistant based on that screen.

So, not Type1, or classic Type2 (as far as I can tell) . Fasting glucose and ability to tolerate carbs do appear very sensitive to cortisol levels: much better when relaxed and well rested. I would say I don't generally tolerate stress that well.

I’d love to hear from any one who has experience of this pattern, but also to know if it's unusual or not.

Best Regards, Yoggy.

The post pandrial abnormal spikes are quite common in T2s. That is why you tend to be intolerant to carbs etc.
I have it as part of my condition.
It is usually called the first phase insulin response.
But should be termed first phase hormonal response, which includes insulin, cortisol as you mention, and others.
Because of also insulin resistance and I wouldn't discount it entirely, the insulin isn't enough to counter the high glucose spike.
By getting down towards remission, well done BTW, the amount of excess insulin is tempered and reduced.
That is why a low carb dietary approach works for most of us.
Hope that helps.

 

[Melgar]

Hi there @Yoggy. I’m similar to you , BMI 19, very fit, low/normal C-peptides, I do weights , I watch my carbs. Very low carb diet for 9 months didn't bring my blood sugars down, but meds brought them down to prediabetic levels. its a wait and see situation. My brother is type 1, having initially diagnosed as type 2. No T2 diabetes in my family. I don’t drink or smoke. I have always been lean, eaten an healthy diet, and was a competitive long distance runner until I was 50. Diagnosed after a routine blood test for something else. I know where you are coming from. There is an element of frustration. You do everything right and still it gets you.

I do have an existing autoimmune disorder - coeliac. I also have a number of positive gene variants such as hashimotos, RA, lupus and psoriasis.

Im assuming they checked your c-peptides and antibodies if they have ruled out T1. Your C-peptides must be normal for them to say you do not have Insulin resistance.
Insulin resistance does fluctuate in everyone depending on food, exercise, and time of day. Mine rises late afternoon, which is when my sugars are at their highest.

Insulin resistance is the bogey here. Research is indicating that it is responsible for many chronic ailments, Alzheimer’s is one of the most significant, vascular issues are up there too, but I digress.
Like you, I am just managing my blood sugars the best I can.

 

[Yoggy]

The post pandrial abnormal spikes are quite common in T2s. That is why you tend to be intolerant to carbs etc.
I have it as part of my condition.
It is usually called the first phase insulin response.
But should be termed first phase hormonal response, which includes insulin, cortisol as you mention, and others.
Because of also insulin resistance and I wouldn't discount it entirely, the insulin isn't enough to counter the high glucose spike.
By getting down towards remission, well done BTW, the amount of excess insulin is tempered and reduced.
That is why a low carb dietary approach works for most of us.
Hope that helps.

Thank you for the reply Melgar. Agree about the insulin resistance. In fairness, I think the endocrinologist only said i probably wasn’t resistant on the basis of the tests. He also tried me on some sitaglyptin, but so far I have not noticed any effect on the post prandials with that.

 

[Yoggy]

Thank you for the reply Melgar. Agree about the insulin resistance. In fairness, I think the endocrinologist only said i probably wasn’t resistant on the basis of the tests. He also tried me on some sitaglyptin, but so far I have not noticed any effect on the post prandials with that.

Sorry names mixed up!

 

[Yoggy]

Hi there @Yoggy. I’m similar to you , BMI 19, very fit, low/normal C-peptides, I do weights , I watch my carbs. Very low carb diet for 9 months didn't bring my blood sugars down, but meds brought them down to prediabetic levels. its a wait and see situation. My brother is type 1, having initially diagnosed as type 2. No T2 diabetes in my family. I don’t drink or smoke. I have always been lean, eaten an healthy diet, and was a competitive long distance runner until I was 50. Diagnosed after a routine blood test for something else. I know where you are coming from. There is an element of frustration. You do everything right and still it gets you.

I do have an existing autoimmune disorder - coeliac. I also have a number of positive gene variants such as hashimotos, RA, lupus and psoriasis.

Im assuming they checked your c-peptides and antibodies if they have ruled out T1. Your C-peptides must be normal for them to say you do not have Insulin resistance.
Insulin resistance does fluctuate in everyone depending on food, exercise, and time of day. Mine rises late afternoon, which is when my sugars are at their highest.

Insulin resistance is the bogey here. Research is indicating that it is responsible for many chronic ailments, Alzheimer’s is one of the most significant, vascular issues are up there too, but I digress.
Like you, I am just managing my blood sugars the best I can.

Thank you! Yes, fasting insulin and c-peptides were not elevated. No markers for the autoimmune thing, but the endocrinologist noted that 5% of type 1 cases don’t show those markers, so even that is not conclusive yet it seems.

 

[JoKalsbeek]

Hello!

I’d love to know if anyone else is in my boat:

I am a mid fifties male. Diabetes was picked up on a health screen with A1C of 56 mmol. After 3 months on a Keto diet it, is back in the pre diabetic range and my weight is pretty much optimal with est. 12% body fat. My fasting glucose via CGM is good but post prandial spikes are sizeable if I try even small amounts of carbs. I am exercising and doing resistance training regularly.

Liver and Pancreas were MRIed and all good. Diabetes screen from the endocrinologist shows no real problems: no markers for type1 and Dr. does not think I am insulin resistant based on that screen.

So, not Type1, or classic Type2 (as far as I can tell) . Fasting glucose and ability to tolerate carbs do appear very sensitive to cortisol levels: much better when relaxed and well rested. I would say I don't generally tolerate stress that well.

I’d love to hear from any one who has experience of this pattern, but also to know if it's unusual or not.

Best Regards, Yoggy.

If you're on a ketogenic diet, insulin resistance might not show up, unless they do an OGTT. Can't measure something if you don't have carbs, after all. I'd not be diabetic if I was tested now, according to my HbA1c, and wouldn't be for the past 7 years or so... And I can assure you, my blood sugars still spike if I have something carby.

 

[Lamont D]

Thank you for the reply Melgar. Agree about the insulin resistance. In fairness, I think the endocrinologist only said i probably wasn’t resistant on the basis of the tests. He also tried me on some sitaglyptin, but so far I have not noticed any effect on the post prandials with that.

Sitagliptin is designed to help with the first phase insulin/ hormonal response .
On an eOGTT, my initial results were a very high spike.
With sitagliptin, my spike was just above 8mmols.
The lowering of the spike, meant I didn't need as much insulin for my second phase. And the effects of the symptoms later were reduced as well. But as I said earlier, it was above 8mmols, so I still triggered the reaction and hypo.
But it will help with your overall issues.

 

[Yoggy]

If you're on a ketogenic diet, insulin resistance might not show up, unless they do an OGTT. Can't measure something if you don't have carbs, after all. I'd not be diabetic if I was tested now, according to my HbA1c, and wouldn't be for the past 7 years or so... And I can assure you, my blood sugars still spike if I have something carby.

Thank you.

 

[Yoggy]

Sitagliptin is designed to help with the first phase insulin/ hormonal response .
On an eOGTT, my initial results were a very high spike.
With sitagliptin, my spike was just above 8mmols.
The lowering of the spike, meant I didn't need as much insulin for my second phase. And the effects of the symptoms later were reduced as well. But as I said earlier, it was above 8mmols, so I still triggered the reaction and hypo.
But it will help with your overall issues.

Much appreciated. Yoggy.