Curiouser and curiouser, said Alice...

[PDR]

My last HbA1c was 37mmol/mol, so at my review last week my DN suggested I could try a few well separated, careful and tentative "experiments" to see if my pancrease was having a "normal" response.

This morning my "wake-up" bg at 07:03 was 6.1mmol/l.

I then took my usual single metformin and had an instant coffee before my monday morning flight oop north to work. On the flight I had a tiny diet coke and a small tube of graze nuts. Someone up here has a birthday, so I decided to experiment by having a slice of cake (sponge with jam/buttercream filling).

The "before cake" BG at 10:46 was 7.5mmol/l (why?). With the cake I had a mug of proper (cafetierre) coffee, black with 1/2tsp of fructose.

I then did the 1.3 mile round-trip walk to the sandwich bar to collect my salad box (salami, turkey, mortadella and egg salad with red pesto mayo).

Pre-lunch BG at 12:34 was 6.5mmol/l, and I then took a single gliclizade.

I then went into a short meeting so my post-lunch BG was delayed until 14:10 - this figure was 4.7mmol/l.

So neither the cake nor the lunch seem to have caused a significant BG rise. What is this telling me?

PDR

 

[bulkbiker]

What is this telling me?

That in a very short term sense your body has recovered a bit of insulin sensitivity and your pancreas is kind of ok providing you don't swamp it with carbs and carry on taking the medication. I'm a bit disappointed that your DN suggested experimenting while you are still taking meds...a very dangerous protocol to start IMO.

 

[Guzzler]

That is what I do not understand, suggesting that a patient who requires bg lowering drugs to experiment with more carbs. Surely this is akin to suggesting that it's OK to have more carbs because the drugs will take care of possible spikes? Wouldn't it be more prudent to suggest experimenting with a very slight reduction in dosage of drugs temporarily to see what that affect has on your bg levels?

 

[Rachox]

I agree with the above two commentators. My last HbA1c in July was 34 and had been mid 30s since Sept ‘17. I suggested to my GP I drop my Metformin dose by one tablet, he agreed. I don’t understand your DN’s rationale at all!

 

[Bluetit1802]

I agree with the others. Your dn made a silly suggestion. You have no idea what your pancreas will do on its own until you are able to stop gliclazide. My suggestion is you are still suffering with insulin resistance, hence the higher than desirable fasting level and the 7.5 before the cake. The lovely low 4.7 could easily have been the result of the Gliclazide you took (this forces the -ancreas to produce extra insulin in addition to whatever it would produce without the Glic. ) Hence you were possibly swimming in insulin, resulting in the 4.7. In that event, had you not had the cake you may have been even lower.

Well done on the very good Hb1c by the way - I hope this doesn't reflect a roller coaster of highs and lows????? Do you ever use a Libre?

 

[hankjam]

I'll add my two bits and agree with the folks up above... it does seem a bit odd.
Nice numbers.
Next time with DN float a reduction in the drugs and see how that goes.
Good luck.

 

[DavidGrahamJones]

. . . . . pancreas was having a "normal" response.

In agreement with everything said so far. I've been type II for 21 years, but although my pancreas is producing insulin in the normal range (c-pep test) that doesn't tell me if my beta cell mass is less and just doing more work. Nor does it tell me anything about insulin resistance which for me is the major problem. Another self funded blood test to show my insulin resistance actually shows that it's something that can change, either way.

We all have different experiences and it certainly looks like gliclazide is doing it's job, increasing both basal insulin secretion and meal-stimulated insulin release (Source: DrugBank)

 

[mike@work]

That in a very short term sense your body has recovered a bit of insulin sensitivity and your pancreas is kind of ok providing you don't swamp it with carbs and carry on taking the medication. I'm a bit disappointed that your DN suggested experimenting while you are still taking meds...a very dangerous protocol to start IMO.

Hello all!
Took a fast look under this headline, and noticed "bulkbikers" answer.
I agree with his statement to 100%, even if I am myself a Type 1.
He's answer sounds in my ears, like a proper advice for a Type 2, and especially the last remark, is worth some extra contemplation...

Added a few seconds later: I agree with the rest of you also, but for some strange reason one have to be far-off, if one does not notice "bulkbikers" answers
No offense meant - meant like credit...