Fasting Blood Glucose

[seadragon]

Interesting discussion with my sister today.

She used to work in a hospital lab so had done thousands of fasting blood glucose tests. She had always thought (and been told) that the fasting blood glucose was always the lowest of the day and so was diagnostic of diabetes. I beg to differ.

Having been told I'm pre diabetic with a fasting blood glucose of 6.6mm and a pre diabetic reaction to the GTT I did the sensible thing and cut out most carbs following the low carb high fat diet that seems to be fairly successful for most people here and certainly helps me avoid the grains and carbs that are bad for us. So I also bought a meter to test my BG levels.

Initially the LCHF diet appeared to give me a lower FBG (and I certainly lost a lot of weight easily, though had never been 'overweight' ) but then I noticed my FBG was rising again. I wasn't adding carbs back so what was happening? I then discovered that FBG is not my lowest BG reading of the day. I also found that if I woke early my FBG was often a whole mm lower than when I eventually got up maybe an hour or two later. I wasn't eating anything in between so it seems my liver was dumping glucose in the early morning. So my liver thinks I should run on a BG of about 6.3mm and if I haven't got it from carbs then it provides it for me. How thoughtful!

Looking at post meal averages i do usually tend to be back to about 6.3 between 1 and 2 hours after meals. My lowest readings seem to be before meals which can range from 4.5 to about 5.5.

I'm fairly sure an Hba1c test would have me at non-diabetic levels but I"m also sure I have abnormal reactions to carbs and glucose in food. I'm also sure if I walked to the doctors surgery next time rather than taking the car my FBG would appear to be much lower. Just makes me think that the catch all Type 2 is so wrong as it covers a huge variety of blood sugar disorders. I also think doctors are for the most part unaware of the spectrum of disorders so simply hand out pills to everyone who presents with any symptoms.

Is it possible to change the way doctors view Type 2? Is there anything we can do to change their views? The doctor I saw was pretty condescending and uninterested in me as an individual and she was the diabetic specialist for the practice. She just wanted to put me on drugs straight away - thought diet and exercise was a waste of time. She wanted me to take statins but couldn't really tell me what their benefit was, talked relative rather than absolute risks and she was also unaware of the documented shortcomings of the various studies on statins/fats/heart disease and the point when I felt like walking out was when she actually said she'd like to see statins put in the water so everyone took them.

What chance do Type 2 diabetics have when faced with medical ignorance and misunderstanding?

 

[Lamont D]

How does anybody know at what specific part of the day is their nadir for the whole time between waking and sleep?
Having done thousands of monitor tests, I believe my lowest, which is between afternoon and tea time when I reach about 4.2.
I hover between usually through the day between 4.5 and 5.7, I never spike above seven after meals! And I eat very small low carb meals during the day.
But it is interesting to here different views on what a blood glucose disorder actually means to the professionals.
This is the problem with the health care of diabetes patients, everyone is unique in there diagnosis. And shouldn't be lumped into one set prognosis.
It has been proved to me that low carb works and statins are unnecessary for diabetes only!
Of course, if you are high risk with heart problems then you should have statins.

I would love to see their faces when they realise that they have inadvertently caused so much harm.
It reminds me of the denaziisation of Germans after the second world war!

 

[Bluetit1802]

I don't know where your sister got her info from that FBG are the lowest of the day. For most type 2's, the lowest reading of the day is before evening meal as insulin resistance improves as the day progresses (for those of us with insulin resistance), and this is certainly so in my case. It is the only time of day I see levels in the 4's. As for FBG there are so many variables and issues outside our control that make them unreliable indicators. My Practice recognises this and now only do HbA1c's, even for non-diabetics having routine blood tests.

By the way, just to show how different we all are, if I walked to the surgery for a fasting test my levels would be sky high! Exercise always raises mine.

 

[seadragon]

My sister worked in an NHS lab for about thirty years. She was just passing on what they were told was the case from the medical professionals they dealt with. I was pointing out that it was incorrect info but seems to still be what most/many medical professionals believe. Until they understand diabetes better (and there is info out there but they are not taught it or not it seems generally interested enough to seek it out), I can't see how the care for diabetics can ever improve.
The more I have researched this whole area the more I believe statins are not only unnecessary for diabetics but not necessary even for those with heart problems and can in fact be positively harmful for both groups. I can see a future where people realise what statins have done to them and start to sue the NHS - then they really will be in financial trouble - and it's all based on the diet/heart hypothesis which has been shown to be false but they still persist in acting as if it is true.

 

[Celeriac]

My GP told me that in 2007 when I was diagnosed, Best Practice was to put T2s on Aspirin - I got it day four. He told me that now, Best Practice is to put T2s on statins.

Medicine has changed from treating symptoms of diseases, to treating us for things we may never get. I refuse any drug on the basis that stats say I'm more likely to get XYZ, but I do believe that vaccination is sensible.

There's anecdotal evidence that low carbing raises FBG but I haven't seen any studies myself.

I react badly to really small amounts of carbs and sugar now. After 6yrs LCHF I don't think my body really knows what to do with it. Most of the time, the carbs in my diet come only from above ground veg and dairy products. If I wasn't low carbing, I think I would be on insulin.

 

[ButtterflyLady]

Interesting discussion with my sister today.

She used to work in a hospital lab so had done thousands of fasting blood glucose tests. She had always thought (and been told) that the fasting blood glucose was always the lowest of the day and so was diagnostic of diabetes. I beg to differ.

Having been told I'm pre diabetic with a fasting blood glucose of 6.6mm and a pre diabetic reaction to the GTT I did the sensible thing and cut out most carbs following the low carb high fat diet that seems to be fairly successful for most people here and certainly helps me avoid the grains and carbs that are bad for us. So I also bought a meter to test my BG levels.

Initially the LCHF diet appeared to give me a lower FBG (and I certainly lost a lot of weight easily, though had never been 'overweight' ) but then I noticed my FBG was rising again. I wasn't adding carbs back so what was happening? I then discovered that FBG is not my lowest BG reading of the day. I also found that if I woke early my FBG was often a whole mm lower than when I eventually got up maybe an hour or two later. I wasn't eating anything in between so it seems my liver was dumping glucose in the early morning. So my liver thinks I should run on a BG of about 6.3mm and if I haven't got it from carbs then it provides it for me. How thoughtful!

Looking at post meal averages i do usually tend to be back to about 6.3 between 1 and 2 hours after meals. My lowest readings seem to be before meals which can range from 4.5 to about 5.5.

I'm fairly sure an Hba1c test would have me at non-diabetic levels but I"m also sure I have abnormal reactions to carbs and glucose in food. I'm also sure if I walked to the doctors surgery next time rather than taking the car my FBG would appear to be much lower. Just makes me think that the catch all Type 2 is so wrong as it covers a huge variety of blood sugar disorders. I also think doctors are for the most part unaware of the spectrum of disorders so simply hand out pills to everyone who presents with any symptoms.

Is it possible to change the way doctors view Type 2? Is there anything we can do to change their views? The doctor I saw was pretty condescending and uninterested in me as an individual and she was the diabetic specialist for the practice. She just wanted to put me on drugs straight away - thought diet and exercise was a waste of time. She wanted me to take statins but couldn't really tell me what their benefit was, talked relative rather than absolute risks and she was also unaware of the documented shortcomings of the various studies on statins/fats/heart disease and the point when I felt like walking out was when she actually said she'd like to see statins put in the water so everyone took them.

What chance do Type 2 diabetics have when faced with medical ignorance and misunderstanding?

The inaccurate information this doctor holds is not a sign that doctors in general don't understand blood glucose disorders, it is just a sign that she is out of step with current best practice. AFAIK, the NICE guidelines allow for doctors to make an individualised decision whether to recommend meds right away or waiting 3 months to see what effect lifestyle changes will have. From what I have read here, plenty of doctors seem to take a similar approach with statins, and are at least not rude to people when questioned about them. It sounds to me like you were unlucky enough to encounter a doctor at the extreme end of misunderstanding basic medical practice. I think the best solution is for bodies like NICE and other professional groups to keep trying to re-educate doctors. Also, if I saw a doctor who said things like this one did, I'd avoid them in future.

 

[Celeriac]

The Dietary Guidelines Advisory Committee in USA came out with the statement " cholesterol is no longer a nutrient of concern " in February.

 

[graj0]

I can see a future where people realise what statins have done to them and start to sue the NHS - then they really will be in financial trouble

Should there ever be a class action, I would like to be on the list please. The pity is that I know the NHS doesn't have 2 halfpennies to rub together but the manufacturers who may or may not be guilty of conveniently hiding a lot of their testing results, and have benefited financially by having half the world (OK, slight exaggeration, but I think you get the picture) taking them, maybe they should be sued.

Sorry, back to topic, FBG, my morning readings are never the lowest of the day, usually. Not only does one size not fit all, but even my day to day readings differ despite a fairly constant diet, carb wise.