GTT: Diabetes, Prediabetes, or Low Carb messed it up?

[Cocosilk]

So I had gestational diabetes and have just done a follow up GTT at 8 weeks postpartum.

Since I had a metre, I decided I would measure every 15 mins while in pathology taking the test so I could possibly know my result before the doctor gets back to me next week.

I was a bit shocked when I saw the 1h peak and am not sure what diagnosis I will get yet. I know noone else is allowed to diagnose me but just interested in your thoughts.

A few things may have messed the test up so I'll mention them:
I didn't get time to fully prepare for the test coming from months on a low carb diet and ate homemade pancakes with honey for the two preceding mornings only. Saw 1h spikes of 8 -9mmol from those and was around 7.6 at 2hs but had been eating for a whole hour. I didn't measure my carbs, just ate 3 eggs, milk, half a cup of flour, butter and around 3 tablespoons of honey. Probably not 150g of carbs per day and not for 3 days preceding.

Next thing, I'd only had 3 - 4 hours sleep per night in the 3 nights leading up to the test (up with baby)
and
I was under extra stress as my 3yo ended up in emergency and has since stayed a couple of nights in hospital with breathing difficulties.

My last GTT was done a few months ago while pregnant. Results were:
Fasting 5.1mmol
1h 9.7
2h 7.4
The fasting result was just on the new bottom limit and got me the diagnosis.

Anyway, here's what my metre read this time:
My fasting was taken a home a couple of hours earlier: 5.0mmol
Then after the 75g glucose drink:
7.4 mmol 15 mins
10.4 - 30m
12.8 - 45m
12.9 - 57m
They drew my 1h bloods
13.8 - 63mins
12.6 - 72m
11.4 - 82m
10.1 - 90m
8.2 - 1h45
8.5 - 1h59
They drew my 2h bloods
7.5 - 2h 07mins
3.7 - 4 hours

Diabetic, prediabetic, or just a messed up GTT?

 

[Resurgam]

If you don't obey the instructions on how to eat before the test, then surely the results are meaningless. Personally I'd have cancelled, rather than waste the time it took

 

[Sapien]

It looks like your meter was giving consistent readings. When you get the lab test back you can see how accurate the finger stick readings were. If the finger stick readings near one and two hours were accurate, I would like to know which meter you use.

If really over 11.1 (200) at one hour, then I would definitely be concerned. It doesn’t really matter so much if it is labeled pre-diabetes or diabetes. High spikes that happen frequently can be damaging. Not eating at least 150 carbs daily in the days before the OGTT can certainly alter the results, but it still is your body’s response.

I don’t care if my doctor says my blood sugars are high normal, pre-diabetic or diabetic. I want to avoid any spikes over 7.8 (140). I am trying to keep all high readings below 6.7 (120) while still eating moderate low carb (below 150 grams / day or so).

 

[bulkbiker]

The high looks similar to mine.. but I was back to almost the pre drink level after 2 hours.

I did this one without carbing up beforehand so was preceded by keto eating for about 1 1/2 years beforehand.

 

[Cocosilk]

If you don't obey the instructions on how to eat before the test, then surely the results are meaningless. Personally I'd have cancelled, rather than waste the time it took

Yeah, I won't be doing another one.

 

[Cocosilk]

The high looks similar to mine.. but I was back to almost the pre drink level after 2 hours.

View attachment 34035 View attachment 34036

I did this one without carbing up beforehand so was preceded by keto eating for about 1 1/2 years beforehand.

Was this the test that got you the diagnosis? And you've had a T2 diagnosis, haven't you? Although that return is really good and shows better insulin sensitivity, doesn't it? Did you do this test before or after going low carb?

 

[bulkbiker]

Was this the test that got you the diagnosis? And you've had a T2 diagnosis, haven't you? Although that return is really good and shows better insulin sensitivity, doesn't it? Did you do this test before or after going low carb?

This was a home test I did about 1 1/2 years after my HbA1c of 87 mmol/m on 15 October 2015 followed by another of 70 mmol/m on 30th October 2015.
Here in the UK diagnosis is usually by HbA1c tests 2 weeks apart. If both are higher than 48 mmol/m then you are diagnosed with Diabetes. Type 2 usually.
This OGTT was done after about 1 1/2 years of keto eating and intermittent fasting without changing my diet beforehand.
I guess I should do another after a year of carnivore to see if the results change much.. then again do I want to drink 75g of glucose .... hmmm

 

[Cocosilk]

It looks like your meter was giving consistent readings. When you get the lab test back you can see how accurate the finger stick readings were. If the finger stick readings near one and two hours were accurate, I would like to know which meter you use.

If really over 11.1 (200) at one hour, then I would definitely be concerned. It doesn’t really matter so much if it is labeled pre-diabetes or diabetes. High spikes that happen frequently can be damaging. Not eating at least 150 carbs daily in the days before the OGTT can certainly alter the results, but it still is your body’s response.

I don’t care if my doctor says my blood sugars are high normal, pre-diabetic or diabetic. I want to avoid any spikes over 7.8 (140). I am trying to keep all high readings below 6.7 (120) while still eating moderate low carb (below 150 grams / day or so).

I was definitely concerned when I saw the 12 then 13.8mmol. In the months that I was gestationally diabetic, right at the start whilw I was still working out what to eat, I got a 10mmol (1h spike) once after eating a meat pie of all things and 8 - 9 after chicken nuggets or weetbix. The 2h was 7 or just over 8mmol then. I stayed right away from those foods after that and have been fairly low carb since then except for having a chocolate that someone gifted us after the birth (and being assured my sugars were probably back to normal now that I'd given birth), and then a few of my pancakes at 4 weeks postpartum when my fasting was around 4.6mmol. I thought maybe things were finally settling down but I spiked into the 8s and returned to 7s.

Still wasn't looking goid and because I wasn't sure how to measure the carbs, I thought I would go and do the GTT again.

I know anything over 11mmol is potentially T2. So I guess I'd better assume the worst and stay strict with my low carb eating.
The morning after the GTT my fasting was only 3.8mmol. I breastfed bubs and waited for dawn phenomenon to kick in. After an hour it only got to 4.2mmol because I hadn't eaten as much as usual. But this morning's fasting was 5mmol again.

 

[Cocosilk]

This was a home test I did about 1 1/2 years after my HbA1c of 87 mmol/m on 15 October 2015 followed by another of 70 mmol/m on 30th October 2015.
Here in the UK diagnosis is usually by HbA1c tests 2 weeks apart. If both are higher than 48 mmol/m then you are diagnosed with Diabetes. Type 2 usually.
This OGTT was done after about 1 1/2 years of keto eating and intermittent fasting without changing my diet beforehand.
I guess I should do another after a year of carnivore to see if the results change much.. then again do I want to drink 75g of glucose .... hmmm

Wait, I'm confused. When you got those results, you'd had the HB1AC of 8.7mmol 1.5 years beforehand and after having eaten keto for 1.5 years and then you did a home GTT straight after 1.5y of keto without a carb up in the 3 days prior?

Was 8.7 mmol your worst HB1AC? Your return to 5.7mmol at 2h on your OGTT shows a healthy response to carbs again?

Whereas my 1h looks properly diabetic and my 2h is probably prediabetic. So I clearly have some work to do.

The thing I am most puzzled about re my own results is how it got that much worse since 28 weeks pregnant when I had been eating even naughty sweet things, but since diagnosis and after the birth I was much lower carb, yet 9.7 became 13.8 at 1h. The 2 hour has not changed all the much but may have gone from not diabetic to prediabetic. This is 18 weeks later. So 4.5 months all lower carb but the first 10 weeks I had the pregnancy hormones making me increasingly insulin resistant. Seems as though it continued postpartum even beyond the 6 weeks. If I had been prediabetic before pregnancy, the GTT in pregnancy should have shown prediabetic numbers, but I don't think they do quite. Under 7.8 at 2h and they won't diagnose you. Although I know that level of insulin resistance is still not a good thing.

Edited: I just got a call from my doctor's office. That's pretty soon after the test. I think I know what she's going to tell me..

 

[Cocosilk]

The high looks similar to mine.. but I was back to almost the pre drink level after 2 hours.

View attachment 34035 View attachment 34036

I did this one without carbing up beforehand so was preceded by keto eating for about 1 1/2 years beforehand.

By the way, if you got this on an official GTT, would they still diagnose T2 because it went over 11mmol? Or will they look at the 5.7mmol at the 2h and send you on your way diagnosis-free?

 

[bulkbiker]

Wait, I'm confused. When you got those results, you'd had the HB1AC of 8.7mmol 1.5 years beforehand and after having eaten keto for 1.5 years and then you did a home GTT straight after 1.5y of keto without a carb up in the 3 days prior?

Was 8.7 mmol your worst HB1AC? Your return to 5.7mmol at 2h on your OGTT shows a healthy response to carbs again?

Whereas my 1h looks properly diabetic and my 2h is probably prediabetic. So I clearly have some work to do.

You have confused yourself by mixing my HbA1c results of 87 mmol/m and 70 mmol/m with finger prick results which were the OGTT figures. These are in mmol/l .
In the UK diagnosis is normally done using HbA1c usually about 2 weeks apart.
The home OGTT I did was using the Rapilose solution that the NHS use and my home meter. The OGTT was 1 1/2 years after my diagnosis of T2 and 1 1/2 years of keto eating with intermittent fasting. I did not change my diet in the days leading up to the OGTT.
So far as I am aware I would have "passed" the OGTT because I was almost back to the pre drink level after 2 hours. The 15 minute tests that I did aren't usually done in the UK so far as I know.

 

[Cocosilk]

You have confused yourself by mixing my HbA1c results of 87 mmol/m and 70 mmol/m with finger prick results which were the OGTT figures. These are in mmol/l .
In the UK diagnosis is normally done using HbA1c usually about 2 weeks apart.
The home OGTT I did was using the Rapilose solution that the NHS use and my home meter. The OGTT was 1 1/2 years after my diagnosis of T2 and 1 1/2 years of keto eating with intermittent fasting. I did not change my diet in the days leading up to the OGTT.
So far as I am aware I would have "passed" the OGTT because I was almost back to the pre drink level after 2 hours. The 15 minute tests that I did aren't usually done in the UK so far as I know.

Okay, good to know! And guess what! I just got back from the doctor's with my results.
I need some help from people here who might have experience with cholesterol issues..
So my GTT results that they took were:
Fasting 4.4 mmol
1 hour 12.1 mmol
2 hour 6.5 mmol
My doctor said, don't worry, you're not diabetic. It was probably the low carb and stress that caused then high reading at 1h.

Then I got an insulin HOMA test on the same day, which she said is fine:
Fasting insulin: 6.3 mU/L (0 - 17)
Fasting glucose: 4.4 mmol/L (3.6 - 6.0)
HOMA Index: 1.2 (less than 2 = probably normal)

2-4 possibily insulin resistant
4-8 possibly glucose intolerant
More than 8 - possibly diabetic



And then my cholesterol...
My doctor wants me to start a statin immediately and I would have to quit breastfeeding my 8 week old baby too.
And eat low fat including margarine instead of butter, and start eating carbs again - no keto.

Total cholesterol: 8.7 mmol / L (3.5 - 5.5)
Trigs 0.7 (less than 1.5)
HDL 2.89 (more than 1.2)
LDL 5.5 (less than 3.5)
LDLC/HDLC 1.9 (less than 4)
Chol/HDLC 3.0 (less than 4.5)

I've seen a few videos from Ivor Cummins and Dave Feldman. Still a bit confused though. Would you take a statin for the high LDL and high Total cholesterol or will the stain lower my HDL too?

 

[bulkbiker]

And then my cholesterol...
My doctor wants me to start a statin immediately and I would have to quit breastfeeding my 8 week old baby too.
And eat low fat including margarine instead of butter, and start eating carbs again - no keto.

Total cholesterol: 8.7 mmol / L (3.5 - 5.5)
Trigs 0.7 (less than 1.5)
HDL 2.89 (more than 1.2)
LDL 5.5 (less than 3.5)
LDLC/HDLC 1.9 (less than 4)
Chol/HDLC 3.0 (less than 4.5)

I've seen a few videos from Ivor Cummins and Dave Feldman. Still a bit confused though. Would you take a statin for the high LDL and high Total cholesterol or will the stain lower my HDL too?

Your Trig /HDL ratio which is considered great at under 0.87 is 0.24 why on earth your doctor wants you on a statin defies logic. They are simply looking at the total and panicking..
Your LDL will be all over the place whilst settling into low carbing and has probably been impacted by giving birth too ( maybe but likely).
No way would I stop breast feeding a child in order to take a pill (not that I have ever done it!) and in your shoes I'd either say no way or at the very least say you want a 6 month settle down period before even considering medication.

I did a thread a while ago about statins etc which can be found here

https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/

It will take a while to get through!

 

[Cocosilk]

Your Trig /HDL ratio which is considered great at under 0.87 is 0.24 why on earth your doctor wants you on a statin defies logic. They are simply looking at the total and panicking..
Your LDL will be all over the place whilst settling into low carbing and has probably been impacted by giving birth too ( maybe but likely).
No way would I stop breast feeding a child in order to take a pill (not that I have ever done it!) and in your shoes I'd either say no way or at the very least say you want a 6 month settle down period before even considering medication.

I did a thread a while ago about statins etc which can be found here

https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/

It will take a while to get through!

Thank you! I'm panicking a little less after hearing that. Last week when she took my blood pressure it was 119/79. Today she took my blood pressure while telling me how bad my cholesterol is and my blood pressure was 143/88. Stress!

I just found the cholesterol code and put my numbers in.
It says I am a lean mass hyper responder and have low risk for everything.

 

[CrumblingWall]

I have a thread made here, but my experience was worse - I peeked at 14.2 mmol/l and went down to 3.9 mmol/l at 3.5 hours.

I honestly am not sure about the problem - it seems like some people claim to have a 'carb up before' view while others say it does not matter. I do not know what is right here. My endo thought it is not diabetes, but ****, I feel unwell when I spike to 10 mmol/l after carbs, and it seriously affects me. I don't know what to believe myself ...

Edited for language by moderator

 

[Cocosilk]

I have a thread made here, but my experience was worse - I peeked at 14.2 mmol/l and went down to 3.9 mmol/l at 3.5 hours.

I honestly am not sure about the problem - it seems like some people claim to have a 'carb up before' view while others say it does not matter. I do not know what is right here. My endo thought it is not diabetes, but ****, I feel unwell when I spike to 10 mmol/l after carbs, and it seriously affects me. I don't know what to believe myself ...

I agree. During the GTT in the second hour I was racing to the toilet evey 20 mins and the 4 hour crash gave me the shakes!

Conversely, I once reached 3.6 while in ketosis from fasting a little too long while breastfeeding and I wasn't shakey. But I did feel slightly euphoric and kept forgetting what I was doing (but I can blame that on my kids for being such a distraction

But even with an all clear from my doctor as far as blood sugar and insulin goes, I still feel like low carb / keto is a revelation and seems a sensible way to eat, except for trying to understand the whole dilemma around high cholesterol..

 

[Sapien]

But even with an all clear from my doctor as far as blood sugar and insulin goes, I still feel like low carb / keto is a revelation and seems a sensible way to eat, except for trying to understand the whole dilemma around high cholesterol..[/QUOTE]

Some advice from Dietdoctor for high cholesterol on low carb.

Don’t overuse butter and coconut oil just to add fat (e.g. bulletproof coffee)

Eat more healthy monounsaturated and polyunsaturated fats (olive oil, fatty fish, avocado, flax, chia, etc.) in place of saturated fat. (Still avoid processed vegetable/seed oils.)

Eat lots of green leafy and cruciferous vegetables. Nuts, seeds, avocado and some dark 85% chocolate.

If you are worried about the LDL you could get particle testing done.

https://www.dietdoctor.com/low-carb/cholesterol-basics

Toward the bottom of the page.

 

[Sapien]

Based on your lab result it looks like your meter was 1+ mmol high at both the one and two hour readings. My I ask which meter you use?

 

[Lamont D]

So I had gestational diabetes and have just done a follow up GTT at 8 weeks postpartum.

Since I had a metre, I decided I would measure every 15 mins while in pathology taking the test so I could possibly know my result before the doctor gets back to me next week.

I was a bit shocked when I saw the 1h peak and am not sure what diagnosis I will get yet. I know noone else is allowed to diagnose me but just interested in your thoughts.

A few things may have messed the test up so I'll mention them:
I didn't get time to fully prepare for the test coming from months on a low carb diet and ate homemade pancakes with honey for the two preceding mornings only. Saw 1h spikes of 8 -9mmol from those and was around 7.6 at 2hs but had been eating for a whole hour. I didn't measure my carbs, just ate 3 eggs, milk, half a cup of flour, butter and around 3 tablespoons of honey. Probably not 150g of carbs per day and not for 3 days preceding.

Next thing, I'd only had 3 - 4 hours sleep per night in the 3 nights leading up to the test (up with baby)
and
I was under extra stress as my 3yo ended up in emergency and has since stayed a couple of nights in hospital with breathing difficulties.

My last GTT was done a few months ago while pregnant. Results were:
Fasting 5.1mmol
1h 9.7
2h 7.4
The fasting result was just on the new bottom limit and got me the diagnosis.

Anyway, here's what my metre read this time:
My fasting was taken a home a couple of hours earlier: 5.0mmol
Then after the 75g glucose drink:
7.4 mmol 15 mins
10.4 - 30m
12.8 - 45m
12.9 - 57m
They drew my 1h bloods
13.8 - 63mins
12.6 - 72m
11.4 - 82m
10.1 - 90m
8.2 - 1h45
8.5 - 1h59
They drew my 2h bloods
7.5 - 2h 07mins
3.7 - 4 hours

Diabetic, prediabetic, or just a messed up GTT?

Hi, you had an extended oral glucose test over four hours.

My second eOGTT, is very similar to yours, but I went lower than your final reading into hypoglycaemic levels.
I too had a fasting levels of 5(ish)
I too had glucose dumping spikes, over 11mmols within the first hour, if not earlier.
I too had good insulin response after the spike and my blood sugar levels lowered into normal levels into a hypo.

I am definitely not saying that you have a different diagnosis, you will need further tests to get a true diagnosis.
But you do have normal fasting levels, what was your last Hba1c?
Have you had any readings of hypo levels?

I have read that some of gestational diabetes symptoms are very similar to RH!
But, doctors would not diagnose this!

Best wishes

 

[CrumblingWall]

Hi, you had an extended oral glucose test over four hours.

My second eOGTT, is very similar to yours, but I went lower than your final reading into hypoglycaemic levels.
I too had a fasting levels of 5(ish)
I too had glucose dumping spikes, over 11mmols within the first hour, if not earlier.
I too had good insulin response after the spike and my blood sugar levels lowered into normal levels into a hypo.

I am definitely not saying that you have a different diagnosis, you will need further tests to get a true diagnosis.
But you do have normal fasting levels, what was your last Hba1c?
Have you had any readings of hypo levels?

I have read that some of gestational diabetes symptoms are very similar to RH!
But, doctors would not diagnose this!

Best wishes

What is responsible for this condition though? Why is our body letting glucose to reach high levels and then overcompensate with insulin to crash the person? What is it if not diabetes?