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

[bulkbiker]

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?

The body reaches high levels of blood sugar during an OGTT because you drink a heavy solution of glucose. It's the time it takes to get back to normal that is measured by the test. It's an artificial way of seeing ho you react to glucose.
Was that what you mean?

 

[CrumblingWall]

The body reaches high levels of blood sugar during an OGTT because you drink a heavy solution of glucose. It's the time it takes to get back to normal that is measured by the test. It's an artificial way of seeing ho you react to glucose.
Was that what you mean?

Yes. What caused me and him to be LATE to get back down to normal? Is it resistance or not enough insulin, or both ...

 

[Cocosilk]

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

Do you always get hypos after a carby meal with reactive hypoglycaemia?

I did have gestational diabetes which to me signifies some kind of underlying issue otherwise every pregnant woman should get it if it were normal.

As far as hypos go, on my home metre, I've seen 3 or 4 readings in the 3s that I can remember over the past 18 weeks. The first was a crash after carbs very early on after diagnosis and while still pregnant.

Another (3.6) was while fasting 14h with only a tiny snack at the 11h mark while also breastfeeding and eating keto.

And again the other morning I had 3.8 close to first thing in the morning and breastfed without eating just to see if it would drop me more ir if my liver would kick in, and 30 and 60 mins later I got 4.2 which seemed to be my liver doing its dawn job.

Otherwise I more often had fasting between 5.1 and 5.6 during pregnancy, for which I was eventually taking 22 units of insulin each night for.

And since giving birth, I was often still getting low 5s but also had some high 4s then the odd 4.6 fasting. Lower fasting levels tend to be between meals for me.

I can remember often getting so hungry I would shake when I was in my 20s and too busy gardening to bother to eat until I was stupidly hungry. So I'm sure I've had mild hypos at different stages. I always had a sweet tooth and this past few months is the only time I've been strict with my diet.

How do they treat reactive hypoglycaemia as an official diagnosis?

I'll probably stick to low carb to be on the safe side from now on anyway. Thanks for flagging that for me. I can tell you the 13.8 reading I got on my own metre during g the GTT certainly didn't feel like a healthy response with all the sudden trips to the toilet to pee for that last hour and neither did the crash afterwards so I still suspect sugars might be a bit of a poison for me now.

 

[Cocosilk]

Yes. What caused me and him to be LATE to get back down to normal? Is it resistance or not enough insulin, or both ...

What if the problem is not actually your body (as in, you should still be reasonably healthy) but the problem is the kind of food that causes those reactions in the body and our expectation that we should be able to deal with it?
I'd take it as a warning from your body to eat differently and see if you can find the right balance.

And it looks like after low carbing for a while, it's a bad idea to have "cheat days" or occasional high carb meals. You'd be better to reintroduce some healthy carbs more slowly to give your body time to adjust.

Don't keto eat and calorie restrict all the time until you work out how not to spit starvation ketones and dehydrate yourself - again, don't do extremes. Step slowly and since you have a metre, test after eating and keep notes. Also of bowel movements to learn how to balance it.

I've had diarrhea too from overconsumption of fats on keto, but also if I didn't eat enough veges over a few days on keto then had a big vege meal to compensate. When I was still eating carbs, I was more often constipated when I ate meat. Now, meat with its fats as a meal on its own seems just fine when it exits.

Of course, we could also have an underlying pathology but as far as carb foods go, especially processed ones, they are not natural for any of us to be consuming and only those who eat them in moderation and probably skip meals sometimes, never snack between meals or overeat, and also have the genes from those who started adapting to this more processed diet can get away with eating carbs longer over a lifetime. But even they are not without some health problem or other and who knows just how much the sugars contribute to it?

 

[Cocosilk]

@CrumblingWall
https://images.app.goo.gl/Cv9rk2CFkZQ8gH1X6

Think of it like that. We are told not to feed the birds because it will affect their health.
Well, humans were wild once too, before they kept being fed by the big food corporations and look what it's done to us.

 

[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).

Yes, that's how I am trying to eat too. I won't be eating carbs that do that to me anymore. I had to pee like mad during the second half of the GTT after spiking up to 12 or 13.8 at the 1h. I felt what it did to me.

My metre was the one they give to gestational diabetic women here in this part of Australia. The brand is Contour next.

 

[Sapien]

Yes, that's how I am trying to eat too. I won't be eating carbs that do that to me anymore. I had to pee like mad during the second half of the GTT after spiking up to 12 or 13.8 at the 1h. I felt what it did to me.

My metre was the one they give to gestational diabetic women here in this part of Australia. The brand is Contour next.

Your Contour Next meter seemed to read 1-2 mmol higher than the labs draws. I have a Contour next and it generally but not always reads higher than my other meter at higher levels - over 6.1 (110) but interestingly consistently reads lower below around 4 (72). I have seen 3.3 (59) on the Contour when the other meter read 3.8 (69). I haven’t yet had the opportunity to compare both meters against labs to see which is closer and if one seems to consistently run high or low.

 

[Lamont D]

Do you always get hypos after a carby meal with reactive hypoglycaemia?

I did have gestational diabetes which to me signifies some kind of underlying issue otherwise every pregnant woman should get it if it were normal.

As far as hypos go, on my home metre, I've seen 3 or 4 readings in the 3s that I can remember over the past 18 weeks. The first was a crash after carbs very early on after diagnosis and while still pregnant.

Another (3.6) was while fasting 14h with only a tiny snack at the 11h mark while also breastfeeding and eating keto.

And again the other morning I had 3.8 close to first thing in the morning and breastfed without eating just to see if it would drop me more ir if my liver would kick in, and 30 and 60 mins later I got 4.2 which seemed to be my liver doing its dawn job.

Otherwise I more often had fasting between 5.1 and 5.6 during pregnancy, for which I was eventually taking 22 units of insulin each night for.

And since giving birth, I was often still getting low 5s but also had some high 4s then the odd 4.6 fasting. Lower fasting levels tend to be between meals for me.

I can remember often getting so hungry I would shake when I was in my 20s and too busy gardening to bother to eat until I was stupidly hungry. So I'm sure I've had mild hypos at different stages. I always had a sweet tooth and this past few months is the only time I've been strict with my diet.

How do they treat reactive hypoglycaemia as an official diagnosis?

I'll probably stick to low carb to be on the safe side from now on anyway. Thanks for flagging that for me. I can tell you the 13.8 reading I got on my own metre during g the GTT certainly didn't feel like a healthy response with all the sudden trips to the toilet to pee for that last hour and neither did the crash afterwards so I still suspect sugars might be a bit of a poison for me now.

Yes, I'm carb intolerant!
If you read the RH forum, the standard norm for typical diagnosis is a carb laden reaction. However, it is my experience that even so called healthy carbs will cause the same symptoms and blood sugar roller coaster ride of spikes and hypos.

The reason is as with some T2, high insulin resistance, because of the IR, a weak initial insulin response, and a secondary insulin overshoot.

 

[bulkbiker]

Yes. What caused me and him to be LATE to get back down to normal? Is it resistance or not enough insulin, or both ...

Could be either or as you say a combination of the two.. For my results it looks like I got a double insulin boost hence the two peaks in the graph which over compensated slightly and sent my bloods lower than when I started the test.

 

[Cocosilk]

Your Contour Next meter seemed to read 1-2 mmol higher than the labs draws. I have a Contour next and it generally but not always reads higher than my other meter at higher levels - over 6.1 (110) but interestingly consistently reads lower below around 4 (72). I have seen 3.3 (59) on the Contour when the other meter read 3.8 (69). I haven’t yet had the opportunity to compare both meters against labs to see which is closer and if one seems to consistently run high or low.

I've seen 0.6 mmol variation in readings on my Contour next with blood taken from the same finger prick.
But there was also a time difference of almost 2 hours between the fasting reading I got of 5.0 and their fasting reading of 4.6. I didn't get a chance to do another reading then.
With the 1h, my 13.8 was a couple of mins after theirs so it probably hadn't risen that fast. And the 2h readings are a mystery because my 2 readings of 8.5 and 7.5 were taken just minutes on either side of their blood draw which read 6.5 mmol. But I guess theirs is more accurate than a home metre, isn't it?

 

[Cocosilk]

Could be either or as you say a combination of the two.. For my results it looks like I got a double insulin boost hence the two peaks in the graph which over compensated slightly and sent my bloods lower than when I started the test.

What does your insulin (/glucose ratio?) look like these days?

 

[bulkbiker]

What does your insulin (/glucose ratio?) look like these days?

My last fasting insulin (from Oct 2018) was 5.47 with FBG of 4.85 gave me a HOMA IR reading of 1.06.
"slightly elevated" according to the results that came with it.

 

[Cocosilk]

My last fasting insulin (from Oct 2018) was 5.47 with FBG of 4.85 gave me a HOMA IR reading of 1.06.
"slightly elevated" according to the results that came with it.

Well that certainlyis interesting...
Mine says Fasting Insulin 6.3 mU/L
Fasting P (?) Glucose 4.4 mmol/L
HOMA Index 1.2 (normal if less than 2)

And my fasting glucose at home on waking that morning was 5.0 although my metre may read a point higher because it was higher on all points during the GTT as well.
But even with what they got, it's classed as normal, yet it's a higher number than yours but yours was slightly elevated.

Also my GTT result of 12.1 at 1h and then my own reading at 4h in the 3s with me having thr shakes makes me thing something is a bit off still, but the comment is that it may indicate glucose intolerance. Suggest repeat GTT or HbA1c in one year.
But no dietary advice.
Just that I should start statins.

I saw my doctor again today and asked her to take a look at Dave Feldman's site. I also mentioned the Lean Mass Hyper Responders who have much higher cholesterol than mine but feel confident nothing is wrong if they have done a carotid artery ultrasound and it comes back clear.
She said that ultrasound is only going to find a problem in its late stages and if there is elevated blood cholesterol she believes it will lead to clogged arteries down the track.
So even if I did get s carotid artery scan, she would expect it to come back clear for me but that would not change her mind about me needing statins...

What do you make of that?

That's just current guidelines about how cholesterol works but it might not be right with this new research, right?

 

[bulkbiker]

Well that certainlyis interesting...
Mine says Fasting Insulin 6.3 mU/L
Fasting P (?) Glucose 4.4 mmol/L
HOMA Index 1.2 (normal if less than 2)

And my fasting glucose at home on waking that morning was 5.0 although my metre may read a point higher because it was higher on all points during the GTT as well.
But even with what they got, it's classed as normal, yet it's a higher number than yours but yours was slightly elevated.

Also my GTT result of 12.1 at 1h and then my own reading at 4h in the 3s with me having thr shakes makes me thing something is a bit off still, but the comment is that it may indicate glucose intolerance. Suggest repeat GTT or HbA1c in one year.
But no dietary advice.
Just that I should start statins.

I saw my doctor again today and asked her to take a look at Dave Feldman's site. I also mentioned the Lean Mass Hyper Responders who have much higher cholesterol than mine but feel confident nothing is wrong if they have done a carotid artery ultrasound and it comes back clear.
She said that ultrasound is only going to find a problem in its late stages and if there is elevated blood cholesterol she believes it will lead to clogged arteries down the track.
So even if I did get s carotid artery scan, she would expect it to come back clear for me but that would not change her mind about me needing statins...

What do you make of that?

That's just current guidelines about how cholesterol works but it might not be right with this new research, right?

This is the exact comment..


You need a more switched on GP would be my take but as always I have researched and will decide for myself what to put in my body. Statins will never be something I will take. The CT scan is not an ultrasound either so she's not that aware of the scan.

 

[Cocosilk]

This is the exact comment..
View attachment 34121

You need a more switched on GP would be my take but as always I have researched and will decide for myself what to put in my body. Statins will never be something I will take. The CT scan is not an ultrasound either so she's not that aware of the scan.

She thought I wanted an angiogram... but I had to look up the ones that I heard people use. One is the coronary calcium score and the other is an ultrasound of the carotid artery. She said "you'll come back clear on those because you are young but you still need a statin."
I think I'll just ignore it for the time being and look for a low carb doctor. Probably have to travel a couple of hours to get to one.

 

[bulkbiker]

I think I'll just ignore it for the time being and look for a low carb doctor.

Possibly unnecessary.. as I always say I decide what goes into my body.. the doc is there for advice.
Providing you are able to investigate for yourself then there's no real need to change.

 

[Sapien]

Your Contour Next meter seemed to read 1-2 mmol higher than the labs draws. I have a Contour next and it generally but not always reads higher than my other meter at higher levels - over 6.1 (110) but interestingly consistently reads lower below around 4 (72). I have seen 3.3 (59) on the Contour when the other meter read 3.8 (69). I haven’t yet had the opportunity to compare both meters against labs to see which is closer and if one seems to consistently run high or low.

I got back lab test with fasting glucose today which I compared to finger stick on my Contour Next (and ReliOn Premier) meters.

1/2 hour before lab:
ReliOn 85 (4.72)

Lab 84 (4.66)

10 minutes after lab:
ReliOn 91 (5.06)
Contour Next 89 (4.94)
Contour Next One 88 (4.89)

It looks like my meters read slightly higher than the lab - consistent with your experience.

Overall I was impressed have close the readings were considering how unreliable I have heard home meters can be. Sometimes I see more variation between my meters but still within 10 mg/dL (or 0.55 mmol/L)

Edited: double checked meters, originally posted from memory

 

[Resurgam]

I found an article in the BMJ open site which gave details of LDL cholesterol and age at death - and it seems that after checking the data on some 68 thousand individuals it is usual to live longer with higher LDL levels.
I printed off a copy and gave it to the nurse I saw at the surgery last time I had a Hba1c test, and she started to read it and talk about levels of HDL until I corrected her and she stopped trying to press me to consider statins