Prediabetes Hba1c 5.8%

[saky]

My hba1c is 5.8%. Applied cgm yesterday. My sugars are rising after eating salad, brocoli fry with tofu, a small piece of almond bread with butter, 2 egg omelet with 2 spoons cheese. Sugars climbed up to.116mg/dl in 50 minutes. After 55 minutes 111 mg/dl.
60 minutes 99 mg/dl
62 minutes 93mg/dl

Why are the sugars rising so high? Am eating low carb only.
My glucometer (acuchek)
20mins .. 105mg /dl
55mins ....99mg/dl
1hour 5 mins....94 mg/dl
I want to go very low carb (currently 80g). Or do keto. Will that help?

 

[HSSS]

You don’t say what they were pre meal. Also cgm are not perfect any more than meters are. There is some tolerance in the numbers and trying to see anything in a mg or two is futile.

At one hour, with a large % of food, the rise will be around its peak. You can see yours begging to fall. In the region of 100 to 120 (5.5 to 6.5mmol ish) is not “so high”. It’s normal. Also the response is usually measured at 90 to 120 mins giving insulin the time it needs to take levels back to pre meal levels - where a non diabetic tends to end up close to. Almost all food will have some effect as very little is zero carb We wont eliminate every variation we just aim to limit them and keep them steady ish https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

 

[EllieM]

I've probably posted this link to you before, but here is what happened when some non diabetics wore a cgm for 10 days. It's normal for nondabetics to have blood sugars that go up and down.

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

www.ncbi.nlm.nih.gov

Your blood sugars seem pretty normal to me

 

[saky]

You don’t say what they were pre meal. Also cgm are not perfect any more than meters are. There is some tolerance in the numbers and trying to see anything in a mg or two is futile.

At one hour, with a large % of food, the rise will be around its peak. You can see yours begging to fall. In the region of 100 to 120 (5.5 to 6.5mmol ish) is not “so high”. It’s normal. Also the response is usually measured at 90 to 120 mins giving insulin the time it needs to take levels back to pre meal levels - where a non diabetic tends to end up close to. Almost all food will have some effect as very little is zero carb We wont eliminate every variation we just aim to limit them and keep them steady ish https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

Premeal 84mg/dl(cgm)

 

[saky]

I've probably posted this link to you before, but here is what happened when some non diabetics wore a cgm for 10 days. It's normal for nondabetics to have blood sugars that go up and down.

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...

www.ncbi.nlm.nih.gov

Your blood sugars seem pretty normal to me

Hba1c is elevated. Will test again tomorrow in another lab.

 

[HSSS]

So using cgm figures, at the absolute highest you rose by less than 2mmol (32mg) at one hour. By 2 hrs it would have been significantly less and likely back to pre meal or close. At all times under 7.8mmol (140mg). Totally normal response. Ideal even. Perfectly acceptable meal imo. What are you wanting to see?

 

[saky]

So using cgm figures, at the absolute highest you rose by less than 2mmol (32mg) at one hour. By 2 hrs it would have been significantly less and likely back to pre meal or close. At all times under 7.8mmol (140mg). Totally normal response. Ideal even. Perfectly acceptable meal imo. What are you wanting to see?

Small spikes like 104 to 105mg/dl.
Hba1c atleast in normal ranges...

 

[catinahat]

Hi saky
I've converted your results into uk units so I could understand your readings
First I'll just mention that you must have read on here that the meters or sensors are not accurate enough to get in a panic over small differences in results.
The next thing to bear in mind is that our blood sugar levels are not stable or fixed at one level until we eat. They are on the move all of the time, reacting to us just living,

So your numbers in UK units
4.7 mmol to 6.4 50min later, a rise of just 1.7 mmol which is an entirely reasonable rise, and shows that your low carb meal released a minimal amount of glucose

5min later your level had fallen to 5.5mmol, a drop of. 0.9, that shows that your insulin has kicked in and is doing it's job.

2min later so just about an hour after eating, your level was 5.2, and just 0.5mmol above your pre meal level.
As mentioned above due to the less than ideal accuracy issues of our testing equipment.
A difference of 0.5 can be considered as being in the same range as your 4.7 reading.

Small spikes like 104 to 105mg/dl

A spike from 84 10 104 =20mg/dl is 1.1 mmol in our units.
Nowhere in anything you have read anywhere, will call a rise of just 1.1mmol a spike, it's not even close to a spike, if you doubled it it would not be considered a spike 50min after eating.
Your expectations are unreasonable, what you are saying is that you are unhappy with a rise of 1.7mmol in 50min, but you would be happy with 1.1mmol

 

[saky]

Am scared it may deteriorate further. I want to keep it under control to avoid kidney damage, eye damage etc. My mum.is in end stage renal failure with type 2 for over 27 year's plush she has heart issued( by pass surgery). She also has dementia now. I want to avoid that situation..

 

[catinahat]

I understand your fears, we all share them, no one wants their health to deteriorate. But you must not let the fear of what might or might not happen ruin your life by obsessing over small inaccurate numbers.
You are doing everything possible by keeping to a healthy low carb diet and exercising, put your meter away for a while, stop stressing over the numbers.

 

[saky]

I understand your fears, we all share them, no one wants their health to deteriorate. But you must not let the fear of what might or might not happen ruin your life by obsessing over small inaccurate numbers.
You are doing everything possible by keeping to a healthy low carb diet and exercising, put your meter away for a while, stop stressing over the numbers.

Yes. I must do that for a while....

 

[HSSS]

Small spikes like 104 to 105mg/dl.
Hba1c atleast in normal ranges...

Completely unrealistic. A 1mg change is totally unable to differentiate anything. Meters have something like a 15% tolerance so a reading of 100mg could be as low as 85 or as high as 115. Nothing you’ve identified is a spike. It’s a completely normal reaction to food. And these tiny rises could just as easily be from walking down the road, up the stairs, a bit of stress or being a bit tired, too cold, too warm or the most minute of colds etc.

A single meal‘s readings will not predict your hba1c. Consistently getting readings such as these is highly likely to give you a normal hb1ac.

You need to reset expectations and realise you’re doing a good job even whilst overthinking things. It’s hard when we’re scared but you are already doing what you can. Stressing will only make things worse.

 

[saky]

Completely unrealistic. A 1mg change is totally unable to differentiate anything. Meters have something like a 15% tolerance so a reading of 100mg could be as low as 85 or as high as 115. Nothing you’ve identified is a spike. It’s a completely normal reaction to food. And these tiny rises could just as easily be from walking down the road, up the stairs, a bit of stress or being a bit tired, too cold, too warm or the most minute of colds etc.

A single meal‘s readings will not predict your hba1c. Consistently getting readings such as these is highly likely to give you a normal hb1ac.

You need to reset expectations and realise you’re doing a good job even whilst overthinking things. It’s hard when we’re scared but you are already doing what you can. Stressing will only make things worse.

Yes. You are right

 

[ajbod]

Hi Saky. ALL the figures you quoted above fall within the accepted variations allowed for meter accuracy. Theoretically the actual precise levels could have been identical.
When you are stressing over nothing, your Insulin levels drop, Adrenaline levels rise, and the liver dumps some Glucose.
Your worrying about nothing is making things WORSE, BUT they are still very good levels despite this.
I would KILL for levels as good as yours, please chill there is NO problem.

 

[CJCoop]

These readings are incredible and within a range of optimal health as per literature and also have relatives who have these numbers well into their 90s with no complications vs higher numbers medically associated with complications. Your fear is understandable but the stress alone with - unfortunately, watching your mother's battles- will gradually move you out of those numbers yourself

I wish you both well