Hi and advice needed.

[Shepster48]

hi

I posted a few days ago on the advice forum as I was getting strange low readings when using a monitor for the first time. Silly me was doing it wrong. Strange it gave me any reading at all and not an error message

So i’ll Start again here And see what you think

I’m 48, male, quite slim but a bit of a belly, just usual for a man of my age. I’m 6ft and 85kgs. Work in an office so very little exercise.
I have Gilbert’s syndrome and fatty liver. After abdominal pain last year I was admitted to hospital where I had a ct scan on my abdomen and after release I later paid for a special mri with pancreas protocol on my pancreas. All came back fine.

For a few years I’ve been getting occasional fainting feeling after doing either a lot of gardening or running and would need to go and eat something sugary and rest for a few minutes until it passed.

Lately this has gotten more regular and is at a stage that I always have to make sure I’ve eaten before I do anything erertive. If I’ve eaten I seem ok.

I’ve had fasting blood tests in the past and as far as I know are ok as my gp has never said anything was wrong.

Over the weekend I decided to get a blood glucose monitor to see when and why I was going faint.
However, my readings have worried me as they are showing I may have diabetes and my glucose is hyper rather than hypo.

24/3 before bed 105

25/3 before breakfast 125
Bran flakes and milk
25/3 after breakfast 203
25/3 before lunch 101
Chicken salad
25/3 after lunch 88
25/3 before dinner/tea 91
Jacket spud, salad, chicken
25/3 after dinner 193
25/3 before bed at midnight 150

26/3 before breakfast 156
Poached eggs
26/3 after breakfast 119
26/3 before lunch 110
Chicken salad
26/3 after lunch 113
26/3 before dinner/tea 100
Smoked fish

Awaiting post 2 hour wait for reading after dinner as we ate late.

I was surprised at the large spike after a modest portion of carbs when I ate bran flakes and when I ate a small jacket potatoe with my tea.
I also don’t understand why my fasting number overnight is actually higher than before I went to bed 8 hours earlier. How is that even possible. Am I not releasing insulin? Nothing was found wrong with my pancreas when it was scanned last year. No pancreatitis or any tumours.

I seem to be hungry all day as I’m trying to eat little carbs but my blood sugar is still over 100.

I’m now really worried as Ive read 2 fasting readings overnight that are over 125 means diabetes.

Do these readings look worrying. I see my gp on Friday and will show him my readings.
What would my readings be if I was insulin resistant?

 

[HSSS]

Ok I’m no going to pass comment about diagnosis (mainly because I’m not familiar with your numbers and I’m too tired to convert them right now). But I can answer a couple of points. Dawn phenomenon is likely why you’re fasting n7mbers are higher then bedtime. Everyone has it to some extent. Type 2 diabetics can have a runaway version. Liver thinks it’s wake up time and dumps some glucose to be helpful. “Normal” people use it and deal with any excess. We fail to deal with any excess and it floats around for longer than necessary.

Carbs, especially grains like bran flakes do cause large spikes for us too. Your reading show similar larger jumps after potato too. It’s not a surprise to me I’m afraid.

Insulin resistance is when we have a huge amount of insulin because it can’t do it’s job of letting the glucose into cells to be used. So we pump more and mor rout trying to get the message (glucose) through. It begins long before diabetes or even pre diabetes is diagnosed. Maybe even decades. Insulin is what needs testing but it’s not done (here in the uk) unfortunately, just the results of its failing to work effectively ie blood glucose disregulation.

If you cut carbs you need more fats. I know that sounds scary but you need energy and if it isn’t coming from one it has to come from the other.

 

[HSSS]

[I’m making an assumption of if anything is diagnosed it’s type 2 in all the below advice.]

Some light reading for you

Can I suggest you take a good look at low carb high fat methods of eating (keto is just a version of this). It helps many of us lose significant amounts of weight, if desired, keep our numbers down and for some even eliminate medications and achieve remission and reduce or improve complications. Try clicking these links for more detailed explanations that are well worth readings


https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple


And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation


and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas


also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.

 

[EllieM]

OK, firstly we're not doctors here and can't diagnose, but....

At a quick glance those readings look consistent with diabetes or prediabetes. They are a little on the high side, and your doctor will probably want to do some more tests to check it out. Given your slightly complicated medical history, I wouldn't want to say more than that.

As @HSSS said, the high morning readings are likely caused by dawn phenomena, where your liver pumps out sugar so you can go out and chase that mammoth/sabre tooth tiger/whatever prehistoric man had to eat, and your body can't quite cope with that amount of sugar in one hit.

The good news, those readings are a little high, but not drastically so. Assuming it's diabetes (it really might not be) there's a good chance you can bring those figures down just by reducing your carb intake.

Good luck.

 

[EllieM]

For a few years I’ve been getting occasional fainting feeling after doing either a lot of gardening or running and would need to go and eat something sugary and rest for a few minutes until it passed.

Did you do any blood tests while having this feeling? Unfortunately if you've been running high blood sugars for a while, you can actually have hypo symptoms at "normal" (though lower than your usual) blood sugar levels. But you definitely should be talking to your doctor about this, as it might not be diabetes related at all.

 

[Shepster48]

Did you do any blood tests while having this feeling? Unfortunately if you've been running high blood sugars for a while, you can actually have hypo symptoms at "normal" (though lower than your usual) blood sugar levels. But you definitely should be talking to your doctor about this, as it might not be diabetes related at all.

Whenever i mentioned this to my gp he did a fasting blood test which seemed to come back fine. I first noticed it happening occasionally around 3 years ago this summer when doing some very tiresome landscaping but it’s happening with just general garden work or lifting stuff in the house for a prelonged period.

 

[Shepster48]

Ok I’m no going to pass comment about diagnosis (mainly because I’m not familiar with your numbers and I’m too tired to convert them right now). But I can answer a couple of points. Dawn phenomenon is likely why you’re fasting n7mbers are higher then bedtime. Everyone has it to some extent. Type 2 diabetics can have a runaway version. Liver thinks it’s wake up time and dumps some glucose to be helpful. “Normal” people use it and deal with any excess. We fail to deal with any excess and it floats around for longer than necessary.

Carbs, especially grains like bran flakes do cause large spikes for us too. Your reading show similar larger jumps after potato too. It’s not a surprise to me I’m afraid.

Insulin resistance is when we have a huge amount of insulin because it can’t do it’s job of letting the glucose into cells to be used. So we pump more and mor rout trying to get the message (glucose) through. It begins long before diabetes or even pre diabetes is diagnosed. Maybe even decades. Insulin is what needs testing but it’s not done (here in the uk) unfortunately, just the results of its failing to work effectively ie blood glucose disregulation.

If you cut carbs you need more fats. I know that sounds scary but you need energy and if it isn’t coming from one it has to come from the other.

Just realised my glucose monitor is set to USA. It was that by default. Oh dear, I guess I never realised as all the literature and numbers I’ve read seems to be American. Sorry.

That’s good if this dawn phenomenon is a normal event. Would someone who is not diabetic or prediabetic still show an increase if they did a test? I guess not or all fasting tests overnight would be high.

I was reading about Keto and having increased fats. Would I do that straight away or wait until I lose weight?
Is it safe to eat fats when I have a fatty liver. I would expect it also has to be good fats rather than trans fats.

 

[EllieM]

That’s good if this dawn phenomenon is a normal event. Would someone who is not diabetic or prediabetic still show an increase if they did a test? I guess not or all fasting tests overnight would be high.

I think the issue is that someone who is diabetic or prediabetic can't process the dawn sugar dump, so their blood sugar goes up. If your metabolism is normal, it isn't an issue.

 

[EllieM]

Just realised my glucose monitor is set to USA. It was that by default. Oh dear, I guess I never realised as all the literature and numbers I’ve read seems to be American. Sorry.

Just make sure you give your doctor figures that correspond to the country you are living in. (As a typical family doctor may not know how to do the conversion.)

https://www.diabetes.co.uk/blood-sugar-converter.html

Basically, divide by 18 to convert your figures (mg/dL) into mmol/L.

And it would help to put your home country into your profile as advice about doctors (eg dial 111 if you want emergency medical advice in the UK) varies by country.

 

[Shepster48]

Just make sure you give your doctor figures that correspond to the country you are living in. (As a typical family doctor may not know how to do the conversion.)

https://www.diabetes.co.uk/blood-sugar-converter.html

Basically, divide by 18 to convert your figures (mg/dL) into mmol/L.

And it would help to put your home country into your profile as advice about doctors (eg dial 111 if you want emergency medical advice in the UK) varies by country.

Will do thanks

 

[HSSS]

I was reading about Keto and having increased fats. Would I do that straight away or wait until I lose weight?
Is it safe to eat fats when I have a fatty liver. I would expect it also has to be good fats rather than trans fats.

Yes you’d eat more fat now whilst reducing carbs. (Having both isn’t a fantastic idea as therein lies excess energy to be turned to body fat). As odd as it sounds fat will help you lose weight, especially if you are impaired at processing carbs as it’s those that end up as fat and the excessive amounts of insulin you produce to try and process carbs is a fat storage hormone. Do read the links I gave that explain further.

Fats do not give a fatty liver directly. See above. Fructose in fruit can also be a contributing factor. Fructose can only be processed and stored by the liver.

Trans fats are no good for anyone. Animal fats on low carb are fine including all dairy. Seed oils are not. Nuts and avocado are good too.

 

[Shepster48]

Thanks

Yes ive read the links, very informative thank you.

Well i dont know whats going on but my bg seems to be getting worse. Ive eaten hardly any carbs since i made the mistake on monday or having some bran flakes for my breakfast and a spud for tea.

This morning i got up to my usual high dawn phenomenon reading of 8. Its never dipped below 6.75 all day and is now 7.5 and ive not even had my tea yet. Ive had absolutely no carbs. I had a couple of scrambled eggs for breakfast, tuna salad for lunch and no tea.

I think i must be diabetes with these readings. I am absolutely starving but daren't eat anything remotely sugary or containing much carbs. I just dont know what to do or eat for the best.

Ive noticed my hands and my thighs have been aching lately and also struggle with my knees although im not really overweight (85kg/6 foot 48 years old). Could this high blood sugar/diabetes cause this or just a coincidence?

I see my gp in the morning. Im going to show him my results, and demand some serious testing.

How will they know if its an insulin resistance problem or my pancreas not producing insulin?

Can i ask a question. I was diagnosed with a fatty liver about 7 years ago. Told it wasnt anything serious and i need to cut dairy and trans fats. They regularly test my liver function twice per year and fbc. It was only when i started telling my gp i was getting these feeling faint with hunger episodes that i had some fasting blood tests done. But im sure it said lupids? Is that the right words rather than blood glucose. It was tested in the morning after fasting though. Do you think they should have done more testing on me when i was first diagnosed with fatty liver. I am not fat at all, quite slim with just a little belly. 36 inch waist.

Im annoyed that i may have had this for years and the docs weren't telling me anything was wrong and im eating lots of carbs thinking its good for me when its been spiralling my bg.

 

[HSSS]

Sadly many of us were not told when tests first started showing issues, instead bumbling along thinking all was good until diagnosis. Lipids tests are cholesterol levels. They are, or should be fasting. Glucose tests are also fasting. Hb1ac are not fasting. Hard to know which was done previously

When you go tomorrow ask for print outs of all tests previously done for glucose, fatty liver, cholesterol etc. You are entitled to these even if they resist. You wish to educate and understand your condition and make informed choices. These results are part of that. Don’t be put off. We can help you decipher these if necessary. And yes push for through testing. Typically an assumption is made of type two unless there are signs that point to type one or other types. There are specific tests for antibodies and insulin production that can be done to help confirm or refute type one. I’ve not been through this and am not well informed so can’t help a lot. Still might be worth asking the dr is these are worth considering for thoroughness but I wouldn’t hold my breath.

Not all type 2 diabetics are fat and lazy despite what the media and some medics tell us. Another myth. Thin on the outside fat on the inside (TOFI) can be true too.

The only other thing that comes to mind is reactive hypoglycaemia where bloods can drop rapidly low as you describe in post #1 but again I know little about this and have no idea how it fits with the higher numbers you are experiencing day to day. Or that feeling could be false hypos where numbers are lower than “your” high normal and make you feel awful despite being technically fine. @Lamont D or @Brunneria might be able to give far better guidance than me here.

 

[HSSS]

Oh and if you’re hungry eat more fats. You still need fuel and if it isn’t carbs then fat is the way to go as it doesn’t affect bgl. Meats, cheese, nuts, avocado, butter, cream, non seed oils, olives, are just a few ideas. No need to go mad but increas eit a bit at least til you stop feeling hungry.

 

[Brunneria]

Thanks @HSSS

And Hi @Shepster48

I think you need the full results for your previous tests, and I think you need to carry on doing your own testing, particularly when you feel wobbly around strenuous activity.

At the moment, you just don’t have enough information to know what is happening...

Regarding the wobbliness you experience with exercise, that could be quite a few things other than a hypo - or it could really be a hypo, but you would definitely need more investigation or hypo numbers on your blood glucose test meter to know for sure. Then your next step would be convincing a doctor to listen and run tests under their controlled circumstances, and replicate the results.

Modern medicine is a thing of numbers and yes/no answers. Unfortunately, the majority of us don’t fit into neat little boxes! But to get anywhere with doctors and the NHS, we need to fit those criteria.

 

[Shepster48]

Thanks hsss, I’ve just had some smoked haddock and feel better.

I still can’t get used to this “eating fats and not carbs” but I really love meat so will give it a go. I also love veg and salad.

I’ve eaten white bread, massive bowls of bran flakes, lots of potatoes, rice and pasta with every meal thinking I was eating well. I’m so annoyed I didn’t do more reading when I was first diagnosed with nafld.

It’s funny you mentioned false hypo’s. On Tuesday I go up and felt really faint and hungry. I tested myself before I ate and it was 7. I was literally sat there feeling like I was having a hypo and I had a 7..... it’s the only time I’ve had one of those episodes this week since I’ve been monitoring it. Wouldn’t I be having more of these as my bg has been kept at a lower level this week?

 

[HSSS]

Thanks hsss, I’ve just had some smoked haddock and feel better.

I still can’t get used to this “eating fats and not carbs” but I really love meat so will give it a go. I also love veg and salad.

I’ve eaten white bread, massive bowls of bran flakes, lots of potatoes, rice and pasta with every meal thinking I was eating well. I’m so annoyed I didn’t do more reading when I was first diagnosed with nafld.

It’s funny you mentioned false hypo’s. On Tuesday I go up and felt really faint and hungry. I tested myself before I ate and it was 7. I was literally sat there feeling like I was having a hypo and I had a 7..... it’s the only time I’ve had one of those episodes this week since I’ve been monitoring it. Wouldn’t I be having more of these as my bg has been kept at a lower level this week?

Yes it’s a mindset change to be sure. Choose fattier meats perhaps. (I still don’t like lumps of fat on meat but tolerate marbling or just juicer meats etc far better now)

Maybe your body is adjusting to lower normals. Just guessing. Keep testing and see what the dr says tomorrow and get the past results.

 

[Daphne917]

Thanks hsss, I’ve just had some smoked haddock and feel better.

I still can’t get used to this “eating fats and not carbs” but I really love meat so will give it a go. I also love veg and salad.

I’ve eaten white bread, massive bowls of bran flakes, lots of potatoes, rice and pasta with every meal thinking I was eating well. I’m so annoyed I didn’t do more reading when I was first diagnosed with nafld.

It’s funny you mentioned false hypo’s. On Tuesday I go up and felt really faint and hungry. I tested myself before I ate and it was 7. I was literally sat there feeling like I was having a hypo and I had a 7..... it’s the only time I’ve had one of those episodes this week since I’ve been monitoring it. Wouldn’t I be having more of these as my bg has been kept at a lower level this week?

@Shepster if it’s any consolation you’re not alone - like many other T2s when first diagnosed I ate what I thought, and had been told, was a healthy diet - low fat milk and yoghurt, whole meal bread, brown pasta and rice, jacket potatoes, bran flakes, 5 portions of fruit inc bananas and grapes etc etc etc not realising that for me it wasn’t healthy. Once I got used to the idea of eating full, as opposed to low fat, and reduced the number of carbs my BS began to improve.