High reading in the morning

[sgiossi]

Good morning,
I have some questions concerning my situation.
My GP believes that I'm at risk of developing diabetes because of my HbA1c result more than a year ago (5.8%, 40mmol/mol). Because of this, I modified my diet a bit, and the most recent HbA1c result at the end of August 2023 was 5.4% (36 mmol/mol). The fasting glucose blood test was 5.2 mmol/L. I still keep checking my glucose level with a blood glucose monitor though (lancet). I must say that now my diet isn't as strict on sugar/carbs as it was some months ago.

I've noticed that on most days, my glucose level early in the morning is between 5.4 mmol/L and 5.9 mmol/L, generally measured between 7 and 8 AM. I often go to sleep between midnight and 1 AM. However, today I woke up really early, at 5 AM, after a sleep of less than 6 hours. I fell asleep at around 11:15 PM. I had late dinner, I started eating at 8:30 PM and had a sort of final snack (chocolate) around 9:30-10 PM. Food included spaghetti and some fruit, so it was fairly rich in carbs.
This morning, my glucose reading was high: 6.8 mmol/L. I took it at 5:10 AM. However, I took another reading after 30 minutes and it was already down to 5.5 mmol/L.
I am wondering if I need to worry. I assume we can't really consider my test as a fasting glucose test because there was barely 7 hours between the end of the last meal and the test.

Moreover, I've been suffering from a relapse of my stomach reflux, which makes digestion difficult. I guess I should eat less at night and wait at least 3 hours before going to bed after a meal. Sometimes because of work and other commitments, such as gym, I can't eat before 8 PM. Also, I've noticed that my readings somehow improve when I sleep more, I'm less stressed and I'm off work.

My questions are:
1. do I need to be worried? Is the reading a sign that I'm developing diabetes?
2. when should I measure my glucose after finishing eating? After two hours? Is this the time when glucose reaches a peak?
3. Is it normal that my glucose dropped so quickly from 6.8 to 5.5 mmol/L?

I'm really confused as it's really unclear whether I'm developing diabetes or not.

Thank you!

 

[IamResistance]

Hi,
Blood glucose should get to normal post meal levels after 2 hours after meal in a healthy individual. I cannot answer other questions as I am not an MP, I just recommend trying a continuous glucose monitor to get more information about your glucose levels and how your organism reacts to different types of foods. For me using CGMs was a complete eye opener - I was able to start curing my diabetes without loosing the food I love after almost a year of inefficient treatment with increasing dosages of metformin.

 

[Antje77]

This morning, my glucose reading was high: 6.8 mmol/L. I took it at 5:10 AM. However, I took another reading after 30 minutes and it was already down to 5.5

The first one could well have been a rogue reading, considering it's unusually high for you and the quick drop back to normal.

 

[catinahat]

. Is it normal that my glucose dropped so quickly from 6.8 to 5.5 mmol/L?

There is just 0.7mmol difference between these two results which is well within the accuracy tolerance of the meters.
The accuracy standard for all meters is plus/minus 15%. You could do two tests on one drop of blood using the same meter and get similar results.
The metres are not accurate enough to worry over a few decimal places, they just give a rough idea of what range our blood sugar levels are in, the 15% means if the result is 5mmol, your actual blood sugar level is somewhere between 4.25 and 5.75 a 1.5mmol range.
A result of 10mmol would be between 8.5 and 11.5 a range of 3mmol.
It's not perfect but it's all we have.

do I need to be worried? Is the reading a sign that I'm developing diabetes?

Your original Hba1c is at the top end of normal, it shows that perhaps you are not processing the carbs as efficiently as you have in the past. It sort of hints that maybe you are becoming resistant to the action of your insulin. Will you tip over border into pre diabetes and onto T2, who knows , not even your Dr could answer that with any certainty. Personally I would take it as a warning, and do something about it. nothing changes unless you change something.

when should I measure my glucose after finishing eating? After two hours? Is this the time when glucose reaches a peak?

If you test before you eat and again in 2hrs, the difference between the two results show what your meal has done to your blood sugar levels.
A perfect meal would see your 2hr result back close to the pre meal one. This would mean that any glucose coming from the digestion of the carbs in your meal, has been taken up by your insulin and used for energy.
Because as already explained the meters are not as accurate as we would like, we allow a 2mmol rise.
So in a nutshell, a 2hr reading no more than 2mmol above pre meal is acceptable.
Anything over 2mmol indicates that there were too many carbs in that meal, and that your insulin is still struggling to deal with the glucose that came from them.
I'm guessing that if you had tested just before your late meal of spaghetti, fruit and chocolate, done a second test say 90min later, you would have seen why most unmedicated T2's wouldn't go anywhere near a meal like that