Home OGTT test - Rapilose and Insulin resistant

In the interests of emulating science, it's more useful to try and have a consistent protocol, ie use rapilose and test every 20mins to see how our response curves look.

Probably more useful with a CGM as that samples more frequently. Caveats obviously apply, ie you'd be consuming 75g of glucose in the process..

Bluetit1802 said:

Rapilose is a pre-mixed drink of exactly 75g glucose and nothing else. Lucozade isn't.

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And quite a lot more expensive I believe, I was going to invest in it anyway though but now think it pointless for me, having come to the conclusion that my steroid medication precludes it as it is a variable that I can't truly factor in. Does that make sense I'm unsure.

JohnEGreen said:

And quite a lot more expensive I believe, I was going to invest in it anyway though but now think it pointless for me, having come to the conclusion that my steroid medication precludes it as it is a variable that I can't truly factor in. Does that make sense I'm unsure.

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I understand what you mean. However, as your steroid medication is ongoing rather than a temporary thing, I don't see that it matters. The result will tell you where you are with your blood glucose and your steroids, which is what it is for you. I don't see it as a variable - it is static. Or am I wrong?

I guess your not measuring insulin because it needs three samples 5mins apart because insulin output has a short term oscillation of ouput on it.
regards
Derek

Bluetit1802 said:

I understand what you mean. However, as your steroid medication is ongoing rather than a temporary thing, I don't see that it matters. The result will tell you where you are with your blood glucose and your steroids, which is what it is for you. I don't see it as a variable - it is static. Or am I wrong?

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Well the fact that I will be taking it indefinitely is true but the dosage has varied and prednisolone itself does not have a constant effect its interference with the livers sensitivity to insulin fluctuates and varies also.

Could be me just feeling a little depressed and sorry for myself thought I had it sussed but am having to reevaluate now.

JohnEGreen said:

Well the fact that I will be taking it indefinitely is true but the dosage has varied and prednisolone itself does not have a constant effect its interference with the livers sensitivity to insulin fluctuates and varies also.

Could be me just feeling a little depressed and sorry for myself thought I had it sussed but am having to reevaluate now.

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What sort of levels are you seeing during the day? Why are you having to re-evaluate? Have you tried a Libre?

Since increasing my preds a couple of weeks back I am seeing levels during the day in the double figures even the low to mid teens while I have not increased my carbs my predicted A1c as gone from 34 to 36 I know not drastic so far but going up all the time.

What I feel I am having to come to terms with is the change in the perception and what I thought was the understanding of my condition I was thinking of my self as T2 in remission, with every thing under control and going to stay that way as long as I didn't do anything silly, where as I was am drug induced T3E with what was tight control of BG and so now I can't truly think of being able to reverse my diabetes or be "cured" of it as while I take the medication it will always be there.and any variation in the medication due to the changing MG will cause the diabetes to become unstable too. The fluctuating circumstances make it hard to adjust or adapt.

It all seems so random now, and I don't like random.

I pondered over getting a libre for too long now they are almost unobtainable when things at Abbott settle down I will take the plunge and get one but that may be some time.away.

Edit to add preds are weird they prevent pancreatic insulin being sensed by the liver so liver chugs on delivering sugar to the blood so blood sugars go up and up then the preds will suddenly drop in their effect for a while and the liver sees effectively a sudden flood of insulin and immediately shuts down so you get a big drop in blood sugar levels even down to hypo levels.

And here I must admit I have been getting for some time randomly high levels followed by a big drop with hypo symptoms I thought it could have been RH but now I think its related to the prednisolone but it was happening once in a while not regularly.

Is this something that may subside a bit once your body is used to the increased dose? I'm sorry but although I know steroids raise levels etc I don't know a great deal else. I do know that my friend is on high dose steroids for life. She has 3 monthly HbA1cs because of this, and has done for a few years. So far she is just pre-diabetic, but how long that will be the case I have no idea. (She is doing nothing to reduce carbs but continues to eat low fat everything. )

Are there any newer steroids that don't have as much effect? Or maybe it is time to try a diabetes med?

I had gone down to 10 mg a day now had to double that am also on Azathioprine supposedly a steroid sparing medication but the steroids are long term first prescribed for me about 15 years ago was at over 40 mg a day for a long time no likely hood of ever coming off them .

What upsets me a bit is had been on them years before anyone thought to check A1c but should have been done a long time ago I thought like you they just put blood sugars up a bit or a lot but the mechanism is a little more complex prednisolone the steroid I and many others take actually reduces the sensitivity of the liver to insulin so the liver does not get regulated in its glucose production as it should and keeps on putting more and more glucose into the system even though the pancreas is shoving out loads of insulin which should stop it or slow it down thus causing high BG and raised insulin resistance. Normally when you stop taking the preds this should restore things back to normal but if you can't stop taking them it's a permanent situation by the way this side affect of prednisolone applies to all insulin that produced by the pancreas or that witch is injected. so any diabetic T1 or insulin dependent T2 who is on prednisolone for what ever reason will be affected to some degree.

I hope that when I become adapted to the higher dose once more things will go back to normal for me but at the moment its very up and down.

There is always hope for new therapies and there are new drugs in development that may help so it's not so bleak.

Will be discussing diabetes meds with GP it may be the only way to go and if so I'm OK with that just wan't to feel a bit better than I do right now, it was all going so well.

@JohnEGreen

Metformin is supposed to reduce the amount of glucose the liver produces, so maybe that is worth considering, at least for an experimental period. That may go some way to counteracting the problem the steroids cause. I wish you luck with it all. I can see how frustrating it must be, and stressful - which we all know won't help the blood sugars.

Hi John,
Sorry to see you between a rock and hard place. Sometimes we have no options on the table. I have been there so I can empathize with your situation.
I hope eventually better treatments are found than the one's that introduce other problems.
Best wishes
Derek

JohnEGreen said:

I had gone down to 10 mg a day now had to double that am also on Azathioprine supposedly a steroid sparing medication but the steroids are long term first prescribed for me about 15 years ago was at over 40 mg a day for a long time no likely hood of ever coming off them .

What upsets me a bit is had been on them years before anyone thought to check A1c but should have been done a long time ago I thought like you they just put blood sugars up a bit or a lot but the mechanism is a little more complex prednisolone the steroid I and many others take actually reduces the sensitivity of the liver to insulin so the liver does not get regulated in its glucose production as it should and keeps on putting more and more glucose into the system even though the pancreas is shoving out loads of insulin which should stop it or slow it down thus causing high BG and raised insulin resistance. Normally when you stop taking the preds this should restore things back to normal but if you can't stop taking them it's a permanent situation by the way this side affect of prednisolone applies to all insulin that produced by the pancreas or that witch is injected. so any diabetic T1 or insulin dependent T2 who is on prednisolone for what ever reason will be affected to some degree.

I hope that when I become adapted to the higher dose once more things will go back to normal for me but at the moment its very up and down.

There is always hope for new therapies and there are new drugs in development that may help so it's not so bleak.

Will be discussing diabetes meds with GP it may be the only way to go and if so I'm OK with that just wan't to feel a bit better than I do right now, it was all going so well.

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lindisfel said:

I guess your not measuring insulin because it needs three samples 5mins apart because insulin output has a short term oscillation of ouput on it.
regards
Derek

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Yup. It's looking at the insulin/glucose response. Measuring the insulin level itself would be fun, but not the kind of experiment we can do at home. Well, most homes anyway.