How do these levels look for someone who’s non diabetic but has PCOS?

Check out this video https://www.diabetes.co.uk/forum/threads/glucose-spikes-the-silent-killer.205341/#post-2715376 which explains the link between glucose spike and PCOS.

smadoom said:

Hi Jo,
You’re not saying too much at all, this is actually very very helpful! I haven’t had any support from the GPs in the 4 years I’ve been diagnosed and coming to these forums is the only help I can really get. I’ll try and be brief with my reply:

• you’re right, confirming IR won’t deviate me from my plan of sticking to low carb, high protein but it will help me to know I’m working on the right root cause.
• I’m attempting to build muscle mass which is taking time and go for regular walks. I try and incorporate a ten min walk at least after my biggest meal which is usually dinner.
• The skin changes I have is Acanthosis nigricans. Ever so slightly around my neck and only under one underarm.
• I do have fungal acne but have noticed it become significantly better since changing my diet
• Someone suggested getting a CGM and I think I might do that for one month so that I can see how the foods in my plan impact my sugar and insulin levels so that I’m eating the right foods
• Yes my hba1c has always been normal although I question normal. What I find is with GPs is that even if a level is at the highest end of the accepted range, to them that is ‘normal’ therefore no further action is needed but to someone else it might seem like it is close to being of concern (does that make sense?) I certainly found this with my PCOS and had to fight tooth and nail for my diagnosis
• My mum is also Type 2 which gives me more of a reason to be careful so that it can be reversed now than to buy myself problems later

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Sorry I wasn't around yesterday: we're on hols and I was running around a couple of zoo's. The AN is something that can crop up in people with elevated blood glucose, and it might resolve as you keep control. (My GP showed me how to cut the little warts that go with it sometimes, off, myself!) As for your HbA1c, do you have actual numbers? The thing is, a LOT of practices never even mention it when someone is in the prediabetic range, as they don't start any active treatments until someone crosses over into the diabetic range. Before that time they just sit back and wait for things to progress, rather than believing their patient isn't 100% destined to be a raging diabetic if they just get a little help before it's too late. So if you know what range you're in, those being normal (under 42 mmol/mol), prediabetic (between 42 mmol/mol and 48 mmol/mol) and diabetic (48 and up), you can guesstimate where you're at. And yes, sometimes the levels seem a bit arbitrary. Some people get symptoms of IR when they're in the prediabetic range for instance, others have no symptoms while they're basically consisting out of sugar water. If you get fungii/yeast/bacterial infections easily, there's sugar present for those things to feast and multiply on. In your sweat, your urine etc. So cutting carbs would go a long way in keeping those issues at bay, as you've already noticed.

Taking myself as an example: Back when I was diagnosed I was quite thoroughly in the diabetic range. I ate normal, carby meals that were in line with the EatWell plate, so "should" have been fine. They most decidedly weren't. I went low carb and got my numbers back down into the normal range, hitting something like 34 or 36 mmol/mol for about seven years. Then my mom passed last year, everything went to hell in a handbasket, and my last HbA1c was 40. Higher than I'd like it to be, and here and there I did get a little symptomatic with weight gain, nocturia and skin problems, but still, in the normal range. Thing is, if I never got a diabetes diagnosis way back when, with the way I eat, I still wouldn't get one now. No-one'd even mention the high-ish end of normal. But I assure you, I am quite diabetic still, I just won't get a HbA1c that'll back that up. Do not put chocolate cake in front of me because I will get a spike that would make some people here freak out. (And rightfully so). If you're on a low carb diet, there is no way the doc can tell, going from blood test results, whether or not you're insulin resistant, prediabetic, diabetic, or not diabetic at all. Though an oral gluose tolerance test would catch insulin resistance and/or diabetes, I don't think, off the top of my head, any of the other tests would be useful at all... They all measure your body's reaction to carbs, and you're not having those. Can't measure what isn't there. So, if you do go for a CGM, keep it alongside a food diary. So you know what dips and rises correspond with what meals. Most GP's haven't got a clue about how carbs affect a diabetic, but it will make things rather clear for you. So it might not be official, but any information you have is welcome, I think?

Anyway... Keep asking questions, keep being your own advocate. A GP has a LOT of conditions to be aware of, but that also, sadly, does mean they can't specialise in the bulk of them. Just go from the assumption that they do want to help, they literally do not know how, more often than not. And that's where we have to suss things out ourselves.
Jo

smadoom said:

Currently at 32mmol, the last record I have of hba1c is 16/01/23 in which it was 35 mmol. Usually test results have ranges but not for the hba1c.

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Very much in the non diabetic range, which could mean you're not having any issues with glucose regulation, or it could mean your current low carb diet deals well with any insulin resistance you may have.

Anything under 42 is normal, 42 to 48 is prediabetes, higher than that is diabetes.

smadoom said:

So I’ve gone and got myself a CGM at least for the next two weeks to better understand my blood sugar levels and spikes caused by food.

Ive only had it on for about 5 hours and so far my level is at 5.3mmol on avg.

whats interesting though is that after dinner my sugar levels dropped to about 4.2-4.3 before steadily rising again to 5.2 and the same happened again after I had my tea. It doesn’t spike but rises back to the avg level of 5 point something. For dinner I had 35g carbs in the form of salmon & baby potatoes.

Since this is my first time interpreting the CGM pattern, I’d love to hear guidance and thoughts. I’ll keep a log and monitor this for the next 2 weeks to see how this pattern and others emerge.

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Most of us find the libre can be odd for the first 24 hours or so. The document says 1-2 hours but...
I put mine on then wait 24 hours before starting it up.
Be interesting to see what yours says from tomorrow.
And double check with a finger prick a few times just to check it corresponds.

If, by any chance your libre doesn't work, Abbott will replace for free so you won't lose out

Hi @smadoom. I had PCOS in my mid 20s, T2D during menopause 30 years later - with big hormone change, essential vitamin deficiencies, terrible SAD diet. (Same doctor diagnosed both conditions - she's fabulous but like many GPs nutrition is not her thing.)

My disease journey, if you like, was done with no knowledge of the dietary cause of insulin resistance. But oh yes - I know a lot more about it now.

My understanding of both these conditions, using a particular theory of insulin resistance, and the blood glucose cycle - is your current situation is about insulin production - not your blood glucose . (And - hopefully will never get to that level! You are here, and low-carbing - this is marvellous for T2D prevention.)

Your body is currently protecting you from too high glucose with higher than normal/healthy levels of insulin. (You can get this tested most cheaply with a C-peptide, and check your insulin production against normal.) But yes - PCOS is absolutely an insulin resistance disease. Too much glucose, too much insulin production to protect cells from glucose toxicity, so insulin resistance kicks in to protect your cells from insulin toxicity. First thing to break down is your fertility, and your sub-fertility will probably vary over the years you have PCOS. (My son was made straight away, but I'd only had PCOS for a few years then.) But your current PCOS could get to past tense,and stay there! this is the goal of course.

Good on you to work on muscle - good way to go to get better. Women with PCOS often/do have what is called an athletic body type (about 25% of women do), as we have more free ranging testosterone than most women. ie bigger muscle than most women. You might have shoulders broader than your hips for instance? (Athletic women often do.) Strength resistance (heavy lifting!) has been an essential part of my life since diagnosis. You need that protein, I would say - my nutrition needs work that way too. (More muscle needs more protein.)

Sadly, having this type of body means that you are probably hyper sensitive to body fat, as in, your fat cells might be super prone to getting sick. (Read up about the sick fat cell theory behind blood glucose dys/regulation.) I was just mildly plumper when I started to get PCOS back in the day. But alas, I was made to be lean - which could be your situation (and your mother's?). Lean and muscular. The high carb, high sugar, high levels of omega 6 ultra processed vegetable fats was dynamite for me. I have a bad reaction to modern wheat too. There is bound to be a role in air and water polution with humanmade polutants also. But you can protect yourself from the body fat aspect, and watch the plastics that could be getting into your diet?

There are websites that educate on highly insulinemic food and drink - I would be focussing on avoiding that rather than focussing on your normal blood glucose level. It could be normal for decades! (Mine was.) Keep up your muscle work. Watch your waist line like a hawk. (To be healthy it should be half or less than half of your height, ie track your waist height ratio - lots of great calculators online.) Belly fat is the dangerous fat, is the line most quoted by those with metabolic disease like me.