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Is This Carnage or Acceptable

jim1951

jim1951

Well-Known Member
Messages
562
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Okay this is the first of a few questions.

From posts elsewhere you will see that I was disappointed with an HBA1C result of 48 which I thought should be nearer 40.

Following advice I self funded a Freestyle Libre and is giving more questions than answers! I am experimenting to see how I react to different scenarios.

Prior to the Libre I would fingerprick and get a reading of circa 5.x before my main evening meal and hardly any increase 2 hours later.

Last Saturday evening I had a glass of cider and some wine plus ciabatta bread at 1900 followed by a Thai curry (all for research purposes!).

At 1900 my Libre said 5.1 and at 2100 it said 4.4 which was confirmed with a fingerprick. This suggests that I tolerated the meal exceptionally well?

However, my Libre told me the following. Whilst my reading was 5.1 at 1900, it peaked at 14.1 at 1945 and was down to 3.6 at 2130. It then rose gradually to 5 by midnight and stayed around this figure until 0400.

My conventional testing would only show that I tolerated my experimental meal exceptionally well but what can the experts on this board tell me?

Does bringing a high figure down exceptionally quickly show a level of control, or, does going up and down so quickly show lack of control?
 
jim1951 said:
Does bringing a high figure down exceptionally quickly show a level of control, or, does going up and down so quickly show lack of control?
Click to expand...

Well, definitely not good that it goes so high, but this is mitigated by it going down so quickly.

Having said that, I would strongly recommend that you back up the reading of 14 by a meter test, as the libre is renowned fpr being very inaccurate for some people (including me).

Having said that, the spike might explain why your hba1c is much higher than expected....

ps I love your research diet :) (couldn't tolerate it myself as an insulin resistant T1 but it sounds yummy.)
 
jim1951 said:
At 1900 my Libre said 5.1 and at 2100 it said 4.4 which was confirmed with a fingerprick. This suggests that I tolerated the meal exceptionally well?

However, my Libre told me the following. Whilst my reading was 5.1 at 1900, it peaked at 14.1 at 1945 and was down to 3.6 at 2130. It then rose gradually to 5 by midnight and stayed around this figure until 0400.
Click to expand...

It shows that you still have a problem and that high carb meals still aren't a good idea.

Your blood sugar after the bread and curry went higher than mine does when performing a pure glucose drink OGTT.

Maybe test higher carb meals after 1 and 2 hours to get a clearer picture.

Your body however worked properly in producing plenty of insulin to drive your blood sugars down to the threes so it may be a bit slow but it is slowly recovering function.
 
Using the Libre or similar exposes the truth about tolerance. Similar results are seen with eating bananas, where the spike is often missed. Alcohol blunts glucose responses, so your true number might have been higher. Libre use is expensive, so in your shoes I would test meals that are liked and tweak accordingly.
 
I thought that alcohol has an effect on when bg rises and falls. Perhaps a more reliable test would be without the alcohol muddying the waters?
 
Probably worth considering that a non-diabetic can hit 11 on a completely random test. So while 14 is clearly higher than this, it's not way out of the ballpark.

And of all the alcohol you can drink, cider is probably one of the worst, carbs-wise. Even most beers look pretty tame, by comparison. I'd say a significant factor in that 14 is likely to be you taking the sugar hit off the cider, once you'd processed most of the alcohol.

I'm still a noob, but my understanding is that you'd need to be close to double your peak reading to pose any immediate health risk, and just about everything else is a longer term issue, and cumulative. Theoretically at least, anything over 8.5 is doing you damage, but surely that means a non-diabetic is doing themselves damage whenever they get into double figures.
 
While I am certainly no expert my thinking is that you didn't tolerate the carbs that well. The 2 hours after a meal is just a standard time frame- You can read about the pizza effect (I think that's what it is called) when the spike might be later than 2 hours due to the fat content- cheese. Similarly the alcohol may have had some effect on the timing of the spike. It is great that your body then dealt with it so that the spike was short lived but I personally feel uncomfortable going into double figures at all and if a meal put me into double figures I wouldn't eat it again.

If you are interested in testing your body's tolerance to see if you can expand the amount of carbs you are eating I would just have a meal with an increased level of carbs and not have alcohol as well. I still test very regularly and even more so if the meal is out as I can't be completely sure of the carbs in it. In these cases I test a few times over the following few hours to make sure I don't miss the spike.

In particular as you were disappointed with the HbA1C I would not be increasing the carbs. Having said that some people do better having a few carbs earlier in the day some do better just fasting and also exercise can have an effect as can stress etc so go ahead and experiment and hopefully you will be able to increase your carb consumption.

Good l.uck.
 
As a long time Libre user, I’ve found that it’s not that reliable when the measurements are above 12.
Interstitial glucose levels, which is what the Libre reads, lag approximately 15 minutes behind blood glucose levels, so you’d need to bear that in mind when combining blood tests and Libre readings.
 
There is also something called the last meal effect. When you have previously been eating much fewer carbs your pancreas becomes used to not producing much insulin - because it is not needed. You could say the pancreas "falls asleep". You then bombard it with a load of carbs that it isn't expecting and it takes a while for it to wake up.

The official instructions for those taking an OGTT is to eat at least 150g of carbs for a few days prior to the test for this very reason. When I did a home OGTT using Rapilose I didn't eat 150g carbs as advised. At an hour after drinking the glucose I had risen to 12 or thereabouts, then dropped and by 3 hours was down to 4.
 
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