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Is this too high for a non-diabetic?

Discussion in 'Ask A Question' started by SarahABC, Dec 27, 2021.

  1. SarahABC

    SarahABC · Member

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    Hello,
    I'm currently wearing a libre 2 because I've been diagnosed with reactive hypoglycemia (blood sugar dipped down to 2.6 during a glucose tolerance test) but it didn't go high so I didn't get any pre/diabetes warning from my endocrinologist.

    I self funded a one off Libre 2 to try and figure out my hypoglycemia triggers but yesterday my blood sugars went up to 9.8 when I tested randomly. Had been grazing for a lot of the day.

    On this website is says - for a non diabetic: 7.8 is the maximum blood sugar "at least 90 minutes after meals". Does that mean it can go more than 7.8 before the 90 minutes or does it mean 7.8 should be the maximum blood sugar full stop?

    My family has a lot of type 2 diabetes so I need to be careful. But the glucose tolerance test showed that I was well within range with a max of 6.2. So if my Libra is accurate at 9.8 then I'm not sure what to do.

    So basically my question is: is 7.8 the max for a non-diabetic or can it be higher (e.g. 9.8) as long as it's 7.8 or less at 90+ mins after a meal?

    Thank you so much.
     
    • Informative Informative x 1
    #1 SarahABC, Dec 27, 2021 at 7:47 AM
    Last edited: Dec 27, 2021
  2. In Response

    In Response Type 1 · Well-Known Member

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    A few things to consider
    - Libre is most accurate for "normal" numbers so it may be over reading
    - Libre is less accurate for the first 48 hours after inserting +many of us activate the sensors a day or two after inserting)
    - people without diabetes can spike depending what they eat. The difference with a diabetic is their levels are more likely to stay high
     
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  3. SarahABC

    SarahABC · Member

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    Hello thank you.
    Yes I've had the libre in for over a week now.
    I was wondering if it was over reading so I did a finger prick test which said 8.8 but there is a lag on the libre so I could have missed the peak by the time I was finger prick testing.
    Ok yes so the stay high thing is interesting as I never stay high. I just peak high and come down (down too low often).
     
  4. Dark Horse

    Dark Horse · Well-Known Member

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    The diagnostic criteria for diabetes (from diabetes.org):-

    "Methods and criteria for diagnosing diabetes
    1. Diabetes symptoms (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) plus:
      • a random venous plasma glucose concentration ≥ 11.1 mmol/l or
      • a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or
      • two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
    2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting random values are not diagnostic the two hour value should be used." https://www.diabetes.org.uk/profess...nitoring/new_diagnostic_criteria_for_diabetes
    In other words, if you have no diabetic symptoms you would need 2 random blood glucoses above 11.1 mmol/l to be diagnosed with diabetes.
     
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  5. SarahABC

    SarahABC · Member

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    Thanks. My 2 random blood glucose came out as 3.0mmol/l!
     
  6. SarahABC

    SarahABC · Member

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    Thanks ok so I need to make sure not over 11.1.

    My 2 random blood glucose came out as 3.0mmol/l! So something isn't right. Not insulinoma as my fasting levels are ok.

    I know I would not get a diagnosis I'm just trying to figure out what's going on and why I'm getting lows and questioning if my highs are too high (and if so have I slipped into beginnings of insulin resistance)
     
  7. Goonergal

    Goonergal Type 2 · Master

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    I’ll tag @Lamont D for comments re reactive hypoglycaemia
     
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  8. SarahABC

    SarahABC · Member

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    Amazing thanks. I've been researching into it a bit and I think reactive hypoglycemia can be a pre-prediabetes state. But I wasn't too concerned as my blood sugar was staying low I thought. But my libre 2 is showing highs of 9.8 it feels too high to be "normal"
     
  9. Dark Horse

    Dark Horse · Well-Known Member

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    In your earlier post, you were talking about a random blood glucose of 9.8.
     
  10. SarahABC

    SarahABC · Member

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    No 9.8 was from the libre.
     
  11. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi @SarahABC and welcome to our forum.
    I realise that you have been reading diagnostic bases from different threads and from different types, it is great that you want to learn and knowledge is key, but with RH, the treatment is different and control is different, despite having the same symptoms and a change in dietary lifestyle.
    The most important difference is you are not diabetic and your Hba1c levels should show that once you have changed your dietary intake. Your fasting levels, once you have lowered your carbs, should be in normal levels.
    RH means that you are carbs and sugar intolerant, that actually is it, you are typically allergic to a certain amount of carbs, because this triggers the reaction. If like me, your initial insulin response is not enough for a certain amount of carbs, this quick spike is the trigger for a secondary insulin response called an overshoot, this will eventually drive your blood glucose levels into hypoglycaemic levels. Which is below for a RH ers is 3.5mmols.
    The reason why your levels can be anywhere between normal or double digits is based on how your body's response to the amount of carbs previously eaten and the time it has been like this, and other issues with your metabolism or conditions.
    If you start the day with carbs, you have to eat constantly or you will suffer with hypos and hypers all day and that is why you have felt awful.
    Your blood sugars will be on a rollercoaster ride of highs and lows, because of carbs.
    There is a very simple but difficult choice of treatment and there is no magic pill.
    It is to stop the first spike of the day by eating as few carbs as possible, and for your meals depending on your tastes and preferences, and replace the carbs with more protein and good fats. Find a healthy balance that doesn't trigger the spike.

    Regardless of dietary advice from so called experts, this condition is not understood by clinicians, dietician, some endos, and the majority of GPs don't have an idea what so called healthy carbs are doing to your body. The insulin required to someone who has too much insulin already, is very dangerous and yes if you don't have good control you will be prone to prediabetes, T2 and the resulting problems associated with uncontrolled blood glucose levels.
    I went through hell until I was diagnosed and this forum.
    My lifestyle is completely different from pre diagnosis of RH. And I have my health back. And my life back. And I lost six stone!
    All my symptoms have gone, my organs are healthy and my recent full blood panel test was very good. My body for my age is great.

    Any more questions, I will gladly answer.

    What other tests have you had?

    Keep safe
     
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  12. SarahABC

    SarahABC · Member

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    Argh I just wrote a long reply and accidentally clicked off the page. Ok starting again.

    Thank you @Lamont D for your response.

    Test results:

    - over many years I have had around 8 random glucose tests and four were 3.0, a could were around 3.6 and a couple were fine.
    - HbA1c normal
    - fasting insulin normal (26)
    - OGTT which showed normal fasting blood glucose, peak of 6.2 and low of 2.6

    I wasn't surprised at the low of the OGTT as (aside from the random 3.0s) I have felt very tired at times and been to the GP several times, only to be told it's probably depression! Fortunately I ignored that.

    I have a lot of T2D in my family but many are/were significantly overweight. I have always been a healthy weight and tall / slim (although of course I could easily be a TOFI and I do carry weight on my waist).

    I have problems with my ears (Ménière's) and there is a link with Ménière's and hyperinsulinemia. However endo told me I couldn't have hyperinsulinemia as my fasting insulin was ok....

    I'm annoyed that my libre 2 isn't picking up my lows (lowest is about 4.1 where I know I'm lower when I feel like I did during the OGTT).

    I'm really interested what you say about the peaks. I think I do eat too much sugar at times.

    I can't shake the feeling this could be a very early stage of T2D. I've attached a paper which I'd like you thoughts on the 4 stages (starting at the bottom right of page one and ending at the top left of stage 2).

    Another question I have is, is it correct that hyperinsulinemia would be high insulin all the time? Or could it be an overproduction of insulin as a response?

    I'm surprised by my high reading of 9.8. I did think I was either ok or low (not high).
     
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  13. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Done that myself, and said flipping heck more than once.
    I have briefly scanned part of the paper and Was you are aware, this paper and yourself are about Meniere's. Which I will study later.
    You are correct about hyperinsulinaemia and also patterns of high levels of insulin at certain times. I have no doubt that my symptoms were close to menier's, I believe that would have been my diagnosis.
    However my specialist, like yourself has done umpteen tests and because the tests are not definitive and are used for elimination. Those tests excluded everything else other than RH.
    Yes I did have hyperinsulinaemia, but my doctors didn't have a clue, what was going on then, and I wasn't tested for insulin until my second eOGTT. And of course you can have normal fasting insulin levels and hyperinsulinaemia, depending on your metabolism, you could have high levels of circulating insulin, insulin resistance depending on your metabolism. And because of this high insulin, your body is creating symptoms of up and down blood levels. And this is the tests they never do, or want to do because hyperinsulinaemia is a major factor in a lotof causes of diabetes. Which could alter their chance of getting T2, if tested early enough.
    If the doctors had tested for insulin instead of glucose twenty years ago, I probably wouldn't have had to go through it all.
    The useless insulin over a few hours gets turned into forms of fat, like visceral fat by your liver, so yes, as stated above, you can have hyperinsulinaemia in the day but can have good insulin levels as well especially fasting.
    And it all depends on what I eat.!....
    And finally if it is the condition of RH, and not the symptoms of RH, then, when in control of your blood sugar, anything over normal will be too high and likely to trigger more insulin. Have you been tested for initial insulin response during the first half hour of an eOGTT?

    We have a rare condition and we react different to each other with the episodes of hypoglycaemia, and it is completely different from diabetes in the way it occurs and the dietary regime you need to stay in control.

    Got to go, but I will answer any more questions or not sure about what I've said.

    Keep safe
     
  14. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    So for balance, I would say 11.1 is 4 points too high. I have never heard any of the low carb / keto MD's / GPS / PHD's or influencers refer to this super high number or anywhere near it. I am not a Doctor or similar but numbers that high are 3.3 mmol/L higher than what is the consensus for damage to blood vessels. I would say I doubt you can get more than 3 long term remission Type 2's on this site to agree that 11.1 is a normal number.
     
  15. SarahABC

    SarahABC · Member

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    @Mbaker thanks. So do you think a healthy max is 7.8 for a non-diabetic person at any time? I'm really confused as it's really unclear as to whether 7.8 is absolute max or max after set amount of time.
     
    #15 SarahABC, Dec 27, 2021 at 7:27 PM
    Last edited: Dec 27, 2021
  16. SarahABC

    SarahABC · Member

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    @Lamont D thank you.

    I guess my only option is low carb. Sorry for the tmi but one issue I have with low carb is constipation which I can't handle.

    Also I don't really enjoy meat and I have a lactose intolerance. If I eat Greek yoghurt (with maybe some pear and a few oats) for breakfast I definitely notice I don't need to keep topping up my sugar levels with snacks before lunch compared to if I'd had Weetabix for example. I also feel fine with fasting but that results in constipation too plus I have to take meds for my Ménière's with food 3 times a day....

    So do you have any food inspiration? I'd love to fast but I just don't think I can. I'm determined to start properly in the next few days (only recently diagnosed with RH) and hopefully be in the full swing of things in Jan.
     
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  17. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    One of the final tests that I had other than more eOGTTs was a fasting test, this was under supervision in my local hospital over four to five days.
    This test is to see if I didn't eat, would I still go hypo?
    If I went hypo, it would not reactive hypoglycaemia, it would be a pancreatic condition such as insulinoma.
    But if I did not go hypo, it was reactive hypoglycaemia.
    This realisation that I didn't need to keep eating to stop going hypo and keeping my blood sugar levels in normal range was strangely good for my health, a lightbulb moment, that I felt better fasting and it was the start of my recovery.
    I fast every day now. Only one or two meals a day.

    And I am lactose intolerant as well from birth. But I can tolerate Greek yogurt, full fat., with a few berries. Fruit you have to be careful because I can have pieces of fruit, but not a lot! Tropical fruit can be too much.

    Sorry, but I'm a meat guy. I can't abide cooked vegetables and only have salad vegetables, no dressings, no sauces.
    I would recommend dietdoctor.com, you will get better dietary advice especially about very or ultra low carb or a ketogenic diet that I would subscribe to. And vegan, even though it is a lot more difficult to get the right saturated fats that you need. And from experience vegetable oils or other plant based ingredients are not recommended.
    Some vegetables are full of starch which is another carb and will spike you. And the rule is, below ground is bad, above ground is good.
    Use your cgm as testing your blood sugar levels to see how much carbs spike you. Use a food diary to log details of the testing and what you eat
    When you think that all our lives we have been told that carbs are healthy, well for me, they were killing me.
    And I have never been constipated.

    Meds, all my meds have no sugar or lactose, and need to be enteric, especially aspirin. Just a heads up seeing that you take repeat meds for Mesiere's.

    Keep asking, keep safe.
     
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  18. SarahABC

    SarahABC · Member

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    Thank so much.
     
  19. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    All I can say is that mine is circa 5.7 after substantial meals (inclusive of berries and the occasional non-ripe plum. In my experience people do not like being told what to do, so one has to review the evidence and make a choice. To outliers such as me, normal is not food-like items with an ingredients list so long and complicated regular people have no clue about.

    I think if it were occasional rises above 7.8, like twice a week, then a healthy diet and body could sustain that, but almost every regular "normal" meal spikes blood glucose and causes a huge insulin response.
     
  20. Ronancastled

    Ronancastled Type 2 · Well-Known Member

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    First of all, relax

    Lets look at what a normal non-diabetic persons BG looks like on a CGM
    https://www.diabetesdaily.com/forum...a-dexcom-what-truly-normal-looks-like.137801/

    Researchers analyzed 10 days of Dexcom G6 CGM data from 153 children (6+ years) and adults with a baseline A1C of 5.1%. The primary findings:

    • Among all study participants, the average blood sugar was 99 mg/dl
    • Time-in-tight-range of 70-140 mg/dl was 97% in this group of people without diabetes
    • Average time in hyperglycemia (blood glucose greater than 140 mg/dl) for the group was 2.1% (just 30 minutes per day)
    • Average time greater than 160 mg/dl was approximately 4 mins/day
    • Time below 60 mg/dl and 54 mg/dl were both negligible
    So let's answer your first question, yes, everyone spikes >7.8, but it's of short duration.

    Complications seem to be more prevalent with higher BGs over a long time frame
     
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