Just after a bit of advice

[JMarie87]

Hi everyone,

I don’t quite know where to turn so hope it’s okay for me to ask here as I consider you experts.

I have a strong chance of developing Type 2 as I have had Gestational Diabetes twice (probably three times but it went undiagnosed during COVID times) and my Mum has it.

Having had my baby in November, I assumed my GD was gone but in March I took a random blood glucose reading and was mortified when it was 11.0, I immediately took it again and it was 9.0, then afterwards 8.5 and it stayed that way for a good couple of hours. By morning it was normal at 4ish, perhaps just under.

It scared the life out of me and I promptly cut out added sugar and started a low carb/high fat way of eating. I also tried to move more. In April I had my Fasting Bloods and HbA1c checked. Results were 3.8 fasting and a HbA1c of 27. I was so relieved and carried on, the weight dropped off at a rapid weight and I’ve lost two stone since and am now a healthy BMI.

Today I let my guard down a bit and had a portion of cake, tested my sugars after an hour and they were 9.6. I’m so confused and honestly, terrified. How can my blood sugars appear so comfortably within the normal range per my lab results, but spike so high off a piece of cake?

Could anybody please suggest what may be happening and if there’s anything I can do to help my health? I was really proud of what I’d achieved but it appears not to have helped.

Thank you so much

Xxx

 

[KennyA]

Hi JMarie 87 and welcome to the forums.

Thing is, as you're finding, that the random fingerprick tests have very little relation to your HbA1c. I find random testing not much use at all, and my main reason for testing is to work out which foods do what to my BG levels. You need a test before eating, to establish a baseline: and then a test after two hours, by which time your system should have cleared the digested glucose out of your blood. And tests can be wrong, too - I've just done two post-meal tests tonight within ten seconds of each other: one was 3.3, and the other 6.3. One is definitely wrong, but it's likely both are wrong.

If it's any help, I know that a small latte will take me from low fives to 9.6 within 30 minutes, and I'll be back to low fives after an hour. The point is not to see "how high you go" - it's to see if, and how well, you can deal with the carb in what you ate. So you probably tested for your cake right at the high point, and it's not all that high. It might be worth having a google for some non-diabetic BGM graphs - you'll see that blood glucose levels rise and fall all the time, and in response or anticipation of many things other than food. I'm attaching one, from a non-diabetic person.

Does that help?

 

[Paul_]

Hi @JMarie87, welcome to the forum.

I don't have anything to add on blood glucose, following Kenny's reply above. From what you've said about hba1c test results etc, you seem to be in a good place right now.

However, you asked for general advice on what you can do to help your health, and I understand your concerns given GD and the fact diabetes has a significant genetic element to it. When it comes to type 2 diabetes, there are lots of areas like genetics, where the factors involved are out of our control. What we can do though is reduce the risk from factors that are within our control, which if not controlled could increase the risk of developing T2D presented by those factors we can't control. These are mostly the usual things, such as a good diet, exercise, maintaining a healthy weight etc. Very large sections of the keto (<20g carbs per day) and low carb (generally less than 130g carbs per day) diet communities have opted for that lifestyle due to wanting to lower their risk of developing T2D, not because they already have it. They're not for everyone, but maybe it's something to look at, if you're concerned.

Beyond that, based on a number of posts I've seen from others, if you have a blood test and they do an hba1c, always ask what the result was. It seems some doctors don't routinely report these results back to their patients, with some having prediabetic results and not being told. Hold your GP accountable and always ask.

My only other advice, as someone who completely ignored this for far too long, is to value your health. It's unimaginably precious. We all know this deep down, but often we don't realise just how precious it is until we aren't healthy. The fact you've come here and asked questions is great, don't lose that focus on your health.

 

[JMarie87]

Hi JMarie 87 and welcome to the forums.

Thing is, as you're finding, that the random fingerprick tests have very little relation to your HbA1c. I find random testing not much use at all, and my main reason for testing is to work out which foods do what to my BG levels. You need a test before eating, to establish a baseline: and then a test after two hours, by which time your system should have cleared the digested glucose out of your blood. And tests can be wrong, too - I've just done two post-meal tests tonight within ten seconds of each other: one was 3.3, and the other 6.3. One is definitely wrong, but it's likely both are wrong.

If it's any help, I know that a small latte will take me from low fives to 9.6 within 30 minutes, and I'll be back to low fives after an hour. The point is not to see "how high you go" - it's to see if, and how well, you can deal with the carb in what you ate. So you probably tested for your cake right at the high point, and it's not all that high. It might be worth having a google for some non-diabetic BGM graphs - you'll see that blood glucose levels rise and fall all the time, and in response or anticipation of many things other than food. I'm attaching one, from a non-diabetic person.

Does that help?

Thank you so very much for your response. That’s really interesting with the non diabetic graph. Is that a healthy response do you know?

You’ve made me realise I’m coming at this from a GD background where you have to check the spike and treatment is based on spike rather than the response as a whole to carbs.

Do you know if there’s any value to be gained from using a CGM for a couple of weeks?

 

[hyponilla]

Just to give you some further reassurance that things are probably fine, I'll echo what @KennyA posted about normal spikes in non-diabetics. I used to test my non-diabetic husband's blood glucose after eating a lot of carbs, and when he had things like ice cream, cake, or candy he would typically spike to 9.x around the one-hour mark and fall back to 5 after two hours. Beer was the worst offender, sending blood glucose above 10 a few times. If the carb load is high and fast-acting the phase 1 insulin response can't keep up and there will be a short spike even in non-diabetics. While it's not the best for your blood glucose to do this all the time, I think you're fine having cake sometimes, providing the levels come down again within a reasonable time. As a science nerd, I'd recommend wearing a CGM and seeing what different foods do to your blood glucose. Also, it might make you more confident that your blood sugar levels are stable as indicated by your HbA1c.

 

[KennyA]

Thank you so very much for your response. That’s really interesting with the non diabetic graph. Is that a healthy response do you know?

You’ve made me realise I’m coming at this from a GD background where you have to check the spike and treatment is based on spike rather than the response as a whole to carbs.

Do you know if there’s any value to be gained from using a CGM for a couple of weeks?

I am not sure what you mean by "a healthy response". It's a normal response. Blood glucose varies all the time as our livers keep topping it up from stores in response to what we need or might need in the near future. Food affects it stress affects it, and this note I found on the internet gives (i think 42 different factors that people have reported as affecting their BGs - note, it's reportage, not a piece of research.

42 Factors That Affect Blood Glucose?! A Surprising Update

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diatribe.org

You'll find loads of similar graphs on the internet - there were a lot on Reddit last time I looked. Some of the T2 graphs are very obviously awry - eg levels that go to 15 and stay there for eight hours. I've attached one of the T2 graphs, but it can sometimes be difficult to tell some T2 graphs from T2s from non-diabetic results.

I found a CGM very useful. It told me what is happening when I'm not testing - when I'm asleep, for instance. Very useful information, but not something I think I need all the time. I'm planning on another CGM trial specifically around strenuous exercise, as it's not really possible to stop and do a fingerprick test when you're in the middle of it - and by the time I've got off the pitch and found the testing kit, things have changed.