Morning/Evening testing times?

[Beating-My-Betes]

I'd go so far as to say MY normal is different from MY normal!

And therein lies the rub

 

[Beating-My-Betes]

Not quite ... my home OGTT results were these.
View attachment 49001

I went up by nearly 8 mmol/l ?

I thought you had an official one done, that peaked lower? Perhaps i was getting confused between the amount of rise with peak.


I am amazed that you tried an OGTT from a start point of 14 mmol/l that's kind of crazy and possibly quite dangerous.

That's why i've decided to go with the raisins i.e something a little less drastic. And I misremembered my own figures, slightly. I thought my meter topped out at 30, but alas...

It topped out at 32, which means I could've gone higher than that. This was my first shot within range, on the way back down.

Either way, my point is that the exponential rise caused by insulin resistance, way over and above the actual quantity of glucose, makes testing foods at the moment just pointless.

Have you ever had a c-peptide test to check on your endogenous insulin production?

I did actually find the blood-test results from diagnosis, but have since misplaced them (Spring cleaning). Turns out that I was diagnosed at pre-diabetic levels and sent on my way with a script for Metformin. The Metformin made for a nasty Summer, after which I just stopped going back for refills. In the following 3 years, despite my best intentions, I have managed to get myself into the position I'm in now.

I'm not currently in a position where i can see a doctor (Too long a story, and not something I'm currently willing to share, here). That situation should hopefully change at some point, within the next year. Until then, I am kinda consoling myself with the thought that perhaps I'm not so far gone that I can't turn it all around. We'll see.

 

[Tophat1900]

I thought you had an official one done, that peaked lower? Perhaps i was getting confused between the amount of rise with peak.


I am amazed that you tried an OGTT from a start point of 14 mmol/l that's kind of crazy and possibly quite dangerous.

That's why i've decided to go with the raisins i.e something a little less drastic. And I misremembered my own figures, slightly. I thought my meter topped out at 30, but alas...

View attachment 49002

It topped out at 32, which means I could've gone higher than that. This was my first shot within range, on the way back down.

Either way, my point is that the exponential rise caused by insulin resistance, way over and above the actual quantity of glucose, makes testing foods at the moment just pointless.

32 mmol.... so what was your starting point?

You seem to be blaming the exponential rise completely on insulin resistance (IR) and none of the blame on what you actually ate. This is a classic example of why so many people test pre and post meals. It helps to show what foods are causing a spike IR or no IR. OGTT does not make testing pointless. These two tests are worlds apart. One is a diagnostic test and the other shows results throughout the day, progress, trends, problems etc. You will learn a lot more from testing. If you regard testing as pointless because you think testing is inaccurate, then why test in the mornings? why at all? As by definition you would view these results as inaccurate also. Not sure why you think these would be inaccurate?

This is also a great example of why T2's imo shouldn't be doing OGTT's post diagnosis especially if you know you are insulin resistant. These are very damaging levels and potentially dangerous, even for T2's in some cases. No one wants to see you in a hospital.

Just to clarify, I'm not stating you must test. You are free to do so or not, entirely up to you, but if you are looking to collect data I just find ironic that you seem to be resisting by any means testing during the day pre and post meals where the bulk of the relevant data is. It's really a case of find out what causes a problem, manage the problem, but you can't if you don't look for the problem.

I'm not bagging on you, I just don't understand your goals or the approach you are taking.

 

[Mike d]

Look where the problem might be. DON'T look at where it isn't.

 

[Beating-My-Betes]

32 mmol.... so what was your starting point?

Will look it up to check, at some point, but it was 14-ish

You seem to be blaming the exponential rise completely on insulin resistance (IR) and none of the blame on what you actually ate.

Not sure what else to blame it on. I took the same 75g of glucose that BB took. I'm pretty sure that pure glucose is pure glucose and that it contains the same amount of energy and carbs, regardless of brand.
BB's sugars rose by approx. 8 mini-moles (Might've been less if he'd carbed up for the preceding days). Either way, if we assume that his response was perfectly in line with the amount of ingested glucose, then mine rising to over 32 is 2.5 times the expected result.

Whether it is just down to IR, I cannot say. But it is clearly a large part of the equation.

This is a classic example of why so many people test pre and post meals. It helps to show what foods are causing a spike IR or no IR. OGTT does not make testing pointless. These two tests are worlds apart. One is a diagnostic test and the other shows results throughout the day, progress, trends, problems etc. You will learn a lot more from testing. If you regard testing as pointless because you think testing is inaccurate, then why test in the mornings? why at all? As by definition you would view these results as inaccurate also. Not sure why you think these would be inaccurate?

I'm not saying that FBG is some kind of gold-standard. However, FBG seems to have a reputation for being one of the last numbers to fall, even as other readings are generally improving. That's the number I want to see falling; initially, at least.

This is also a great example of why T2's imo shouldn't be doing OGTT's post diagnosis especially if you know you are insulin resistant. These are very damaging levels and potentially dangerous, even for T2's in some cases. No one wants to see you in a hospital.

Thanks for your concern. It's also not something I don't intend to do regularly, at all. That's why I'm going to use a weekly test that I think is more manageable, but that should give me at least an idea of whether things are improving.

Just to clarify, I'm not stating you must test. You are free to do so or not, entirely up to you, but if you are looking to collect data I just find ironic that you seem to be resisting by any means testing during the day pre and post meals where the bulk of the relevant data is. It's really a case of find out what causes a problem, manage the problem, but you can't if you don't look for the problem.

I'm not against testing. In fact this entire thread started with an enquiry as to whether adding another point-of-testing would be useful. I'm just against useless testing, that will just tell me what I already know i.e that my response to carbs is not accurate.

I'm not bagging on you, I just don't understand your goals or the approach you are taking.

Not at all; I appreciate your tone and manner. So thanks

The approach I am trying to take is to live in a way that supports my body's natural/innate abilities, to both heal and to thrive.

 

[bulkbiker]

The approach I am trying to take is to live in a way that supports my body's natural/innate abilities, to both heal and to thrive.

Which to be honest is fairly unlikely on the dietary path you are electing to follow.

 

[HSSS]

I’m totally confused. Genuinely. What are you hoping to learn with your daily testing?

You say you know that pre and post meals will show insulin resistance - to the carbs you have just eaten predominantly -so you don’t want to know about which foods do that more and which don’t (ostrich approach because you know you won’t like the answers already?)
You consider IR, food, sleep, exercise, stress as confounders rather than essential constituents of what effects the bgl etc
You know that fbg is the last to respond but it’s where you intend to look first?

it all seems so contradictory or I’m totally failing to understand your points.

 

[HSSS]

I don't test for meals because I'm very insulin-resistant. My before meal numbers are high, the rise exponential, and the comedown slower. I've also been sleeping badly for well over a year and like most people took an activity hit during lockdown. There is nothing worth knowing, for me, in all that morass.

Would you rather not eat meals that don’t cause exponential spikes and come down faster (thus doing less insulin stiumlating) and reducing that problematic insulin resistance? How do you think it’ll reduce if you are constantly poking the bear? Being very IR is exactly why you should test not a reason to avoid it imo and I don’t understand your logic at all.

 

[Beating-My-Betes]

I don’t understand your logic at all.

Which is fine. But in that case, perhaps don't accuse me of burying my head in the sand.

It's not about not wanting to know the results, it's about knowing them without bothering to test. I know that every single carb I eat will raise my sugar exponentially and take longer than it should to fall. It's not a truth I'm hiding from. I'm not throwing away hundreds of strips a month, which my parents are currently having to pay for, just to find out that I currently have an issue with carbs.

It would absolutely be useful test all my meals if I were planning on removing 'offending' foods from my diet. But for the moment, I'm not. What I am doing is removing most of the fat from my diet and concentrating on natural foods, getting more exercise, losing weight, improving my sleep etc. and generally trying to live in a way that improves insulin sensitivity. If it turns out that it is not viable then I'll have to change my plan.

 

[HSSS]

Which is fine. But in that case, perhaps don't accuse me of burying my head in the sand.

It's not about not wanting to know the results, it's about knowing them without bothering to test. I know that every single carb I eat will raise my sugar exponentially and take longer than it should to fall. It's not a truth I'm hiding from. I'm not throwing away hundreds of strips a month, which my parents are currently having to pay for, just to find out that I currently have an issue with carbs.

It would absolutely be useful test all my meals if I were planning on removing 'offending' foods from my diet. But for the moment, I'm not. What I am doing is removing most of the fat from my diet and concentrating on natural foods, getting more exercise, losing weight, improving my sleep etc. and generally trying to live in a way that improves insulin sensitivity. If it turns out that it is not viable then I'll have to change my plan.

Woo. Ok. Effectively you’ve already identified the problem foods. That wasn’t clear to me. Fair enough, many of us reduce testing once we’ve done that.

Why focus on fats that don’t cause a problem? And what’s natural food? Do you mean remove processed foods? Good idea. The research seems to show processed food, seed oils and carbs are the main foods that increase insulin thus increase IR, obviously exercise and sleep are good things too.

It just seem contradictory to leave in the foods you know cause you a problem (carbs). Why not reduce those if they cause exponential spikes that are even now contributing towards more IR and potentially damage in tiny amounts each exposure?

 

[Beating-My-Betes]

Woo. Ok. Effectively you’ve already identified the problem foods. That wasn’t clear to me. Fair enough, many of us reduce testing once we’ve done that.

I think this is getting mixed up. I haven't tested everything to know what my problem foods are. I don't consider the foods problem foods; rather that it's my system that is currently problematic. And that's what I'm attempting to change.

Why focus on fats that don’t cause a problem? And what’s natural food? Do you mean remove processed foods? Good idea. The research seems to show processed food, seed oils and carbs are the main foods that increase insulin thus increase IR, obviously exercise and sleep are good things too.

I'm focusing on lowering fats, as carbs are my preferred fuel source. It's the combination of high amounts of both that contribute to issues, especially in combination with metabolic damage, obesity etc. That's why people are having success on either side of the divide (high-carb, low-fat and low-carb, high-fat).

Even if I were to have no doubts about the long-term health outcomes of a low-carb or keto approach, the fact is that a vegan keto diet is extremely restrictive and not something I'd consider unless I had no other option.

Carbs in isolation, or independent of other lifestyle factors and conditions are not an issue.

As for "natural" foods: For me, that would consist of mainly whole plant-foods i.e fruits, veggies, starches (Preferably of the water-rich tuber kind e.g potatoes and carrots), botanical/seeded fruits e.g peppers, cucumbers, tomatoes courgette etc. Also, tender leafy greens and beans, legumes nuts and seeds. I have no issues, either philosophically or digestively, with minimally-processed foods e.g soy products. I also have no personal issues with use of juicing or blending.

My intention is to move towards an oil-free, added-sugar-free, salt-free and grain-free diet. My ideal would be a raw-vegan diet. But short of the odd short-term period, it's probably a way off.

 

[lucylocket61]

My intention is to move towards an oil-free,

You might want to have a look at this;
https://www.healthline.com/health/fat-deficiency

 

[Beating-My-Betes]

You might want to have a look at this;
https://www.healthline.com/health/fat-deficiency

Why?

I didn't suggest I would be going fat-free, just that I'd be looking to reduce fats and cut out oils. It's actually impossible to be fat-free on a plant-based diet, as all plants contain some amounts of fat (To help absorb the vitamins, perhaps).

There is no requirement for oil in the diet, and while I don't want to overdo salt I'd eat olives instead of using olive oil.

I currently get over 5 grams of omega 3's from chia seeds. And while i eventually would like to perhaps add some other occasional fats, I'd prefer to wait until I have sorted out my health issues first. I feel that keeping them to a minimum is going to help me get to where I want to be.

 

[HSSS]

I think this is getting mixed up. I haven't tested everything to know what my problem foods are. I don't consider the foods problem foods; rather that it's my system that is currently problematic. And that's what I'm attempting to change.



I'm focusing on lowering fats, as carbs are my preferred fuel source. It's the combination of high amounts of both that contribute to issues, especially in combination with metabolic damage, obesity etc. That's why people are having success on either side of the divide (high-carb, low-fat and low-carb, high-fat).

Even if I were to have no doubts about the long-term health outcomes of a low-carb or keto approach, the fact is that a vegan keto diet is extremely restrictive and not something I'd consider unless I had no other option.

Carbs in isolation, or independent of other lifestyle factors and conditions are not an issue.

As for "natural" foods: For me, that would consist of mainly whole plant-foods i.e fruits, veggies, starches (Preferably of the water-rich tuber kind e.g potatoes and carrots), botanical/seeded fruits e.g peppers, cucumbers, tomatoes courgette etc. Also, tender leafy greens and beans, legumes nuts and seeds. I have no issues, either philosophically or digestively, with minimally-processed foods e.g soy products. I also have no personal issues with use of juicing or blending.

My intention is to move towards an oil-free, added-sugar-free, salt-free and grain-free diet. My ideal would be a raw-vegan diet. But short of the odd short-term period, it's probably a way off.

My preferred energy source was custard creams. Doesn’t mean they did me any good.
So natural means vegan? Humans have always eaten meat and animal products. You may choose not to, your perogative entirely. Doesn’t mean they aren’t natural.

Good luck. I think you’re going to need it and I think you’ll need to rethink but for your sake I hope I’m wrong and weight loss alone will be enough and you don’t deprive yourself of essential fats, amino acids, b vitamins and iron rich foods that cause other issues beyond diabetes in the process. I’ll bow out here.

 

[VashtiB]

I'm another who is confused. You say that your preferred fuel source is carbs- that I get. I would also love to include carbs in my diet.

You are trying to address your insulin resistance. That I get but I don't understand what you are doing to reduce it. Adding more carbs to a system that is insulin resistant will only increase the insulin resistance as the body will have to keep producing more insulin to deal with the glucose produced by the carbs.

The way I think of carbs is as an allergy or intolerance. I am also intolerant to gluten (I don't really know what gluten is or looks like but it is in all the yummiest food). What I have found is that if I continue to eat gluten my body doesn't run as well. I am more tired and emotional and generally don't feel great. If I am really careful to avoid gluten (which is actually easier with low carb) then my body feels better. If I then eat gluten I feel really really sick. I know my system is being damaged by eating gluten but before low carb I would eat gluten anyway. So I guess I do understand why you want to be able to avoid getting rid of carbs. The difference is that I could not quantify the damage I was doing with eating gluten but you can. It is generally accepted that to avoid damaging your body you should try to keep your levels below 8. So your levels are really high and I really worry that you are doing yourself damage. You indicate that your parents would have to buy strips for you to do regular testing. As a parent I would be more than happy to buy strips to avoid my kids doing damage to themselves.

Take care.

 

[EllieM]

Either way, if we assume that his response was perfectly in line with the amount of ingested glucose, then mine rising to over 32 is 2.5 times the expected result.

As a T1 with some insulin resistance (thanks T2 dad genetics), I notice that if my bg is above normal then my insulin resistance goes up significantly. Maybe that's just me but I definitely wouldn't assume that your IR is independent of your starting blood sugar level. And given that T2s all have different levels of insulin resistance, I'm not sure there is an expected result for an OGTT, other than if it's more than a certain level it's indicative of some form of diabetes.

Look, the reason so many of us are low carb advocates here is that for many of us it has allowed drastic reductions in bg levels and drastic reductions in medications, even up to some T2s being able to drop insulin.

You want to try other methods, which is fine, but I'd urge you to make sure you are doing something. Exercise and weight loss are known to help IR, though given that weight gain is a side effect of high bgs and high circulating insulin, then I'm never sure whether excess weight is a cause or effect.

And your levels sound pretty high at the moment, so if your current steps aren't improving things then please don't leave it too long before you try something else. eg if you were LADA (not impossible though I don't know any of your personal details so cannot comment on the likelihood) you'd need to keep a close watch on your ketones so that you don't get the diagnosis via a trip to A&E and diabetic ketoacidosis.

My adult son is a committed Vegan, and as 3 of his 4 grandparents were/are T2 he's at very high genetic risk of IR/T2. I was discussing diet with him yesterday (he's overweight due to a bit of a sugar addiction) and he's sure that he can manage things by giving up all the added sugar, which he's currently doing. Given that he's also pretty well giving up bread (possible gluten allergy and white bread has added sugar) I suspect that this will probably work for him, but he's not prediabetic yet. (We assume, he's had a lot of blood tests recently so hopefully they would have checked hba1c along the way.)

Honestly, I suspect that the vast majority of T2 and prediabetes could be prevented from happening in the first place just by drastically cutting the amount of added sugar present in the typical supermarket aisle. (And that is not diet blaming anyone, it's just really hard to push all the added sugar hidden in typical supermarket products.)

Anyway, good luck.

 

[Resurgam]

Unfortunately, for a type two diabetic, our ability to deal with fats works fine, it is the carb processing which is up the creek.
I'm rather concerned that you are going to ignore the problem you have and try to fix things by targeting fats which have been unfairly demonised for so long.
I reduced carbs and was no longer diabetic in 6 months, been fine ever since.
I'm not trying to be nasty about your choice to avoid eating the low carb foods I have on my menu, but I do think you should be making choices which are more likely to lower blood glucose.

 

[Beating-My-Betes]

Still intend to answer the posts here, but at a slower pace. I just wanted to thanks those who have offered well-wishes and to let y'all know that I will be tracking more often during May. Just need to work out a plan that might yield some useful data points.