Need advice!!

[GM1986]

Guys I’m really confused and need some advice from people who have actually been through this. The diabetes website says you should have a blood glucose reading of below 5.6 before eating ideally and it should return to normal within 2hrs. If you wake up and your blood glucose is 6.7 do you still eat breakfast anyway, knowing it will cause your BG to surge up to 10+ or do you wait for it to slowly come down, sometimes taking hours to do so?
I tend to only allow myself to eat if my blood sugar is 6.0 or below but it is becoming very difficult to manage and my Doctor is no help.

 

[KennyA]

Hi - which diabetes website says you should be below 5.6 before eating? That's new to me. can I just check - you don't have diabetes?

The idea about testing is to take a baseline reading before you eat, and then one two hours later. If your insulin response system deals with the carbs (if any) in what you eat, you should return to within two points of the baseline reading (and not above 8) at the two hour mark. If you don't, there were more carbs in what you ate than your system could effectively handle.

You also need to bear in mind that glucometers have a permitted inaccuracy of 15% - so a "true value" of 5.0 could show as anything from 4.3 to 5.8.

And blood glucose is not only affected by what you eat. It's perfectly normal for BG levels to vary, rising and falling throughout the day. Our livers are constantly adjusting blood glucose levels in response to what they think we currently need. Morning fasted readings are usually entirely controlled by liver activity rather than food. My morning level will go on rising slowly until I eat something, which seems to satisfy my liver. I'm not surprised you're finding it difficult to manage if you're waiting for levels to fall - your liver will be busy topping up your BG all that time.

People also report many things affecting bg levels - illnesses, ambient temperature etc. Link has more:

https://diatribe.org/diabetes-management/42-factors-affect-blood-glucose-surprising-update

So to answer your question: if I wanted/needed to eat, the baseline level wouldn't put me off. If I was seeing a level around 10 two hours later, I wouldn't be eating that meal again.

 

[ajbod]

The advice for below 5.6 is the ideal, we know life doesn't run like that. If you are eating to reduce your overall levels, they should eventually get there, but not always. Your level could be as much as 8, and if you are hungry then you need to eat. The 5.6 is a target to aim for eventually, but it's a case of getting as close as your body allows.

 

[GM1986]

Hi - which diabetes website says you should be below 5.6 before eating? That's new to me. can I just check - you don't have diabetes?

The idea about testing is to take a baseline reading before you eat, and then one two hours later. If your insulin response system deals with the carbs (if any) in what you eat, you should return to within two points of the baseline reading (and not above 8) at the two hour mark. If you don't, there were more carbs in what you ate than your system could effectively handle.

You also need to bear in mind that glucometers have a permitted inaccuracy of 15% - so a "true value" of 5.0 could show as anything from 4.3 to 5.8.

And blood glucose is not only affected by what you eat. It's perfectly normal for BG levels to vary, rising and falling throughout the day. Our livers are constantly adjusting blood glucose levels in response to what they think we currently need. Morning fasted readings are usually entirely controlled by liver activity rather than food. My morning level will go on rising slowly until I eat something, which seems to satisfy my liver. I'm not surprised you're finding it difficult to manage if you're waiting for levels to fall - your liver will be busy topping up your BG all that time.

People also report many things affecting bg levels - illnesses, ambient temperature etc. Link has more:

https://diatribe.org/diabetes-management/42-factors-affect-blood-glucose-surprising-update

So to answer your question: if I wanted/needed to eat, the baseline level wouldn't put me off. If I was seeing a level around 10 two hours later, I wouldn't be eating that meal again.

I haven’t been tested in nearly a year and in that time my blood glucose levels have gone up considerably. Fasting levels usually above 6.7 every morning and often takes 3hrs+ for my glucose to return to normal after eating.
I limit my carb intake as much as I can on my own but my diet is already quite restrictive due to allergies.
If I’m honest I don’t trust my doctor or their advice of stop testing and don’t worry about it, I think that’s how people end up getting very ill or sick. I’m overweight and have a disability that prevents me from exercising much so diabetes is a real concern.

 

[ianf0ster]

Hi @GM1986 I note that you don't have diabetic blood glucose numbers, and are merely pre-diabetic. Thus, you may not need to take much action in order to get your BG numbers back down into the normal range.
But what is the plan you are following in order to achieve this?

You mention various BG readings, so at least you have taken the initial step of enlisting your own diabetes expert (your BG meter or your CGM).

I'm a diet only controlled T2D in remission for over 4yrs. For me, the most important use of my BG meter was in testing various meals and specific foods in order to find out which ones my body struggled with and which ones were fine for me - unfortunately we are a diverse bunch and so it isn't the same foods for everybody. For example, apples, parsnips, even raw carrots raise my BG too much so I avoid eating them, while many T2D's have little Bg reaction to some of those.

I have a Low Carb way of eating, which has led me to no longer eat 'breakfast' - at least not to eat before noon. This is because I'm no longer hungry in a morning since my body became 'fat adapted', meaning it can switch fuel between carbs and fats enabling my own body fat to provide energy whenever required.
But when I did eat breakfast and when I did test Bg before eating, I would only try not to eat if my BG was already 8.0 mmol. For me a meal is fine unless it raises my BG my more than 2.0 mmol or raise my to more than 8.0 mmol 2 hrs after the first bite (I didn't care what the BG was before the 2hrs). I would eat only when I was hungry and even after a pre-prandial BG reading of 8.0, if I just ate boiled, fried or scrambled eggs (no bread etc), then often my BG after 2hrs was actually lower than before eating them.

There is a thing called Dawn Phenomenon, which is where the liver dumps glucose into the bloodstream in the morning in order to provide energy for us to go hunt/gather our first meal of the day just as our cave dwelling ancestors did. I found that I regularly had DP, but that a low or zero carb meal/snack would stop it in it's tracks.

 

[KennyA]

I haven’t been tested in nearly a year and in that time my blood glucose levels have gone up considerably. Fasting levels usually above 6.7 every morning and often takes 3hrs+ for my glucose to return to normal after eating.
I limit my carb intake as much as I can on my own but my diet is already quite restrictive due to allergies.
If I’m honest I don’t trust my doctor or their advice of stop testing and don’t worry about it, I think that’s how people end up getting very ill or sick. I’m overweight and have a disability that prevents me from exercising much so diabetes is a real concern.

If you haven't had your HbA1c done recently how do you know your glucose levels have gone up? They might well have, but basing your judgement only on glucometer readings might be a bit shaky.

The problem with fingerprick testing is that you only see what is going on at the point you test. This works well for assessing how you deal with food but tells you nothing about what happens when you're not testing - while you're asleep, for example. Given the normal variance in levels over a day random fingerprick tests may not actually tell you much.

It might help people reply to you if you could set out the sort of things you can't eat because of allergies. There's no point recommending (eg) dairy if you're lactose intolerant, for example. It does sound as if your diet is too carb-heavy for you, if you're getting the sorts of results you describe.

 

[Melgar]

Your sensitivity to insulin can be lower in the mornings, putting it in another way , your insulin resistance is often higher in the mornings, which raises your blood sugars, along with dawn phenomenon or DP for short. Insulin resistance rises because of the release of cortisol and other hormones such as growth hormones. Perfectly normal. In someone with a healthy endocrine system, this rise is short as it is quickly dealt with by the body. In someone with diabetes, or Prediabetes it can take the body longer to bring those early AM blood sugars down. Sometimes they don’t come down until you eat something.