need help, does this look like Early t1d / t2d / RH???

[womaninthegarden]

My first time in here, I don't know where to post this but I am a slim young (152cm, 44kg, 20yo), asian female, living in england. I have a very strong family history of diabetes; 2 diabetic parents, 3/4 diabetic grandparents, all t2d. My hba1c is currently 27 / 4.6%, last year was 34, the year before than 33, so I've never had a diabetic or even pre diabetic hba1c. I am pretty sure I have reactive hypoglycaemia as after carbs I feel extremely hungry, shaky and weak. I first noticed an episode of hypoglycaemia when I was 11yo. I bought a cgm and got these readings that I have attached below. Mist the day my blood sugar is good, with my fasting always in the 4's, but I have huge peaks with carby meals. My lipid / liver profile are all perfect, I have rlly low cholesterol and triglycerides. However my tsh increased from 0.72 to 3.8 in one year and this could be causing me to have low sugars right? Because I've been getting more lowish sugars recently. Also I woke up and my blood sugar was 3.6 ( 64), and that was after I had eaten rice right before I slept, so my insulin still works, but maybe too well? I've been to the GP two times and they don't seem to know / care and brush me off and are taking forever to refer me to the endocrinologist. What do you guys think?

 

[Melgar]

Hi and welcome to the forum @womaninthegarden . Looking at those graphs they look perfectly normal to me. Mild hypoglycaemia is anything below 3.5 mmol/ls Having your blood sugars in the low 4's is a very good place to be. Those elevated levels , I note one was about 13 mmol/ls depends on what you had to eat. Non diabetics can see a rise in blood sugars after eating, it is perfectly normal. Carbohydrates, starches and sugars will all raise your blood sugars. The body turns all carbohydrates and starches into sugar ( glucose) so the body can utilize it. So things like Pasta , rice , anything containing flour can raise your blood sugars , starchy foods like potatoes too, starchy rice even more so. Root veggies and of course fruit juices and sweet deserts.

Another important note , CGM devices tend to be less accurate once they are out of the 'normal range'. So it maybe your blood sugars at the lower end are actually higher. Most diabetics cross check their blood sugars with a glucometer, often referred to as a finger prick, gives you a more reliable reading, especially when blood sugars appear to be low, and indeed high.

There is also an allowable accuracy of 15%+/-. As with most measuring devices. To me those graphs look normal .

Edited spelling

 

[Zhnyaka]

I would also say that it looks like a healthy person's sugar graph. Although diabetes can be inherited, it is not always the case. In addition, any person will feel hungry if they eat only fast carbohydrates without enough proteins and fats. Calories from fast carbohydrates are burned fairly quickly, which is why people try to eat more protein.

Judging by the graph, your body copes well with carbohydrates and bg of about 3 is the norm for a healthy person, diabetics consider it hypoglycemia, because the insulin that we injected will not stop working and we may lose consciousness, but your pancreas isn't as stupid as artificial insulin, so it will not producing insulin when you don't need it.

 

[KennyA]

As an example of what normal non-diabetic blood glucose readings look like, you might want to have a read of this short study. You'll see that BG levels vary all the time, but particularly in response to meals with higher carb content. All this is normal.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2769652/

 

[Jaylee]

Hi,

No one can or should diagnose on the forum. Specific rules forbidding so..
We are not medical professionals.

However, from experience & common knowledge diabetes normally presents with consistent higher than normal BG levels by it’s nature?

I’ve seen graphs from non-diabetic “bio hackers” using sensors to experiment with refuelling during exercise looking similar? Then start questioning the odd spike..

I’ll tag in @Lamont D on the subject of RH.

Best wishes…

 

[womaninthegarden]

Hi and welcome to the forum @womaninthegarden . Looking at those graphs they look perfectly normal to me. Mild hypoglycaemia is anything below 3.5 mmol/ls Having your blood sugars in the low 4's is a very good place to be. Those elevated levels , I note one was about 13 mmol/ls depends on what you had to eat. Non diabetics can see a rise in blood sugars after eating, it is perfectly normal. Carbohydrates, starches and sugars will all raise your blood sugars. The body turns all carbohydrates and starches into sugar ( glucose) so the body can utilize it. So things like Pasta , rice , anything containing flour can raise your blood sugars , starchy foods like potatoes too, starchy rice even more so. Root veggies and of course fruit juices and sweet deserts.

Another important note , CGM devices tend to be less accurate once they are out of the 'normal range'. So it maybe your blood sugars at the lower end are actually higher. Most diabetics cross check their blood sugars with a glucometer, often referred to as a finger prick, gives you a more reliable reading, especially when blood sugars appear to be low, and indeed high.

There is also an allowable accuracy of 15%+/-. As with most measuring devices. To me those graphs look normal .

Edited spelling

hi, thankyou for your reply.
Do you rlly think my blood sugars are normal? because I regularly peak at 9,10,11 after carby foods, and I don't eat huge portions, like half a plate of fries makes me go from 4ish to 10,11, then rapid drop back to 4ish or lower and it makes me feel super shaky and weak and I can't think properly and I have to eat more carbs to feel better
Also I read that non diabetics should rarely or never go to 11 and one reading above 11 is automatic diabetes diagnosis, and I go to 11 kind of alot . I'm jus very worried cos my whole family is diabetic and Im scared about having insulin resistance or something. Also when I had my cgm, I double checked some readings with my parents fingerprick glucose monitor and it showed readings above 10 as well . Also we did a non clinical ogtt in university and I peaked at 12.7 and NO ONE ELSE was as high as me, and there was 80 people in the lab, all same age as me, everyone else was like 8-9 max so I was super worried and scared.

 

[Lamont D]

I agree with the others that it is not diabetes and looks normal.
However, depending on what you had to eat for breakfast on the third graph, that is a very rapid spike. You are still producing insulin, but the prelude to prediabetes is irregular high spikes and rapid sugar crashes which the symptoms are synonymous with false hypos.
But there is another reason for high spikes with medium carbs, is your first phase insulin response may be overwhelmed by the amount of carbs and the glucose derived from the food.
But I could be so wrong. Until you do see an endocrinologist and get the necessary tests it is very difficult to ascertain what is going on.
Keep hold of the data, the endocrinologist will make more of the data than I could.
It is known that RH symptoms are in a lot of metabolic systems, but doesn't mean you're gonna get diabetes.
3.5mmols is considered going into hypoglycaemia, but many people live with those levels and are unaware of them and considered normal.
best wishes.

 

[Jaylee]

@womaninthegarden .

What I do see on the Dexy graph are a few scatty “star” like constellations on the graph? (At certain points.)
Are you wearing tight clothing over the sensor?

The reason why I ask is I’ve seen similar myself wearing multi layered clothing with the tight base layer in cold weather working on a job like hand sawing timber? Yep, I know I cold use a power saw… (like to get exercise when I can?)
It’s all open to interpretation, because the sensor reads & interprets interstitial fluid under the skin & not actual blood..

 

[womaninthegarden]

I agree with the others that it is not diabetes and looks normal.
However, depending on what you had to eat for breakfast on the third graph, that is a very rapid spike. You are still producing insulin, but the prelude to prediabetes is irregular high spikes and rapid sugar crashes which the symptoms are synonymous with false hypos.
But there is another reason for high spikes with medium carbs, is your first phase insulin response may be overwhelmed by the amount of carbs and the glucose derived from the food.
But I could be so wrong. Until you do see an endocrinologist and get the necessary tests it is very difficult to ascertain what is going on.
Keep hold of the data, the endocrinologist will make more of the data than I could.
It is known that RH symptoms are in a lot of metabolic systems, but doesn't mean you're gonna get diabetes.
3.5mmols is considered going into hypoglycaemia, but many people live with those levels and are unaware of them and considered normal.
best wishes.

hi, thankyou for your insight. I agree with you, I think I have a blunted first phase insulin response and an overcompensating second phase insulin response, which is worrying because im so slim and young but caused by ****** genes ig. and in the graph where I spiked to 13, I had a plate of basmati rice . also we did a non clinical ogtt in university as I am a biomedicine student and I was the ONLY PERSON in the whole lab ( 80 young people) who had above 12 peak, NO ONE ELSE had this, and my professor of metabolism and physiology said it could be because I'm rlly small ( 4'11.5, 43/44kg)and the glucose load is proportionally bigger on me, but he also said to get my hba1c tested and I did and it was 4.6% / 27 which is way better than average and way below even pre diabetes so idek whats going on. also everyone's else's fasting was like 4.8-5ish and mine was 4.1 so I had the lowest fasting as well in the whole lab. also after the ogtt, 3 hours later, I felt INSANELY SHAKEY, sweaty,hungry and my blood sugar was 3.4 ( with fingerprick) and that was cos I drank pure glucose solution on empty stomach and basically went from 4 to 12 to 3 within 3 hours which is super stressful for My body. ALSO whenever I go gym I always feel like my blood sugar drops and I have 0 energy for the workout and all my muscles feel jerky as well and I get hot so easily as well. This is so frustrating and my GP literally said she's gonna get advice from an endocrinologist cos she doesn't know what's going on but they're taking ages to reply.

 

[EllieM]

and bg of about 3

Do you really mean 3 here?

 

[Zhnyaka]

Do you really mean 3 here?

Yes, because people without diabetes have a fasting bg of 3.3-5.5 mmol/l.

 

[Lamont D]

hi, thankyou for your insight. I agree with you, I think I have a blunted first phase insulin response and an overcompensating second phase insulin response, which is worrying because im so slim and young but caused by ****** genes ig. and in the graph where I spiked to 13, I had a plate of basmati rice . also we did a non clinical ogtt in university as I am a biomedicine student and I was the ONLY PERSON in the whole lab ( 80 young people) who had above 12 peak, NO ONE ELSE had this, and my professor of metabolism and physiology said it could be because I'm rlly small ( 4'11.5, 43/44kg)and the glucose load is proportionally bigger on me, but he also said to get my hba1c tested and I did and it was 4.6% / 27 which is way better than average and way below even pre diabetes so idek whats going on. also everyone's else's fasting was like 4.8-5ish and mine was 4.1 so I had the lowest fasting as well in the whole lab. also after the ogtt, 3 hours later, I felt INSANELY SHAKEY, sweaty,hungry and my blood sugar was 3.4 ( with fingerprick) and that was cos I drank pure glucose solution on empty stomach and basically went from 4 to 12 to 3 within 3 hours which is super stressful for My body. ALSO whenever I go gym I always feel like my blood sugar drops and I have 0 energy for the workout and all my muscles feel jerky as well and I get hot so easily as well. This is so frustrating and my GP literally said she's gonna get advice from an endocrinologist cos she doesn't know what's going on but they're taking ages to reply.

Your hba1c is brilliant.
I was diagnosed with non diabetic Late Reactive Hypoglycaemia.
Ok, have had five or six eOGTTs, that means a supervised extended glucose tolerance test. Which is five hours at least long. It can be cut short, if you do go hypo, or if you don't.
The standard measure glucose solution is 75g.
A cannula is fitted into your vein, and are taken in regular times.
You have your BG levels taken every half hour or fifteen minutes.
My spike time is around 45 minutes and always goes around 13-15mmols.
My hypo timing is around 220 minutes.
And the lowest I have been is in the 2s, and have had many readings after food of a reading of 'I'm on my glucometer.
Before diagnosis I didn't have any awareness but plenty of different symptoms. Too many to post.
It is in the RH sub forum sticky.
After diagnosis, my awareness started and I was able to cope, before I went hypo.
I never over treat a hypo. A few grams of carbs, helps nudge it back into normal levels.
I try to stay in or around normal levels. That is the healthy choice I try.
Avoiding those carbs which I am intolerant to.
RH is a food intolerance condition. you could say carbs and sugars intolerant.
It's not easy.
During the tests, a woman was another test subject, her bmi was much lower and she could tolerate more. That is the only thing I have read to the question of weight and size.
Exercise with RH is tricky. I can't do strenuous activity because my liver will react with a liver dump, which is natural but will act as an carbs meal. And gives me an unwanted spike.
After diagnosis my fasting levels were always in normal levels. I'm currently struggling because of many reasons.
If the doctors are looking for hypoglycaemia, for a glucose test, it is always a fasting test.
Keep asking.
Have a read of our forum. There are many reasons for getting readings of hypoglycaemia.
Best wishes.