Newbie with a couple of questions

just_undiscovered_ said:

Ok I'm confused, am I meant to be test at 1hr after I've eaten a meal and then again at 2 hrs after? I've only been testing 2 hrs after... Also, I've seen members post readings only going up like 1 or 2 mmol after a meal, is that what I should be aiming for? At the moment I'm just concentrating on it not going above 8.5, should my goal be not to have a BS rise of more than say 10mmol when I eat a meal? Hope I'm making sense here, as I'm still trying to figure all this out and it's been month and I'm non the wiser.

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My view, and the view of many who intend to achieve normal blood glucose levels, is that it is important to catch the peak (which varies, but around an hour is a good place to start looking).

People without diabetes rarely go above 7.8, and that is the level which, if chronic, the elevated blood glucose alone starts to do damage to blood vessels, organs, nerves, etc. A study in December tied prediabetes to undiagnosed chronic kidney disease. Prediabetes is an A1c of 5.7 to 6.4 % percent, equivalent to an average blood glucose of 6.5 - 7.6 (Assuming I did my conversion from US units correctly) Spiking above 7.8 frequently following meals, for a period of up to an hour, would move my A1c perilously close to the prediabetess level, at which damage has now been documented to occur.

So, since my goal is to keep my blood sugar in the range of someone without diabetes, I need to test when I expect a spike - at around 1 hour. I believe that while it is important to control the rate at which your spike declines is important, it is also important to cap the spike.

The American Diabetes Association defines "tight" control as the diabetic normal ranges (based on A1c and BG level 2 hours post eating). Apparently less than half of people with diabetes achieve even that control - which I expect contributes to the lackadaisical attitude about even suggesting truly tight control, which requires much more rigorous testing and (typically) dietary restrictions.

So one of the things you will need to decide for yourself is whether you believe that the targets set by most diabetes/health organizations are sufficient to prevent the consequences of diabetes that you (and not they) will have to live with, if they are wrong about whether spikes matter.

Took my bg this morning it was 4.7 so what level am I expecting hba1c results to be ?

Amandlaz said:

Took my bg this morning it was 4.7 so what level am I expecting hba1c results to be ?

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You can't predict a HbA1c result from one meter test. The meter isn't 100% accurate, and one reading could be inaccurate for a number of reasons. It is only a guide to your BG level at the moment you take it.
But if you were to get readings at that level consistently over several weeks, your HbA1c test, which measures your BG levels over the previous 8-12 weeks, would probably show a HbA1c of below 30, in the non-diabetic range, which is below 42.

@Prem51 @AloeSvea so I have been using the SD Codefree meter from beginning of January to current date, testing before meals and 2 hrs after meals, a couple of random tests during the days. I know the meter gives a 7/14/30 average reading, so which average is best to look at say if I want to estimate what my next HBA1c could/would look like? The pre meal or post meal ones? There is also another average on the meter, but not sure what that is thanks

@just_undiscovered_ The HbA1c blood test measures your Blood Sugar levels over the previous 8-12 weeks, so none of those options is going to give you an accurate prediction of what your HbA1c reading will be. But I suppose the 30 day average would probably be the best guesstimate.

Hi. I have to come into this conversation and say: the HBA1C blood test result is for your Diabetes Team so they can see how tightly controlled your diabetes is. I was told many years ago, when first diagnosed that a lot of people "make up" false readings and log them in the record book - so it looks like they have good control. The HBA1C does not lie and says it how it is.

liam1955 said:

Hi. I have to come into this conversation and say: the HBA1C blood test result is for your Diabetes Team so they can see how tightly controlled your diabetes is. I was told many years ago, when first diagnosed that a lot of people "make up" false readings and log them in the record book - so it looks like they have good control. The HBA1C does not lie and says it how it is.

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Sounds like typical arrogant doctor thinking. There are quite a few reasons that HbA1c may not reflect average blood glucose levels. I've given up listening to standard medical professionals' advice on type 2 diabetes as they generally have no clue.

@Amandlaz, I hope you are being reassured by us, as I think that is what you are looking for? You got diagnosed as just in the prediabetic range? You are freaking out, or freaked out at going on the diabetic pathway, so you came on to the forum, lowered your dietary sugar a lot, and are now just waiting for your next blood lipids test and HBA1c. And in the meantime you are keen to know you are on the right (non-diabetic!) path. (Forgive me if I have not understood your situation correctly.)

We can't predict your HBA1c better than you BG meter can, but a Fasting Blood Glucose reading (FBG) in the below 5s sure looks great (and absolutely non diabetic). The next important reading is post meal, and I have read that if your blood glucose regulation is breaking down that is the first reading that indicates it - your fasting level is the last one to go (and as you are here on the forum and doing so well - you may very well NEVER get to that situation!). It's to do with different phases of insulin production and secretion by your body, and at what stage of ill-health each stage starts to break down. (If they break down! And to what extent.)

So, yes, you need to focus on your post meal readings, as your FBGs look just fine.

To find your own peak-time post food, choose a time when you haven't eaten in a few hours, and eat an apple. Apples, as well as being delish and good for you in so many ways - are very high in carbohydrates - and this is to see how and in what time your body can deal with those carbs. Take a BG reading, note it down, and eat the apple. Take a BG reading every 15 minutes, over - plan for a three hour period, but your BG may get back to normal quite quickly. See when your BG was the highest? That is your post-food highest peak time. After that, the BG readings and times show you how your body is doing with insulin secretion to deal with the glucose, and in what time period - so how efficient it is.

According to Jenny Ruhl - the healthy range (or the non-diabetic goal for diabetics) is a FBG (on waking) of 5.5 or less, one hour post food 7.8 or less, at two hours post food 6.8 or less.

If you are wanting a 'super healthy non-diabetic folk' goal (suggested by Dr Perlmutter I believe but I'm not entirely sure where I got these 'super healthy' BG goals from now):
FBG: 4.6 or less
Premeal: 5.0 (or less)
1 hour post meal reading: 7.8 (or less)
2 hour:Between 5.6 and 6.7
3 hour: 5.0 (or less)
No readings over 7.8

So '7.8' does seem to have an almost magical significance healthwise!

I hope this helps you understand what those BG readings are all about, and helps you get an insight into how your blood glucose regulation is working in your body. And most of all - I hope I have reassured you some more! Or more's the point - help you reassure yourself.

just_undiscovered_ said:

@Prem51 @AloeSvea so I have been using the SD Codefree meter from beginning of January to current date, testing before meals and 2 hrs after meals, a couple of random tests during the days. I know the meter gives a 7/14/30 average reading, so which average is best to look at say if I want to estimate what my next HBA1c could/would look like? The pre meal or post meal ones? There is also another average on the meter, but not sure what that is thanks

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Hi there - I hope my post to Amandlaz might help you too?

To be honest - I had to be diabetic and experimenting hugely, and getting very regular HBA1cs for two and a half years before I could predict my HBA1c! (ie very recently.) And that was just a pleasing wild card. (Maths and numbers is not my strong point.)

Is there any chance you can get frequent HBA1c's? Like once a month. (That was what I got - as my GP and I have a good understanding, and she knew I would like to see results as often as possible - as you do it seems, and rightly so. She even did me a great graph charting my dramatic HBA1c lowering over 6 months.)

But, learning about how my blood glucose dysregulation actually works in my body so I could work really hard on getting better - now that's another story in the interesting-if-not-pleasing department! Seeing what those numbers actually reflect - what they actually mean - now that's the trick!

Do the apple test too? Have a good look at Jenny Ruhls good non-diabetic goals for a diabetic person, and Dr Perlmutter's super-healthy range in my prior post above, and, by eating the apple and recording the results, get a good feel for how your body is responding to carbs, and in what time frame. That way you will see how each stage of insulin secretion is working for you (this info is on Jenny Ruhls Blood Sugar 101 website, and she has written what must be a very good book.)

http://www.phlaunt.com/diabetes/

and particularly on the insulin stages here:

http://www.phlaunt.com/diabetes/14046621.php

But basically there are three insulin-release stages: the basal release, phase 1 and phase 2. Basal release goes/breaks down first, apparently. That's the continuous pumping of insulin from our cells (And sadly for me sure explains my BG readings!). Phase 1 is the burst release on eating, and eating carbs - the big response to glucose from food, phase 2 is the mop-up phase just in case phase 1 didn't deal with it all - in non-diabetics. After over two years of taking my own readings and food diarying I know my poor old bod can do a mean mopping! Which is something.

From reading many people's experiences in here, and watching their HBA1c's as well as my own very closely, some early diagnosed folk, and even folk who have had the dysregulated blood glucose/T2D for some years, can get normal BG levels after changing their diet, and revving up their muscle motors in the action department. They are the ones who can get their HBA1c's into the 30s range within a matter of months after going low-carb, or by a short and sharp low calorie diet and maintaining the low weight. But alas, that was not me. But it could be you! And it might be me just in a longer period of time if I am lucky. (And I accept that my poor pancreas and beta cells might not ever get that much better functioning. But we shall see!)

Best wishes to you on your getting-better journey!

Hi @AloeSvea thanks very much and yes it has helped me also to understand a bit more how everything falls into place. I was only diagnosed last November and am due my HBA1c this week. I have been monitoring my blood levels before and after meals and readings are not that bad and I am also following the LCHF regime. I am hoping that I will be one of those folks that can lower my HBA1c within months with diet and exercise Mind you, I only started at the beginning of January as most of December I was still shocked about the diagnosis and was on holiday so wasn't really paying much attention to my eating. All my GP did was send me away and said "avoid the obvious sugars, take Metformin and NO you don't need to buy a meter to test it's the old fashion way of doing things"!! It wasn't until I returned from holiday that I discovered this website, bought myself a meter and started testing (the new fashioned way) As usual, the Metformin didn't agree with me and he changed it to the SR one which also didn't agree with me. He then prescribed Glicizade?? which I haven't yet started to take as I don't like the idea of hypos and having to eat more carbs!! I restarted the SR Metformin to see if it was a one off and so far so good am on day 3 today, previous problems started around day 4 as recommended by others, I am trying to have it in between finishing a meal and not after the meal.
I did the apple test and it seems that my highest peak is around the half hour point, after which it started to decrease and was back to or near starting BS within 2hrs. Will see what my HBA1c results and keep on following a LCHF regime and some exercise.. Best wishes to you too in getting those BS numbers closer to where you want it to be

AloeSvea said:

Hi there - I hope my post to Amandlaz might help you too?

To be honest - I had to be diabetic and experimenting hugely, and getting very regular HBA1cs for two and a half years before I could predict my HBA1c! (ie very recently.) And that was just a pleasing wild card. (Maths and numbers is not my strong point.)

Is there any chance you can get frequent HBA1c's? Like once a month. (That was what I got - as my GP and I have a good understanding, and she knew I would like to see results as often as possible - as you do it seems, and rightly so. She even did me a great graph charting my dramatic HBA1c lowering over 6 months.)

But, learning about how my blood glucose dysregulation actually works in my body so I could work really hard on getting better - now that's another story in the interesting-if-not-pleasing department! Seeing what those numbers actually reflect - what they actually mean - now that's the trick!

Do the apple test too? Have a good look at Jenny Ruhls good non-diabetic goals for a diabetic person, and Dr Perlmutter's super-healthy range in my prior post above, and, by eating the apple and recording the results, get a good feel for how your body is responding to carbs, and in what time frame. That way you will see how each stage of insulin secretion is working for you (this info is on Jenny Ruhls Blood Sugar 101 website, and she has written what must be a very good book.)

http://www.phlaunt.com/diabetes/

and particularly on the insulin stages here:

http://www.phlaunt.com/diabetes/14046621.php

But basically there are three insulin-release stages: the basal release, phase 1 and phase 2. Basal release goes/breaks down first, apparently. That's the continuous pumping of insulin from our cells (And sadly for me sure explains my BG readings!). Phase 1 is the burst release on eating, and eating carbs - the big response to glucose from food, phase 2 is the mop-up phase just in case phase 1 didn't deal with it all - in non-diabetics. After over two years of taking my own readings and food diarying I know my poor old bod can do a mean mopping! Which is something.

From reading many people's experiences in here, and watching their HBA1c's as well as my own very closely, some early diagnosed folk, and even folk who have had the dysregulated blood glucose/T2D for some years, can get normal BG levels after changing their diet, and revving up their muscle motors in the action department. They are the ones who can get their HBA1c's into the 30s range within a matter of months after going low-carb, or by a short and sharp low calorie diet and maintaining the low weight. But alas, that was not me. But it could be you! And it might be me just in a longer period of time if I am lucky. (And I accept that my poor pancreas and beta cells might not ever get that much better functioning. But we shall see!)

Best wishes to you on your getting-better journey!

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Hi @AloeSvea, I started the test with a 5.4 reading, 5.8 (15 mins later) 6.8 half an hr later. 15 mins later it started to drop 6.7, 6.2, 5.9, 5.7, 5.5, 5.5... Well I am on day 4 of my Metformin and still doing ok... Had a bout of nausea yesterday and today, but I got through it.. Mind you I am only on 1x 500mg daily and I am suppose to increase it weekly by one tablet.. Am booked in to see the nurse next week where I should have the results of my HBA1c test.

AloeSvea said:

Many thanks for the well wishes @just_undiscovered_ .

Yes - this forum is a godsend for sure!

And I'm really pleased you did the apple test! Now you know when your BG peak is - a half hour after eating (is how I have understood the apple test at any rate.) It's a great way to see how the diabetic bod is working - and so simple. (You just need three or four hours where you can happily eat an apple and take BG readings every 15 minutes thereafter! I did mine at an airport gate that happened to have a cafe selling apples, during a surprise three hour delay. I found it a very engaging way to deal with such a situation, but I may have worried fellow airplane passengers with the constant beep beeping of my BG meter?! .)

Back to starting BS within 2 hours is good! May I ask what that reading was?

And also - if you find you can't take the metformin, there are a couple of other alternatives that I have read about here on the forum, that do the same thing -ish - as metformin - berberine - and one other I can't remember right now (I can hunt up the second one at another time). I've made a note of them somewhere, for if and when I go the 'turning off the liver glucose dump switch' (which is mainly what metformin does) route, and I might need a non-metformin alternative.

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AloeSvea said:

ps - had a look through my notes, and the other alternative to metformin that is reputed to do the same thing (ie turning off the liver switch for releasing glucose), other than berberin, is vanadyl sulfate. It is one of those situations where you probably need to discuss taking either of those as an alternative with your doctor, because it does react to other medications you might be taking.

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Thanks very much for this, much appreciated. So far (touch wood) the SR metformin seems to be OK and it's day 7 today I can only assume that day of horrible abdominal pains was a one off. The standard ones were definitely a problem for me though. I need to increase it now to 2 daily a week, so will see how I get on with that. At least I now know the alternative one to mention to my GP if need be. Enjoy your weekend

So I've had the results of my HBA1c 3 months after being diagnosed last November and I've gone from 9.8% to 7.2%.
Am happy to be heading in the right direction, considering I've only been doing LCHF and testing from 6th January
Nurse was quite interested in hearing how I got those results and was very encouraging. She reckoned she could also see the weight loss in my face. My cholesterol went from a 4.1 to a 4.6, somehow she didn't have the breakdown for November's reading, but current reading is LDL 3, HDL 1, she didn't give me the triglycerides but I have to assume that was 0.6 if the total was 4.6? Blood pressure reading was 125/70 which is pretty good considering I am on medication for it.. All in all am pleased, just need to get my weight moving, been stuck on the same for like 4 weeks and lost 1 measly pound!

just_undiscovered_ said:

So I've had the results of my HBA1c 3 months after being diagnosed last November and I've gone from 9.8% to 7.2%.
Am happy to be heading in the right direction, considering I've only been doing LCHF and testing from 6th January
Nurse was quite interested in hearing how I got those results and was very encouraging. She reckoned she could also see the weight loss in my face. My cholesterol went from a 4.1 to a 4.6, somehow she didn't have the breakdown for November's reading, but current reading is LDL 3, HDL 1, she didn't give me the triglycerides but I have to assume that was 0.6 if the total was 4.6? Blood pressure reading was 125/70 which is pretty good considering I am on medication for it.. All in all am pleased, just need to get my weight moving, been stuck on the same for like 4 weeks and lost 1 measly pound!

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Nice progress. You should ask for a printout of your lab results. That way you won't be guessing.

NoCrbs4Me said:

Nice progress. You should ask for a printout of your lab results. That way you won't be guessing.

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Thanks much, will try and do that the next time. Everything here in the UK is about cutting costs and I'm sure she will probably be telling me we will be saving the NHS money if we don't print your results

She did say another strange thing which was "we don't like diabetics going below 6.5, so try to keep your readings/results between 6.5 and I'm sure she said 7.5)