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Prediabetes Not insulin resistant - what's going on?

Discussion in 'Ask A Question' started by JuliaAR, Jan 23, 2017.

  1. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    Hi,
    I'm a bit confused at the moment.
    Having posted a thread on here about failing to find a control solution for my meter to check it's accuracy a very bright person suggested that I go to a lab to simultaneously have a fasting glucose test and use the same sample to test my meter. So that it exactly what I did and it's 100% accurate which is great.
    However, having read something online yesterday about insulin and insulin resistance testing I decided to get this done at the same time and it turns out that I have a perfectly normal insulin level (3) and am way out of the insulin resistance bracket. The margins were >10 normal to <5 insulin resistant and my count was 43. At the same time my fasting glucose count was 7.2 (129) with a recent HbA1c of 6.1. Also my accurate meter is giving me readings all over the place from 4.7 to 7.8 at different times and in different situations so I definitely have a problem with glucose control.
    I'm really confused. Can you be prediabetic and not insulin resistant? o_O
     
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  2. Alison Campbell

    Alison Campbell Prediabetes · Well-Known Member

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    One reason might be a low carb diet or other weight loss but I'm not sure.
    I read a few studies by Dr Defronzo (don't agree with his conclusions of medicating prediabetes) but he seemed to seperate IFG with IGT in prediabetes. Maybe you have the first not the second? Sorry still trying to figure things out 6 years later.
     
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  3. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    Not really a reply to your main question about your insulin resistance test as I don't know how that test works. However if you are really testing BG randomly, then even a non diabetic can get readings between 4.7 and 7.8 depending on what they ate and how long ago.
     
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  4. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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  5. Jamesuk9

    Jamesuk9 Prediabetes · Well-Known Member

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    Yes, you can. It would appear you have impaired fasting glycemia but normal postprandial insulin response. It's the IFG that raises the hba1c level. You may or may not progress to impaired glucose Tolerance and subsequent T2d onset, however it is less likely than if you had both IFG and IGT together.
     
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  6. Brunneria

    Brunneria Other · Moderator
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    Have a read of the www.bloodsugar101.com website. Lots of information on there about how different people have impaired glucose experiences, and the different routes towards diabetes.

    Also worth remembering that insulin resistance is a very variable thing. A few days of low carbing and/or fasting and the resistance can drop dramatically, while a few days (or even a single high dose of carbs) can send it up in response.

    I think because many people eat carbs consistently, they also have consistent IR, but my experience is that it is very much affected by lifestyle and food choices.
     
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  7. Daibell

    Daibell LADA · Master

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    Hi. Those readings are pretty good. Yes you can have diabetes on the way but without insulin resistance. This is the situation with Late onset T1 where the pancreas starts failing to produce enough insulin.
     
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  8. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    Having bloodsugar between 4.0 mmol to 7.8 mmol are considered normal and not diabetic. Readings from 4.7 to 7.8 are not what I would call "all over the place". Non-diabetics can even have spikes up to 11.1 mmol after a high-carb meal. So from a medical point of view you don't have a problem with glucose control.

    But answering your question, you can be diabetic and not insulin resistant, like type 1 or lada in adults. Type 1 and lada both have a "sort of" "prediabetic"phase were the beta cells are destructed, but that are usually asymptomatic.

    Yes 7.2 are high for a fasting blood test, but on the other hand you can't rule out diabetes from one single test. Also HbA1c from 4.0-6.0 are normal values, so I wouldn't worry too much about a slightly elevated HbA1c. I would guess you're not prediabetic (at least not yet) as your blood sugar still sounds normal.

    My advice are not to stress it. Take a new HbA1c in 3 months, then you can make sure if it were just a one time slight elevated result or if you have early signs of prediabetes.
     
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  9. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    Thank you all for your input and ideas.
    I have looked at all the links provided but I can't really find anything that doesn't relate diabetes to insulin resistance, unless I just haven't got that far yet. Which comes first the glucose intolerance or the insulin resistance? This still seems to be up for debate.
    I have made an appointment with a doctor on Thursday to discuss the results so I will get back to you then. I don't hold out much hope of any real insights as local doctors are not very up-to-date with their ideas. I will probably be told off for going low carb!
     
  10. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    Glucose intolerant will say that your body aren't able to process carbs fast enough, leaving you with a higher blood glucose. Which means insulin resistance comes first if you're a type 2 diabetic.

    If I understood your condition correct your doctors diagnosis of you say that you're not insulin resistant. Your blood sugars are also normal and no where near diabetic ranges, meaning your most likely not glucose intolerant either.

    So my question are why do you suspect diabetes? Do you have any symptoms beside that slightly elevated results you got last time? Remember, other conditions like infections, flu, common cold or other meds can elevate blood sugar slightly. And since your blood suger never goes above 7.8 I would guess there some other reason for your slightly elevated blood results.

    But please tell us if you experience any symptoms or why you suspected diabetes in the first case. That would really help, and make things more clear.
     
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  11. Jamesuk9

    Jamesuk9 Prediabetes · Well-Known Member

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    There was a time when a diagnosis would have been made on the basis of 2 fasting levels over 7. A hbA1C of 6.1 is clearly indicative of a Prediabetes diagnosis too. Heavily influenced by high fasting numbers no doubt. I found the quickest fix for fasting numbers, esp if you have a good phase 2 insulin response would be a small carb snack, around 5g right before bed. My fasting numbers were around 6.7 prior to snacking before bed and are now stable at 4.8-5.5 after 8 hours sleep. If I go to bed without snacking I am always over 6 and if I don't eat as soon as I rise it will keep climbing until I do. A mini cheddar at under 2g carb is enough to stop my morning rise. A meter will give you a clearer understanding of what issues you have and how to fix then and get those numbers down.
     
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  12. Alison Campbell

    Alison Campbell Prediabetes · Well-Known Member

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    This is the link I was reading that might be helpful

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598604/
     
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  13. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    So, went to doctor today and, as anticipated, it was a complete waste of euros. He took one look at my fasting blood glucose of 7.2 and went straight to the prescription pad to give me metformin. He was not interested in the fact that my result also showed that I am not insulin resistant and simply said that that was not a test that he did to diagnose Type 2 diabetes. He was also not impressed by the low carb diet (as predicted) and said that I could eat anything I wanted to except sweets as long as I had 5 small meals a day at regular intervals and had salad with every main meal ... at this point I gave up listening.
    So, I am none the wiser for my visit to the so called diabetes expert at my local clinic - heaven help all those on this island with Type 2 diabetes if this is the advice that they receive. No wonder Cyprus has such a high incidence and poor track record with diabetes!
    Having done my own research again (I know it's a dangerous occupation) I have found two quite thought provoking articles. If you are interested take a look at these two links:
    http://www.progressivehealth.com/vitamins-that-help-reduce-high-blood-sugar.htm
    http://www.hormonesmatter.com/metformin-madness/
    Back to my situation. I will try to get an appointment with my UK doctor when I go back in March. Until then I shall keep up the low carb diet, do more exercise and take on board all the advice given by my very helpful co-members on this site.
    Thank you all. :cat:
     
  14. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    Hi Emile-the-rat.
    It wasn't my diagnosis at all, it was my doctor's after a routine annual health check. On the strength of one elevated fasting glucose test, she wanted to put me straight on to medication. I had the HbA1c done then of my own accord because I wasn't convinced of the diagnosis. The HbA1c turned out to be slightly above normal (5.9) at 6.0 and so a second doctor I saw said I was prediabetic. She suggested the low carb high fat diet and put me onto this site (thank you doctor!). Unfortunately she was only a visiting doctor so isn't here anymore and I can't consult her.
    After a few months on the LCHF diet I decided to repeat the blood tests and that's where I found out that I wasn't insulin intolerant but infact quite insulin sensitive.
    I do have a slightly raised HbA1c of 6.1 now but with the lack of insulin resistance I was posing the question as to whether my raised levels of blood glucose could be due to some cause other than prediabetes. I know when I take my readings at home, then go to the clinic and have them taken, there can be up to a 2 point rise in the levels. I am a stressful and anxious person (you might have guessed this already!) so could it be that? I don't know.
     
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    #14 JuliaAR, Jan 26, 2017 at 1:45 PM
    Last edited: Jan 26, 2017
  15. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    Thanks for this advice. I will try it out and see what happens.
     
  16. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    I think it is strange that the doctor prescribded metformin so quickly. I agree with the part that your blood tests done at the clinic were a little bit elevated and hints toward pre-diabetes.

    Did you take fasting blood sugar once or twice? Because I think you need minimum two fasting reading above 6 to be qulified as pre-diabetic. At least thats what my doctor told me.

    Really strange that your blood test get elevated when you are doing the test at the clinic, but just fine at home :/

    I do not know if your overweight, or have any other family members with type 2 diabetes, but if you have it won't hurt to avoid high glycemic food until your next appointment to see if the values go down.

    But I understand your frustration and confusion. I have the oppsite problem of you, my fasting blood sugar are usually normal when I visit my doctor. But at home I have several times got reading from 12-15 mmol (not fasting, but still too high), but that won't show on my HbA1c because I am a hypoglycemic that struggles with episodes of very low blood sugar. So I feel your pain, it can be really confusing when you have blood sugar results that won't fit with the standards.
     
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  17. JuliaAR

    JuliaAR Prediabetes · Well-Known Member

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    Thank you so much for your reply and your support.
    No I have never been overweight. The heaviest I have been is 10st (BMI 24) and I am now 8st 10lbs (BMI 20) after going on a low carb diet. I'm 5ft 5ins btw. I have had two fasting glucose levels above 7 both of which were taken at the clinic one on a day when my home test an hour before was only 5.7 so I think it is stress.
    My mother had type 2 when she was in her 80s but I'm only in my 50s. It's a mystery especially with the insulin sensitivity being so high (43 when the normal rate is >10). I can only think that it was previous steroid treatment to do with cancer which has kicked me into prediabetes. Who knows.
    Anyway I am determined to carry on with the low carb (my weight has stabilized now) and do more exercise as this really seems to help my levels. I will give myself another 6 months of self testing and if I see any worsening I will go back to the doctor. Not much hope of any help there, though.
    I'm not familiar with reactive hypoglycemia - With reference to your readings of 12-15 - how long do they stay this high? If your HbA1c results are normal then it must be spikes that go down pretty fast. Have you looked at the foods you are eating in relation to your highs and lows? Is there any way to get better control of the figures?
     
  18. Emile_the_rat

    Emile_the_rat Type 1.5 · Well-Known Member

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    Yes they are spikes, usually start dropping rapid 15 mins after I reached the top. And that combined with series of low blood sugar makes my HbA1c pretty normal.

    Well the clue for me is to eat LCHF and often, but I am not very good at it as I usually eat whatever I want. But always keeping a snack at hand helps.

    My strange blood sugar issue started after I had used prednisolone for a couple months. My doctor first though I had gotten steroid inducted diabetes, a condition that goes a way after some months when the medications (prednisolone/steroids) get out of your system. Unfortunally that's 2 and a half year ago, so it was a permanently blood sugar issue I had, the prednisolone had only triggered it. So know I am diagnosed as a hypoglycemic...

    But as your BMI are pretty low and your blood sugar at home stays normal I still don't think type 2 are likely in your case. Maybe your high tests are a result of the steroid threatment you got, as steroids tend to raise blood sugar slightly? If that's the case the blood sugar should stabilize it self after a couple months. But not a doctor here, only talking from my own experience :)
     
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