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Not sure what to make of OGTT results

Discussion in 'Blood Glucose Monitoring' started by AdamJames, Apr 24, 2018.

  1. AdamJames

    AdamJames Type 2 · Well-Known Member

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    I've just done my first OGTT test tonight.

    What I didn't do was spend the last 3 days eating 'normal carbs', or 150g of carbs or whatever the guide is, rather I've been eating much less than that, I'm pretty certain less than 50g a day in spite of having about 30g in one sitting last night before burning it off quickly on a walk.

    I didn't eat 'normal carbs' in the run-up because I'm not in a position to do so safely at the moment. Plus I'm only really interested in comparing one of my results to the next so I've noted the food I ate and my activity levels in the 48 hours leading up to this OGTT, and I'll be repeating things as closely as possible in a month.

    As expected, the readings were pretty horrific but what surprised me was that when I just look at the first and last reading, I just, by a whisker, avoid the 'diabetic' classification and instead would fall in the 'impaired glucose tolerance' bracket.

    But when I compare graphs online of non-diabetic OGTT results, it's clear that what was happening to my blood glucose in between the start and 2 hour point was extremely unhealthy.

    My readings were:

    0 min: 6.1 mmol/l
    20 min: 10.6 mmol/l
    40 min: 15.8 mmol/l
    60 min: 17.6 mmol/l
    80 min: 17.2 mmol/l
    100 min: 11.1 mmol/l
    120 min: 10.6 mmol/l

    I used Rapilose for the test, and on the packet it suggests only measuring at zero and 120 minutes, probably because the WHO classification only specifies those times. I'm glad I measured every 20 minutes otherwise I could have presumed my metabolism was handling carbohydrates better than it really was!

    I'm not sure what to make of this.

    All I can think of is that I know that when I'm losing weight (I am currently) I can reliably get a healthy-looking fasting reading in the mornings even if I've eaten a very high amount of carbs (say 300g) the day before so long as the calories are low (hence don't interfere with losing weight).

    So in a sense, that tells me that my body must be getting rid of the glucose from my blood fairly quickly at the moment - quick enough to at least lower things to healthy levels overnight in spite of unhealthy levels during the day due to excess carbs. I'm actually confident that in spite of this OGTT finishing quite late tonight, and now I'm about to have a late dinner, I'll have a decent fasting reading tomorrow morning.

    Why, exactly, I don't know. I've presumed that the really important thing about being in a state of weight loss is that it means your liver won't have much fat in it and that helps enormously with glucose control. Perhaps this OGTT result and my observations about losing-weight-equals-good-fasting-readings point to the same underlying biological functions, but I'm not sure.

    Does anyone have any insight into this?
     
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  2. NoCrbs4Me

    NoCrbs4Me I reversed my Type 2 · Well-Known Member

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    At the risk of stating the obvious, those results suggest you should avoid carby food.
     
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  3. AdamJames

    AdamJames Type 2 · Well-Known Member

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    Yes, clearly! Especially in the form of a Rapilose OGTT solution. It didn't even taste very nice, which was probably the most upsetting thing :)

    I was curious about the "shape of the curve" though. I haven't graphed it yet but clearly it's a very steep rise to dangerous levels then quite a steep fall. From the example graphs online they suggest someone with T2 can expect a much smoother 'graph' and to "stay high" for quite some time.

    Mine was very steep, got to an even higher level than some of the example graphs, then had a very steep fall. Had I not measured every 20 minutes, I might have thought I just had "impaired glucose tolerance" as per the WHO guidelines. But the massive rise in between suggests it would be crazy to assume I had merely had "impaired glucose tolerance".

    Have you ever done an OGTT and if so what sort of "shape" did you get?

    Or anyone else reading this?
     
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  4. bulkbiker

    bulkbiker Type 2 · Oracle

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    Hi @AdamJames
    These are my results from my home OGTT
    Screen Shot 2018-04-25 at 13.39.25.png

    I measured every 15 minutes but had to go out at the 3 hour mark hence the later readings similar shape to yours although less extreme.
    I too refrained from the pre test "carb up"
    Remember this is after 2 years of ultra low carb whereas you are still in fairly early days. The good thing is you have a baseline against which to check future results.
     
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  5. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Adam - Did you do this from fasting, first thing? I understand that's the usual protocol; fast overnight, rock up - test, down the drink, sit around for a couple of hours, then test again.

    I did mine at home, reading the forum in between testing every 15 minutes. I didn't carb up either, on the guidance of my Endo, although to be fair that specific discussion was relating to coeliac testing.

    If you had eaten before your OGTT, you may have corrupted your own results.

    As @bulkbiker posted his, I'll add mine in, but with the same caveat of being about three and a half years in at that time. I stopped when I did because I had naturally rebounded off the low
     

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    Last edited: Apr 25, 2018
  6. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    Please do not try to compare your results with other people's. It can either depress you or lead to false elation! We are all at different stages etc etc.

    I didn't carb-up beforehand. I had intended to but couldn't think of what to eat so didn't bother.

    I tested every 15 minutes for 3 hours. I started at 5.9 and peaked at exactly one hour with a 13.6mmol/l (so a rise of 7.7) and was back to below where I started at 2hrs 45mins then I continued to drop down into the low 4s before having a well deserved cup of tea with milk followed by lunch.
     
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  7. millenium

    millenium Carer · Well-Known Member

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    U dun have diabetes or even impaired glucose intolerance based on what u attached. U really reversed your type 2? From what i read online there is no cure for diabete.
     
  8. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    Well, you can make your mind up about whether you believe in reversal. Different people have different outcomes.

    In brief, I was diagnosed T2 since October 2013. No medication.

    HbA1c Lab Results:
    October 13: 73 or 8.8% (How did that happen?)
    February 14: 37 or 5.5%
    May 14: 34 or 5.3%
    August 14: 32 or 5.1%
    November 14: 33 or 5.1%
    May 15: 31 or 5.0%
    October 15: 33 or 5.1%
    September 16: 31 or 5.0%
    November 17: 33 or 5.1%
    March 18: 30 or 4.9%.

    Work in progress, but GP has taken me off the Diabetes Register.
     
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  9. Brunneria

    Brunneria Other · Guru
    Retired Moderator

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    @AdamJames
    Have you heard of 1st and 2nd insulin responses?
    I don't want to bore you, if you have read it all before, but there is some interesting info on the www.bloodsugar101.com website on the subject, if you are interested.
    I believe the info is in the section on how blood glucose dysfunction develops.

    Hope that helps.
     
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  10. britishpub

    britishpub Type 2 · Well-Known Member

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    I don't have mine in a graph form, but my result was similar to @bulkbiker, albeit with a lower peak measured at 11.8 and without the second peak afterwards.

    Again I hadn't done any prep before hand.

    @AdamJames what prompted you to undertake this extreme "experiment" on yourself ?
     
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  11. millenium

    millenium Carer · Well-Known Member

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    Maybe u r relatively young and added quite a bit of lean mass on your body.

    Did u share somewhere here on what did you do to reverse?

    Prior to this, i only wonder when i saw members here putting "i reverse my diabete" and assume they actually meant "i controlled my diabete with exercise and low carb". I actually thought this... put them on an ogtt and they will have to face reality as what i read online about "there is no cure".
     
  12. AdamJames

    AdamJames Type 2 · Well-Known Member

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    Lovely graph, thank you. Similarly steep to mine, and not like the graphs I see online in a quick Google image search! I wonder where exactly those graphs come from, I'll do some better searching later.

    This really makes me question the WHO guidelines. According to them, you would not be picked up as diabetic, yet comparing the overall shape of your graph to that of a non-diabetic person (again, if the graphs I see on Google are truly representative), the difference is clear.
     
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  13. AdamJames

    AdamJames Type 2 · Well-Known Member

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    No, I didn't follow any of the guidelines in the run-up because I don't want to compare my results to a standard, so much as compare them to my next results next time I do one. So long as I do the same things in the 48-hour-run-up next time, I think I'll know if I'm making my glucose tolerance better or worse.

    Thanks for your lovely results. Those not only pass the WHO guidelines but look very like I'd expect from a truly non-diabetic person, based on the sample images I see online. I'm going to graph them later if you don't mind, and superimpose and zoom in-out just to compare "shapes" of other graphs, regardless of levels. I don't actually know why I'm going to do that, but I know I won't be able to resist.
     
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  14. AdamJames

    AdamJames Type 2 · Well-Known Member

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    Don't worry, I'm not at all emotionally invested in comparing my results to others! This is pure curiosity. I'm just surprised at the shape of the graph, and really questioning the use of the WHO guidelines.

    :)
     
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  15. AdamJames

    AdamJames Type 2 · Well-Known Member

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    Yes I have thanks, and this was my main assumption about why the graph looks like it does. I presume that my levels were allowed to climb so high to rapidly because there wasn't much if any insulin being produced in the first phase, but then there was plenty produced in the second phase so that explained the steep decline.

    I'm still curious that the typical shape of an OGTT for a T2 diabetic looks so different to mine. I suspect that a lot of the ones online are taken from T2s who haven't taken lifestyle intervention to lower their fasting levels and go into weight loss mode to get nice lean livers.
     
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  16. AdamJames

    AdamJames Type 2 · Well-Known Member

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    I'm curious to know if my current approach to things makes any measurable improvements a month down the line, and at any point in the future down the line.

    I've got my fasting levels down into relatively safe territory first - that was easy to measure. But if I just go off the fact I can keep my fasting levels safe, I'm in the dark as to any underlying improvements that may be going on in the long term. If my next OGTT is much worse in spite of good fasting levels, I'll re-think things. If it's much better, I'll carry on.
     
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  17. AdamJames

    AdamJames Type 2 · Well-Known Member

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    It was shown clearly in the first Newcastle study that it is possible to go from failing an OGTT to passing one, via the restoration of first-phase insulin response. The method used to achieve that was rapid weight loss. This corresponded to removal of fat from the liver (quite quickly) and the pancreas (more slowly).

    There is good but not universally accepted evidence that what happened was that beta-cells which had stopped functioning due to fat content (inside the cells, interestingly, not surrounding them), once the fat was removed, started functioning again.

    Another question mark is: if the method requires substantial weight loss, how sustainable is it? The stats for losing significant weight and keeping it off are not great, i.e. appalling.

    Another question mark is time - it seems to get much less likely to succeed at around the 10 year mark from diagnosis.
     
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  18. millenium

    millenium Carer · Well-Known Member

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    Good info.

    Ok. Losing fat around the waist and those around the liver and pancreas is the key, i would think also adding muscles to the body as well.

    Most likely, only for early stage where a high % of beta cells can still reverse the damage.
     
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  19. britishpub

    britishpub Type 2 · Well-Known Member

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    I agree there.

    Although from a BG pov I can eat more carbohydrate without disastrous results, I find that if I do increase my intake I can put weight on quite quickly, and remove it quickly too when I do the opposite.
     
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  20. millenium

    millenium Carer · Well-Known Member

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    Once u lose enough fat around the waist and gain significant muscles, u can take the test. Good luck.
     
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