Questions Answer Please

Bojansthlm said:

hi is there anyone here who can answer these questions? I would really appreciate your opinion
Here is some information about me: I always have slightly higher morning sugar, 5,5-6, especially if I eat carbs the night before. I heard it can be a dawn phenomenon effect. My long term sugar is 30 and I passed the OGTT. The doctor said that I’m not diabetic, but I’m worried that according to the ADA, my fasting glucose levels are pre diabetic.

And here are the questions, thank you so much.
1. When it comes to people who are diabetic, with higher fasting morning levels; does their blood sugar level decrease after 2-3 hours after they wake up? That’s what happens to me.
2. If I was pre diabetic, would my long term sugar be higher than 30?
3. Can one be pre diabetic just from their fasting levels or does the long term sugar also play a role in defining that?

Thank you all again! Have a great day!

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As a general rule a diagnosis of Diabetes is made against the results of the hbA1c test which looks at your average over the previous 8 to 10 weeks.

https://www.diabetes.co.uk/what-is-hba1c.html

@Bojansthlm Hi

To the best of my knowledge the answers to your questions are as follows.

question 1 it depends on your starting point if fasting level low then it's more likely to rise rather than drop but this varies from person to person mine goes higher throughout the day then drops in the evening for others it may actually go down if starting high.

Question 2 Prediabetes is normally defined as a HbA1c of between 42 and 47 mmol/mol (6.0–6.4%). HbA1c being long term sugar.

Question 3 Diabetes and Prediabetes is usually diagnosed by the HbA1c or long term sugar fasting levels are a snap shot of sugar levels at any one time after not eating for aproximately 8 hours or more.

1.My dawn phenomen affected levels drop depending on what I eat and do so I can’t easily answer that.
2. That’s an excellent number definitely not prediabetic even on the hb1ac scales
3. I’m not sure medically about when the dawn phenomenon ceases to be normal and when it becomes problematic. Try looking up impaired fasting glucose - a form of insulin resistance. Type 2 diabetes can creep up over years and even decades with increasing levels of insulin resistance that has to start somewhere.

My advice to my teenagers who currently show no signs of diabetes is to monitor hb1ac during their lives, not to eat large quantities of carbs, most obviously but not exclusively any added sugars, to eat real, unprocessed foods avoiding chemical laden rubbish including low fat stuff and to move their bodies when they can.

@Bojansthlm whilst your morning bg may be higher than other times of the day, it is not within diabetes or prediabetes ranges.
Is there a reason why you are testing your bg enough to notice this?
You have raised multiple questions about your symptoms over the last month and seem to have received the same constant message about DP happening to everyone and your bg is not high. You mention you have undergone multiple tests for abdominal pain and the doctors have not found any problems related to diabetes.

@JohnEGreen . There’s a coincidence . I now know the answer to the question. Kinda proves a point don’t you think?

To be honest yes I am diabetic drug induced and if my HbA1c was 30 I would be ecstatic 30 is a non diabetic level.

Highish fasting levels are normally caused by the liver releasing some of it's stored glucose into the blood stream in order to fuel your body for upcoming activity but again this varies between individuals and if fasting levels are very high and combined with a high HbA1c can be a cause for concern and a doctor should be consulted.

Bojansthlm said:

Thank you so much for your answer, it means a lot to me. If I understood correctly, then it means that one doesn’t have diabetes or pre diabetes if the long term sugar is 30, even if fasting levels are high?

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If your fasting level is high, it does still show a problem and I would reduce carb intake to give your liver a chance to deplete its stores over time to try to correct it.

Bojansthlm said:

Thank you so much for your answer, it means a lot to me. If I understood correctly, then it means that one doesn’t have diabetes or pre diabetes if the long term sugar is 30, even if fasting levels are high?

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Generally you would not be diagnosed as diabetic if your HbA1c is in the 30's especially if you have had more than one HbA1c test giving those numbers non diabetics can have random or postprandial and even fasting sugar readings that may be considered as on the high side.

If concerned discuss this with your doctor we here can't diagnose we can only advise.

If I were you I would not be overly concerned about diabetes.

But there may be other issues.

Bojansthlm said:

Thank you for your response, I have been quite worried lately, as you noticed. If I could please have your opinion and ask you few questions I would really appreciate it. My long term sugar levels are 30 as you saw, but the 5,5-6 morning sugar according to ADA is pre diabetic and that worries me. My fasting insulin levels are low and I passed the OGT with 6,8 after two hours. What I would like to ask you is:
Usually I eat very healthy and after doing LCHF for one month my C-peptide levels went down from 0,44 to 0,20, which started to worry me that perhaps my insulin response decreased after removing carbs from my diet. Today I had pasta and one hour after it was 5,8; two hours 6; three hours 6,3; four hours 6,8 and then at five hours it went down to 6. I had a stronger response after I had a burger for the first time I ate carbs after being on no carb diet. Could it be that bread and pasta can lead to a much later spike than the usual 1-2 hours? I know that the spike wasn’t so high today, but the pattern of it being three hours later worries me.

How long do i need to reduce the carb intake? After reducing carb my fasting is 4.8 after a couple of days but then i started to worry that my body is not producing enough of insulin.

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I'm no expert but if you want my honest opinion after what I've read recently (you might not like it) as I understand it, the reality is that too many of those kinds of carbs have no place in a human's diet so expecting our bodies to continue to tolerate them is a misunderstanding of our own biology.
I'll link a couple of great articles I read recently. They can explain things in better detail:

https://paleoleap.com/what-to-know-blood-sugar-spikes/

And this one should answer your question about the higher spikes with carbs after a low carb diet, at least as far as the morning fasting levels go. There is another article I read about the slower insulin response when reintroducing carbs after low carbing and it's a similar principle I think. It's your body thinking "finally, I can produce a more reasonable level of insulin" (because it's not good to have a lot of insulin floating around all the time) but then the old assault of a carb load shocks the body and catches it off guard when it had gotten used to only needing a small insulin response.
https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

I don't think that lower level of insulin production in response to a low carb way of eating is a bad thing. It's not the same as what will happen if you continue with all the carbs, which is to wear the pancreas out so it eventually can't produce enough insulin (which is what type 1 diabetes is I think).

If they did a c-peptide, did they do a antibody test?