Something the doctor said

[nabilla]

Hi, I spoke with my doctor today about a chest infection I have. I mentioned that I'd had two high readings on my glucose meter, one before dinner and one two hours after (13.2 and 8.4). I said all my others were in the normal range and asked the same question I asked here--why would that happen? With the very highest reading I'd had a very low-carb meal and with the 8.4 I'd had 40g of basmati with my homemade spinach and cheese, not managing to eat all of it.
He said that it could be the fact that I'm ill. Then when he summarised my sick line, he said that I have 'possible diabetes'. When I asked why he'd say that, he said because of the high glucose readings. I get the feeling he's talking nonsense--what do others think? How can he say something like that on the back of two home readings?

 

[KennyA]

Question - was the 13.2 the pre-meal? And are you sure it was a very low carb meal?

Secondly - the fingerprick monitors hare not 100% accurate. They can vary by up to 15%. So a true value of 10.0mmol/l could result in a reading of anything between 8.5 and 11.5. And 1 in 20 readings is allowed to be completely outside that. I had a reading of 1 point something last week - it was clearly very wrong. A retest showed 5ish. The fingerprick works best to build up a long-term pattern, rather than focusing on one possible spurious result.

I really have no idea what was in your doctor's mind at the time. But I personally prefer to be taking control over what I do and how I manage my condition.

 

[nabilla]

The first result was before I ate dinner. For lunch, I'd had some lettuce, cucumber, two small tomatoes, a smoked mackerel with a third of an avocado followed by full-fat greek yoghurt with a medium pear in it. I also had a wee plate with 24g of tallegio, 7g Brazil nuts and 20g chorizo. Trying to include more fatty stuff as I initially lost 6lbs in a week whilst largely ill on bed on a new low carb calorie deficit diet (I got muddled). Maybe three-4 hours after that was the 13.2 as I only tested before dinner because I wanted to try eating some white rice. So that was pretty low carb unless I'm missing something?
The 8.4 reading was two hours after eating home-made Palak paneer with 40g of basmati that I struggled to eat (ironically, after wanting it so badly!) total carbs for tge whole day, weighing all ingredients = 87g. I understand many here eat less than 50g but I don't think I need that. However, if I were to get more readings like that I'd look into it more seriously. Surprised by how tasty a plate of nuts, chorizo and cheese could be, without bread or crackers. Actually better in many ways.
I'm hoping it was an anamoly or because I'm unwell just now. My doctor's pretty eccentric.

Another nice surprise from all this is the fact that I had 10g of 90% cocoa chocolate and loved it. I've not been able to eat dark chocolate for years and had been developing a taste for white chocolate after the switch to milk maybe ten years ago. Just shows how fast your taste buds adapt. It also didn't affect my glucose levels

 

[EllieM]

I definitely find that illness pushes my blood sugar readings up, and as a T1 I have to inject more insulin when I'm ill. eg during a recent cold my levels were soaring and I had to increase my background insulin by 20% just to keep any sort of control.

Not sure how illness effects levels in prediabetics but it wouldn't surprise me at all if it pushed them up.

I'm a big fan of 90% and 95% chocolate, though I find 100% is just too bitter. Enough taste so that you really enjoy it but it's hard to binge on it. (Not saying impossible, but I've never had more than 4 squares of 90% Lindt in one sitting, whereas in the old days when I took less care of my bg levels I could eat a whole bar of "normal" chocolate.) And 70% is too sweet for my taste buds now, so it's definitely a question of what you are used to.

But if your doctor thinks you might have diabetes, I think he should just order an hba1c test for you. I don't think you can tell much from a few isolated bg readings when ill.

 

[Melgar]

Hi @nabilla , I had a heavy cold earlier last year, my control had been relatively good. Then I got this nasty cold. I can tell you that my blood sugars stayed over 9 mmol/ls for days. At no time, day or night did it fall below 9mmol/s. I was barely eating a thing, so I can well imagine 13.2 mmol/ls could be down to your body being under stress as it dealt with your illness.

 

[nabilla]

Hi @nabilla , I had a heavy cold earlier last year, my control had been relatively good. Then I got this nasty cold. I can tell you that my blood sugars stayed over 9 mmol/ls for days. At no time, day or night did it fall below 9mmol/s. I was barely eating a thing, so I can well imagine 13.2 mmol/ls could be down to your body being under stress as it dealt with your illness.

Thanks Melgar and @EllieM. The information I'm building here on this forum will be very useful. It's kind of what I thought might be going on, so it's good to hear others have had similar experiences.
I've also had lots of strange burning sensations in my body, which the doctor said might be due to high sugar. This, too, has been much worse whilst ill. However, before I got ill I'd been getting weird burning knees. I'm now hopeful that when I'm better, and eating a lower carb diet with as little refined sugar as possible, that the knee burning might go too! I think it may have been the effects of high sugar levels!
And yes, my HBA1c is only 42, and that was taken about 3 weeks ago, so I can't imagine I've jumped to being diabetic.
I feel a bit sorry for my doctor--I think he's under chronic stress, but he just flings out diagnosis over the phone. Last night he wanted to give me omeprazole (suspected ulcer!) and antibiotics (chest infection) without examining me and when I have an urgent colorectal referral in next two weeks, where surely a specialist might be better placed to investigate why I'm bleeding.
I think he just needs to do something.
I imagine with the prediabetes, I'll be better using a mix of NHS (for annual HBa1c tests), and my own lifestyle and diet changes, using a BGM to monitor what spikes me.
I'm considering getting a trial of the libre when I'm better. My plan would.be tomuse it experimentally to see how certain higher carb foods affect me. Is there any website or person here who might give me.info about how to run tests/experiments? I thought morning tests might be most effective. For example, if I want to see how I fare with a baked potato, do a fasting blood.level.on waking, eat a baked potato.for.breakfast, and then test 2 hours later. However, I read that the body handles carbs better later in the day, so maybe I should.stick.to normal eating times. I'm also open to criticism of this idea. I can see it's hardly scientific. I can't afford a libre linger term. Maybe I'm better sticking with BGM to try new foods. I do find it hard to get blood out and have to soak my hand every time!

 

[Robbity]

@EllieM said:

I definitely find that illness pushes my blood sugar readings up, and as a T1 I have to inject more insulin when I'm ill. eg during a recent cold my levels were soaring and I had to increase my background insulin by 20% just to keep any sort of control.

Not sure how illness effects levels in prediabetics but it wouldn't surprise me at all if it pushed them up.
...
But if your doctor thinks you might have diabetes, I think he should just order an hba1c test for you. I don't think you can tell much from a few isolated bg readings when ill.

@nabilla: - I'm T2 but have been able to keep my overall glucose levels to prediabetic mumbers since 2-3 months after diagnosis. Howevet I've always seen a rise due to illness (snd stress. pain etc), and I've just assumed that it's normal for our livers to provide extra fuel to deal with such issues.

 

[nabilla]

@EllieM said:

@nabilla: - I'm T2 but have been able to keep my overall glucose levels to prediabetic mumbers since 2-3 months after diagnosis. Howevet I've always seen a rise due to illness (snd stress. pain etc), and I've just assumed that it's normal for our livers to provide extra fuel to deal with such issues.

Thanks for the info-- sorry to hear you've been unwell and had stress. I hope you're doing OK.
In response to people's experiences on the forum, I've done a bit of reading around I'll ess and stress and blood glucose and it's comforting. I also contacted my doctor and asked for 'possible diabetic' to be removed from my records so that it's just prediabetic.
I've been quite chronically stressed for maybe the past 5 years and I have wondered if that may have triggered the prediabetes through wear and tear of my system! But I have to just accept the unknown and get on with addressing the issue at hand. Thanks for all the support--very useful, especially when the doctor is a little unreliable (he has a huge workload--too big and obviously GPs are by definition generalists and doing their best like I do at my work)

 

[Melgar]

@nabilla when you are stressed your body releases adrenaline which increases your body’s ability to respond to the ‘threat’ - the fight or flight response. Major stress hormones released include cortisol. Cortisol increases the blood sugar in your blood stream. It changes your immune system responses and slows down your digestive processes. Chronic stress therefore does a number on you and can cause a number of possible health problems anxiety , digestive problems tension sleep issues and weight gain to list a few. I have seen chronic stress cited as a contributor to raised blood sugars - prediabetes.

 

[nabilla]

@nabilla when you are stressed your body releases adrenaline which increases your body’s ability to respond to the ‘threat’ - the fight or flight response. Major stress hormones released include cortisol. Cortisol increases the blood sugar in your blood stream. It changes your immune system responses and slows down your digestive processes. Chronic stress therefore does a number on you and can cause a number of possible health problems anxiety , digestive problems tension sleep issues and weight gain to list a few. I have seen chronic stress cited as a contributor to raised blood sugars - prediabetes.

Thanks @Melgar. That makes sense. I responded to the stressful situations with good diet/exercise/good sleep routine. My partner had a series of very unexpected health issues over a number of years, nearly dying many times. I did a lot of medical research (Google scholar, reading peer-reviewed medical papers) while he was ill, and some of it really had a massive impact on his health and outcomes. For example, I pushed for a second opinion as I was sure he'd been misdiagnosed at one point and when the second doctor did his examination, he agreed with my theory, which led to a ten-hour operation the next day to remove lots of infected tissue and bone that if left much longer would have killed him. We'd been told the infection was gone, despite my partner having ongoing pain. The second doctor was a friend of a friend who was the father of my son's friend at school. That led to a total obsession with his health and unfortunately the pattern repeated several times (diagnosis by Google scholar changing treatment plans, sometimes radically, of course only because the doctors were not only brilliant medics, but also because they were willing to investigate my ideas, even when I had lots of ideas and more of them were wrong than were right.)

However, the one thing I couldn't learn to control well was my anxiety. I still jump at the slightest thing, have night terrors and have developed a range of irrational fears that really annoy me. I do yoga most days. I've tried therapy but I can't afford the type that worked best for me years ago (psychotherapy weekly over three years, before I really had anything to stress about but I was just neurotic). I'd just started to feel a bit more relaxed and then this. However, I do think I've developed some coping mechanisms and am trying not to read too much. As many of you will know though, through your own experiences with pre diabetes and diabetes, your own research can often be a survival tool that can't so easily be cast aside, especially when it's helped you or a loved one to survive or thrive. I'm also aware that I'm really lucky this has been caught so early and while my HBA1c levels are right on the borderline.