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Trying to understand what I am dealing with

Discussion in 'Diabetes Discussions' started by [email protected], Jan 1, 2020.

  1. D@n1el

    [email protected] Prediabetes · Active Member

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    Happy 2020!

    I went to the doctor, had some tests, and got the following results
    Fasting Glucose: 97 mg/dL
    Fasting Insulin: 4.2 mU/L
    HbA1c: 5.4%.
    Estimated Average Glucose: 108 mg/dL
    HOMA-IR: 1,00
    HOMA-Beta: 44.26

    The doctor agreed to hold medication a bit and see if physical activity (muscle building and jogging) would help. I've been sedentary for over a year.

    It happens that at I've bought a OneTouch Glucose meter and then started to check my levels daily. At least 3 days a week I get something between 101-111mg/dL. After reading one of Dr. Bernestein books, from which I've got the clear impression that there's no such thing as prediabetes to him, I then started to prefer to consider myself a diabetic.

    My BMI is 21,8, so I don't have much weight to lose. I'm trying to read a lot, but as far as I can see there's little attention to lean diabetes (rarely I've got a paragraph in which Dr. Bernstein talks about it, and I suppose Dr. Fung also doesn't say much about that).

    Wonder if there's any easy answer to some questions that have been bugging me.
    1) What does a normal/almost low HOMA-IR (=1) and a very low HOMA-beta (=44.26) mean? My guess is that it means that my insulin sensitivity is OK (no insulin resistance), but I've got beta cell dysfunction.

    2) Would intermittent fasting and its variants be of any help to people with no overweight? I've been working for 4 weeks on eTRF (eating between 8 and 15 hours), it's not working for me.

    3) A low carb diet but with enough calories (so I won't lose weight) will help? I am combining this with eTRF, so I get 2300 calories a day, 130g of protein (after all the doctor told me I should build some muscle), 180g of good fat, but only 30g of carbs.

    4) Physical activity sometimes raises my glucose. Half an hour after jogging for about 30 minutes in last Monday's morning, it went 131 mg/dL (fasting glucose was 87, my breakfast had 9g of calories!). Well, probably thanks to that, the next day my fasting glucose was 103 mg/dL. Some days before that, I ran for about 15 minutes and it did me absolutely no harm (it raised my BC just a little)! Should I insist with physical activity, is it possible that in time it will not raise my glucose that much?

    5) Glucose patterns are a little hard for me to understand. Sometimes last year I abused immensely on sugar and desserts, but the next day I've got 91 mg/dL. Then, a week later I would do something slightly more responsible and would get 107 mg/dL. Sometimes jogging is good, other it seems to be bad. Is there an explanation for this kind of thing?

    Thank you very much in advance!
     
  2. VashtiB

    VashtiB Type 2 · Well-Known Member

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    Hello and welcome,

    I don't have the answer to most of your questions but wanted to welcome you to the site.

    There are a few people on here who have never been overweight so I'm sure they will be along here shortly to respond.

    I'm not one of those. However, I also find exercise does increase m y blood sugar levels- particularly if I haven't eaten prior to exercising. My understanding is that the liver dumps glucose into your blood- evolutionary speaking to allow you to hunt and gather food. I think that it you eat something before exercising it may reduce the increase- I haven't tried that yet as I still have a fair bit of weight to lose.

    Good luck and welcome.
     
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  3. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Welcome and happy New Year!

    I am not familiar with those tests either. Did you have a result for HbA1c? Are you in the US?
     
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  4. ert

    ert Type 1 · Well-Known Member

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    Welcome and Happy New Year.
    I'm also a Berstein fan. You were lucky to have the HOMA tests which aren't routine here. I had them through a specialist. If you're still worried (about your HOMA-Beta), can you get a referral to a specialist?
     
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    #4 ert, Jan 1, 2020 at 9:05 PM
    Last edited: Jan 1, 2020
  5. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    Hi [email protected],
    I am a slim(ish) Type2 diabetic in remission (due to LCHF and TRE or IF as most call it - TRF is usually the term applied when it is used for rodents in labs. People like me are known as Thin Outside, Fat Inside (TOFI). About 10% of Type 2 Diabetics were never more than a few pounds into the Overweight BMIs. We have excess body fat, but have few fat cells under our skin (sub-cutaneous), so when on a high Carb diet our Insulin forces the excess Glucose to be 'safely stored' as fat in and around our internal organs including Liver, Pancreas and Kidneys. Thus many of us have/had Non-Alcoholic Fatty Liver Disease, even if not diagnosed as such.


    The HOMIR tests you mention are not standard in the UK, so I can't comment on your results - I presume that whoever ordered them understands them.

    We are all different, different taste, different genes, different micro-biome, different state of Pancreas, Liver, Kidneys etc. So the specifics of what works for one person may not work the same for another. We each need to find what works best for our own bodies.

    Here are my comments on your remaining questions:
    2). Yes, but it very much depends upon what you are eating during the restricted time eating period. If you load up with Carbs, and if you have any problem with either Insulin production or with Insulin Resistance then your Glucose from the Carbs will stay high for a long time, which in turn will keep you producing Insulin (whatever you can) for long periods of time. Neither high Blood Glucose, nor high Insulin are good (especially for prolongued periods).
    I only introduced IF into my LCHF Way Of Eating (not a diet as such since I never deprived myself of Calories) after I was already fat adapted. Meaning that my body could use any stored body fat to supply energy during the time periods I was skipping breakfast. But I never went hungry, so my body and my Blood Glucose Meter dictated how much, of what and when I ate.

    3). In my experience and looking around the forums an LCHF way of eating works for many/most provided the person can follow it. My personal experience is that of a TOFI, so I never tried to lose weight - just to control my BG as best I could without going hungry. But I was still losing around 6lbs to 8lbs per month at first.

    4). Yes. physical exercise can either raise or reduce Blood Glucose. Any intense aerobic exercise is likely to increase Blood Glucose if done for more than a very short time. Moderate sustained aerobic exercise or resistance exercise (e.g. weight lifting) builds muscle which forms a larger reservoir in which to store Glucose - thus reducing BG and raising Metabolic rate both of which are good for Type 2 diabetics. The effect of exercise is much lower than that of what and when you eat. We have a saying that 'you can't out-run a poor diet'.

    5).Some of us can eat fruit and/or potatoes, grains, pasta with impunity. I can't even eat a medium sized raw carrot without a spike in my Blood Glucose! Carbs eaten with Fats cause a slower more moderate spike than when eaten on their own. Alcohol delays Blood Glucose spikes - since the body need to process it before any carbs (or Fats or Protein) since it is a toxin.

    It isn't just carbs (and to a smaller extent Protein) which raises BG. Illness, Injury, Stress, exercise, Lack of exercise, lack of sleep and medication including Statins and Steroids also can raise Blood Glucose. So unless you keep a suitable diary you are probably not comparing like with like.
     
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  6. Jam&Scones

    Jam&Scones MODY · Well-Known Member

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    Hello and welcome - another skinny type 2 here!

    Exercise helps, but I have found diet to have the main impact on glucose levels. Further to Ian's excellent response above - lots of fructose can seriously inhibit your ability to burn fat, 1) it can only be processed into glucose by the liver 2) it gets stored there too and you have to burn that before you burn fat. It is also what causes fatty liver. The body will always burn off the glucose first before turning to fat for fuel (which makes sense because they are your stores). So depending on how much you have, that will dictate how quickly the store is burnt through. How quickly that burns is down to your metabolism (I have heard that IF kick start that... But I guess if you have lots of glucose to burn through, a smaller period might not help?).

    There is also 'dawn phenomenon' where your blood sugar continues to rise in the morning, even if you havent eaten anything. Sometimes there is no pattern, sometimes the spike hits much later (Type 1's - I dont know how you do it, but I respect your efforts!).

    Finally; I wish I could eat potatoes with impunity :D
     
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  7. OrsonKartt

    OrsonKartt Type 2 · Well-Known Member

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    Hi. I'm a skinny type 2 who maintains reasonable sugar control by self monitoring. I read all I can and try out stuff that's Recomended. Sometimes it works sometimes not. - it's a tough one but keeping a diary and monitoring what ever I can , I kind of find a direction which works until it doesn't. Sorry but I don't have any easy answer than to advise you that you are doing the right thing and you now have to have patience and keep on doing it. Sometimes it helps to share stuff on this site. There's so much info and help here. Best thoughts and happy new year
     
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  8. D@n1el

    [email protected] Prediabetes · Active Member

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    Thank you all for the great help and answers. I honestly thought that I wrote too much and would not get help. This is a great place!

    Also nice to know there are members with experience on being lean and have diabetes. I was a little disappointed that many books wouldn't go into that. Read Bernstein's 1000 answers on Type 2, and there was not much info on that. Now I am starting Diabetes Code (Jason Fung), and, apparently, the author is not worried with lean diabetes. He talks a lot about insulin resistance and obesity, and I believe my HOMA-IR says I don't have IR, what I do seems to have (HOMA-BETA) is beta cell dysfunction.

    If I may answer the questions that came up with the replies, I live in Brazil and I was surprised to find HOMA-IR and HOMA-Beta on my exams. My doctor actually did not ask them, but he asked fasting glucose and fasting insulin. My guess is the lab simply applied the HOMA-IR and HOMA-Beta formulas and brought the results.

    Oh yes, I forgot to add HbA1c. Mine is 5.4%. Estimated Average Glucose is 108 mg/dL. Will try to update my first post in order to include them.

    I am expecting that, in time, with practice, my body might react more positively to jogging (could that happen, or is it a wrong thought?), so my BG would not raise that much. When I was running 15 minutes, I did not see substantial BG raise. But beyond 30 minutes, that happened.

    Thanks again
    Great to be here!
     
  9. Antechinus

    Antechinus Don't have diabetes · Well-Known Member

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    HOMA-IR of 1 is indicates non insulin resistant. Though the individual score is variable for an individual due to their genetics. For Anglo-Saxon a result greater than 1.5 is considered resistant.
    At 1 you should be able to lose fat from adipose tissue if you want.
     
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