Dx PD, yet BG <110 after meal

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yana2100
New Member


Date Joined Jul 2009
Total Posts : 12
   Posted 7/27/2009 11:00 PM (GMT -7)   
Hi, everyone, I'm new to this forum.
fasting BG , typical 80-100 at home test. +1 hr later at Hospital, BG becomes 100-115
post-meal (+2hrs) BG , typical 75-110,  rarely >110. only one time =125 max ever
 
Most of time, post-meal BG is less than fasting BG.
I am wondering anyone out there has heard this kind of  BG behavior.
Dr said I 'm PD.
But , anything wrong with BG is always <125?
Thanks. yana2100
 
 
 
 

TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 7/28/2009 6:25 AM (GMT -7)   
Hiya yana, welcome to the forum!
 
I'm no expert but your numbers are a little higher than normal I think.  Your doctor's PD comment I believe means pre-diabetic.
 
What stage of the game are you at?  Did he prescribe medications or recommend further tests? 
Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July/'08
~ Dropped 40 or so pounds after following HealingWell advice
~ Diabetes under control / no meds - so far - knock on head
~ My doctor thinks HE is responsible (Don't tell him! He's happy ;)

I used to eat 100% wrong -- now I eat 95% right


Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 7/28/2009 9:45 AM (GMT -7)   
Yana, it is possible this is entirely normal for you and there is nothing to worry about, but at the same time it wouldn't hurt to keep an eye on things. If you doctor hasn't ordered one yet, he really should do an A1c, which is a test of how you BS levels have been in the last couple of months and then do some follow up A1C's every 3-6 months depending on the results.

While at home meters are fairly accurate and the ones hospitals and doctors offices typically use a little more accurate, the actual lab tests are the most accurate indicator of all. There are a lot of things that can effect your immediate readings from food, drink, stress, illness, your body's own self correction mechanisms, etc which is why the 2-3 month average A1c test is needed before a real diagnosis can be made.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


yana2100
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Date Joined Jul 2009
Total Posts : 12
   Posted 7/28/2009 11:40 AM (GMT -7)   

My A1c was always very stable around 6.0+-0.1.

I argued often with my family Dr on catergorizing me as PD (Pre-diabetic).

But Dr always pointed out to my borederline A1c which is a little higher

than that of a "normal" person.   Dr also kept sending me to do eye check and everytime was OK.

Unfortunately, my PD status became the primary reason of rejection whenever I applied for new private medical insurance policy.

A year or two ago on internet, I came across some people posted a similar inquiry.  I do think I am not alone having this kind of weid BG "problem".

I have this "symptom" well over 23 years.

I wonder this may not be any problem at all, but the classification of PD or D is not adequate or well-defined. 

Thanks Yana


LanieG
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Date Joined Nov 2006
Total Posts : 5392
   Posted 7/28/2009 2:42 PM (GMT -7)   
Your post with your fasting and pp levels seem to be fine on the surface, though a non-diabetic probably wouldn't have post-prandial readings up to 120 unless it's after meal with a lot of carbs.  Your A1c is another story.  That's higher than doctors want and probably why the doctor said you're pre-diabetic.  That result says your average blood sugar was 120-123 more or less.  If that's the average, what were the highs?  That's the point.  This shows that you're not metabolizing carbs normally although you're not a full-blown diabetic.  The good news is that you could probably bring all the numbers lower by changing your diet and doing regular exercise.  One reason your pp could be less than your fbs is because of 'dawn phenomenon'.  In the early morning your body wants to wake up and get going so it raises your blood sugar to give you the energy to take on the day.  It doesn't happen in everyone but it might be doing this with you.  Some people try to eat a protein snack before bed to head it off.  In general, I think (and I'm not a doctor, just a pre-diabetic!), your numbers are not critical and could be lowered by your own lifestyle.


Lanie
forum moderator - diabetes
diabetes controlled so far by low/no carb diet and exercise; no meds
                                                                 

Post Edited (LanieG) : 7/28/2009 4:04:39 PM (GMT-6)


yana2100
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Date Joined Jul 2009
Total Posts : 12
   Posted 7/29/2009 8:57 AM (GMT -7)   
My post-prandial readings from past two years are consistent and <110 (75-110, never spiking above 125) which is "normal" as if I were non-diabetic.  My A1c should be <6 (ie. average BG<125+-) accordingly since BG is always <125 all day long.   My "speculation" is that my red blood cell could be "different" and "stickier than normal red cell for attaching Blood Glucoe" such that A1c is dis-proportionally higher.  Make sense? Any idea?  Thanks  Yana
 

Phishbowl
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Date Joined May 2006
Total Posts : 547
   Posted 7/29/2009 1:33 PM (GMT -7)   
From the info provided..... I would not classify you as pre-diabetic (IMHO).

- Your 5.9, 6.0, & 6.1 HBA1C are within "normal" range: 4%-6.5%.
- Your PP are within "normal" range if they're always below 110 within 2 hours of when you start eating.
- A spike of 125 is also "normal" with large or high-carb meal. Even going much higher can be considered "normal" if BGLs are within acceptable PP range within an hour or two.

about the A1C.... the average life cycle of a red blood cell is approximately 90 days. Red blood cells are continuously being generated. When you have the A1C test done, it captures a moment in time (just like when we do our finger sticks) and gives a picture of what your blood sugars have been averaging over the past approximately 90 days. That average is weighted. Meaning that the 30 days just before the test have more input into that average than say the first 30 (90 days ago). That's why sometimes a week of not-so-great control can have a significant affect on that average, especially in the later part of that 90 days. The A1C is also an average and should be looked at as such. The log book is where the details are on how to accurately address a (i.e. high A1C) situation.

What your A1C tells you, yanna, is that there may be times that you're going higher than you think or are capturing with your meter. Shake up your testing routine and try testing a meal say... before, 1, 2, and 3 hours afterwards. This info tells you how you metabolize a particular meal if you want to know what foods cause your highs. Try a 3:00 am test. This data is good for determining dawn phenomenon. Have you ever been low/below 70?

I'm not a doctor but, I don't think you have diabetic issues. Your A1C of 6% is normal, IMHO. It's on the higher end of normal but it's still normal. I would suggest it be a good idea to regularly check that it's not starting to creep up but, I think the occasional finger test would suffice. Your fasting test will usually show any changes first.
Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"What's Not Measured Is Not Managed"

"It is impossible for a man to learn what he thinks he already knows"-Epictetus


yana2100
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Date Joined Jul 2009
Total Posts : 12
   Posted 7/29/2009 4:23 PM (GMT -7)   

 

Only once  BD<70 for both fasting and PP (+2hrs) in past 2 years.  morning fasting BG=110, morning PP (+2hr)=64  in the same day.

I did a lot of dinner PP(+2hrs) and the following morning fasting - some examples

( evening PP / next morning fasting BG _home test) --  (118/120) , (90/90), (86/75), (113/117),(104/84), (87,98), (80/89), (103/79) etc.   

There were many fasting data <100 when test was done at home.  Unfortunately, they all became higher >100 at Hospital test +1hr later.

If A1c is accurate, then the only explanation for my case is that there exists a big spike right after meal which also comes down fast at +2hrs test time.  ie. the peak is well high to cause high average A1c value.  I need to check at shorter PP intervals as you've suggested.

Thanks Yana

 

 

 

 


Phishbowl
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Date Joined May 2006
Total Posts : 547
   Posted 7/31/2009 5:49 PM (GMT -7)   
Thought I'd take a look at the ADA web site, as I hadn't been there for some time. It appears they've updated their info to include details about pre-diabetes. From what I understand, a FPG "fasting plasma glucose test" (I.e. lab blood work/ vein blood draw) result of 100 - 125 classifies as pre-diabetes, 126+ as diabetes, and under 100 as normal. There was a classification range for the OGTT test, too (<140 is normal, 140-200 is pre-diabetes, and over 200 is diabetes) and even a question in the FAQ section about insurance, not that it said much other than they're all different.

They specifically say:
"If your blood glucose level is abnormal following the FPG, you have impaired fasting glucose (IFG); if your blood glucose level is abnormal following the OGTT, you have impaired glucose tolerance (IGT)."

Apologies that my initial response didn't take into account the updated info on the ADA web site. I certainly didn't mean to add to any confusion :-) It's possible that your doc is up on the latest info and has you classified pre-diabetic according to the newly published range.

The good news is that often some small changes or modifications to lifestyle (i.e diet, exercise) can see that A1C average into the normal range relatively quickly and easily. There are a number on this forum that can attest to that. Knocking your A1C down a 1/2 percent would put you into "normal". Might be the best time to shop for insurance? (Sorry, I'm Canadian and don't understand the US insurance game very well).
Cheers,
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"What's Not Measured Is Not Managed"

"It is impossible for a man to learn what he thinks he already knows"-Epictetus


TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 8/1/2009 5:41 AM (GMT -7)   
I can attest to what Phish says -- I brought my A1C down from 10.0 to 4.7 in 3 months just by cutting out carbs in my diet. Lost a bunch of weight too. My doc told me that if he hadn't seen me before, he would have told me I was normal.

Give us some examples of what you're eating. There might be some clues in your food choices.
Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July/'08
~ Dropped 40 or so pounds after following HealingWell advice
~ Diabetes under control / no meds - so far - knock on head
~ My doctor thinks HE is responsible (Don't tell him! He's happy ;)

I used to eat 100% wrong -- now I eat 95% right


yana2100
New Member


Date Joined Jul 2009
Total Posts : 12
   Posted 8/2/2009 10:07 AM (GMT -7)   

 

I just did another round of BG tests before and after dinner at -0.1hr,+1hr,+2hr,+4hr,+11hr and +13hr.  Dinner at about 60 Carb.                               I typicall eat 60 Carb for 3 meals with two snack times at <45 carb in mid-after and late night.

BG(-0.1,+1,+2,+4,   +11,+13)= (78, 106, 125,    94, 92) ;   FPG at 94/92

1. My FPG was always betwenn 100-120 when it was done at Clinics for past 2 years, despite that home-tested value was  80-100, rarely >100.  Is home test kit accurate?

2. It appears my BG is always <125.  A1C should be less than 6.0%.

3. The Johns Hopkins Diabetes 2009 White Paper  "the panel recommended using an HbA1c cutoff of 6.5% as a screening test for diabetes and suggested follow-up tests to confirm the diagnosis of diabetes. These recommendations await consideration by major medical associations, but one day they may allow many people to become diagnosed sooner."    A1C spec for diabetic will be raised from 6.0% to 6.5%?

Thanks Yana

 

   


yana2100
New Member


Date Joined Jul 2009
Total Posts : 12
   Posted 8/2/2009 10:09 AM (GMT -7)   

sorry, correction ---

BG(-0.1,+1,+2,+4,   +11,+13)= (78, 106, 125, 68,   94, 92) ;   FPG at 94/92

Yana


TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 8/3/2009 4:52 PM (GMT -7)   
As Phish said, you're "..., on the higher end of normal but it's still normal....," so health-wise, this is good but you definitely should keep an eye on things.  Personally, I applaud the lowering of accepted standards, if only as an indicator that the A.D.A./C.D.A and the medical profession in general are starting to awake.
 
I infer that your main goal is "My PD status became the primary reason of rejection whenever I applied for new private medical insurance policy."
 
Well, you can kill three birds with one stone, so to speak, by drastically cutting down on your carb intake over the next 3 months.
 
1)  You will lose weight, have better, personal control over your BG and be healthier
 
2)  Your next A1c will drop dramatically
 
3)  Your next medical insurance application will be accepted
 
Editor's Note:  Number 1 is the most important result turn


Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 40 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right


yana2100
New Member


Date Joined Jul 2009
Total Posts : 12
   Posted 8/5/2009 2:25 PM (GMT -7)   

 

Thanks for the comments.

What I like to find out is that anyone out there Dx with Pre-Diabetic -

1. What is their A1c range?    <6.0 or >>6.0 ??

2. What is their after-meal BG level?   "normal" at <125 or much higher than 125??

Thanks Yana


TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 8/5/2009 5:21 PM (GMT -7)   
Again, I think the answers to your questions depend upon your personal goals.  Mine are health-driven.
 
1.  My last three A1c's came in at 10.0, 4.7 and 5.2 (next results in 6 days)
2.  Varied ... depends on my discipline ... the weather ... phases of the moon
 
These numbers were the result of me researching everything I could find, drastically changing my diet and taking control of my disease.  I've never disputed the Dx but to be fair, I've never had to apply for financial medical assistance either.  After seeing the second and third A1c numbers, my doc said I was normal and would have signed an affidavit to that effect but I know me better than he does.  He's a busy guy so I don't blame him ... he has to check his notes to remind him of who I am every time I see him.  He might be after the Doctor of the Month Award for all I know.  I do know that while he may be using outdated information, he is not my enemy and has the best of intentions.  My goal is to keep my fingers, toes, legs, senses, sanity ... live longer & better.  I know I'm diabetic, if only based on family history and watching close ones suffer and die far too early.
 
You're one of us (diabetic ... pre, post ... whatever) and have some decisions to make and some work to do.  That's the downside.  The upside is that, especially for us PD's, its not all that much work.
 
I suggest a couple or three things:
 
1)  Focus on changing your diet.  Over the next 3 months (assuming you have an A1c scheduled -- PD's recommended treatment as far as I know), eliminate as many carbs (potatoes, cereals, pasta, rice, dairy, sweets ...  anything starchy or sugary) as you possibly can.  That's it.  Then, go for your blood tests and doc's appointment.  Let your doc explain why you are normal.  You will probably qualify for your med insurance application at that point -- I don't know for sure but its worth a try right?  Its just a matter of switching goals -- if you get healthy, you'll qualify for the insurance coverage but you won't need it 'cuz you're healthy !?!  Stoopid and ironic, I know tongue
 
2)  Research, read and think.  Hang around here (HealingWell.com ... a great place ... apparently there's a Company Car we can borrow around here somewhere ;-) and as many other sources of information as you can find.  Ask questions.  Consider the answers.
 
3)  Forget about the numbers.  Personally, I hope for the day when normal A1c determinations are 0.0000001975482.  When that happens, good, healthy food will finally become available to everyone, at reasonable prices and the term diabetes will no longer exist.
 
Sorry for the diatribe yana .... GET HEALTHY! ... and the rest will follow :-)
 
 

Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 40 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right

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