High Fasting Glucose Level

[TromboneAl]

Thanks guys, looks like you may be right. All my measurements with my glucose meter have been totally normal: 93 before dinner (chili, beer, cottage cheese, cauliflower), 113 1 hr later, 111 2 hrs later, 101 3.25 hrs later, and 90 this morning (12 hrs of fast). If I can trust the meter, that's a big relief.

I still plan to go see the PCP next week.

[Rich_by_the_Bay]

Quote:

Originally Posted by TromboneAl Thanks guys, looks like you may be right. All my measurements with my glucose meter have been totally normal: 93 before dinner (chili, beer, cottage cheese, cauliflower), 113 1 hr later, 111 2 hrs later, 101 3.25 hrs later, and 90 this morning (12 hrs of fast). If I can trust the meter, that's a big relief..

As for that 101 3.5 hrs later, I'd rather have seen a 99, myself.

[brewer12345]

Related question:

Just got back from a visit to the Dr. because I feel like crap (appears to be a bacterial infection piggybacking on my cold). He mentioned that last year (about a year ago), my regular blood test showed a glucose reading of 102. Since they did not bother to say anything at the time other than a vague reference to lay off the sweets/carbs, I assume this is probably not a big deal? He has me coming in for another annual blood test in 2 weeks, so I suppose we will see then. FWIW, I am 36, in generally good health, 200#, 5'11', reasonably decent diet, generally hit the gym 3 to 4 times a week for cardio and weights plus have fairly active hobbies (hiking, camping, brewing - which is quite physical). No family history of diabetes that I know of, aside from some hugely obese types on my mother's side (but my heavy parents are not diabetic.).

[Rich_by_the_Bay]

The values under consideration in prior posts refer to 10 hour fasting specimens, so the 102 may have been completely normal if you weren't fasting.

This whole issue reflects a well-meaning desire to increase disease detection by adjusting the "normal" range to make it more sensitive. This almost automatically increases the per cent of positive results which are "false positives." Maybe it saves lives, maybe it doesn't. But it sure generates a lot of cost and worry.

It wouldn't surprise me if outcome studies eventually prove that the current recommendations are too stringent. Then disease advocacy groups will protest when they loosen them up (as just happened with the mammogram recommendations).

Tough stuff to get your head around sometimes.

[brewer12345]

Quote:

Originally Posted by Rich_in_Tampa The values under consideration in prior posts refer to 10 hour fasting specimens, so the 102 may have been completely normal if you weren't fasting.

This was a fasting number.

I think in the case of diabetes the costs of the disease unmanaged are so huge relative to what they could be if early detection and steady management were routinely pursued that I can understand the aggressive stance and a certain amount of false positives. Dunno if this is the case with other conditions, just happen to have read up on diabetes related to an investment (the company that had all those lae night WIlford Brimley cable ads).

Reading between the lines of your response, it sounds like 102 is nothing to get all that alarmed about unless the follow up results (a year later)are not encouranging.

[Rich_by_the_Bay]

Quote:

Originally Posted by brewer12345 I think in the case of diabetes the costs of the disease unmanaged are so huge relative to what they could be if early detection and steady management were routinely pursued that I can understand the aggressive stance and a certain amount of false positives.

It depends. My guess is that when the glycohemoglobin/HgbA1C gets better standardized we will identify some who will go on to develop diabetes and complications and some who don't. Already, if you are in the range of 5.7 or so and stay there, complications are not common.

The jury is still out; it's an important question and some times public policy gets ahead of the evidence.

[Buckeye]

Do fasting glucose results and fasting insulin results have anything to do with each other?

Current PCP had DH and I take a fasting insulin test as well as the fasting glucose test.

[Rich_by_the_Bay]

Quote:

Originally Posted by Buckeye Do fasting glucose results and fasting insulin results have anything to do with each other? Current PCP had DH and I take a fasting insulin test as well as the fasting glucose test.

It is not customary to measure serum insulin levels for diabetes. While it can help distinguish how much of the problem is low insulin production rather than insulin resistance (within the body's fat cells, for example), the picture is usually a blend of the two (in type 2 - type 1 results from insulin deficiency). So, for example, a normal fasting glucose could be associated with high insulin levels, since the body is producing it in excess in order to overcome insulin resistance, and to maintain normal glucose.

Some doctors tailor their medications depending on the insulin level but the bottom line is glucose control. I am not aware of any evidence that routine insulin measurements lead to better treatment or outcomes.

[TromboneAl]

Here's my perspective, based on my recent experience.

Being in a situation where you find that you have diabetes, or that you are quite likely to develop it, is much, much worse than you can imagine unless you've gone through it. Consider never being able to have a piece of chocolate cake, pancakes, or a cookie. Not being able to eat the spaghetti that someone serves you at a dinner party. Imagine having to prick your fingers multiple times per day, or to have to inject yourself with insulin after every meal.

Trust me, it's different when it happens to you. This book can give you a feeling for it:

Amazon.com: The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed (First Year, The) (9781569242650): Gretchen Becker, Allison B. Goldfine: Books

So, from that perspective, you want to do whatever it takes to avoid this. And avoiding it is easier if you start before your blood glucose levels get high enough to start wearing out your insulin-producing cells. There's a point of no return, and you want to take care of business before you reach that point.

It's true that if you don't have the diabetes genes, you're not going to get the disease no matter what you do. But if you do have those genes, the gun is loaded, and carbs and being overweight will pull the trigger.

I found out that my 66 year old sister has been pre-diabetic for a year (fasting glucose 103). Even if my test was an error, I'm not taking any chances. I'd rather be anorexic than diabetic.

[Buckeye]

Quote:

Originally Posted by Rich_in_Tampa So, for example, a normal fasting glucose could be associated with high insulin levels, since the body is producing it in excess in order to overcome insulin resistance, and to maintain normal glucose.

Yes, he was checking for insulin resistance now that I think about it.

[Buckeye]

Quote:

Originally Posted by TromboneAl I found out that my 66 year old sister has been pre-diabetic for a year (fasting glucose 103). Even if my test was an error, I'm not taking any chances. I'd rather be anorexic than diabetic.

Does your sister do all the good stuff you do (exercise, diet, weight)?

[Rich_by_the_Bay]

Quote:

Originally Posted by TromboneAl Here's my perspective, based on my recent experience. Being in a situation where you find that you have diabetes, or that you are quite likely to develop it, is much, much worse than you can imagine unless you've gone through it. Consider never being able to have a piece of chocolate cake, pancakes, or a cookie. Not being able to eat the spaghetti that someone serves you at a dinner party. Imagine having to prick your fingers multiple times per day, or to have to inject yourself with insulin after every meal. Trust me, it's different when it happens to you. This book can give you a feeling for it: Amazon.com: The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed (First Year, The) (9781569242650): Gretchen Becker, Allison B. Goldfine: Books So, from that perspective, you want to do whatever it takes to avoid this. And avoiding it is easier if you start before your blood glucose levels get high enough to start wearing out your insulin-producing cells. There's a point of no return, and you want to take care of business before you reach that point. It's true that if you don't have the diabetes genes, you're not going to get the disease no matter what you do. But if you do have those genes, the gun is loaded, and carbs and being overweight will pull the trigger. I found out that my 66 year old sister has been pre-diabetic for a year (fasting glucose 103). Even if my test was an error, I'm not taking any chances. I'd rather be anorexic than diabetic.

You'd be surprised how many people with diabetes or pre-diabetes don't see it quite that way. They make the adjustments, have small quantities of nearly everything they always have eaten; some take oral meds, some don't. And about 5% of pre-diabetes enter the diabetes range per year (roughly).

Your reaction may be getting ahead of your reality. I mean that in a reassuring way. Not to discount the importance of this pre-disease, but trust me: there are a lot worse. And don't go crazy with "anorexia" - it is probably riskier than your current nearly ideal body weight.

You'll be fine.

[Alan]

This is a fascinating thread. Thanks to everyone who is sharing their experiences.

[TromboneAl]

Quote:

Your reaction may be getting ahead of your reality.

Yes, that's entirely possible.

Quote:

Originally Posted by Buckeye Does your sister do all the good stuff you do (exercise, diet, weight)?

I gave her a copy of Younger Next Year 1.5 years ago. She really took it to heart, and started exercising more. She was very grateful (I guess that happens now and then), and bought several copies for her friends. She isn't overweight.

However, I think she falls off the wagon now and then.

Also, I'm not sure she understands the carbohydrate issues. Here's a quote from an email:

"My latest saga. Last night I had a bowl of cous cous with veggies and clam sauce for dinner. ...My glucose was 207! Higher than ever!!!!!!!!!! for me."

I wouldn't eat much cous-cous.

[haha]

Quote:

Originally Posted by Rich_in_Tampa Not to discount the importance of this pre-disease, but trust me: there are a lot worse.

My Dad had diabetes for 45 years or so until he died still in pretty fair health at age 88. Not nearly so much was known about the proper diet for diabetes during much of this time. Overall, the advice given him might have been better early on, before the low fat mania began.

Anyway, his take was that it isn't that bad a disease as diseases go, particularly for someone with a little common sense. Last year at my HS reunion I saw an old friend who was type 1 since he was 8. He looked great.

It's a bad disease compared to immortality, but as Rich says, there are a lot worse. Like most of the others.

Ha

[Achiever51]

I've been reading this thread with great interest, but for another reason entirely. Several years ago, my DH was hospitalized for a cardiac procedure. During the routine lab tests prior to the surgery, his doc asked DH when he was diagnosed with T2 diabetes. Both DH and I were shocked as this was news to us. Doc showed us the results and postponed the surgery until the blood glucose was under control (i.e., DH started on insulin.)
After DH was released from hospital, he was fully compliant with meds, exercise and diet, but he was unable to replicate the high blood glucose readings with his meter. When he saw his PCP, the results were "high normal", borderline, but nothing like the numbers in the hospital. This went on for about a month.
Finally got a referral to a top endocrinologist who did a full battery of tests, including taking hair samples and nail scrapings. Every test came back normal. DH did not and does not have T2 diabetes at all. No one was able to explain how this diagnosis came to be.
HOWEVER, we spent the next year trying to remove that diabetes tag from the insurance.

[Buckeye]

Quote:

Originally Posted by TromboneAl However, I think she falls off the wagon now and then.

So does that mean her and your fasting blood glucose measurements are pretty close even though you are much stricter and vigilant than she is?

Or are those few points a big difference which can be explained by your strict diet and exercise routine?

[rescueme]

Quote:

Originally Posted by Achiever51 ...he was unable to replicate the high blood glucose readings with his meter. When he saw his PCP, the results were "high normal", borderline, but nothing like the numbers in the hospital. This went on for about a month.

Don't discount the effect of stress (all kinds) on your readings, regardless of diet.

Back when I was first diagnosed (9 years ago) I tested several times a day; today weekly, at most. However, in those early days I could see a direct correlation to my skipping exercise and higher readings.

It seemed that I was able to get rid of excessive stress by just the time I spent on the treadmill.

Being in the hospital is a big stress inducer. I see your DH's pattern as "normal", considering the situation at the time...

[TromboneAl]

Quote:

Originally Posted by Buckeye So does that mean her and your fasting blood glucose measurements are pretty close even though you are much stricter and vigilant than she is? Or are those few points a big difference which can be explained by your strict diet and exercise routine?

Hard to say. She's 10 years older than I am, which is probably the most significant difference between us.

[tmm99]

I used to have a friend who had Type 2 diabetes. (In fact, one point in my life, I was surrounded by diabetics-all on oral medication, a couple on insulin) This friend would avoid sugar/sweets like a plague, but then, when we went to chinese restaurants (her favorite food), she would request less grease on dishes, and ate a lot of veggies, but only a small amount of protein (chicken, fish and tofu only) and tons of rice. I would tell her white rice turns into sugar once digested, so she should lay off the rice and eat more protein to get full. Of course, she never listened to me. Whatever the standard way of healthy eating her doctors told us about (or whatever the guide books she got when she was first diagnosed in 1980's or 1990's), she followed. She exercised (a few miles of brisk walk every day - rain or shine), and her diabetes was sort of under control, but she had bouts of hypoglecemic episodes and she had a cataract surgery when she was in her 40's.

10 years or so ago, I read a book "Diabetes Solution", written by an engineer turned doctor. He is supposedly the first person to use the glucose meter to monitor blood sugar.

Richard K. Bernstein - Wikipedia, the free encyclopedia

Here is the book.

Amazon.com: Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars (9780316167161): Richard K. Bernstein: Books

The book details what he went through (He is diabetic himself) (with his experiments on himself) to find the solutions to diabetes. He even decided to become a physician in his 40's just so he could publish his findings (and actually having the findings recognized by other physicians).

I gave this book to another diabetic friend of mine (who had a heart attack at age 40 and was in a very bad shape - probably because he never watched what he ate and never exercised. He had a couple of surgeries from blocked arteries. He also has a lot of issues with blood circulations to his feet and almost lost a toe a couple of times.), I have a feeling the book is probably just sitting on his book shelf unread.