Interesting Dr follow up with LCHF friendly doc for T2
Replies
-
cstehansen wrote: »
Boston Heart did the genetic testing.
Thanks.
Was all the interpretation provided by Boston Heart, or did your new doctor participate as well?0 -
Boston Heart put the part on the report itself. The doc just verbally added explanation to it0
-
A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?0 -
Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?1 -
Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.1 -
Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...0 -
cstehansen wrote: »Edited....
I really wanted to post these primarily because I feel like most doctors out there run the most basic of tests and then assume everyone falls into the "norm" which is not always the case. Both my GP and Endo flat out stated I was IR because that is the normal reason someone becomes T2D despite the fact that I had never been obese and at the time of diagnosis was within 10-12 lbs of my ideal weight. I can't stress how important I believe it is to make sure people find a doctor who is willing to look at everything to determine what the true cause of the problem is.
Everything I was originally told by the doctors was how to become more insulin sensitive including taking metformin, HIIT exercise, etc. Now that I know insulin sensitivity is NOT my issue, I am able to focus on those items which appear to be my issues - stress management and some micronutrient deficiencies. If I had not fired my doctors, I would still be working on the wrong things and getting more and more frustrated about not making any progress.
This is just awesome beyond words. So happy you found a dr. who knew what he was doing. I'll be looking to see if my dh can order one of these tests. This is very good information to have. Thanks so much for sharing this information.
May the New Year treat you kindly.1 -
Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.3 -
midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
Yeah. I wasn't sure what to expect. I told her to check fasting tomorrow and to check 2 hours after meals noting what she ate and without drinking anything but water after to get more info.2 -
I agree about thyroid testing, but not just TSH, but also T4 & T3. Along with that, my doc checked iodine. Because of iodine deficiency, my TSH was fine, but T4 was borderline and T3 was low which can cause higher BG.2
-
cstehansen wrote: »I agree about thyroid testing, but not just TSH, but also T4 & T3. Along with that, my doc checked iodine. Because of iodine deficiency, my TSH was fine, but T4 was borderline and T3 was low which can cause higher BG.
Don't forget rT3 as well.
2 -
Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
The light headedness upon rising could be postural hypotension. I have this. Blood pressure drops when you get up intsead of rising. I had it forever. I remember trying to see how far I could get across the house before my vision returned (close to fainting).
Salt definitely helps. I salt my water every morning. Salt my coffee. Salt everything whereas before I was "heart health" conscious and ate low sodium. Sheesh.
Anyways, when my doctor discovered it, my adrenals were putting out low hormones. Not alarmingly low but around the bottom of normal. The doctor put me on fludricortisone to address the postural hypotension and hydrocortisone to address other low hormones. Within a year my prediabetes really made iteslf known.
I don't like her fasting number either but the post pop and food number seems within reason after a sugar/carb load.
When I was glucose loaded (OGTT) my BG rose quickly, peaked at 1 hour (at slightly higher than I'd of liked) and was lower than where I started after 2 hours, which I interpretted to mean my insulin was slow to get going (high peak) then finally caught up and passed what it was needed for.... It would be interesting to know what her numbers were 1 and 2 hours later.
It could be a bit high because she is a part time low carber. Maybe? The liver could be pumping out too mucg glucose in response to low levels and she could have a bit of temporary insulin resistance from low carb.
I dunno. Others know MUCH more about this than I do. I do hope your friend is okay though.3 -
Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
The light headedness upon rising could be postural hypotension. I have this. Blood pressure drops when you get up intsead of rising. I had it forever. I remember trying to see how far I could get across the house before my vision returned (close to fainting).
Salt definitely helps. I salt my water every morning. Salt my coffee. Salt everything whereas before I was "heart health" conscious and ate low sodium. Sheesh.
Anyways, when my doctor discovered it, my adrenals were putting out low hormones. Not alarmingly low but around the bottom of normal. The doctor put me on fludricortisone to address the postural hypotension and hydrocortisone to address other low hormones. Within a year my prediabetes really made iteslf known.
I don't like her fasting number either but the post pop and food number seems within reason after a sugar/carb load.
When I was glucose loaded (OGTT) my BG rose quickly, peaked at 1 hour (at slightly higher than I'd of liked) and was lower than where I started after 2 hours, which I interpretted to mean my insulin was slow to get going (high peak) then finally caught up and passed what it was needed for.... It would be interesting to know what her numbers were 1 and 2 hours later.
It could be a bit high because she is a part time low carber. Maybe? The liver could be pumping out too mucg glucose in response to low levels and she could have a bit of temporary insulin resistance from low carb.
I dunno. Others know MUCH more about this than I do. I do hope your friend is okay though.
Blood pressure is a definite consideration. It used to freak my wife out when I would fall down after getting up too fast. Now she thinks it's funny, although I have learned to get up slower. I went to the minute clinic last week for an ear infection (I know weird for a guy my age) and my BP was 90 over 60 which is not unusual for me. My diastolic can get near 50 at times. Between that and my resting pulse sometimes getting into the 40's makes me much more susceptible to head rushes/light headedness upon rising. Salt doesn't seem to make a difference, but hydration does to some extent.2 -
midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
ETA: I need to go look for a more specific reference, since (on a second reading) this quote is still referencing the 2 hour PP time. I set 140 as my cap, since I'm pretty sure that is the top of the range for people without diabetes - but it's been a while since I searched for the source of that information. If I find it within my edit window, I'll modify it.
ETA - again: Here is a better explanation that more clearly addresses the spike in non-diabetics:
"Textbooks that plot BG levels during the day in diabetic and nondiabetic individuals often show the nondiabetic levels as ranging from about 80 mg/dL before meals to close to 100 after some meals and about 120 after the largest meal of the day"
In a study using 24 healthy individuals, "the mean BG level was about 80 mg/dL before meals and went up to 110 or 120 after meals. But the individual curves show that some people had premeal levels closer to 60 mg/dL and went up only to the 80s or 90s after meals, whereas others had premeal levels in the 90s and went over 160, especially after breakfast." The quesion the variation raises is whether those who started in the 90s and went over 160 were actually already on the path toward prediabetes.4 -
midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.2 -
midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
ETA: Here's a link to the actual study referenced: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/
(This is not the study I got my information from a little over a year ago when I picked the BG cap I was willing to tolerate of 140 - but it is consistent with everything I found at the time: Generally people without diabetes have a peak BG concentration of around 120; 140 is the high end of normal for a person wihout diabetes.)4 -
midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.0 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.3 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
There is another difference I noticed: Interstitial glucose is not blood glucose.
In another way, comparing apples and oranges.1 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.
See bolded part. We agree on that. After 2 hours, a healthy person will have returned to NORMAL BG. If you still think we disagree about 2 hrs., please clarify your position.
I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
1 -
Agree or disagree, this is such a debatable issue for sure.
It just seems troubling to me to see a bg of 145 on a metabolically healthy person even if eating high carb food and drink. It's the combination of that and that fasting bg that really makes me suspicious that something isn't working quite right. If it were just one thing or the other and my both, I would probably not be as concerned.
With 1 in 3 people being insulin resistant to some degree, I think it's smart to address even slightly higher numbers asap.3 -
Thanks for this timely discussion. Questions about "average" and "normal" nondiabetic BG and A1c levels have already appeared since the ball dropped....
FYI, here's Dr. Bernstein's take on "normal" BG for nondiabetics.The Nondiabetic
In the fasting nondiabetic, and even in most type 2 diabetics, the pancreas constantly releases a steady, low level of insulin. This baseline, or basal, insulin level prevents the liver, kidneys, and intestines from inappropriately converting bodily proteins (muscle, vital organs) into glucose and thereby raising blood sugar, a process known as gluconeogenesis.
The nondiabetic ordinarily maintains blood sugar immaculately within a narrow range—usually between 80 and 100mg/dl (milligrams per deciliter), with most people hovering near 85 mg/dl. There are times when that range can briefly stretch up or down—as high as 160mg/dl and as low as 65—but generally, for the nondiabetic, such swings are rare.
You will note that in some literature on diabetes, "normal" may be defined as 60-120 mg/dl, or even as high as 140mg/dl. This "normal" is entirely relative. No nondiabetic will have blood sugar levels as high as 140mg/dl except after consuming a lot of carbohydrate. "Normal" in this case has more to do with what is considered "cost-effective" for the average physician to treat.
Since a post-meal (post-prandial) blood sugar under 140mg/dl is not classified as diabetes,and since the individual who experiences such a value will usually still have adequate insulin production eventually to bring it down to reasonable levels, many physicians would see no reason for spending their valuable time on treatment. Such an individual maybe sent off with the admonition to watch his weight or her sugar intake. Despite the designation "normal," an individual frequently displaying a blood sugar of 140mg/dl is a good candidate for full-blown type 2 diabetes. I have seen "nondiabetics" with sustained blood sugars averaging 120 mg/dl develop diabetic complications.
3 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.
See bolded part. We agree on that. After 2 hours, a healthy person will have returned to NORMAL BG. If you still think we disagree about 2 hrs., please clarify your position.
I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
My research suggests that normal daytime BG for a non-diabetic person is generally 80-100. So when you say the BG should return to normal in 2 hours, a much larger class of individuals would meet your standard of normal - because your normal goes up to 140. You seem to be using the ranges most diabetics are given on diagnosis, which are not non-diabetic ranges.
I encourage you to read the study I linked to that followed non-diabetics with continuous glucose monitoring, none of whom had the kind of response (or the 2-hour pp readings) you are categorizing as normal. If you find the oatmeal study, I'd be glad to take a look at it to see what's up, because the numbers you are reporting don't match any of the research I've found.2 -
Sunny_Bunny_ wrote: »Agree or disagree, this is such a debatable issue for sure.
It just seems troubling to me to see a bg of 145 on a metabolically healthy person even if eating high carb food and drink. It's the combination of that and that fasting bg that really makes me suspicious that something isn't working quite right. If it were just one thing or the other and my both, I would probably not be as concerned.
With 1 in 3 people being insulin resistant to some degree, I think it's smart to address even slightly higher numbers asap.
That was my point - an elevated blood glucose reading and a BG of 145 at any time are consistent AND suggest the beginning, at least, of metabolic issues.4 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.
See bolded part. We agree on that. After 2 hours, a healthy person will have returned to NORMAL BG. If you still think we disagree about 2 hrs., please clarify your position.
I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
My research suggests that normal daytime BG for a non-diabetic person is generally 80-100. So when you say the BG should return to normal in 2 hours, a much larger class of individuals would meet your standard of normal - because your normal goes up to 140. You seem to be using the ranges most diabetics are given on diagnosis, which are not non-diabetic ranges.
I encourage you to read the study I linked to that followed non-diabetics with continuous glucose monitoring, none of whom had the kind of response (or the 2-hour pp readings) you are categorizing as normal. If you find the oatmeal study, I'd be glad to take a look at it to see what's up, because the numbers you are reporting don't match any of the research I've found.
I think there is a communication breakdown here. I am using 80-100 as NORMAL.0 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.
See bolded part. We agree on that. After 2 hours, a healthy person will have returned to NORMAL BG. If you still think we disagree about 2 hrs., please clarify your position.
I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
My research suggests that normal daytime BG for a non-diabetic person is generally 80-100. So when you say the BG should return to normal in 2 hours, a much larger class of individuals would meet your standard of normal - because your normal goes up to 140. You seem to be using the ranges most diabetics are given on diagnosis, which are not non-diabetic ranges.
I encourage you to read the study I linked to that followed non-diabetics with continuous glucose monitoring, none of whom had the kind of response (or the 2-hour pp readings) you are categorizing as normal. If you find the oatmeal study, I'd be glad to take a look at it to see what's up, because the numbers you are reporting don't match any of the research I've found.
I think there is a communication breakdown here. I am using 80-100 as NORMAL.
If you're using 80-100 as normal, then we are in agreement as to 2-hr pp levels. Our disagreement is whether it is ever a normal response for non-diabetics to go higher than 140 mg/dL. All my research points to anything above 140, at any time, being at least an early sign of a metabolic disorder.2 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »Sunny_Bunny_ wrote: »Sunny_Bunny_ wrote: »A friend of mine has been off and on low carb one day to the next but she's very young, 23, and active just always out and about and horseback riding and walking leisurely biking and just an active young person.
Anyway, she mentioned feeling lightheaded upon getting out of bed in the morning and we talked about sodium and possibly low blood sugar. She had her grandma check bg expecting to see it as low only to discover it was 124 fasted. Her grandma, a retired nurse, wasn't the least concerned. Her grandparents and uncle, and probably her mom (my good friend has lots of signs but refuses to let me check bg) are T2D.
We decided to check while she was here. She had eaten a soft pretzel about 2 hours prior but had also been drinking a regular soda up until arriving at my house. So maybe had gone 30 minutes without sugar at this point.
Bg was 145.
She is not overweight at all but does have a rare disease called hereditary angioedema. She says it's not autoimmune. She also doesn't feel stressed.
I'm wondering about autoimmune diabetes, perhaps LADA or maybe the over production of glucose scenario... or maybe her body is naturally more stressed due to the blood disease. ???
Anyway, she's having blood work done next week for other things and is going to ask for an A1c and fasting insulin test. I'm going to send her the names of the antibody tests for T1D and LADA too. Do you think anything else would be good to ask for, knowing this is not a naturopath do they won't likely run such thorough tests as you had done.
Those are all I can think. I think they should answer the question of why is blood sugar going high. Right?
Whew. She's lucky to have you for a friend!
Some possible tests - the usual bloodwork panels + thyroid, immune system, and adrenal hormone tests?
Sounds like steroids are not part of the picture, since she's young and there's been no autoimmune diagnosis. Any other meds?
I don't know her meds. She's part of a medical research study for the HAE. She's using a new medication not available by rx yet. I think that's where she's getting blood drawn.
I'll let her know your suggestions.
Standard medication for her disease is called Danicrine. Not sure if spelling. But that's not what she's taking. Don't know if study medication is the same type of med or not.
Thank you for the suggestions. Very helpful.
She should be getting some lab tests if she's in a clinical trial. ?? If so, bring copies.
@KnitOrMiss @midwesterner85 @nvmomketo @albertabeefy @geneticexpectations @GaleHawkins @neohdiver @Dragonwolf @PaleoInScotland et al. might have some insights...
Hmm... not sure on the 124 mg/dl fasted number. It might warrant more testing. However, 30 min. after drinking a regular soda? In a healthy person, I would expect much higher than 145 mg / dl. Those two results contradict each other.
When healthy people eat carbs, they still have a BG spike and it still takes around 1.5 - 2 hours to return to "normal" BG range. The spike is usually not as steep, though, because some insulin starts acting much faster than for a diabetic taking an injection at the time of eating, which is earlier than the non-diabetic is receiving insulin and the injected insulin has to travel before it takes effect. So 30 min. after drinking soda, I would expect closer to 180 mg / dl unless she really drank it slowly and just finished it 30 min. ago. If she drank the entire can between 60 and 30 min. before testing, 145 mg/dl is lower than I would expect.
The results are consistent with each other (and with prediabetes). For a healthy person 145 mg/dl is on the high side - even after drinking a can of coke. Yes, there is an increase after eating high carb foods - but in a healthy person it rarely goes above 140 mg/dl.
"Healthy, non-diabetic people normally have blood glucose levels of less than 120 milligrams per deciliter two hours after a normal meal, rarely exceeding 140 mg/dL, according to an American Diabetes Association article in the April 2002 issues of 'Clinical Diabetes.'" http://healthyeating.sfgate.com/expected-blood-glucose-after-highcarb-meal-3529.html
(emphasis added)
This is wrong. I would have to find the study again, done out of Atlanta where a group of type 1's and a group of healthy people were each given oatmeal and BG was monitored. At 1 hr., the type 1 group was at 200 mg/dl on average. Everyone who is a type 1 understands the post-prandial spike. Here's what most people who don't understand this would not have expected: In the healthy group, average BG was 180 mg/dl at 1 hr. Why?! Simply because even healthy people have post-prandial spikes. It doesn't go quite as high because insulin begins to work more quickly, but it is not as instantaneous as some people seem to think.
See the information I added after you responded. It links to a study with the actual data. 180 is outside of the normal range for non-diabetics. Yes, there is a PP spike, but it is considerably lower than 180 for non-diabetics (see the charts in the article I linked to). Anything above 140 suggests movement toward diabetes.
We are comparing apples and oranges.
You: 2 Hours post-meal
Me: 1 Hour post-meal
ETA: In other words, we agree about what happens after 2 hours.
No we actually don't agree. Non-diabetics at 2 hours would normally be back in the 80-100 range.
I based my cap on the consensus for the absolute peak for non-diabetics (based on the studies and medical literature I reviewed about a year and a half) - which is 140. Standard medical textbooks put it at 120, but other studies I found suggested it might be slightly higher in real life - at 140. The study I linked to used continuous glucose monitoring. The mean peak for the non-diabetic subjects (whether it occurred at 5 minutes or 2 hours) was 120. If you click through to the links, you'll see that there are very few subjects who ever went above 140.
You may be confusing the target ranges for diabetics - which are considerably higher than what non-diabetics actually experience.
See bolded part. We agree on that. After 2 hours, a healthy person will have returned to NORMAL BG. If you still think we disagree about 2 hrs., please clarify your position.
I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
My research suggests that normal daytime BG for a non-diabetic person is generally 80-100. So when you say the BG should return to normal in 2 hours, a much larger class of individuals would meet your standard of normal - because your normal goes up to 140. You seem to be using the ranges most diabetics are given on diagnosis, which are not non-diabetic ranges.
I encourage you to read the study I linked to that followed non-diabetics with continuous glucose monitoring, none of whom had the kind of response (or the 2-hour pp readings) you are categorizing as normal. If you find the oatmeal study, I'd be glad to take a look at it to see what's up, because the numbers you are reporting don't match any of the research I've found.
I think there is a communication breakdown here. I am using 80-100 as NORMAL.
If you're using 80-100 as normal, then we are in agreement as to 2-hr pp levels. Our disagreement is whether it is ever a normal response for non-diabetics to go higher than 140 mg/dL. All my research points to anything above 140, at any time, being at least an early sign of a metabolic disorder.
Yes, we agree on 2 hr., but disagree on 1 hr.0 -
I'm going to jump into the fray here and add my 2c to the conversation, because both blood glucose targets and HbA1c testing are hugely important to me, and I believe the evidence is clear but the information just isn't getting to the general public.midwesterner85 wrote: »...I'm saying healthy people have high BG about 1 hour after carbs. Specifically, with around 75g of oatmeal, they would have an average of 180 mg/dl at 1 hour post-meal. That is where we disagree.
I personally believe oft-times we're confusing "healthy" or "optimal" with "normal". In the USA and Canada (where I live) we're seeing more and more cases of both diabetes and pre-diabetes. I think we all agree it's an epidemic that could likely be prevented with dietary/lifestyle changes.
That being said, it hasn't happened overnight. I would suspect if we could go back 50 years and do some serious HbA1c and OGGT testing on non-diabetic people we'd see very different mean results on those tests than today, and find that what was 'normal' 50 years ago ... isn't 'normal' or even common now.
One of our problems is the numbers game. We consider it "normal" and neither diabetic nor pre-diabetic to have an HbA1c of 5.6%. Yet it's pre-diabetes the moment it climbs to 5.7% ? The same goes for post-prandial testing. An OGGT result of 139mg/dl after two hours is somehow 'optimal' whereas 140 is suddenly impaired?
Are we seriously suggesting that people don't intervene and take control of their blood glucose until a certain number is reached and a concrete diagnosis is made? There's the problem right there.
Personally and professionally I believe that post-prandial glucose targets are MUCH more important than HbA1c in controlling/reducing complications of elevated blood glucose. I disagree that "healthy" people ever have a high (above 140mg/dl or 7.8mmol/L) BG at either 1 or 2 hours after carbohydrate ingestion, and absolutely agree with the 140mg/dl post-prandial cap.
Regardging that Atlanta oatmeal study mentioned ... If we say that "normal" people have a 180mg/dl peak in blood glucose concentration at any point in any kind of testing methodology, are we saying that they are "healthy"?
I'm sorry, but serious damage happens when blood glucose is elevated above140mg/dl.
We KNOW from multiple studies now that neuropathy/nerve damage occurs when blood glucose rises over 140 mg/dl (7.8 mmol/L) on OGGT.
http://care.diabetesjournals.org/cgi/content/full/24/8/1448
http://www.neurology.org/cgi/content/abstract/60/1/108
http://archneur.ama-assn.org/cgi/content/full/63/8/1075
An Italian study showed β-Cell dysfunction begins at 2-hr OGTT readings over 100 mg/dl (5.6 mmol/L), and an American study shows β-Cell die off in people whose fasting BG is over 110mg/dl (6.1mmol/L). Another US study shows that β-Cell are also destroyed in people with prolonged exposure to BG over 140mg/dl (7.8mmol/L). (These studies would suggest why higher HbA1c is positively associated with age - we're killing our β-Cells over time.)
http://www.springerlink.com/index/MV0L2YK570H8GMKG.pdf
http://diabetes.diabetesjournals.org/cgi/content/full/52/1/102
http://ajpendo.physiology.org/cgi/content/abstract/279/5/E997
The AACE (American Association of Clinical Endocrinologists) has targeted post-prandial levels of 140mg/dl for diabetic patients YEARS, regardless of the ADA's (and CDA in Canada) ridiculous and highly-toxic target of 180mg/dl (10.0mmol/L). The reason for the AACE's tighter guidelines? They KNOW and CARE that even moderate post-prandial hyperglycemia (above 140mg/dl / 7.8mmol/L) is; #1: more indicative of atherosclerosis than fasting or HbA1c tests, and; #2: exerts direct detrimental effects on the endothelium.
The same goes for the IDF - International Diabetes Federation. They have the same targets for post-prandial blood glucose. Their position and evidence statements are quite clear on the harm of any readings above 140mg/dl for macrovascular disease, retinopathy, oxidative stress, inflammation, endothelial dysfunction, cancer risk and impaired cognitive function in the elderly.
https://www.idf.org/webdata/docs/Guideline_PMG_final.pdf
So I apologize if I offend anyone, but to suggest any reading at any time above 140mg/dl (7.8mmol/L) is either "normal" or "healthy" is not just incorrect, it's also dangerous.
Regarding HbA1c and what's 'normal' ...
Dr. Richard Bernstein claims 4.2% to 4.6% is a normal, non-diabetic HbA1c. I'd personally suggest those may be "optimal", but on the low-side of healthy in my opinion.
Most studies in the USA and Canada show an upper limit of 5.6% as 'normal', non-diabetic readings for adults, and 5.7% being the lower-limit for 'pre-diabetes'.
However, since research shows β-Cell dysfunction begins at lower levels than most realize (for both fasting and post-prandial targets) I'd suggest that younger healthy adults should have lower HbA1c levels. Indeed, a recent European study of healthy college students (all tested to rule out diabetes/pre-diabetes) showed HbA1c levels ranged between 4.6% and 5.4%.
We know that diabetes is a disease that is progressive if untreated. It doesn't start the first moment you reach a number at which you're diagnosed. It starts long before that. We could probably save our countries a very-large fortune if we were to suggest that:- People be regularly screened for not-just elevated fasting BG (as it's often the last symptom of both diabetes/pre-diabetes) but regular screening of HbA1c ... AT NO COST TO THEM;
- Intervention upon a HbA1c reading above 5.4% that includes evidence-based education on both carbohydrate-reduced diets and post-prandial testing guidelines... again, AT NO COST TO THEM;
That's my 2c. Aaah, yes, I do long for a perfect world. <sigh>
13 -
oops double post. hopefully some mod will delete.0
-
@albertabeefy once again fantastic information and thank you for taking the time to include references.
I definitely wouldn't want anyone to tell my friend not to be concerned about her numbers so I hope she gets good advice after testing. If not, I can show her these links so that she can understand what she's really risking if not taking consistent and proper action.2
This discussion has been closed.