More self experimentation - MODY?
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cstehansen
Posts: 1,984 Member
I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
4
Replies
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cstehansen wrote: »I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
You are more of an expert on MODY, but those BG's look a lot like a T2 patient. I recall a study once comparing non-diabetics to T1 patients and the timing of insulin. The control group - non-diabetics - ate oatmeal and rose to 180 at 1 hr. post meal before dropping again. Getting to upper 200's definitely is an indication of a problem. This is expected in T2's, but I suppose the same symptoms could also occur in your case if there is a delayed insulin response.1 -
midwesterner85 wrote: »cstehansen wrote: »I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
You are more of an expert on MODY, but those BG's look a lot like a T2 patient. I recall a study once comparing non-diabetics to T1 patients and the timing of insulin. The control group - non-diabetics - ate oatmeal and rose to 180 at 1 hr. post meal before dropping again. Getting to upper 200's definitely is an indication of a problem. This is expected in T2's, but I suppose the same symptoms could also occur in your case if there is a delayed insulin response.
I wasn’t able to get good numbers for what to expect for this. All I could find was that I should expect a delayed response but it should get back near baseline by the 2 hour mark - my baseline that is. It actually got lower than that (100 vs 117).
If oatmeal got non-diabetics up to 180, I would think straight glucose would cause it to go higher. I will do some more searching to see what normal peak is. Everything I found so far just referenced the 2 hour mark.1 -
Is there a different treatment for MODY vs T2D?
This is amazing, and I love to hear about individuals self-experimenting!1 -
cstehansen wrote: »midwesterner85 wrote: »cstehansen wrote: »I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
You are more of an expert on MODY, but those BG's look a lot like a T2 patient. I recall a study once comparing non-diabetics to T1 patients and the timing of insulin. The control group - non-diabetics - ate oatmeal and rose to 180 at 1 hr. post meal before dropping again. Getting to upper 200's definitely is an indication of a problem. This is expected in T2's, but I suppose the same symptoms could also occur in your case if there is a delayed insulin response.
I wasn’t able to get good numbers for what to expect for this. All I could find was that I should expect a delayed response but it should get back near baseline by the 2 hour mark - my baseline that is. It actually got lower than that (100 vs 117).
If oatmeal got non-diabetics up to 180, I would think straight glucose would cause it to go higher. I will do some more searching to see what normal peak is. Everything I found so far just referenced the 2 hour mark.
Yes, that is another good point. Dextrose should work faster. Perhaps you could try with a bowl of oatmeal - for science?1 -
midwesterner85 wrote: »cstehansen wrote: »midwesterner85 wrote: »cstehansen wrote: »I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
You are more of an expert on MODY, but those BG's look a lot like a T2 patient. I recall a study once comparing non-diabetics to T1 patients and the timing of insulin. The control group - non-diabetics - ate oatmeal and rose to 180 at 1 hr. post meal before dropping again. Getting to upper 200's definitely is an indication of a problem. This is expected in T2's, but I suppose the same symptoms could also occur in your case if there is a delayed insulin response.
I wasn’t able to get good numbers for what to expect for this. All I could find was that I should expect a delayed response but it should get back near baseline by the 2 hour mark - my baseline that is. It actually got lower than that (100 vs 117).
If oatmeal got non-diabetics up to 180, I would think straight glucose would cause it to go higher. I will do some more searching to see what normal peak is. Everything I found so far just referenced the 2 hour mark.
Yes, that is another good point. Dextrose should work faster. Perhaps you could try with a bowl of oatmeal - for science?
I actually did freak out a bit when I saw numbers that high because even when I did experiments early on with a large chocolate chip cookie dough blizzard from dairy queen I stayed below 170. That has 195 g carbs with 142 of them as sugar. Of course with that, I only checked 1 hour and 2 hours after finishing. I wonder if it would have been higher had I checked 1 hour after starting it. Even though it only took about 15-20 minutes to eat it, the difference between my 60 minute and 75 minute readings were significantly different. I will not claim that was my smartest self experiment. I was never big on deserts - except ice cream.1 -
cstehansen wrote: »I have posted some of my n=1 experiments here as I have tried to understand my high blood glucose as I have not responded or had very minimal response to pretty much every intervention I can find. I think I may have figured out why, so I decided to test.
As background, I am not, nor have I ever been significantly overweight. At my heaviest, I briefly hit 220. At 6'1" and a 30+ year weight lifter, that still had me at only a 34 inch waist and frequently being called "thin" by people I worked with. I was diagnosed as T2 3 years ago after I had decided to back off the weights a bit and lean out. At the time, I was between 195-200 with bf % of 17-18%. My A1c was not super high at 6.6, but high enough to be classified as diabetic.
Eating keto/LCHF keeps my A1c around 6.1 and also put me down closer to 180-185 and 14% bf. My fasting BG has not really changed at all through this whole process staying in the 115-120 range for the most part. I think the drop in A1c is just a product of not having any post meal spikes.
Fast forward nearly 3 years and I was pointed in the direction of an article on MODY2 (AKA GCK-MODY). Because MODY stands for Mature Onset Diabetes of the Young and the first article I saw indicated it was diagnosed only under age 25, I did not pursue that research long ago.
However, after much more extensive research and finding there are at least 7 variations of MODY, I found it very well may be what I have. Although MODY is not common, it is almost always misdiagnosed as either T1 or T2 depending on which variation it is. MODY2 is the second most common. One of the first things about it that really made it sound like a fit was a chart showing how the average A1c for someone like this goes on a slightly upward trajectory just like someone without diabetes, but about a point higher. See chart below:
This looks like a perfect fit, not just for me, but for my dad and his dad who both were diagnosed as pre-diabetic, but never were overweight, were quite fit and never progressed to diabetic.
In going through the research, the dominant factor of MODY2 is a higher set point for FBG. The insulin response is fine and there is no insulin resistance. Again, I have several different tests showing I am not IR and I process both fructose and glucose better than average.
To go along with this, the curve for an oral glucose tolerance test for someone with MODY2 should follow a curve similar to that of a healthy non-diabetic person but possibly just a bit higher. Here is where my self-experimentation came into play.
I bought some glucose tabs from the pharmacy. Each one is 4 g of glucose, so I took 19 of them (76 g total) to come as close as possible to matching the 75 g used in the OGTT by doctors. I put them in my Ninja and ground them to powder, added water and blended until it was well dissolved. I decided to test BG every 15 minutes. On many of the readings, I would take multiple readings to make sure I got the best possible data. If there was much variance between the two, I would do a third and take the middle one. There was only a large discrepancy 1 time.
For the test, you are supposed to fast for at least 8 hours but preferably less than 14, so I fasted for just over 11. My results:
pre-test - 117
15 min - 149
30 min - 179
45 min - 263
60 min - 288
75 min - 226
90 min - 196
105 min - 128
120 min - 99
Since a reading below 140 is supposedly non-diabetic, this would indicate I am not diabetic despite my high FBG and my 6.1 A1c. For grins, I kept checking every 15 minutes for the 3rd hour:
135 min - 79
150 min - 73
165 min - 77
180 min - 86
So, it kept going down until about 2.5 hours and then started rebounding back up. I didn't keep going because it was lunchtime and I had some really awesome left over smoked brisket calling my name, but based on all my previous experiments, I am fairly certain within an hour or so, I would have been back to hovering around 100-105.
Supposedly, around 2-4% of people diagnosed as T2 are actually MODY. This is not a high percentage, but given how many thousands of members we have on in this group and the number of them diagnosed as T2, I would think the odds are we have some here.
@midwesterner85 and @RalfLott - I would be interested in your takes if you don't mind this really long post.
@cstehansen
I find this fascinating. I would imagine that my testing arc would be similar to yours, though shifted lower in the spectrum. With a normal meal, I don't generally spike above 120 that I've noticed... But I've not tested with straight glucose in any form, either. I do know that any spikes and drops I've got going on still are in that same threshold - the 30-90 minute range, and not consistent, and I've started considering that I ALREADY have a type of diabetes that isn't commonly diagnosed or something. I do have IR per tests, but I have done higher level tests, not the detailed ones you have, But my fasting glucose is in the 80-90 range, and my A1C is 5.3%, give or take, so I'm pre-diabetes, based on the IR alone, and the the A1c is in the danger zone for risk factor.
I might talk about this more to my Endo when I go back in October, but I can't afford a meter or testing supplies currently, so no experimenting presently.
TANGENTIALLY RELATED -- However, I've been experimenting around, too, again, and my thyroid dysfunction seems to be the RESULT of adrenal/cortisol issues (with which I was diagnosed first), but have remained under the radar since then because of no red flag results, whereas my thyroid got bad enough for medication and I've finally gotten level with it... I've done screenings for "initial diagnoses" that seem to point to adrenals being the source of my issues, but my endo tested the ones he was worried about, to no avail...all acceptable results. So I'm at a loss for how to proceed in researching.
Any suggestions?
I'll keep following this in case you repeat this experiment and get more info.0 -
I treat adrenal issues with Licorice Root (assuming normal or low blood pressure) or Nervous Fatigue TCM (for high blood pressure).
These are just nutritional support for the adrenal system, not adrenal stimulants. Generally the adrenals are already overstimulated (most commonly by stress) and most diets lack the nutrients the adrenals need to recover from chronic stimulation.0
