For the last three evenings I have had normal, fasting level glucose readings 2 hours after dinner. Tonight I had meat, several low carb veggies and 2 small baked potatoes plus a dish of regular ice cream for dessert (my second dish today, I don't normally do this) I tested at 8pm and it read 91!! Could it be possible that I don't have a problem with 2 potatoes? Naturally I think that maybe all my elevated results in the past several weeks were due to improper testing technique and I'm really perfectly normal. If so, then I was consistent in my poor technique!

Has anyone had this happened-foods that you would expect to cause a problem have turned out to be okay? I know I will have to have a test meal of the offenders again to see if they cause the same elevations. Could it be that regular ice cream (not low fat) may not be as bad as it would seem?

Chris

Hi Chris
___NO, you're not experiencing bad testing techniques...So many times have so many foods surprised my wife and I. The fats are not the concern, but the sugar in the ice cream is what to consider. My wife, who is an insulin dependent very brittle diabetic (spikes, spikes, spikes), is not physiologically offended by spaghetti with meat sauce. And as for a baked potato, as long as it's well buttered, it isn't that bad either. Take the meat out of the spaghetti, and the butter off of the potato and WOW! The fats and oils in the ice cream, the fats in the spaghetti sauce, and the butter on the potato all seem to slow down the assimilation. I've always said, totally controlling my wife's blood glucose is like pushing a chain down the street...God bless,,,Oldguy

WOW, that's really interesting. I haven't been checking my sugars regularly. I keep thinking I know what is happening by the way I eat. But I guess I really need to check blood sugars more often.

Chris, how often do you check you sugar? I most often do a fasting am and sometimes an afternoon prior to dinner. Thanks, Barb

Hi Old Guy:

I have an update since I posted this about getting 3 normal readings 3 nights in a row and questioning my previous testing technique. Last night I ran a pasta test meal-it was cheese ravioli with meat sauce and a salad. My reading at 2 hours was 176, at 3 hours 174, and at 5 hours 145. So I am sure my previous technique was fine. I would have thought the cheese in the ravioli would have helped, but the results were almost as bad as the night I had a regular pasta meal.

So what does this mean? I shouldn't eat pasta? (I am sure there are other foods I may not have tested yet that would give similar results)

When I tell my doctor about my research project when I see him in about 6 weeks, what should I expect him to do? A random glucose test or a 2 hour glucose drink test done in the am could very well be normal. Would that be the next logical step?

I'm not sure what to do about this.

Chris

Hi Barb:

I have not been diagnosed with diabetes, this is a little research project I've been conducting on myself since having a hemoglobin A1C of 6.3 I thought that was a tad high for someone who wasn't supposed to be diabetic so I bought myself a home glucose meter and started testing at various times per day. I rarely test in the am because my fasting level is normal, but you can see I have been getting some abnormal results, mostly from meals big on carbs. now I have to figure out what to do about the results.

CHris

Hi Chris,
I am not sure if impaired glucose is a term for being on the lowest scale for diabetes? That is sort of how I think of it. But anyway, have you ever had insulin levels checked? My understanding is that this is expensive and not done routinely. I recently met a woman who was on glucophage. She had normal sugars and Hba1c but her MD told her she had high insulin levels and she improved on the glucophage. I am sorry, can't remember what symptoms she was having that she went to the doctor for. Maybe you doctor will be open to checking insulin levels to see if you have insulin resistance?

Hi Barb:

I think it is what you would call "impaired tolerance" and used to be what they called "borderline diabetes". Apparently there is no such thing anymore and you either have it or you don't. Those that have "impaired tolerance" can go on to develop diabetes (and after just reading Eades book Protein Power it sure sounds like that is the next step) or may never, but may still suffer the same consequences. According to the Joslin Diabetes Center Website, these people (in this impaired tolerance category) should be followed carefully. They also said that they do not find insulin levels clinically useful. I'm not sure what my doctor will do and I don't know what I should expect him to do. What tests to order? I have wondered if treating with one of the diabetes drugs that does not tend to produce hypoglycemia (Actos?) would be better than taking drugs for cholesterol, hypertension, and exertional angina!

Chris

Hi Chris,
It's my bet that he will check your fasting glucose and repeat your Hba1c. The glucose tolerance test is still used because it can be done in the office and is so simple. But most of the time they use it to check for the opposite case, hypoglycemia. If he doesn't give you that, he'll likely wait for the lab report, then put you on glucophage. It prohibits the takeup of fat in your intestines and will likely cause you gastrointestinal distress. Your initial reading of 174 is just a tad over the permissible level for a high carb meal, but to have it high after 5 hours indicates to me that you are becoming insulin resistant. I would prefer going on Actos or Avandia, since this does not raise your blood insulin levels but raises the sensitivity of your fat cells to your own insulin. This is why weight gain is a side effect of the glitizides, and that's easier to take than G.I. distress.
___An endochrynologist would be better to go to, since he will likely check your thyroid functions and thyroxin level in your blood. Too often this isn't considered by the PCP (used to be called the GP or general practitioner).
___I have my own test for insulin resistance.
If after four hours, your B.G. is high, either ride an exercycle or jog in place for 5 minutes...(that's a long time). If your sugar takes a good drop of say 20 points, you've got insulin, but your not using it. The muscles take a lower level of insulin for glucose transport. The threshold for your fat cells is going up.
___I'm researching a different compound for insulin resistance, and if I find it safe, I'll try it. The compound is not approved for ingestion so I hesitate to name it until I've really researched it. It's lightening outside and I don't want to blow my box, so I'll check back later...God bless,,,Oldguy

Hi Old Guy:

The sources I have say that "normal" people's blood sugar should return to close to fasting levels by 2 hours. I thought a normal response would put out enough insulin to deal with it, assuming you didn't eat a mountain of spaghetti. I would imagine there could be some lag time there, by like you said, not 5 hours. How many grams of carbs would be considered "high carb?" It doesn't always stay high for that long, pasta is the worst although chicken and stuffing wasn't much better. It actually went higher than that at 2 hours-238 but didn't stay high as long as the pasta meal.

If he repeats my fasting glucose it will most likely be normal. Not sure about the hemoglobin A1C. That's another question I have though-if I do keep an eye on my carbs until I see him in May, won't that affect the results of any glucose tests he does? For example, I have read that before a GTT you should eat 300gm carbohydrates each day for 3 days. Is this to make sure you are "primed" and get a proper insulin response?

What would you expect from a 2 hour glucose challenge test (in my situation) ?

I'm already on thyroxine and will be getting that checked too, as I do every year.

You really think he's going to put me on glucophage? Surely not on top of toprol, lipitor, and imdur. The one thing that scares me about something like Actos or Avandia is that it is so new-what if the same thing happens with them as happened with Rezulin?

Chris

Hi Chris,
___Yes, 2 hours is the norm, and in some cases, less than that. But there are some foods that although they are assimilated into the bloodstream very rapidly, they are still hard to digest and hang around in the G.I. tract for some time. Potatoes, milk, and most cheeses are some of them. Bread and pastas are rapid, (I'm surprised your pasta hung around long). To say that they spike your blood sugar really means that the body has little to do to convert to usable blood glucose what's assimilated through the intestinal mucosa. It's kind of like a lemon drop, it'll spike your sugar, but there's a lot left in your mouth yet.
___Your Hba1c is hard to fool. It'll give you your average glucose level over the past three months, and I'm sure your doc will take this.
___If he does give you a glucose tolerance test, which is easily done at his office but I doubt if he will, I would expect you will have a fast rise to a fairly high plateau, which will last beyoond two hours. The normal person generally gets an insulin bounce, which means the glucose level will rise, then fall almost to fasting level, then rise to a stable level. This is why toast and sweets given to the kids when they leave for school will usually make them groggy for a while. Better a steak for breakfast.
___In each GTT I've seen, the person generally comes in fasting. However, a person should continue with his normal lifestyle and diet before the test date.
___My daughter had papillary carcinoma of her thyroid and had to have it removed totally. She has to have her thyroid level checked every four to six months. This will have an affect on your glucose level if it's too low.
___Imdur (isosorbide) is a long lasting nitrate for prevention of angina. You will develop a tolerance for this; however, taking 600mg of N-acetylcysteine will help prevent that. Toprol (metropolol) is an antihypertensive. Neither of these will med-med with the glitizides. If anything, Glucophage will work with Lippy to bring down your cholesterol..likely you'll have to cut down on old Lippy.
___Actos and Avandia are glitizides that function totally different from Rezulin. (In fact, Resulin should never have made it to market...corruption was involved). The glitizides a strong antioxidants and have been found to slow athergenesis and neuropathy by that function alone. Its too bad that some people develop a tolerance to them and they may become useless in about 6 months. The only side affect that's common is weight gain.
___This has been lengthy, and I wrote it all last night, but when I went to push the submit...it all disappeared. So I double checked this all for little white lies...and there are none. God bless,,,,Oldguy

Hi Old Guy:

Thanks for all the information. If I get the reaction you describe from the glucose tolerance test won't I be diagnosed with diabetes? Based on my reactions to food, I would say that if I did it in the am it would probably be normal or perhaps questionable, it I did it in the afternoon or evening it would probably be abnormal. (I mean the 2 hour glucose challenge, not the 3-4 hour test) Since labs don't work in the evening, that won't happen. I would think that at the very least he should do a random glucose test. We'll see I guess.

I don't want to take glucophage on top of lipitor, I want to take it instead of lipitor! Actually I don't want to take it all, it sounds awful, isn't there anything better. I didn't mean I thought the drugs would interact with each other, just that adding another gives me the creeps. If I understand it correctly, imdur is formulated so that you don't develop a tolerance. In fact, if I exert myself in the evening (12 hours after I've taken it) I notice discomfort that I don't notice in the hours after I've taken it. This condition I could have is supposed to also respond to calcium channel blockers and I plan to ask him to switch me from imdur and toprol to a calcium channel blocker to cover the hypertension and angina in one pill. Although I hate to rock the boat, my blood pressure is great.

Both times I ran a test meal of pasta I got the same reaction-abnormal levels for up to 4-5 hours after eating.

Well, thanks again for the info. I'm down to one test strip so I wont be testing for awhile.

Chris