OGTT Results- Advice Needed Please

EeyoreButterfly · #1 (**permalink**) 11-30-2008, 09:35 PM

I posted this on the thread about getting the OGTT approved, but wasn't getting a lot of response. I have my three month follow up on Wednesday so I'm hoping to get some advice in regards to the dicussion I need to have with my GP, especially in regards to requesting an endo appointment:

Well, it's done, and I'm not sure whether I am relieved or more confused.

My fasting was 91 (81 on my meter.)
One hour was 162 (185 on my meter).
Two hour was 160 (175 on my meter).

That is firmly in the prediabetic range, which on one hand makes me feel relieved. On the other hand, I have had readings as high as 280, as of a couple of weeks ago I was having readings well into the 200's several times a times a week. This past week my readings have been a lot lower than they've been, so I'm still kind of wondering what's going on. Were the high readings a fluke or temporary thing? Or the low readings? Oh well, for now I will take it as a good sign.

The only part that sucked was that I dipped down to 45 while on my way to get lunch after the test and stupid me just had one glucose tab left in my purse. :stars: I felt like I was going to pass out. Thank God Panera was not busy and they made my drink quickly (at my request) so I could get my sugar back up. Note to self: next time bring something to eat right away.

On a side note: Several people here have recommended seeing an endo, and my mom wants me to see one. I'm wondering if that is necessary at this point. Perhaps it would be better to take a wait and see approach. These numbers are not very close to the diagnostic criteria for diabetes, so as long as I don't keep going above 200 is there any reason to see an endo?

Funnygrl · #2 (**permalink**) 11-30-2008, 10:18 PM

A lot of people will probably disagree with me, but I do not think an endo is necessary at this point. You're doing a good job seeking information on your own. You're smart. You're following a healthy lifestyle. You know the difference between reliable and bs information. You're monitoring on your own. There's nothing shocking or imminently dangerous about those numbers, and you're paying a close enough eye on things to know quickly if this changes. You're right about those numbers being firmly pre-diabetic. You're doing all the right things and I don't think an endo will add much at this point.

Caravaggio · #3 (**permalink**) 11-30-2008, 11:10 PM

Quote:

Originally Posted by EeyoreButterfly

On a side note: Several people here have recommended seeing an endo, and my mom wants me to see one. I'm wondering if that is necessary at this point. Perhaps it would be better to take a wait and see approach. These numbers are not very close to the diagnostic criteria for diabetes, so as long as I don't keep going above 200 is there any reason to see an endo?

Only you can answer your question. Why do you think you need to see an endo?

You can see an endo to (a) get a confirmation as to whether or not you are pre-diabetic or diabetic given your recent BG numbers, (b) advise you on what to do, (c) give a second opinion and/or (c) hold your hand or give you peace of mind.

You may decide it's too early to see an endo because (a) your BG is in control, (b) your GP is doing fine as your medical doctor, and (c) you read up on your own.

I have T-2 but do not have an endo, as I have a good GP who is doing well as my diabetes doctor. I don't see how an endo will do better.

Harold · #4 (**permalink**) 12-01-2008, 12:03 AM

Typically a type 2 without other issues or meds that could cause it would not go as low as 45. A doctor seeing an office reading for a random glucose level over 200 would say you have diabetes, no pre to it. Yes, I think you should see an endo just in case you have other issues.

Subby · #5 (**permalink**) 12-01-2008, 12:20 AM

You are getting some rather big fluctuations. The hypo was really quite low - and is obviously becoming a danger. The high you mention is really quite high. That the OGTT seems pretty normal doesn't reflect the intermittent fluctations you are getting. In the end it's these fluctuations that define the paramaters of your situation more than the OGTT results.

You sound a little confused about what it all means (as would most anyone in your position). It is certainly a variable, changing situation. If you can get onto a good endo who might shed more light about what stage you are at and what to expect and what exactly to try doing about it (after all they see far more pre and diabetic cases than other doctors), I'd definitely recommend it. What have you got to lose - some cash and maybe a waste of time. On the other hand they may have useful information about your confusing situation. I say go for it.

davef · #6 (**permalink**) 12-01-2008, 03:43 AM

Eeyore,

It does tend to be a personal thing. However you do seem to be struggling with your diagnosis, I would be thinking along the same lines as Harold, if you are seeing numbers around 200 then it is likely that you have diabetes and not pre-diabetes. As Subby has said, you appear to be getting a lot of fluctuations from high to low. So seeing an Endo at this stage may well help you understand your diagnosis as either full blown T2 or something else. If I recall correctly, you have been asking your Doctor to run some other tests but this has not happened, if you see an Endo it is likely they will run all the tests you and they need to make a definitive diagnosis.

Personally I only see my GP, but there was no doubt that I have full blown T2 as when I was checked my FBG was 378 (21) with an A1c of 11.6%.

In reality, what harm can seeing an Endo do? Are you inclined to take the wait and see approach because you don't want to be told you have full blown T2, that would be understandable, but it would be better for you and your diabetes management to get a proper handle on your exact status.

TomB · #7 (**permalink**) 12-01-2008, 07:02 AM

EeyoreButterfly,
Now that you've seen how it's done, you know that an OGTT is not exactly hi-tech. So if you are still concerned, once a month do it yourself. Look around the kitchen and see what you can drink that is around 75mg of sugar. A soda might have 40mg but chugging 2 cans in a few minutes might be a problem. How about maple syrup? Whatever you choose, being consistant is more important than getting exactly 75mg of sugar. You also know that your meter is 10 or 20mg off. This is normal, (try measuring the same drop of blood twice). Record your numbers so you'll be able to detect a trend, month to month. If it blows by 200mg a couple times then it's time to take your data to your doc and see about getting it down.
. One very important item for you to consider: stress can make BG numbers go high and stay high. Take a deep breath, have a glass of red wine and try taking a walk or whatever. Tally Ho, Tom

Rad Warrier · #8 (**permalink**) 12-01-2008, 12:53 PM

Quote:

Originally Posted by EeyoreButterfly

I posted this on the thread about getting the OGTT approved, but wasn't getting a lot of response. I have my three month follow up on Wednesday so I'm hoping to get some advice in regards to the dicussion I need to have with my GP, especially in regards to requesting an endo appointment:

...

On a side note: Several people here have recommended seeing an endo, and my mom wants me to see one. I'm wondering if that is necessary at this point. Perhaps it would be better to take a wait and see approach. These numbers are not very close to the diagnostic criteria for diabetes, so as long as I don't keep going above 200 is there any reason to see an endo?

EeyoreButterfly, I believe it would be better for you to see an endo. The lows you are mentioning are not characteristic of a type 2 diabetic who is not taking insulin or oral medication to stimulate pancreatic insulin production. And random readings above 11 mmol/L (198 mg/dL) are considered diabetic not pre-diabetic. It would also be nice to ask the endo if you require the different antibody tests to rule out type 1 or type 1.5.

On Wednesday, please ask your GP why you are getting the lows quite untypical of type 2 diabetics not on diabetese medication. And also if your 200 mg/dL readings are normal for a pre-diabetic. I hope he/she recommends endo consultation.

Regards,
Rad

Funnygrl · #9 (**permalink**) 12-01-2008, 01:42 PM

The lows are pretty classic reactive hypoglycemia. A person who is insulin resistant but not yet insulin deficient will have a delayed response to the glucose load, causing the body to push out more insulin, eventually resulting in a hard crash, especially when there's no protein or fat to buffer the simple carbs, like in a gtt. The solution is a low glycemic diet with protein and fat accompanying carbs. It's a fairly common part of pre-diabetes.

lorilei · #10 (**permalink**) 12-01-2008, 02:30 PM

EB,
based on your previous posts, I would say you need a new doctor regardless...one that takes you seriously and of whom you are not timid about asking for testing and referrals. If you can ask around a find a good endo, then that would be a great solution...and I still reiterate, if the numbers are not alarming to a doc then stress how you are feeling...people feel differently at different numbers and it has not sounded to me that you feel all that great to just sit around and play the waiting game. Good luck!

EeyoreButterfly · #11 (**permalink**) 12-01-2008, 08:35 PM

Is the low really that abnormal? I mean, I basically drank straight sugar and didn't have anything to eat for three hours. I've never gone that low before, but I don't normally have a meal consisting only of 75 grams of carbs and nothing else. I was under the impression reactive hypoglycemia is pretty common, especially in prediabetes and the early stages of Type 2.

Funnygrl · #12 (**permalink**) 12-01-2008, 08:55 PM

Quote:

Originally Posted by EeyoreButterfly

Is the low really that abnormal? I mean, I basically drank straight sugar and didn't have anything to eat for three hours. I've never gone that low before, but I don't normally have a meal consisting only of 75 grams of carbs and nothing else. I was under the impression reactive hypoglycemia is pretty common, especially in prediabetes and the early stages of Type 2.

No, I don't think it's that abnormal. Straight sugar will do that to almost anyone who's in the early stages of pre-diabetes, and even some "healthy" people. (Healthy in quotes because I don't think diabetes excludes health, I just use the phrase to mean non-diabetic here).

Funnygrl · #13 (**permalink**) 12-01-2008, 10:16 PM

Quote:

Originally Posted by tealas

You need treatment or you're going to exhaust your pancreas.

But the only treatment available or effective for hypoglycemia is a low glycemic/high protein diet, which she's already doing, and an endo won't help much with.

Quote:

I think you need a good doctor

Agreed, and I don't think her GP is that doctor, just because she doesn't seem to be taking her concerns very seriously or ordering all the testing that should be done.