I need a guide for sugar levels

[lisalu]

Although not "officially" diagnosed with Pre-D, because of risk factors and some high fasting sugar levels, I have taken it upon myself to do occasional testing. (I take all the preventative measures like diet and exercise.)

I need a general guide to what numbers I should be looking for. I did a fasting test this morning and it was 118 which doesn't sound so good. I have had only coffee so far this morning, I'll eat a light (200-300 calorie) meal then exercise for 45 minutes and eat my next meal around 2:00-3:00. I'll eat dinner at 7:00

I know my mealtimes may sound weird but after months of tweaking this is what works for me as far as eating regularly scheduled meals. I'm not hungry until 10:00-11:00 in the morning, then I'm hungry every four hours during the day. But after dinner I eat nothing or a very light snack in the evening. Total about 1200 calories for weight loss and it seems to be working.

Anyway, given this meal schedule when should I test and what numbers should I expect to see? I assume my lowest numbers would be right after exercising (which would also be about two hours after I eat).

Thanks for any advice to get me started. I am currently looking for a good MD who can help me manage this.

[xMenace]

Checking Your Blood Glucose - All About Diabetes - American Diabetes Association (http://diabetes.org/type-1-diabetes/blood-glucose-checks.jsp)

Glucose Monitoring guidelines - Google Search (http://www.google.com/search?q=Glucose+Monitoring+guidelines&rls=com.microsoft:en-us&ie=UTF-8&oe=UTF-8&startIndex=&startPage=1)

[xMenace]

Your morning fasting numbers are a big indicator of changes. Do that at least once a week.

Your pre-prandials should be around 90 to 100. Your 2 hr post-prandials should be 140 or less; though sites will tell you 180.

I'd recommend a fasting and one meal's pre and post prandials a week plus a bedtime test. You are looking for longer term trends. You don't need to test every meal every day unless you are on insulin or are running high. If you start running high, increase your testing. Beware of meter fluctuations and variability too. If you have a bad test, retest it after washing our hands.

Your meal times are a non-issue.

[princesslinda]

To get a good overview of how your levels are running, i'd check them at different times on different days....one day check pre and post meal #s...one day fasting #s...one day random.

You may find your blood sugars elevate after exercise..I know mine do at times.

Post meal #s should be under 140....personally I like to keep mine in the 120's or less as I have tested my non-diabetic husband 2 hrs after a meal and his #s are regularly under 100 at the 2 hr level. His fastings are generally in the 80's as well.

According to the normal values for fasting blood sugar on my lab sheets, normal fasting blood sugar is 70-99.

The closer to "normal" levels you can keep your blood sugars, the better off you'll be.

[lisalu]

You guys are so helpful. Thanks for taking the time to educate me - my own doctor didn't give me this much info!

So one day of testing for the first time:

AM fasting: 118

Post exercise/before lunch (after a very light breakfast):108

Exactly two hours after lunch: 103

I'll check again at bed time and then maybe just do some random time of days for a while to compare. Funny, so far my fasting level was the highest. ?????

[matingara]

Hi Lisalu!

i am pretty new to this also - being diagnosed Type 2 in July of this year.

i am on the half max dose of a medicine called gliclazide. the Doc said i can stop that if my A1C goes below 6. Based on my calcs (from testing over the last 4 months) i hope to come in at 5.3. i am getting it done next week! fingers crossed!

i started out testing 6-7 times a day. my D. Educator had told me to do it twice a day - but i wanted to know what was going on. she reprimanded me for my amount of testing and i told her flat out that i wanted to understand what certain foods did to me.

i switched to a restricted carb diet and my numbers have been very good for the most part. i have scaled back my testing now and i test 4-5 times a day. after i get my A1C result next week, if it is good, i will probably scale back even further.

the last day i did 7 tests was Nov 9th and here are the results:

fasting/waking: 79
2 hrs after bfast: 77
pre lunch: 83
post lunch: 110
pre dins: 90
post dins:139
before bed: 112
next morning: 97

looking back over the November diary i see that my lowest fasting number was 74. my highest fasting number was 119.

my lowest reading for the month of November was 59 (after skipping breakfast one day).

my highest reading for the month was a 178. post lunch on the 19th of Nov. not sure what i ate. probably a sandwich - bread (of any type) really gets to me.

i hope this info is of some use!

:)

-- Joel.

[matingara]

my highest reading for the month was a 178. post lunch on the 19th of Nov. not sure what i ate. probably a sandwich - bread (of any type) really gets to me.


i should also add that after that 178 my bgl dropped to 119 (after exercise) before dinner and then down to 106 AFTER dinner (what is up with that?).

by the next morning it was down to 95.

-- Joel.

[Ronin]

Hi Lisalu!

You have asked a common question from the perspective a a Pre-Diabetic diagnosis.

Fasting levels are used as part of the diagnostic process and the guideline is that FBG levels should be below 100 for someone who is not Pre-D. However, the high FBG needs to be followed up with an HbA1c test that will show your 90 day average BG levels (actually weighted average leaning towards the last four to six weeks). This will confirm where your body is working/not working at managing BG levels. If this shows you in the Pre-D range they you need a Oral Glucose Tolerance Test (OGTT) with C-Peptide values to diagnose not only if you are becoming diabetic but if you are headed towards Type-2 (high C-Peptide readings) or a Type-1.5 (low C-Peptide readings).

Use your meter to learn about your body and how it works with carbohydrates. Don't be overly concerned about the "numbers" unless they go above 200 post prandial or if the HbA1c says you have a problem.

[sweetblood]

what about 200 plus randoms...what does THAT mean...along with runs of normal bgs no matter what i eat...maybe a wk of bgs under 150 randoms that is...

[sweetblood]

2 hr post prandial is normal UNLESS i take predinisone than 2-3 hr pp is 160-170...what does THAT mean...im so confused...could i be headin to the big D?/

[sweetblood]

BTW...a1c is normal at 5.1 last check...but i DO get hypos in 50s...

[Ronin]

Hi Sweetblood!

Are you on any kind of medication that will influence your BG levels? Your HbA1c would indicate that you do not have diabetes. However, if your BG is fallling into the 50 range and you are not on medications this is probably the indiaction of some other, and potentially more serious, problem.

[sweetblood]

like what kind of problem??

drs just kinda shrug it off or ignore it wen i mention hypos...so i no longer tell drs abt it...

i dont think meds im on influences bg levels, but u never know...

[sweetblood]

i think i just need to eat every 3 or 4 hrs to prevent hypos...altho im always sucking on regular soda so youd think that would prevent hypos...

[drsanjaynayak]

Dear Ronin
how did u know you were a Pre D ... was it a routine test?? or was the Hb 1Ac high and then controlled?? lurking among the posts of prediabetics i have seen many having a high Hb1Ac ( more than 10 sometimes) and then low once they come toknow of their condition
sanjay

[Ronin]

Hi Sanjay!

My diagnosis of Pre-D is the result of a long process with lots of testing. The confirmation was the C-Peptide reading that is at the very low end of normal, despite a FBG consistently above 100.

At present my body handles sugars largely due to the amount of exercise that I get daily despite the low insulin production. It just takes me a bit longer than "normal" to get it down. Therefore, all factors considered, I am a Pre-D probably headed towards insulin dependence at some time in the distant future.

For the time being I am holding my own with a combination of diet modification and exercise. How long will I stay this way? Nobody can be sure.

[lisalu]

I just need a general answer here:

Since I've been doing my testing just to keep an eye on things (and having little knowledge of what the numbers mean) I just want to know is it a GOOD sign or a BAD sign if my numbers remain pretty much the same throughout the day - not a lot of variation.

All my readings have been between 100-130. Is it bad to never go under 100?

I am still looking for an MD, it will probably be after the first of the year before that happens. So meantime, I want to learn all I can about my risk and how to prevent full blown diabetes.

Thanks! (I am not on meds of any kind, BTW)

[Harold]

I just need a general answer here:

Since I've been doing my testing just to keep an eye on things (and having little knowledge of what the numbers mean) I just want to know is it a GOOD sign or a BAD sign if my numbers remain pretty much the same throughout the day - not a lot of variation.

All my readings have been between 100-130. Is it bad to never go under 100?

I am still looking for an MD, it will probably be after the first of the year before that happens. So meantime, I want to learn all I can about my risk and how to prevent full blown diabetes.

Thanks! (I am not on meds of any kind, BTW)At 100 to 130 you might eventually develop some complication or you might find your readings increasing. Keeping your readings in the 80 to 110 range you probably would avoid any complications including developing Syndrom X or even full blown Diabetes.

[lisalu]

Okay, thanks for the info. Only thing, I have no idea HOW to get it lower! I already have an extremely healthy lifestyle. I exercise 45 minutes a day and eat healthy (very little or no refined carbs). I have recently lost about 20 lbs.

I'm so afraid a doctor is going to try and put me on meds...I want to avoid that if at all possible!

[Ronin]

Hi Lisalu!

I went back over the postings you have made so far. While you may be diagnosed Pre-Diabetic that is not the end-of-the-world. As I said in a previous post -- daily monitor readings are only part of the story, the smallest part in the diagnostic process.

If your MD wants to put you on diabetic meds based only on FBG levels my advice is to find a better MD. The proper follow up to a high FBG is an HbA1c test. If that is in the Pre-D range then a OGTT with C-Peptide readings is necessary to confirm the diagnosis.

I've been in the place you are at right now -- frightened, confused and in a panic. That is normal, however, you cannot live there. The only way to know where you are at is to get the additional testing because in this condition knowledge is really power.

One book that helped me to understand the whole process is: Know Your Numbers, Outlive Your Diabetes by Jackson and Tenderich. There is a chart that lists all the tests required for diagnosis and where your values should be. It also has specific recommendations for any numbers that are out of normal range.

In the mean time, realx a bit and enjoy your life. Obsessing over this condition only damages your life (I know, I was in OCD Overdrive when I first heard the words "Pre-Diabetic.)

[lisalu]

Thank you. Yes, I will try to find that book. Then maybe I can better understand it.

My MD didn't diagnose Pre-D, she never said anything to me at all except that my FBG was high. Since I know I have several risk factors, that really made me sit up and take notice. I didn't care for the lack of info I got from her which is why I am seeking a new MD and in the meantime trying to figure out where I stand. I am a firm believer in taking responsibility for my own health as much as I can and I want to control/prevent Type 2 if there is any way possible.

I appreciate everyone here taking the time to answer my questions. :)

[Spike Jones]

Hi Lisalu,

I'm in a similar situation. I started measuring a few months back, and found regular FBG levels of 108, which I knew to be high-ish. I thought this was new information, so went back to blood test results that I got last May and found, to my surprise, that the tests indicated the same. Looking at the other numbers from the same tests, I found high triglycerides and high LDL, and, along with being about 25 lbs overweight, the indicators were all there. The numbers that could have clinched it, like the A1C, weren't part of that particular series.

I got mad at the doctor, and just came back from my appointment this morning to ask for a full slate of relevant tests (A1C etc.). I asked the doctor why she hadn't brought this to my attention half a year ago, and she said that there weren't enough additional risk factors (blood pressure, early heart attack), and that (most interestingly) she'd been catching flak from the diabetes educators who accused her of over-diagnosing the condition and sending too many people their way. Sometimes, the doctor's got a reason. I can't tell if that was a good or a bad reason, but it was a reason.

It just says that we have to educate ourselves. My appointment with the doctor was much more productive today because I was armed with all my facts, and I could help bring salient information to her attention that she hadn't thought to ask for. A lot of doctors get bent out of shape when we try to 'help,' but she didn't and she listened, which I appreciate.

[drsanjaynayak]

folks
i tested the moment i got up today and it was 112 and after an hour of my daily walk it was 86 and then about one hour later it was 94 and all this was on empty stomach . i want to know whether
1)the high BS in the resting state is normal .....
2) Fasting blood sugar can be done after exercise?? ( Thats what my Med told me)
3) C peptide levels testing should be done at fating or postprandial ?? or with Oral GTT. Can it be done independently??
4) every time i test after a walk its in the range of 85 to 90 and postprandial varies like 124 to 145 . Am i prediabetic ?? can i reverse this condition?? can i delay the onset of the BIG ' D' by a few years . i have a small daughter and it scares me to death of my family losing me . i am depressed sometimes too and stress also raises the BS . i am not on any medications at the moment and i do not want my pancreas to get into sleep mode
please help

[Ronin]

Hi Drsanjaynayak!

All of your questions are good ones, I'll give you answers based on what I have learned.

1)the high BS in the resting state is normal ..... 112 is high, but that is likely due to the Dawn Effect/Phenemon which drives us all just a little bit crazy.

2) Fasting blood sugar can be done after exercise?? ( Thats what my Med told me) Yes, you can do your FBG whenever you want as long as you are still fasting. As most of us get fasting values for venious values we're usually out of bed and active for some time before we get tested. (Does anyone do their own blood draws at home?)

3) C peptide levels testing should be done at fating or postprandial ?? or with Oral GTT. Can it be done independently?? C-Peptide levels can be done separately from other testing and a fasting level is part of the OGTT protocol.

4) every time i test after a walk its in the range of 85 to 90 and postprandial varies like 124 to 145 . Am i prediabetic ?? can i reverse this condition?? can i delay the onset of the BIG ' D' by a few years . i have a small daughter and it scares me to death of my family losing me . i am depressed sometimes too and stress also raises the BS . i am not on any medications at the moment and i do not want my pancreas to get into sleep mode. I cannot, and should not, offer any diagnosis. Only a qualified MD can make a diagnosis. What I can tell you is that all of us have been where you are at one time. Fear is a large part of the problem and when we are afraid our thinking processes disappear.

As far as avoiding "The Big 'D'" that is the open question. Genetic theory says that if you have a predisposition towards developing diabetes you can delay but not prevent it. The environmental theory says that your diet and exercise patterns make the condition happen and getting into good diet and exercise patterns will prevent the condition from forming.

The upside is that adopting a healthy lifestyle cannot do you harm, it may delay or prevent the onset. Clearly you have already done someting to bring your A1c down. I am surprised that with an initial A1c of 12.1 your MD didn't get an OGTT done.