Prediabetes, GTT Advice

[T.R.]

Hi All,

I am new to this forum and need a little advice. I am a 39 yo male 5'8" 15-25 lbs overweight. Mild hypertension (bp averages about 145/94). I eat rather low carb (60-75/day), high protein, high fiber diet. I have a family history of reactive hypoglycemia and T2 DM. I have suspected I've had hypoglycemia related symptoms for the past 20 years. Over the past several months my mood swings and lack of energy have increased.

Recently, I decided to perform my own glucose tolerance test. Bought a One Touch Ultra Mini, increased my carbs 3 days prior, fasted, then drank the 75 grams of glucola. The results prompted me to get an appointment to see my gp.

I checked fasting numbers a few times and it's generally in the 80s.

My dr checked A1C (5.3%) and cholesterol and triglycerides (both a little high except hdl). He said I was fine. I practically had to plead with him to order the OGTT, he did.

I got the results today:
0m - 88
30m - 203
60m - 216
120m - 170
180m - 71
240m - 76
I took my meter along and also checked about 2-3 minutes after each draw.
0m - 84
30m - 180
60m - 209
120m - 200
180m - 71
150m - 57
240m - 63
My readings were close to the lab's except the 30m and 120m when my levels were changing rapidly. Are these meters with finger checking accurate when blood sugar is changing that fast?

At 150m my heart was pounding, I started shaking and I got disoriented, felt I was going to black out. The lab tech took me to the back and gave me water and had me lie down. I remained somewhat disoriented for nearly an hour after that.

My doctor said, through the nurse of course, my 120m bg was high, that I need to see a dietician and that I had had a normal reaction to the OGTT and it was not a hypoglycemic event.

I suppose I will see the dietician and be told to eat <30 carbs per day. I have been more and more frustrated with my dr. especially since the only test he wanted to order was the a1c, not considering that I already ate pretty well.

I am feeling a little lost about what I should be doing to feel better. I would appreciate any advice. Thanks, T.R.

[xMenace]

Are these meters with finger checking accurate when blood sugar is changing that fast?

Meters can be off by 20%. They are not accurate at all. Use them as guides, not absolutes.

At 150m my heart was pounding, I started shaking and I got disoriented, felt I was going to black out. The lab tech took me to the back and gave me water and had me lie down. I remained somewhat disoriented for nearly an hour after that.

150 won't do that. You are likely that high quite often. I'll be frank. You sound high strung and stressed. This whole testing thing and fear of the results very likely got to you and put you over the edge. I've done it giving blood. No biggie.


My doctor said, through the nurse of course, my 120m bg was high, that I need to see a dietician and that I had had a normal reaction to the OGTT and it was not a hypoglycemic event.

You were a bit high, but it is not that abnormal. You have a fantastic A1C at 5.3%! Your doctor is right. I don't care if you tested 1,000 at 120m. If you had an A1C that low, you are doing just fine.


I suppose I will see the dietician and be told to eat <30 carbs per day. I have been more and more frustrated with my dr. especially since the only test he wanted to order was the a1c, not considering that I already ate pretty well.

Less is not necessarily better. Remember you do need carbs to function properly. If you don't get enough, your body will release sugars anyway. You need a balance right for you.

He likely wants the dietician to go over GI and make sure your already limited quantity are slow acting enough and varied enough.



I am feeling a little lost about what I should be doing to feel better. I would appreciate any advice. Thanks, T.R.

Dude! You are fine.A little diet adjustment may be in order, you may need to exercise, but your BGs are doing just fine. Enjoy life!

[T.R.]

150 won't do that. You are likely that high quite often. I'll be frank. You sound high strung and stressed. This whole testing thing and fear of the results very likely got to you and put you over the edge. I've done it giving blood. No biggie.

The 150 was minutes (3 1/2 hours) my bg was 57 according to my meter. I will go to the dietician and give it a try. Thanks for the advice.

[BlueSky]

According to the GTT result, you have what they call Impaired Glucose Tolerance. Your blood glucose at 2 hours was between 140 and 200 mg/dl. The blood glucose dropping down to 57mg/dl at 150 minutes suggessts reactive hypoglycemia. Eating low-carb is a good way to minimise this effect, and to retard progression to type 2 diabetes. If eating like this is working for you, stick with it. A dietician will probably tell you to eat 180+ grams of carb a day, but to split it up into lots of small meals.

[Montana1]

Hello TR,
Now, am I reading your numbers correctly? the number on the left is the minutes and the number to your right it your blood sugars at that time in the test?
I had GTT several months ago. They only did the test at the two hour point after drinking my solution. The result right at the two hr. point was 149. I guess normal is between 70-140. Now yours was at 180-200? right?
This is what my doctor suggested for me:
Loose weight ( I needed to loose at least 20 lbs too)
Go low carb
exercise, exercise, exercise
Take lots of fish Oil.
check blood sugars at least 2-4 times per week.
Did your doctor suggest any of these? If not I would get a glucose meter so you would know where you are at. Workout and try to keep numbers low. I know you will do just fine. Write back and tell us how it goes.
Montana

[T.R.]

Thanks for the replies.

Montana, my 2 hr blood sugar was 170. My doctor's nurse said I do not need a follow up with my doctor and he is referring me to a dietician, so no specific suggestions from him.
I do have a meter. I assume you too have impaired glucose tolerance, so did your doctor tell you which is the best time for you to test, fasting or after meal?
I will update after my visit with the dietician.
Thanks, T.R.

[Montana1]

T.R.
Yes, I have impaired glucose tolerance. My doctor's advice was to test several times per week. I usually test two hours after the first bite of a meal. Fasting numbers are to stay below 126. I test after eating too many carbs, like a pizza meal or such. I am a little obsessive and test alot, maybe 2-4 times per day. This past week my doctor asked me to just test 2 or 3 times per week. I do try to eat very low carb and just recently asked my doctor for a prescription of Metformin. I try to keep my bs below 100 2 hrs pp. I am fairly new at this too, But will be happy to answer any more questions.
Take care,
Montana

[jcbart]

Hey T.R.,

I just had a 2 hour oral glucose tolerance test:

Fasting: 98
30 mins: 139
60 mins: 111
120 mins: 72

My A1c was 5.3. I want to get that below 5. I believe I'm right on the borderline of being prediabetic and I want to control it now. I'm going to a second endocrinologist for a more involved glucose tolerance test.

[Simon]

An A1c of 5.3%. Normal range is about 4 to 6.2% so you're right in the middle already. That's not to say getting your weight in a healthy range isn't always a good idea though.

[Montana1]

JCBart,
Which number in your GTT tells you you are close to being pre-diabetic? It is my impression that the really important bs is the 120m. and yours is terrific in the 70's. I am really new at this, but I think your numbers look pretty normal.
Montana

[T.R.]

Hey JCBart,
Your fasting bg is close to the Impaired Fasting Glucose (IFG) range of 100-125. From what I have read, I think you GTT result is close to normal. It is common to have either IFG or Impaired Glucose Tolerance (IGT) without the other (Isolated IFG , Isolated IGT) with pre-diabetes.

What are you looking for in another GTT? longer time, additional tests? Do you periodically check you fasting BG?