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Help - I've got one 116 fasting glucose reading

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#1
tomgriffith

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I was labeled prediabetic with one 116 reading from a 10 hour fasting glucose test. My doctor didn't give me squat for information, just platitudes about losing weight and exercising more.
I run 30 - 50 miles a week and have a body fat content of 11% at age 46.
I've got another 10 hour fasting glucose test tomorrow and a referral to a diabetic dietician.

My first question - does marathon training elevate glucose levels? Part of the education for marathon training talks about the kind of running I do is designed to improve glycogen storage by as much as 40% over non marathon training folk. Does this change things?

Second question - If this next 10 hour fasting glucose test gives me a prediabetic reading, what should I ask for next in the way of testing? I belong to Kaiser and don't have a lot of confidence that they will be proactive in this. If I push they will probably just go straight to drugs - something I would prefer to avoid if possible.

I'm pretty worried about this and would appreciate any advice this forum can give to help me figure out what to do next.

#2
xMenace

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116 isn't outlandish. Typically diabetics in your physical condition progress pretty quickly as they usually turn out to be type 1.5s. Type 2's are typically insulin resistant due to combinations of genetics and metabolic syndrome (no I don't wish to debate this in this thread!). You don't fit the typical slow progressing profile we see here. But of course we're not doctors.

I'd ask for a Hemoglobin A1C test. It's a measure of your longer term sugar levels. It's what we all use. If it's pushing 6, I'd be concerned. If it's closer to 5, pfft!

Improved glycogen stores triggers alarms with me re the "dawn phenomenon." It may be a simple case of you having a freakishly high DP that's raising your fasting numbers. I'd also like to see your two hour post prandial readings for each meal. Do you have a glucose meter?

Virginia Woolf: “Consider how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness, how we go down in the pit of death and feel the waters of annihilation close above our heads and wake thinking to find ourselves in the presence of the angels and the harpers when we have a tooth out and come to the surface in the dentist's arm-chair and confuse his "Rinse the mouth-rinse the mouth" with the greeting of the Deity stooping from the floor of Heaven to welcome us - when we think of this, as we are so frequently forced to think of it, it becomes strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature”
Back on MDI and doing well. Trying Victoza and loving it. A1C 6.0, no major hypos; a few highs; lots of shots. Diagnosed Oct 19th, 1975.
HDL-101; LDL-64; TG-36; TOT-172


#3
BrianSCohen

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Although you might think that diabetes is caused eating twinkies all day, sit on the couch getting fat, it is really more complicated than that. Being overweight is just as likely to be a symptom of diabetes, which you have avoided because of your activity level. You may very well could have emerging diabetes. In fact, endurance activities might accelerate the emergence, particularly if you push yourself into overtraining. The stress related to these activities is not necessarily good for your health, and can contribute to elevated blood sugars.

The bottom line, keep an eye on things. Should you really be an emerging diabetic, you can still deal with that by modifying your diet to restrict carbs and changing your exercise a bit. You might want to consider moderating your endurance running with a mix of strength training. Just because you are diabetic, does not mean that you can't lead a long, healthy and complication free life.
...brian

T2 since 7/05. 48 yrs. 5'11 195 lbs.
Exercise, very low carb diet
HbA1c 9/07 - 6.3%, 3/08 - 6.2%, 6/08 - 6.2%

#4
volleyball

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I would not trust a doctor who said lose weight to a person with 11% bodyfat. At 11%, I'd suspect you have a two, four or six pack. If you are paunchy like a lot of runners, your processed carbs are too high and I could understand the doc's comment.
So a diet makeover may be all that is needed.
I would get the doc to run further tests to see what type you may actually be and to get a meter and test strips
Diabetes is a condition that you have to manage or it will manage you. The care team is only there in a supporting role

#5
tomgriffith

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Thank-you for responding.

Brian, I didn't mean to imply anything about diabetics bringing it on from being couch potatoes; I was sharing the seemingly knee-jerk response about weight and excercise from my doctor and wondering if distance running affects glucose levels.

My Hemoglobin A1c is 5.6 in the same testing period I had the fasting glucose of 116.

This morning they took blood, said I was at 100 then had me do the 2 hour test after taking some drink. I'm still waiting for those results.

I also have a referral to a diabetic dietician after the I asked my doc about specific diet advice.

I also incorporate basic strength training into my week to keep myself in balance (rather than just a set of lungs on legs)

My main concern has been my doctor's apparant lack of knowledge in the area of diabetes and prediabetes. I'm having to push Kaiser to follow-through.

I found this forum because I'm trying to learn enough to be able to get a sense of what Kaiser is doing (or not doing). What I don't want is to ignore an emerging issue or overreact if there is no real issue. Or have them do what they've done in the past, start prescribing meds that address the symptoms rather than the cause.

#6
soso

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my advice FWIW..get a meter and check your 2 hr after meal numbers for a week.. that will tell the story..
I was diagnosed with an A1c of 5.4 when running 5 times a week in the best muscular shape I was ever in.. 2 yrs later I was on insulin...
SoSo


Dx Sept 2004
A1c 5.5
MDI

#7
David_S

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You know being pre-diabetic isn't a diagnosis of one type over the other.. I was in good shape .. tall , thin and in shape from walking delivering mail 6 days a week. I guess the process for me becoming diabetic was slow over time as my beta cells were " killed off" and I am type 1 not type 2. I never had blood work prior to the diagnosis .. say a year prior showing any raise in my numbers.. so i have no idea when that all started. But I imagine if I had at some point the rising number would have been pointed out to me.. but I would never have guessed in a million years that I would have type 1 at age 37.
[SIGPIC][/SIGPIC]Diagnosed 1.5 10/20/06
Pittsburgh,PA.
Lantus 10 units PM
Novolog to scale and 2 units at dinner

A1C 10/23/2006 14.2 :eek2:
A1c 03/23/2007 6.3 :nurse:
A1c 02/25/08 6.1 ;)
A1c 06/26/08 6.3 :smile:
A1c 10/23/08 6.5 :dontknow:

#8
Real4

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My first question - does marathon training elevate glucose levels? Part of the education for marathon training talks about the kind of running I do is designed to improve glycogen storage by as much as 40% over non marathon training folk. Does this change things?


The training should elevate the stored glucose within muscle, not blood glucose. The specific task of insulin is to "move" (with a lot of details) glucose from the blood into the cell, most especially into the muscle cell. That should keep blood glucose levels normal ~ 85.

The fasting glucose test you took measures your body's response to a high level of glucose. It's OK, if your blood glucose level goes high for a short period, but it should then rapidly decrease to the normal level. If it doesn't, then there is a problem.

#9
Tropo

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I was labeled prediabetic with one 116 reading from a 10 hour fasting glucose test. My doctor didn't give me squat for information, just platitudes about losing weight and exercising more.
I run 30 - 50 miles a week and have a body fat content of 11% at age 46.
I've got another 10 hour fasting glucose test tomorrow and a referral to a diabetic dietician.

My first question - does marathon training elevate glucose levels? Part of the education for marathon training talks about the kind of running I do is designed to improve glycogen storage by as much as 40% over non marathon training folk. Does this change things?

Second question - If this next 10 hour fasting glucose test gives me a prediabetic reading, what should I ask for next in the way of testing? I belong to Kaiser and don't have a lot of confidence that they will be proactive in this. If I push they will probably just go straight to drugs - something I would prefer to avoid if possible.

I'm pretty worried about this and would appreciate any advice this forum can give to help me figure out what to do next.


You're in better condition and exercise more than 99.9% of the population so a fasting level as high as that could be quite significant.

I just cannot believe what your doctor told you. Lose weight? Exercise more? That's unbelievably pathetic. You definitely need a new doctor.
HbA1c's

Oct 07 -- 5.7
Apr 08 -- 5.7
Jun 08 -- 4.9
Sep 09 -- 5.5
Jan 10 -- 4.8

No medication yet.

Exercise daily.

#10
shutterbug

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Like others have mentioned, check if you are type 1.5
Welcome to DF
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Diagnosed - 02/28/08

A1C - (8/10/2009= 5.7; 03/02/09 = 5.6 ; 12/29/08 = 5.8 ; 09/17/08 = 5.5 ; 05/27/08 = 5.7 ; 04/03/08 = 7.7 ; 02/29/08 = 10.1)

____________________________________
Diet and exercise only since 01/15/09

#11
Ronin

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Hi Tom!

Welcome to the club you never wanted to join.

From your description of the test as well as your HbA1c results your high reading could have been from what is know as the "Dawn Phenomenon" -- simply explained your liver, reading the signals from your body early in the morning when you need energy, dumps a lot of glycogen into your blood stream and your BG goes up. This should be a very short lived incident but the test could be an indicator of trouble ahead.

There is one test you need to demand -- a C-Peptide reading. From the description of your MD's response you will need this information to get a solid diagnosis. I'm going to go out on the proverbial limb and speculate as others here have that you are most likely a latent Type-1.5. A low C-Peptide value will confirm this. It means that your pancreas is working albeit not as efficiently as it had in the past.

This is important because most MD's see any adult onset high FBG levels as an indicator of Type-2 and prescribe drugs to increase sensitivity to insulin. That works for Type-2's but is a flop for Type-1.5's because they don't have sufficient insulin in the first place.

So, demand that C-Peptide test (make sure to have the lab send you a copy of all tests in the future) and let us know what is happening.
Be well, do good work, and keep in touch
[Garison Keilor]

Ronin (a.k.a, George N. Wells, CPIM)
Tandemist/Lay Theologian
Enjoying Life and Learning about myself everyday.

Pre-D -- Not on Insulin :D (yet) :eek:
For Cholesterol though:
2500 mg Niacin
5 mg Zocor
2013 Cycling Miles: 4880 (31 Dec)
2014 Cycling Miles: 4615 (17 Dec)

Fasting C-peptide 1.4 (02 Oct 08)

HbA1c's:
 
01-Aug-2014 -- 5.2%
01-Sep-2014 -- 5.5%
01-Oct-2014 -- 5.7%
01-Nov-2014 -- 5.7%
01-Dec-2014 -- 5.5%

#12
BrianSCohen

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Thank-you for responding.

Brian, I didn't mean to imply anything about diabetics bringing it on from being couch potatoes; I was sharing the seemingly knee-jerk response about weight and excercise from my doctor and wondering if distance running affects glucose levels.

My Hemoglobin A1c is 5.6 in the same testing period I had the fasting glucose of 116.

This morning they took blood, said I was at 100 then had me do the 2 hour test after taking some drink. I'm still waiting for those results.

I also have a referral to a diabetic dietician after the I asked my doc about specific diet advice.

I also incorporate basic strength training into my week to keep myself in balance (rather than just a set of lungs on legs)

My main concern has been my doctor's apparant lack of knowledge in the area of diabetes and prediabetes. I'm having to push Kaiser to follow-through.

I found this forum because I'm trying to learn enough to be able to get a sense of what Kaiser is doing (or not doing). What I don't want is to ignore an emerging issue or overreact if there is no real issue. Or have them do what they've done in the past, start prescribing meds that address the symptoms rather than the cause.


Tom,

I did not mean to imply that you thought that diabetics were couch potatoes, just that is a popular misconception (even with doctors) and that doctors are frequently minimally competent and as you note give knee jerk reactions when obviously that is bad advice.

You do need to understand that when you exercise, you affect your metabolism and blood sugar in ways that are not observed in normal populations. When I weight lift, my blood sugar rises dramatically. As I noted, if you are pushing yourself, you could cause ongoing stress which affects your blood sugar. A HbA1c of 5.6% is good, but given your athletic background a foreshadowing of some emerging diabetes.

Yes, your doctors, particularly Kaiser are not going to give you the best advice and may actually be pretty useless in some areas (like nutrition). Your biggest problem is going to be balancing the best diet for managing diabetes, which most people believe is a low car diet against the argument that endurance athletes need high carbs to maintain energy levels. You are going to have to become an expert on these issues and decide yourself.
...brian

T2 since 7/05. 48 yrs. 5'11 195 lbs.
Exercise, very low carb diet
HbA1c 9/07 - 6.3%, 3/08 - 6.2%, 6/08 - 6.2%

#13
tomgriffith

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Okay, my latest test was a fasting glucose followed by a 2 hr post GTT

Glucose, fasting 100 H
2.0 Hr post-GTT 100

So my doc, when specifically asked just said "Your Fasting blood glucose is 100, normal Fasting blood glucose is 99 or less. 99 is just one below 100."

I asked what a no change result of 100 after 2 hours post GTT means and he gave me this
"Your 2hrs post fasting glucose is within normal limits. There are many variable involved, ie fluctuation of metabolism in the body that has the ability to increase or decrease glucose concentration to maintain a normal state by various hormone and enzymes beside what you eat and digest.
Differrent batches of testing with different control may play a role as well"

This means basically nothing to me.

Any thoughts from the forum?

-Tom

#14
ShottleBop

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You need a doctor who knows more about diabetes than this one does?
Functionally, a Type 2 (missed the label by th-a-a-a-a-t much)
Dx prediabetic 02/08 (FBG 127 and 123), A1c 6.5
So far, controlled without meds.

#15
tomgriffith

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That one I had already figured out. I do have an appt to talk to a diabetic dietician in two weeks. I figured it can't hurt.

#16
Tropo

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That one I had already figured out. I do have an appt to talk to a diabetic dietician in two weeks. I figured it can't hurt.


That 2 hr post GTT reading is low and nowhere near prediabetic.

I think you're worrying too much at this stage. I would suggest you get your own meter and test your FBS levels regularly as well as your 1 hr and 2 hr post prandial readings. Eat your normal diet while testing so you can monitor your normal responses to what you always eat.

I also think you should get an HbA1c test done to see how you've been doing over the last 3 months BEFORE you start modifying your diet.
HbA1c's

Oct 07 -- 5.7
Apr 08 -- 5.7
Jun 08 -- 4.9
Sep 09 -- 5.5
Jan 10 -- 4.8

No medication yet.

Exercise daily.

#17
tomgriffith

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I met with a dietician/nutritionist specializing in diabetic issues.
She felt that I'm probably not prediabetic, but that my liver dumps a lot of glucose into my system in the morning, creating the high fasting level. She said over time this could place stress on my system. She recommended managing my diet so that my "fasting" period is a short as possible. She also got on me about other diet composisitions. I'm making those changes and will go on with what I'm doing and have it checked again in a couple of months.
Thank-you for all the responses and suggestion in this group. It has been tremendous help for me gaining an understanding of diabetes and prediabetes, especially from a psychological standpoint.

#18
harryjacobs

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Glad you are getting retested, it could just be an anomoly for some strange reason, as indicated the liver could have just dumped some sugar into your blood stream. But 116 is not panic mode. My yourself a meter and test yourself and see what happens through out the day.

As for marathon training, I can tell you from experiance. When I trained for my marathon I had the time of my life pretty much being able to eat a few extra carbs a day. After a 20 mile run on sunday my treat of the week was to go to starbucks and have a grande Chi Latte, and I would test myself when I got home and I did not budge over 90.

While Excercise can bring your Blood sugar up for shorter activites, Running over 1 hour you are not going to see a rise in your blood sugar at all. In fact your body takes very little sugar out of your blood when you are running those long distances.

I ran a marathon on basically 50/50 gatorade and water. Eating one pack of Cliff blocs 25gm of carbs. Through the marathon. After the event was over that is when you have to be careful when you start fueling those muscles. It sucks blood sugar like mad.

So don't give up the marathon running, I haven't. my arthritis has more of an impact on my running that my diabetes Type II has.
Harry Jacobs

A1C November 3, 2008 5.4 (no meds, diet and exercise)
Blood pressure 116/56 (thanks to meds)

http://thediabeticrunner.blogspot.com

#19
xMenace

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She felt that I'm probably not prediabetic, but that my liver dumps a lot of glucose into my system in the morning, creating the high fasting level. She said over time this could place stress on my system.


I have a high dawn phenomenon (DP) too. My testing suggests that my liver sugar releases are pretty stable, and it's more my insulin resistance that fluctuates rather than sugar output. The simple fact that my morning insulin:carbohydrate ratio is higher prooves this. My morning I:C is 2.5 comparesd to 1.0 at lunch. My morning average basals are 3.2 times my afternoon average basals, so roughly 75% of the increase is due to resistance while 25% is due to increased sugar release.

:confused:

Virginia Woolf: “Consider how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, what ancient and obdurate oaks are uprooted in us by the act of sickness, how we go down in the pit of death and feel the waters of annihilation close above our heads and wake thinking to find ourselves in the presence of the angels and the harpers when we have a tooth out and come to the surface in the dentist's arm-chair and confuse his "Rinse the mouth-rinse the mouth" with the greeting of the Deity stooping from the floor of Heaven to welcome us - when we think of this, as we are so frequently forced to think of it, it becomes strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature”
Back on MDI and doing well. Trying Victoza and loving it. A1C 6.0, no major hypos; a few highs; lots of shots. Diagnosed Oct 19th, 1975.
HDL-101; LDL-64; TG-36; TOT-172


#20
EeyoreButterfly

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Looks like you dodged a bullet there. To the best of my understanding, it takes two readings to diagnose prediabetic or diabetic unless it's way out in outer space. You can see why from your own experience.

Typically they say your fasting blood sugar should not be above 99. 100 isn't that far off the mark. Your post meal should be under 140. For your two hour test you were at 100- that is great!

Did you say why you were tested in the first place? Was part of a routine exam or were you exhibiting symptoms of some sort? Either way, it wouldn't hurt to keep an eye on it, especially your fasting readings since that seems to be your problem, but at this point it sounds like there is no need to worry.
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One Touch Ultra Mini Purple named Rosalie
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