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tovli

Advice On Self Administered Glucose Challenge

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tovli

Ellis Toussier's "Assess Your Pancreas" self administered glucose challenge  (50g glucose from 400cc fresh orange juice) seems like it will provide me with a datum that can be repeated in a year to give insight if my new "lower carb diet" (~100g/day) is sufficient or that I will need to join the "true" LCHF folks.

 

Therefore looking for advice:

1) Time of Administration:  

- I have read ("The FatBurn Fix") that it is desirable to delay carb consumption to lunch or dinner. 

- Does that imply that performing the glucose challenge in the morning, will give different blood glucose readings than performing the challenge at lunch or dinner?

 

2) Fasting Baseline:

- My morning fasting BG readings seem to be about 5 mg/dl higher than before meal readings taken later in the day. 

- Should I plan to do the challenge as my lunch? 

- If it is advisable to take the challenge later in the day, does it matter how long I fast before starting the challenge? 

  - Should I skip breakfast?

 

3) Daily Variability:

- I have seen some people report that a particular food may spike them one day but not the next.  I have questioned if perhaps a differing meal mix was at play.

- How much variability should be expected in this self administered glucose challenge if I repeated the test holding the pre-test diet, pre-test fasting time, and administration time of day consistent? 

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meyery2k

Tough love here but my question would be why you would do something you know is not good for you?  I admit to being curious as to how a glucose test would look like now but I also know I don't work right so I don't pursue it.

 

My opinion is a combination on fasting testing and an a1C every couple months would provide the baseline.  CVS has a 2 pack of at home a1C for about $40.  My experience is they test accurately when compared with a lab result.  

 

I like to test monthly so I found an OK deal on Amazon.  The a1C is my canary in the coal mine since the fasting BG is often the last metric to be affected.

 

As far as the other questions, I think it just demonstrates we are a living organism with many variables and not a machine and this is normal.  In my cycling routine, I never know how I will perform until I start pedaling.  I go out some days feeling strong and put in a mediocre performance.  Some days, I feel bleh and crush it.  No rhyme or reason lol...

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tovli
3 hours ago, meyery2k said:

[1] why you would do something you know is not good for you? 

 

[2] I admit to being curious as to how a glucose test would look like now but I also know I don't work right

 

1) The compulsive engineer in me is always pushing for specifics, measurements, and detailed understanding of everything, to the point of being downright pedantic. 

 

Additionally, did I not know all these years that eating two chocolate covered Krispy Creme donuts for breakfast was bad for me, but when walking past them in the supermarket the wife asks "Do you want donuts for breakfast", did I have the sense to say "No, I would never eat something that tastes divine right now but might be the thing that kills me someday"?  (Wow, terrible run-on sentence but then, my brain is always running off on something.)

 

Actually, the thinking went something like: "I ate at Jon Smith's a lot before, so one more time on my birthday is minor by comparison to the knowledge I'll gain."

 

[2] I don't know have a measure for my "I don't work right." The situation is a medical system that does not think I have a problem, and a slightly pessimistic me that tends to latch onto the "latest thing to worry about".  First it was my prostate cancer, then my abnormal heart, and now blood sugar.

Edited by tovli

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meyery2k

I am a field tech in telecom and I can empathize with that answer since a good deal of my job involves, observation, change, then observation.

 

When I was first dx'ed, I fixated on numbers.  I did that when starting to cycle too.

 

It took some time to unlearn that.  For the diabetes, I just diet LCHF as best I can and exercise after observing the results.  I have tools to measure and I stay within the baselines I have defined.  Cycling, and life in general, became much more enjoyable as I learned to focus less on metrics.  I know cyclists who live and die by metrics and they enjoy that immensely.  That taught me there is room for everyone lol...

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tovli
1 hour ago, meyery2k said:

Cycling, and life in general, became much more enjoyable as I learned to focus less on metrics.  I know cyclists who live and die by metrics and they enjoy that immensely.  That taught me there is room for everyone lol...

 

Data is one of my constant battles.  I don't cycle with power or cadence sensors, but absolutely will not leave the garage without my trusty CatEye started, **AND** my phone running GPS,  **AND** the chest strap tracking heart rate and zone,  **AND** the watch to validate the chest strap.  When I finish, the phone metrics go to Strava and MyHealth, and after validation with the CatEye get entered into annual and lifetime spreadsheets of every cycling session since 1970.  Of course it is overkill, and useless, but I cannot bear the thought of lost data. 

 

Some folks say if you didn't get a photo it didn't happen - If I don't write something down I forget it.  Eventually I will beat myself up for not remembering the name of that 56 mile 7000 foot climb (Mt. Evans Challenge - 1992 Colorado) or the people I trained with for the six months leading up to it, and whether the snowy descents were in training or at the event, (until I go find it in my notes). 

 

I told my cardiologist that my heart rate goes up very, very fast and that I'm a 3-sigma "high beater."  He said he isn't worried about me - "you are running 5k three times a week - your heart is doing great".  "But Doc, what about those pains I feel?" - "You worry too much" he answered. 

 

It may be that worrying about my blood sugar is worse than not knowing about my blood sugar.  (The library just alerted me a Sci-Fi ebook is ready for me to escape into.  I'll probably just start worrying about fictional characters in fictional lives.  I'm a mess, but my wife puts up with me so I'm a happy mess.)

 

I have tried to detox (from my technology addiction) - it is actually scary where my thoughts end up so I accept this is who I have to be.

 

Talk about taking a thread off-topic... Sorry.  Thanks for your replies - it feels good to hear your thoughts.

Edited by tovli

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meyery2k

Always great to meet a fellow cyclist!  I have only really been at it for about 4 years now.  It keeps me in shape after beating a battle with obesity and a sedentary life style.  Like you, I just like to know distance.  I use a simple wheel counter (wireless) computer and it pretty closely checks with my GPS.  I use an ANGI at my family's insistence in case I crash.  My watch also has a GPS and HR monitor and it is good enough for me.

 

I live on the Big Island of Hawai'i and there are amazing rides even right in Hilo, the town where I live.  Hilo is in a bowl right on the water's edge so going anywhere generally means a climb.  If you ever read that shield volcanoes rise gently out of the ocean, I can tell you that is a lie lol...

 

Speaking of hearts - mine will go down to the 40's when sitting and resting.  Always freaks out new doctors and especially nurses.  My PCP (retired) was a cyclist and he knows how much I ride so he says not to worry.  As long as your heart kicks in when needed you are fine.  The nurse at my new PCP measured my pulse 3 times to convince herself it was really 45 bpm.  She then asked if I felt OK.  It really amuses me.

 

That higher reading might be dawn phenomenon.  Your liver releases a shot of glucose into the bloodstream so you have energy to get up and face the day.

 

PM me and we can talk about our bikes and all the other geeky stuff we cyclists love! ~ Mike

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Kit

Ok a few suggestions.

 

Drop the orange juice or, for that matter, any other food item.  You want glucose tabs.

 

The amount of sugar in any food item can vary depending on the particular harvest.  Other elements in the food item in question may also affect absorption rates.

 

Glucose tabs are specifically for diabetics to counter lows.  Each tab has a very specific amount of glucose in it.  When you are having a low, you don't want to have to guess.  It also works very fast, you don't want to have to wait when you are having a dangerous low.

 

You then want to monitor your blood glucose levels for about a week.  Take readings when you wake up, take readings before meals, take readings after meals.  Take readings before bed.  Take readings if you are fasting.  After a week, look at the numbers.  Look at the variations.  You have to factor those variations into the results of any tests you do with the glucose tabs.  That's difficult to do.

 

Also, you are not going to get the data you really need if you want to track your condition.

 

See the problem with T2 diabetics isn't high levels of blood glucose.  That is a secondary symptom, not the primary.  A person who is insulin resistant can eat a high glucose meal and still end up with good non diabetic numbers.  Why you may ask?  Its because the problem is actually hyperinsulinemia, or high levels of circulating insulin.  This is the reason we see new diabetics here all of the time trying to prove they aren't diabetic by eating a high carb meals and ending up with lower than normal BG levels.  Their bodies have to produce very large levels of insulin, which can lead to a reactive hypo response.

 

We don't become diabetic until the insulin resistance gets to a point where our pancreas can no longer produce enough insulin to keep our numbers down.  However, this is still a dangerous health issue.  The root of all of the metabolic diseases (heart disease, high blood pressure, abdominal obesity, high lipid levels, and similar( is hyperinsulinemia.

 

Hyperinsulinemia is THE cause of insulin resistance.  My research over the last almost 7 years has led me to agree with the newer thinking about insulin resistance.  Its not that the insulin key no longer works in the cell's lock.  Our cells are stuffed to bursting with glucose already.  We can't store anymore, there's no more room, and so blood glucose levels finally start to rise.  Obesity is actually just the body's defense against too much glucose.

 

How well that works seems to be tied into genetic factors.  Some people don't seem to have as much defense and will start becoming diabetic and normal weight levels.  Some people can have very large capacities to store that glucose in their cells as body fat.  You can have people at 300+ pounds who have normal glucose levels because their bodies are more efficient at that storage.

 

We become diabetic because modern "healthy" diets aren't even close to being healthy.  They are jammed pack full of heavily processed carbohydrates and industrialized seed oil (canola, corn, cottonseed, soy, sunflower, safflower, grapeseed are the ones I see most often) which get pushed on us as the healthy vegetable oils.  Those oils are also very high in inflammatory omega 6 fats.  I've actually seen some experts say that completely removing the seed oils from your diet is likely THE most effective way to improve your health.

 

BTW - those metabolic conditions were virtually unknown before the mid 20th century.

 

And then we get diagnosed and we spend an amazing amount of energy trying to either keep eating the crap that got us to this spot in the first place or finding replacements for the same crap.

 

To get the information you are looking for, you want an OGTT (oral glucose tolerance test) with insulin assay.  This means that not only do they check your BG levels, they also check your circulating insulin levels.  And it needs to be checked multiple times over around a 4 hour period.  There is no meter you can have at home that will give you this information.  This has to be lab work, which means you need to get a doctor to agree with it and its going to take up a good amount of your day.

 

Honestly I'd love it if I could get my doctor to go for it, but I can't even get my doctor to agree that I should be checking my BG levels at all.  Yeah, she's fired as soon as I get around to finding someone I hope will be better.

 

Edited by Kit

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tovli

@Kit Thank you for your investment to think on my question and your attempt to elucidate this complex subject.

 

I understand and like the concept of using glucose tablets to ensure a more precise 50g glucose challenge dose.

 

I understand your suggestion that I take readings for a week. 

- I have been using the CarbManager app to track my food for several months.

- For a month and a half now, I have been using a Contour Next One meter/strips and a spreadsheet to log

  • Morning fasting glucose 
  • Before Meal glucose (sometimes)
  • Meal Carb Total and Meal foods with portion size
  • 1hr after start of meal glucose every meal
  • 2hr glucose for any 1hr over 140 mg/dl

I believe yesterday I ran into the first "variation" in response as you described, albeit not significant in this case:

- Both my wife and I ate a meal we had eaten before (Eggplant Lasagna, Salad, 4oz Chianti - 51g carbs) 

- We both had surprisingly low 1 hr readings

- This time 1hr: 104 ( my average 1hr over the prior 45 days is 139)

- Prior time 1hr: 120

 

You then state that this "Pancreas Assessment" will not be useful to track my condition. 

 

And after that you totally lost me.  I'll have to reread the rest a few times.

 

Thanks for taking the time for me.  

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Kit
34 minutes ago, tovli said:

 

You then state that this "Pancreas Assessment" will not be useful to track my condition. 

 

And after that you totally lost me.  I'll have to reread the rest a few times.

 

 

I got off on a bit of a rant.  Its valuable information to fully understand this family of diseases, but I realize its a lot to dump on a beginner.

 

http://www.tuitnutrition.com/2015/09/its-the-insulin-1.html

This is a decent starting point on the subject if you are interested.

 

But yes, I do not believe a pancreas assessment is a truly useful tool, because its not looking at what's really important.  If you end up with normal BG levels, all that tells you is your pancreas was able to provide enough insulin to handle the glucose load.  But it doesn't tell you how much insulin it had to produce to do that.  The insulin is the truly useful value.

 

For example:  your BG level goes high.  Is it because your body's cells just can't take up that glucose or is it because your pancreas is making less insulin than average?

 

Or, I can get an idea that there are cats lurking around outside by monitoring the behavior of the small birds in the area.  The more cats are around, the more the birds will react.  But that honestly doesn't tell me how many cats, just how many birds are reacting to cats.  But then maybe the birds are reacting to a hawk that I can't see.  Or there are a couple racoons lurking around.

 

I don't think its totally useless.  I don't think it hurts at all to see just how our bodies react to that load even if its just a reminder that we're somewhat broken and don't do that again.  :)

 

BTW - kudos to you for being proactive.  This is a serious subject that has major affects on our health.

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tovli

The "unofficial test" results are in.  

 

1) What can be learned from the peaks?

2) Can anything be learned from the post test level?

3) (Can anything be learned from this in relation to the datum - 1hr post 110g carb Jon Smiths lunch reading of 217?)

 

(Wife only consented to four test points)

 

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Edited by tovli

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