X-posting: Blood sugar too high?

I believe you're well on your way to type 2 diabetes. Your fasting levels are just slightly high, but it's concerning that your levels don't seem to be decreasing very well on their own (like your multiple after lunch readings). You SHOUD be below 100 when you haven't eaten in a few hours, and it looks like your body is becoming insulin resistant enough that it can't get your levels down on its own.

In the progression of diabetes, control over your fasting glucose is one of the LAST things to go, yet an elevated fasting value is usually the first time any docs will pay attention. Once your fasting values are elevated, you've likely already been insulin resistant for years, sometimes as long as 10 years.

Depending on your insurance and your individual doctor, you'll likely be told these readings are nothing to worry about. However, I strongly believe they are an indicator of things to come.
To help your struggling pancreas, you should reduce the number of carbs you're eating (especially things like sugary drinks and refined crappy carbs like Doritos!).

At this early stage of diabetes, an HBA1C won't necessarily be very telling; your post-prandial spikes provide a much better idea of what's going on. Continue taking readings at 1 and 2 hours after meals to see how your body is handling those meals. You're doing the right thing by testing frequently (even though the fingers don't appreciate it!).

Which WLS procedure are you heading for and when?

Hey Jillybean thanks for the response and advice. The Doritoes are a fluke, by the way, as is the soda. I MAYBE have something like what I did for lunch yesterday only a couple times a month but I was running late and didn't grab a lunch from home. I do try to stay away from that stuff especially now that I know I may not do well with it after surgery. Anyway, I will continue the finger sticks since my biggest concern is how high the numbers jumped from what was normal for me.

I am hoping to have the DS at the beginning of the year. I am still in early stages of getting everything put together for the insurance so we will see how long it takes me to get approval.

Those are very 'normal' in range BS for an obese person who will be at risk for diabetes but you aren't in the treatment range yet. Fastings of 120.....post prandials of 150-200 that hover for a while...that's a concern. As others have suggested an A1c - called a glycosolated hemoglobin will give you a trend of your BS that is far more helpful. It's good to be concerned as we all have to be, but don't overthink things at this stage. Discuss with your doctor. s/he'll be pleased with your motivation to take control of your health. Susan

I can't disagree more with everyone who's sayng a HBA1C is a better indicator of how you're doing. I've seen people who have tested in the 200s at times - higher than anyone with normal, non-impaired glucose metabolism should ever test - and yet they still have completely normal HBA1Cs because the spikes are either short-lived or balanced by some lows/hypos. That doesn't make the spikes okay, and they are still an indicator of a problem.

I certainly don't think you need to be put on medication or insulin at this time, but I would certainly start limiting your carb intake (I know you said the Doritos and regular soda were not everday things). If you want to persue additional testing, I would ask for a glucose tolerance test, which is more likely to show if there are issues before an A1C would. Also, while most docs wouldn't acknowledge a problem until your A1C is above 6 (or even 6.5, depending on the doc and insurance), normal healthy adults don't typically have an A1C of higher than 5.5. There is literature that shows that having glucose levels higher than 140 can cause organ damage, so while you're not over 140 all the time, it's wise to be concerned.

I'm so glad to hear you're on your way to a DS - that's the best way to battle (or prevent) type 2 diabetes as far as WLS procedures go.

Jilly, I agree...a 3 month LOG of daily readings has far more info than an A1C. And reading of 6-10 times a day not once or twice.

Now, *I* still consider myself on the border of diabetes because my last A1C was above 6 but it is heading in the right direction. It's not an overnight drop.

MY daily fasting is now 80-98 and my 2 hour post pradial stays under 140. Until this week, I was still on metofrmin. I finally discontinued that and my readings stayed the same so it wasn't doing anything for at least a week or two now. My next A1C should prove interesting.

How diabetes is diagnosed (not for you, Jilly but for those reading this).

The following tests are used for diagnosis:

• A fasting plasma glucose (FPG) test measures blood glucose in a person who has not eaten anything for at least 8 hours. This test is used to detect diabetes and pre-diabetes.

• An oral glucose tolerance test (OGTT) measures blood glucose after a person fasts at least 8 hours and 2 hours after the person drinks a glucose-containing beverage. This test can be used to diagnose diabetes and pre-diabetes.

• A random plasma glucose test, also called a casual plasma glucose test, measures blood glucose without regard to when the person being tested last ate. This test, along with an assessment of symptoms, is used to diagnose diabetes but not pre-diabetes.

Test results indicating that a person has diabetes should be confirmed with a second test on a different day.

http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/index.htm

Liz

I still consider myself diabetic, too, even though my last two A1Cs were 4.8 and 4.9, and my fastings were less than 90. I know by testing myself at home that if I suck down something super carby/sugary (a milkshake, for example), I will still spike into the 200s. I won't stay there long, and it's not as high of a spike as I used to get pre-op, but it's still not normal.

I'm also one of those people who believes there is no such thing as "pre-diabetes." You either ARE or you AREN'T, just like you're either pregnant or you're not. Pre-oregnancy just means NOT pregnant, just as pre-diabetic, to me, means NOT diabetic. I know it's not a lightswitch moment like with pregnancy, but I think giving people that gray area gives too many folks a false sense of comfort ("Well, it's not REALLY diabetes yet, so I don't have to worry about it as much..."). That's clearly not the case with the OP, but definitely for the majority of patients. I do believe you can be early on in the progression of diabetes, but I hate the term "pre-diabetes." In my mind, if you've got abnormally high glucose values (including post-prandial, not just fasting), then you've got diabetes; it's just a matter of how severe or controlled it is. My father has been told he is "pre-diabetic." He's had multiple fasting glucose values in the 110-120 range. I want him to treat it like diabetes, not be passive about it because it's not "full blown"...yet.

While we're at it, I also disagree that someone who has been diagnosed with diabetes should have glucose level goals higher than those of normal non-diabetic folks. For example, aiming for 180 post-prandial means you're still doing damage to your organs. It will slow the progression of your condition more than if you're in the 200s or 300s post-prandial, but it won't stop it. I've seen multiple resources recommending diabetics aim to get their A1C below 7.0. Good lord, an A1C of 7.0 converts to an approximate average blood glucose level of 155, which means you're damaging your organs more often than not, and you're surely not going to prevent the worsening of your condition. Sorry, now I'm just ranting...

* Please note everything I am discussing is specific to type 2 diabetes.

Liz, as you mentioned in your post, most of this is not directed at you, but at others reading   :)

Jillybean again thanks so much for the info. I will definitely talk to my PCP about the glucose tolerance test and see what she says as well as the A1C test. Who knows maybe we can catch this and I can do some modifying now to prevent a future problem :D Happily she is really open to my ideas especially when I can show I have done my homework lol.

Normal ranges are defined like this:

Normal and Target Blood Glucose Ranges Source: American Diabetes Association. Standards of Medical Care in Diabetes—2008. Diabetes Care. 2008;31:S12–S54.

Normal Blood Glucose Levels in People Who Do Not Have Diabetes
Upon waking—fasting	70 to 99 mg/dL
After meals	70 to 140 mg/dL

Target Blood Glucose Levels in People Who Have Diabetes

Before meals	70 to 130 mg/dL
1 to 2 hours after the start of a meal	below 180 mg/dL

Source: American Diabetes Association. Standards of Medical Care in Diabetes—2008. Diabetes Care. 2008;31:S12–S54.

You can see the chart here: http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/

My doctor no longer considers me an active diabetic as my numbers fit itn the normal range and my last A1C was 6.1. I will always have to answer, "were you ever diagosed as a diabetic" with a yes.

Liz

Liz- it looks like the table got "cut & pasted" wrong.

"non-diabetic"  BS nonfasting #'s should all be below 140

Sorry

Pup

Thanks, I fixed it.

Liz