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  • Confused about blood glucose numbers

    During a health checkup the fasting blood glucose of 102 came up. The doctor recommended me to be more active and eat less carbs. I'm 37 years old, male and my BMI is 24. Afterwards they also measured the A1C, which was 4.8%.

    To be honest, I was kinda surprised about the fasting blood glucose. My diet the 3 months before the test, was kinda mixed and not primal. Probably around 200-250g carbs per day. My parents and brother have a fasting blood glucose of 80 to 90.

    I would like to react to potentially problems early, therefor I got myself a glucometer.

    Fasting:
    96, 101, 95, 96, 99, 92, 106, 107, 94
    (The values of over 100 were measured after eating a lot of carbs the night before. The other ones during eating low carb for two weeks.. around 100g of carbs per day)

    Post meal glocuse was mostly okay. When eating around 40-50g carbs, the glucose was mostly around 120g one hour afterwards and around 95g after two hours.

    Two more extreme tests looked like this:

    150g Chocolate cookies (90g carbs, 37g fat, 9g protein)
    before: 91
    1 hour: 131
    1 hour 30 mins: 90
    2 hours: 122
    2 hours 30 min: 123
    3 hours: 123
    3 hours 30 mins: 90

    75g Glucose Drink from the pharmacy
    nüchtern/davor: 94
    30 min: 175
    1 hour: 178
    1 hour 30 mins: 147
    2 hours: 123
    2 hours 30 mins: 107
    3 hours: 64

    I now went to another doctor to get second opinion. He also lists diabetes under his specialities.

    His opinion was that the fasting blood glucose of 102 was normal, because it was measured around 10am and after 12 hours of fasting. Cortisol and other hormones simply raised the glucose. He also said that the other fasting values in the mid-90s and the home-made OGTT are also okay. The extreme spike during the OGTT is normal and that the value after two hours matters.

    To be honest, I was a bit surprised that he was so relaxed about it. I've read that starting with a fasting blood glucose of 90s there can be potential negative consequences and that a lot of people make the mistake of assuming that 99 is perfectly fine and with 100 you you all of the sudden have prediabetes.

    Regarding the OGTT, I've read that the value after 2 hours is relevant for diagnosis, but that extremes spikes before that are also not normal.

    What's your opinion on this? Is this really normal or should I seek a 3rd opinion?

  • #2
    Yup. Fasting is fine in context of what your A1C is and your OGTT. No worries. Keep up the good work.

    One test does not a diagnosis make. Clinicians need to take in the full picture when it comes to assessing metabolic function. A bit high on fasting glucose could be a problem if your A1C was say 6 or more....or your OGTT was off. But when those others are good....well then it's just that FOR YOU a waking fasting glucose lvl in the 90s is normal.

    All these tests basically derive their cut off points via population studies. Averages of "healthy" and "unhealthy" individuals. But there are still standard deviations. You are an individual...not a statistic...people can still be very healthy just outside of the prescribed norm, especially when other testing corroborates that likelihood as your other two tests do.
    Last edited by Neckhammer; 10-06-2016, 05:27 AM.

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    • #3
      Oh, for your A1C!

      As Neckhammer said, your FBG is right for you. At worst, I would think of it as "high normal."

      The A1C is what matters.

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      • #4
        Originally posted by OnTheBayou View Post
        The A1C is what matters.
        Really? I've read so often that the A1C can be falsely low or high and that it should only be used to see if somebody's blood glucose managment gets worse or better compared to the time of the previous A1C test.... but not to diagnose.. for example here:

        https://chriskresser.com/why-hemoglo...liable-marker/

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        • #5
          You still don't have a problem unless you are anemic (low A1C) or your blood sugar spikes after carb heavy meals and STAYS UP. It's not happening, from what I see. If your red blood cells are long lived, moreso than the "average", then your A1C will be higher. Still no problem. Don't stress so much. ;-)

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          • #6
            Thanks!

            Is it also fine that the OGTT done at home has such a extreme spike at 30 mins and 1 hour (175) and drops to 64 at 3 hours?

            I've read that the value at 2 hours is used for diagnosis, but that also the 1 hour reading in truly normal people shouldn't go above 140 and that later on it should just drop to baseline, but not so much lower..

            My normal glucose reading when fasted or 3 or 4 hours after eating is around 90-90.. But not 64 like when I did the OGTT.

            Not trying to be paranoid. Just wanna catch any potential issues as early as possible instead of just letting them slide unknown for years.

            I've repeatedly read that high fasting glucose is usually one of the last things that shows when you progress to diabetes and that often other signs were already there for years, but just usually not tested for.

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            • #7
              You do realize that there are actually 3 types of diabetes? Juvenile is type 1 and is genetic. Adult-onset (a consequence of improper living and no longer limited to adults) is type 2. The third, called diabetes insipidus, is apparently an electrolyte-unbalanced affliction, whereby the sufferer drinks excessive amounts of liquids due to insatiable thirst. After years of managing T2 with a low carb diet, hubby was just diagnosed with Insipidus. Lots of fun, as liquid restriction seems to be the only treatment, and hubby vehemently refuses it.

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              • #8
                Originally posted by tom36_ View Post
                Really? I've read so often that the A1C can be falsely low or high and that it should only be used to see if somebody's blood glucose managment gets worse or better compared to the time of the previous A1C test.... but not to diagnose.. for example here:

                https://chriskresser.com/why-hemoglo...liable-marker/
                Whatever the inadequacies of an A1C are, they are nothing like trying to figure things out by using momentary readings over a period of time. Was that reading fasting, pre or post prandial, how was the carb load, and all the other confounders.

                Your A1C is great, you return to normal levels fast, Dr. Bayou suggests: Stop with the worrying, already.

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