New at testing blood sugar....have questions about results

WaveRider was helping me in the Diabetes forum (thanks again, WaveRider), however, this is the forum I need to be in since I have not been diagnosed as diabetic or even pre-diabetic....yet.  I am concerned, however, because my brother and Grandmother have diabetes and my last A1c was 5.9.   I'm post menopausal, age 61,105 lbs, exercise 3-4 days per week.  My meds include Lotrel 5/20 & 25 mg spironolactone for blood pressure, 20 mg Zocor and 500 mg SloNiacin for cholesterol, and 50 mcg Synthroid.  I recently purchased a glucose meter and I have questions regarding results.    An hour after dinner last night (where my only carb was half a sweet potato), my BG was 121, two hours later it was 97. This morning my fasting glucose was 88. This morning we went to the local diner and I ate an American cheese egg white omelet with two pieces of lightly buttered rye toast, coffee w/half & half.  One hour after I started eating, my BG was 149.  An hour later it was 103.  Can you tell me what these numbers indicate?  I guess I should stay away from rye bread, yes?  I am willing to eliminate any food that raises my BG too high.  Thank you.

[Helkaet]

I am diabetic and have been for about 13 years. I would do anything for an A-1C of 5.9.  An A-1 C of 5.9 is perfect. It means that your blood sugars have consistently been within normal ranges for the last three months. Your blood sugar was slightly elevated at 149, but it was only one hour after eating. It is best to wait 2 hours after eating to take an after meal blood test.

Right now your numbers are within normal, healthy ranges. Stay away from processed flour, high fructose corn syrup (READ ALL LABELS THIS STUFF IS IN EVERYTHING) and sugar-- and you should be okay.

[Helkaet]

Also, just about anything you need to know is at http://www.diabetes.org/.

[Ruthiejb]

Thank you, Helkaet.  I appreciate your response and advice.  I hope to stay healthy in my golden years and will do what's necessary.  Good luck to you!

[Ruthiejb]

This morning I exercised for 50 minutes, 2 hours later we went to the diner again and this time I had no carbs.  I ate tuna salad with a green salad and balsamic vinaigrette.  The only carbs was the small about of half & half I put into my coffee.  One hour after eating, my BG was 87.  So, I guess the exercise and no carb breakfast made a big difference.  I didn't check my fasting BG this morning because I only had one more test strip and I wanted to see what my level would be after eating.  I'm off to the drugstore now to buy more strips and lancets.  

[nursegirl6572]

Let me ask you a question, why are you concerned about your glucose?  Has your doctor said something?  Did you have a high result at one point?

It honestly doesn't sound like you need to be monitoring your glucose at home on a regular basis, did your doc recommend that?  Your A1c levels are fine, and so are your BGM readings.  Guess I'm a bit confused where the concern lies?

[Super_sally888]

Hello,

actually the timing for your testing should be based on when you peak.  For some people their highest is at 2 hours, in your case it is at 1 hour.  That's fine to know.

Truely normal HBA1C is in the 4s.  So yours is not terrible, but it is also not completely normal and it is great that you are motivated to prevent this progressing.

Your approach is great.  Avoid the foods that make your blood sugar high.  If your blood sugars are consistently kept at normal range then your pancreas is not having to work too hard and hopefully it will not progress.

If you are really aiming to be 'optimal', avoid any food that puts your blood sugar higher than 120 at your peak.  If you are less than 110 at 2 hours then it is perfect!

Most people find that low carb works best.  Some carbs can raise you more than others.  Ie. the sweet potato worked better for you than the rye bread.  When you are eating low carb make sure you eat more fat (unprocessed is best) so that you won't feel hungry.  Nuts, full fat dairy, avocado, butter, olive oil, fat that comes with the meat are all good sources.  However, do avoid deep fried foods and transfats that are present in many processed foods.

If you are interested look up the book Diabetes Solutions by Dr. Richard Bernstein.  Get the 2011 edition.  It goes into a lot of detail about low carb diet for managing diabetes. / prediabetes.

[Ruthiejb]

Thank you both for replying.  Nursegirl, the reason I'm being so viligant is because I recently learned that I am genetically at high risk for heart disease (my fraternal twin has CAD), and my brother has diabetes, so at this point in my life (when these issues tend to develop), I'm doing all that I can to prevent it.  I started the low carb diet for health reasons and was dismayed when I found out that my a1C is 5.9 which, while normal, is very high normal and, to me, it wouldn't take much to bring it to unhealthy.  My doctor doesn't know I'm monitoring...this is just  for my own education concerning how my body reacts to different foods.  Supersally, my thinking mirrors yours....I simply wish to avoid foods that will raise my BG to levels like 149 (like the rye bread).  I know it came down to 103 after an hour, but I'd rather stick to foods that don't raise it that high .   Right now, this monitoring is experimental to see if I can bring my A1c down.  Frankly, I was shocked that my A1c went up because for the past 6 months the only carbs I've eaten were from vegetables, sweet potatoes, fruit, Atkins bars and low carb bread that I buy at the Health Food store (Julian's Bakery, 14 grams protein per slice, 13 g fiber, 137 calories and 2 net carbs).  The rye bread with breakfast the other morning was part of my experiment.  I would like to know what foods I'm eating are driving up my BG to the average indicated by an A1c of 5.9.  Thanks again for your responses and I'm always welcome to any comments and suggestions.

[WaveRider]

Bookmark this web site for food nutritional data, it eliminates a lot of guess work. Also, helps you by breaking down foods into different serving/portion sizes. This is US based, not for folks living elsewhere.  http://nutritiondata.self.com/

Question would be what the restaurant served you; was the rye bread made with white or whole wheat flour? The former will elevate your blood sugars. Then there is the American cheese. Under imitation cheddar ND has one slice containing 17g of carb sugars.

[Ruthiejb]

I did have my doubts about the rye bread, but I didn't know that about the cheese, thanks WaveRider.  Have bookmarked the site and will get a lot of use out of it.  Question:  you write, "the former will elevate your blood sugars".  So, will it elevate the blood sugar of someone who has no insulin/sugar impairments or only someone who does?  It's my understanding that a "normal" person's blood sugar would not have gone up to 149 an hour after eating that bread because their body would've taken care of it before it got that high.  Is that correct?

[WaveRider]

"Question:  you write, "the former will elevate your blood sugars".  So, will it elevate the blood sugar of someone who has no insulin/sugar impairments or only someone who does?"

Yes for everyone. But a normal person will see their blood sugars return to normal levels 2-3 hours postprandial, prediabetics and diabetics will not.

"It's my understanding that a "normal" person's blood sugar would not have gone up to 149 an hour after eating that bread because their body would've taken care of it before it got that high.  Is that correct?"

Not necessarily true. It would depend on the contents of the bread and also the individual. One hour postprandial is not a relative level to judge ones glucose level. In OGTT [oral glucose tolerance test] it is used to see how high ones glucose elevates [peaks/plateaus]. If you're going to test postprandial, the proper postprandial testing time is 2-3 hours after a meal. My preference is 2.5 hrs.

[Ruthiejb]

Great information, WaveRider.  I see that I was under the wrong impression about how foods affect non-diabetics vs. pre- or diabetic people.  I thank you again (and again) for the education.  

[WaveRider]

You're welcome Ruthiejb. Glad to help out.

[nursegirl6572]

Thanks so much for the additional info.  I can certainly understand your worry about your increased risk for diabetes, and it sounds like you are doing everything you can to be proactive.

I WILL say, however, and others may disagree, that you checking your glucose several times a day at home is both overkill and not necessary at ALL.  Even if you still want to check it at home (which I don't think you need to), you could definitely decrease the frequency.  Really, in your situation, with no problems identified, or even beginning, an annual physical with the related labwork should suffice.

Congrats to you for your commitment to your health!  Way to go!!

[Super_sally888]

A person with no diabetes at all and no insulin resistance would rarely have their blood sugar go above 100, even if they ate lots of carbs.  This is becuase their pancreas can react rapidly to changing glucose levels. In persons with prediabetes, their pancreas is in the process of losing the ability to control blood sugar.

I don't think you are testing too much at this point, when you are trying to discover what makes you go high.  However, later on you probably won't need to test so much as you can eat tried and true foods and meals and only test occassionally to see that you are still on track.  If you are comfortable testing the way you are (and are able to get useful information from the testingthat you then use to adjust your diet approach, then there is no issue).  The inconveneince of testing is a small price to pay compared to the benefit of preventing / delaying the onset of diabetes.

You will find that it is both the total amount of carbs eaten at a meal and the type of carb that affects your blood sugar.  Processed carbs like cereals, breads, cakes, potatoes, anythbing made with flour, sweet fruits, tend to have the biggest effect.  Non-starchy veges and regular fat dairy should have a lesser effect.  Best cheeses are the unprocessed ones, which have I think 1 g of carb/1 oz serve.  But you can look it up.

Try eating different amounts of carbs/ meals.  A starting point would be about 30 g/meal and you can adjust up or down from there.

If you read the Bernstein book "diabetes solutions' he recommends 6 g of carbs for breakfast and 12 each for lunch and dinner.  His diet can definitely prevent progression of diabetes and makes diabetes management for those who already have it far easier.  You may not need to be as strict as he recommends, but key is to normalise blood sugars.

[Ruthiejb]

I have to tell you l that I do appreciate everyone's input into my situation.  You've all been very helpful.  I'm sure I'll cut way back on the testing after I get an idea of gow my BG reacts to different situations (fasting, exercise, different foods).  I'll probably cut back to testing only after eating at a restaurant to see how my body reacts to the meal.  Again, thank you all.

[nursegirl6572]

I think that's a good plan.  Honestly, from a medical point of view, I'm not seeing anything concerning in your numbers at all.  It's not unheard of to have an occasional higher than normal reading, that doesn't mean you are pre-diabetic.  That's why the A1c is so valuable, it  gives a broader picture of what your glucose has been running over a period of time, rather than in just one moment.  Everything looks a-ok from my standpoint...which is fabulous.

Keep doing what you're doing, and I doubt you will have much to worry about.  I still maintain that you do not need to be testing at home, but I also understand that you made that decision for many reasons.  Being a nurse, I'm a firm believer in "less is better".  I would tell the person who had ONE borderline high blood pressure reading the same thing...I wouldn't recommend that they start taking their BP at home several times a day.

Very best to you, glad you got some helpful information.  The people on this site are truly amazing, a very knowledgeable and caring bunch.  Please stop in and let us know how you're doing, and certainly feel free to ask any other questions that pop up.  If you SHOULD start seeing numbers that concern you, please do let your doctor know right away, I can't emphasize enough the importance of keeping your doctor abreast of any situation you are concerned about.

[Ruthiejb]

Thank you for being the voice of reason.  I do tend to become obsessive when it comes to health....my husband is used to it by now :-).  You've helped my psyche a great deal, nursegirl, and that's invaluable.  All the best to you as well.

[nursegirl6572]

LOL, I was going to say that you sounded a bit overboard, a little obsessive with this, but didn't want to offend you.  You're doing everything right, honestly, there is no need to be checking your sugars at home.  Plus, why would you want to stick your fingers when you don't have to?  :0)

Hopefully, it will never become an issue for you.  For now, my advice would be to stick with what you're doing.  An annual physical is sufficient.

You have inspired me..I wish I could be dedicated like you.  I really need to start working on my health.  Just entered the wonderful world of the 40's, everything is going to start going downhill!

[Ruthiejb]

Take it from experience, NurseGirl, you have a very l-o-n-g way to go before it starts going downhill.  So, please allow me to give you some advice and that would be to enjoy your youth because you are very young!

[nursegirl6572]

Aw, thanks Ruth!  Some days, I don't feel young, lol.