DMII fasting, GTT question

[ledzepp880]

Hello. Posted the other day, had another question as I have began monitoring my blood gluscose levels using a home monitor. To sum up - am 25, but my am overweight (gained a fair amount the past couple of years as my activity decreased). I was concerned when I was drinking/urinating a lot (not sure if it was really jusy psych. Issues/fear of diabetes or a real problem). My only test in the recent past was a random blood glucose (lab, vein) which was 79 (and most likely somewhat falsely decreased due to the delay in lab analysis).

So am waiting to get an appointment w/an endocrinolgoist or int. med doc (long wait here), so in mean time go the monitor. I decided to do my own fasting bloog glucose ansd GTT test, here is the procedure/results/abnormality which would really appreciate if someone with experience in the field could offer me some reassurance.

What I did was eat a regular diet for the past 3-4 days (not unhealthy, just ATE but "better" food).

Yesterday, I woke up, had cereal and fruit. I then relaxed for a little, had some more fruit a few hours later and finally had 1.5 tuna sandwiches on rye bread at 445pm. I began my 12 hour fast at this point (as I am up early to leave for my job, so had to do it before).

So, 445pm had tuna meal (nothing else after that except water), measured my bloog glucose 8h later (around 1245am as I was still awake watching tv) and my sugars were 85, 87 (did twice to check). I thought that was great, right around where I needed to be. Then woke up this morning at 5am, got up, washed my face and immediately checked my sugar, and it was 103,104 (now I had fasted at this point about 12.5h). Is that normal/at all indicative of diabetes, or is that because I was fastying TOO long, or because it was so early - bloog sugar higher on waking at that hour)? What I don't understand is how my bloog sugar could have been in the 80's, then went UP when I didn't eat anything at all, just woke up in the morning (also, I verified before w/the control solution that monitor is working correctly, got results w/no errors).

As for the GTT, the numbers I did at home were within the normal limits - I found a link saying pregnanct women did a study w/jelly beans and a 50g GTT (28 jelly beans), so what I did was do a 75g jelly bean test (42 jely beans), and measure them at baseline, 1h, 2h. Here were my results for that (which according to the website/lab results I found online, are normal.

Baseline (fasting 8h - 12:45am):85,87
(fasting 12.5h - 5am):103,104
1h: 134
2h: 119

Any help would be much appreciated, thanks for you help.

[Zoelula]

If you are prediabetic, yes, DP could apply to you. Different people have varying patterns of onset of glucose impairment, some having higher fasting but normal PPs, some the opposite, some having impairment in first phase insulin response to food, some in second. Often, for Type 2's this process begins years before they are actually diagnosed, and it is only in recent years that pre-diabetes is diagnosed at all! Jenny Ruhl talks about these concepts in her book  Blood Sugar 101 which you can access online or in book form. I have the book because it's a good basic text to refer back to. It's really not always possible to predict what your blood sugar will do without having observed your own patterns for a period of time, but yes, for some people they are a bit higher when they first get up and it comes down a tad. All these variations are the reason why fasting blood sugar is no longer considered the test of choice for diagnosis but an A1C is, because it is an average of all the blood sugars for 3 months. OGTTs are useful because they measure reactions to the drink from about 30 minutes on so can see when the blood sugar spikes and by how much, illustrating the first and second phase insulin responses to food. Random blood glucose tests are even less meaningful than fasting, because there are just too many variables.

[ledzepp880]

I understand the dawn phenom., but does that apply to non-diabetics also? Is that even possible? I completely understand that a blood glucose (fasting) of 103. 104 would be considered "pre-diabetes" range, my only question is it possible this is/was due to the time I tested (ie; at 5am my sugar was spiking, liver unloading, insulin not lowering it quick enough)...had I checked it at 8, 930 (not having eaten yet), would it be back down under 100 (in the 80's, as it was earlier than night around midnight)?

Thanks.

[Zoelula]

When you get up your body produces glucose to get "ready for the day". I generally (but not always) wake up a tad lower than I go to bed, but some people also have something called Dawn Phenomenon (sp?) where their blood sugar will continue rising in the morning until they eat. Diabetes and blood sugar is a pretty complex thing and many things vary between people and even at different times for one person.

[ledzepp880]

Or anyone else who can comment on that specifically...how fasting blood sugar 8 hours in could be 85,87 and then at 12 hours (at 5am - not sure if that plays into it) goes up to 103,104 - with NO food taken in at all...is that possible, abnormal response at all? Thanks.

[ledzepp880]

Thanks for help...agree on advice, but any idea whgy my fasting blood glucose would go UP (in the 8-12 hour overlap...how is that possible if I hadn't eaten anything? Was it because fast TOO? Thanks.

[Zoelula]

I never thought I'd say this, but you might want to wait to get information and draw conclusions till you see the doctor. You seem to have aquired a little information about diabetes, but still don't fully understand things, and, imho, you are drawing false conclusions and in general just way overthinking things. However to answer your questions:

Your fasting blood sugar numbers of 103 and 104 are in the pre-diabetes category, but only barely (over 100). Your "OGTT" was in the normal range as well, but you need to have a lab OGTT done with a high sugar drink which is absorbed much quicker. The best advice I can give you is that being proactive regarding your health is good, of course, but I think you are driving yourself nuts. There doesn't seem to be a lot to worry about in your numbers, so I would relax, wait for your appointment, and if you end up being pre-diabetic you can look at making some changes in your carb intake, exercise and weight loss if needed. If you want to make some of those changes now, that can only help your overall health no matter what the test results show.