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Should I go for that GTT or trust my data?

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Posted 3/22/2008 4:14 PM (GMT 0)
Good Afternoon

I have a question for the board. My GP recently recommended that I have a 3 hour GTT as they spotted a fasting blood sugar that had moved from 100 to 105.

I'm normally a REALLY compliant patient but I put this off to do some information gathering of my own. Having recently lost my mom I have massive supplies of testing gear on hand and decided to start a log.

Testing about 3 times a day fasting, two hours after meals and one more time at random I've come up with a 30 day average of 108 according to this meter. It's recently been calibrated so I trust the results.

I DON'T need one more condition on my chart (read my sig) and I don't want to go for this test. It's expensive, eats an entire morning and I think it's going to be a negative. Oh....and it's expensive. Did I mention that it's expensive?

I exercise 4-5 mornings a week at the gym, am only mildly overweight and eat healthy foods. I have Ulcerative Colitis so that balancing act with all the whole grains is tough.

Last question is - If I exercise in the morning without eating my sugar should be low, right? Instead if I come home all pink from exercising and do my fasting then it can rack up between 117 and 122. If I'm lazy and just do it straight from bed it's between 87 and 99. I don't get that.

I've only just begun studying this problem and would love some imput! Thanks in advance for a mini-analysis from a trained professional volunteer!
Posted 3/23/2008 12:30 AM (GMT 0)
RG,
The elevated sugars after exercise are from your body kicking out more glucose from the liver to help keep up with the muscle demands. When you start working out the muscles quickly use up whatever glucose that they have on hand so they send a signal to your liver to do a glycogen dump and convert the stored glycogen into glucose. You know that you are going to quit the workout after a time but the muscles don't know this. As far as they are concerned they are going to 'be prepared' in case you just started a 20 mile hike. When you stop exercising this extra 'insurance' glucose is stuck wandering around your blood stream for a while until it's absorbed into the cells.

Why don't you make up a printout of your glucose log and fax or mail it to your doctor. If it shows foods consumed, exercise levels and blood sugar readings two hours after a meal and also one or two pre-meal readings per day it should give him/her a pretty good idea of what's what. Just my 2ยข but your doctor might just be very careful with your health. If you promise to do your sugars at least once a week, I'll bet that he/she will be ok with that. Your numbers arent' that bad, but you could be headed toward pre-diabetes. Explain your worries about another dx to your doc and state that you arent' doing the ostrich thing... just don't want to spend that money to find out you are fine.
Posted 3/29/2008 3:47 PM (GMT 0)
I've seen a study on Pubmed that showed you are likely to fail an OGTT when your FBG is 115 or higher.

Also, to add to the previous answer, if you have any "dawn phenomenon" at all, your levels will continue to rise in the morning after you get out of bed, until you eat something. That's my understanding, anyway.

The postprandial readings are supposed to be better indicators of trouble for women, so that approach seems like a good compromise and a much better fit for your budget (both time and money).

Also, isn't the prednisone notorious for making BG levels worse?
Posted 3/29/2008 4:24 PM (GMT 0)
Rotgut, Prednisone elevates your blood sugar. Assuming you're only going to be on a short course, I'd suggest explaining that to your doctor and asking to wait until after you taper off and re-evaluate.

My fasting went to 115 when I was on Pred. I just followed the routine of my DH, who has mild type II. Now that I'm off Pred, my FBS is back below 100. Hope this will be your experience also.
Posted 4/12/2008 10:15 AM (GMT 0)
Nice!

Thanks Board Members.

I did go back to my GP with my journal and a month's worth of readings. She said skip the GTT for now and schedule that test (AC1?) for June in case I just don't have a clue what I'm doing.

She was on my team right away in terms of keeping that out of my files and encouraged me to keep trucking and dieting. I'm down 25 pounds and 3 points on my 14 day average on my meter. It's at 107 for the 14 day moving average.

SPRING BREAK and this old teacher is going to PLAY!

Happy Saturday and thank you.
Posted 4/12/2008 4:54 PM (GMT 0)
The glycohemoglobin test gives a 3 month average of your sugar readings. It's supposed to be between 4.4 and 6.6 but most peeps with diabetes aim for 5.5 and lower. Just keep on doing what you're doing and checking your sugars and be sure to notify your doc if anything goes askew. Hope you have a great break.
Posted 4/12/2008 7:14 PM (GMT 0)
Jeannie, "The glycohemoglobin test gives a 3 month average of your sugar readings. It's supposed to be between 4.4 and 6.6 but most peeps with diabetes aim for 5.5 and lower. Just keep on doing what you're doing and checking your sugars and be sure to notify your doc if anything goes askew. Hope you have a great break."

Thanks Jeannie,

I'm getting a mental picture of this. What might the meter be reading over time to hit between 4.4 and 6.6?

Thanks!
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