Pre to full diagnosis- a years perspective

Type 2
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I was tested by a clinic a year ago. 134 FBGL. Doc tried to prescribe metformin. I balked and studied up, lost 10 lbs and tested again. 126 FBGL

-one organization says 130 FBGL makes you diabetic, another says 126 FBGL. and finally bloggers more realistically state that there is no ‘magic’ number or you don’t really need a ‘diagnosis’ to be concerned over ur BGL. oky dokey!

-so i toddled along in blissful ignorance, testing myself periodically with meters that in and of themselves have a certain % of tolerance. To my credit I bought the meter that tested best, Contour and its upgrade, Contour Next. What i did find with several different meters over 12 months that the meters in and of themselves were reliable, compared to each other. I have not compared them to a blood screen from a clinic. That is to say i have not tested at clinic and then compared that to a meter test. Simply because i have not had a clinic test since then.

-So I range , depending on factors i cannot really adduce, from a FBGL of 117 to 130. sometime I exercise heavily but these last 7 days i didn’t exercise at all. My FBGL these last 7 days, with an average daily carb intake of between 60 and 100 NET CARBS/day, has been closer to 130 than 117. This has been the case for the last few months as i have been too busy to exercise regularly. I don’t know if my BGL has morphed. For the previous 10 months i usually got alot closer and more often to 117 than 130 with very regular exercise and fairly high amount of drinking.

2 things that are different. Over the past 2 months i exercise alot less( which was 1 hr on elliptic at a pretty high MHR. see EXCARBS* below.) When i exercise i am hungry and no amount of meat and cheese and nuts is gonna fill me up. Meaning i will do 150 to 200 NET carbs a day.

  • i used EXCARBS.com to figure exercise carbs burned. Then i read that body will only burn 50/carbs an hour at most. So every time i do ellipitic for an hour I simply deduct 50 carbs from gross daily carb intake.

the 2nd thing that is different is that I drink alot less alcohol. Iam a binge drinker, meaning I usually don’t drink during the week but on the weekend i usually get a 6-8 cocktails in me. Distilled alcohol has no carbs so a rum and diet coke or 8 has no carbs. I do not know what,if anything, not drinking does to BGL.

I like some many am trying to avoid any medication at all. As i get closer to thinking that may be necessary(see increased BGL story above) I am scrutinizing the situation more thoroughly.

for instance just this week a study was produced by Internists saying that BGL can be higher that ADA recommendations. I love the sound of it.

The point being here is that i can’t simply throw up my hands in confusion and surrender. I have to make some choices and decisions. I also understand that I am likely to be wrong. I don’t say that to be self deprecating. I really am making decisions on scant or uncertain empirical facts and uncertain verities amongst the pros.

I just now, this week , started to take post meal readings, having understood that readings above 180 can cause physical damage. And by that i mean I have read or ascertained by bloggers that physical damage doesn’t much occur until BGL reaches 180 , and even then i don’t know how long it must remain above 180.

My current mission is to

  1. debunk any of my own fool notions
  2. get a consistent frame of reference when we speak of BGL.

by 2.) I mean i haven’t much paid attention to BGL ‘norms’. I was close enough to be comfortable. Now that i am ranging into a higher average BGL I want to monitor more closely. Here is the issue. Folks, pros and bloggers alike , I think, blend non-diabetic numbers with diabetic numbers either off meds or on meds, to great confusion.

For instance someone will say that are regularity at a FBGL of 60. My first thought is why are they bloggin at a Diabetic Forum. Without inferring some facts otherwise not presented, i cannot understand if they got to 60 FBGL with insulin, without, with metformin, without or any all the meds available. Blithely stating your BGL without the caveat of your describing your regime is confusing to me.

When i read guidelines or ranges I note there are non-diabetic norms and diabetic norms. I have strived to hit diabetic norms thru diet and exercise but NOT non-diabetic norms. My thinking maybe very stupid here. Being that i can live with the label as long is I am in the an acceptable range. Which again is to say as long as my FBGL is close to 126. As I said ignorance was bliss on this front. But now i read about folks meeting non-diabetic numbers(FBGL of 60-80) and I am thinking I have gotten it quite wrong and that i ought to aiming for non-diabetic numbers. Of course that certainly means medication as its hard to get carbs below 50 or even if you did it wouldn’t take BGL down to non-diabetic levels

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This is a key point. Most of us don’t use the concept of acceptable “diabetic norm”. I think of it as the warning zone, to make changes to get back to the non diabetic range before and after meal BG levels as soon as possible.

Not saying that’s wrong, but may explain why you aren’t getting the answers you’re looking for.

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A few observations based on my experience:

A post meal reading of 180 would freak me out. I have always tried to never go above 140 and I am usually successful. I know some around here shoot for an even lower number. I have been diagnosed for 8.5 years. Recent eye and kidney tests reveal almost no damage from my diabetes, although my kidneys are damaged from an unrelated cause. This means to me that keeping below 140 is working for me.

When I was first diagnosed the ADA recommended keeping post meal numbers below 180, they also said diabetes inevitably progressed. I think these 2 things are related.

Another thing I read is that fasting blood sugar is often the last thing to go, so I tend to watch my post meal numbers more closely than fasting numbers.

Your fasting numbers indicate Insulin Resistance. I have been successful in lowering my Insulin Resistance through intermittent fasting. I just skip breakfast and this gives me approximately 16 hrs fasting and 8 hours eating. I use insulin and IM has enabled me to cut my insulin usage approximately in half, indicating a significant drop in my Insulin Resistance.

Finally I have used “Eat to Your Meter” to keep my post meal numbers in range. This means I set a goal, 140 in my case", and then figure out through testing which foods are causing me to exceed my goal. Sugar and starch are the main culprits and so I have eliminated them from my diet. You may or may not be able to meet your goals by just reducing problem foods, your meter will guide you. For me net carbs of 20 to 50 g/day works out best.

Everyone’s diabetes is different, you can use testing using a meter to figure out what works for you, good luck hope this helps.

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this is the question i have: do we try to maintain the ranges for diabetics, so often published as:

Fasting
Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)
Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.4–7.2 mmol/L)

2 hours after meals
Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)
Official ADA recommendation for someone with diabetes: Less than 180 mg/dl (10.0 mmol/L)

so many posts here are suggest they get numbers in normal range without reference to how they were treated. so if someone say his FBGL is 60, i want to know how he is diabetic and gets that low of a reading.

and again i ask the question, because if diabetics are trying to maintain numbers in non-normal range as opposesd to normal range, 126, v. under 100, then i can do that without medication. but , and again i repeat, if we must get to normal range to avoid complications then i could never do that without meds.

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You are looking for an absolute where there is none.

On the other hand there will always be people willing to provide specific and concrete numbers regardless of whether it is actually backed up by proven science or not. At the end of the day you have to do what makes you comfortable.

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Unfortunately, there are no absolutes with diabetes, there are too many variables. Some variables we can control, some we cannot.

What studies have shown is that the closer you stay to non diabetic BG range (and cholesterol and other measures), the less likely or more delayed the complications may be.

As a comparison, do you wear a seat belt when you drive ? What if you never get in an accident. What a waste, you used a seat belt and didn’t need to, nothing was prevented.

Same with trying to stay in non diabetic BG range, its a precaution, not a guarantee. It increases the chance of a better outcome. You could also choose to stay in the pre-diabetic range, and you might or might not get complications. You indicated you were 60 or 61 when diagnosed in another post. That already means there is less chance of complications simply due to length of time with above normal BGs.

I have type 1 since age 5, so my situation is different. I have many more years of high blood sugars because we didn’t have the tools we have today, including home BG testing. So FOR ME, it is very important to keep as close to non-diabetic numbers and stop progression of complications I have.

In general population, you may find more people with your thoughts about being ok in the warning zone. That’s your choice. (Those who post here tend to be folks trying to reduce their numbers).

But what if you tried low dose of metformin, and were able to get BG in non diabetic range, along with the other changes you mentioned (diet, exercise ). That MAY reduce risk of complications, but you would never know for sure. Like wearing the seat belt, but never really needing it.

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When my doctor sent me the results of a FBG and suggested that I exercised more and cut down on sugar, I was floored. I was fit (run, cycle, swim), and thin but I did have celiac disease (autoimmune and linked to TD1). I was NOT going to give up gluten free cupcakes without more evidence. I questioned my HA1c result since I have also have Thalassemia and some anemias can impact results).

I found the Blood Sugar 101 website, bought a cheap meter and started testing. I tested for a month tracking everything. I was shocked. I then changed my diet to a low carb, high fat, gluten free diet. My results were dramatic. I shared my data with my doctor. We agreed that since I tested oddly for celiac disease (antibodies), we would wait and watch. After a year, I was able to keep my HA1c in the prediabetic range. We were both satisfied. Four years later, my A1c is in the normal range.

Normal. That is where I strive to be. I wanted to avoid Metforim for as long as possible because I already have GI issues (celiac disease). I have learned that food can heal and promote good health (my celiac disease is in remission based on a recent biopsy). I want to avoid becoming like my extended family members who have suffered from long-term TD2 complications which is the diagnosis my doctor and I have assigned to me for now.

My doctor is conservative and promotes ADA recommendations, but he advises, “ I should keep doing what I am doing.”

Over the past four years, I have learned to eat to my meter. I periodically fall off the wagon (never for gluten), but I get right back on. I have also learned that everyone is different and that there is no “one size fits all” treatment or diet. Each individual must find their own way.

I must add that I am motivated by my meter. I wish there was a comparable tool for identifying gluten exposures. Only fear of months of illness keeps me motivated to remain gluten free.

Research and continue to ask questions, because honestly, your doctors can only do so much. Be your own advocate.

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I was dx in early 2007. Within a few months, I found TuD’s welcome mat was out for me and I came over the threshold into the warm embrace of this amazing family. Within a few months of that, I stumbled into a discussion of Bernstein’s approach. My husband and I gave it a shot and found it worked really well for me.

It still does, but I still very much honor the diabolical whimsy of this scourge, in that “If you wish to treat diabetes ‘by the book’, you must write a new book for every diabetic.”

As Tim and MM said—there are absolutely no absolutes! I personally, when life is just tootling along, shoot for keeping myself in a range from 85 fasting to 140 or less post-prandial.

When life goes off the rails for awhile, I adjust my expectations and over the years, have learned to Not beat myself up about it. Most recently, I had to make some serious adjustments due to a fall that broke a femur and ended me up in the hospital for 10 days, followed by 5 weeks in a nursing facility.

So. Life happens and we do the best we can. TestTestTest and at least for awhile, keep a log of your numbers and what you eat—“Eat to your meter” definitely…Good luck…Judith in Portland…

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i appreciate the replies. as far as getting to a non-diabetic range of 85 FBGL i know i could not do that with diet alone.

so i will have to settle for pre-diabetic numbers, less than 130 FBGL. interestingly my PM ranges are closer to non-diabetes. if i eat sugar pdts. cake, etc. it will spike up pretty high. +180

i might try metforim. is there any problem with doing metorim for a while and quitting? also how long before metafonim would show results?

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no problem with doing metformin and quitting - I did that after four months because I had some intolerable side effects. Metformin usually starts showing some benefit after between 3 days and 3 weeks.