I am with you Melitta ...living with d for over 30 yrs, no known complications ...am much more concerned about my day to day well being than my A1C results , which is due this week .Travelling abroad for 2 weeks( jet lag ) , participating in the Amsterdam Marathon event , home for 4 days and getting the sniffles will have no doubt an impact ...all beyond my control ?
I found my cgm to be almost completely inaccurate about 90% of the time which was why I returned it. If he had finger sticks at 200 he is probably pre D. Or something is going on he might want to look into. I did have hypoglycemia long before D. I had 2 readings in the high 30's range(this was an older meter so it would have been more like high 40's I guess). I tested twice to confirm them and had symptoms which made me test in the first place, but the symptoms were nothing like my hypos on insulin. I never felt in danger of passing out and I had lower bg overall which is typical of women. All I had to do was eat some protein and carbs and I went back to a normal level in the 80's- it passed with no real effects. I never tested after lots of carbs though so I have no idea how high I went. I agree with not being too hard on ourselves because it is very difficult to do the job of your pancreas. I think if you're not back down to 80's-90's by two hours something is wrong. I know how I feel when my bg is too high, I feel damage happening so of course I will try to avoid it, but I have relaxed a lot about corrections and so on and being obsessive because I feel that is damaging too if it causes fluctuations which I have too many of already and if it causes too much emotional/physical stress.
It really depends on the individual though. For me, sweating the numbers is a game. It's like having a math problem to distract me from serious life stressors. I also feel that because I was LADA and it took so long to diagnose, a fair amount of damage was done to my body, and I can't afford more damage.
I agree with Scott about making the numbers a game. Diabetes is a freaking grind and anything that you can do to brainwash yourself into getting into it is a good thing.
I look at it like fantasy baseball. When I got my pump, I was kind of into that although I'd run into issues (getting killed) as I was also really into Tae Kwon Do at the time nd wasn't as dedicated as I should have been about managing my team. Perhaps it created an odd environment that helped me get things focused in terms of diabetes. "Here's what I want to do, how do I do it..." and combining bits and pieces of the brilliance available in the DOC "waiver wire"
yes, me too. i had a slow, long onset too. although after diagnosis i've never had an A1C over 6.5%, i too already have some complications, neuropathy, my hands go numb sometimes, bowel problems....guess it just depends on the person. we can't see what's happening in our bodies, that's the bad thing about this. however, i've sat in those 'diabetes clinics' and have seen first hand (blind, kidney transplants, amputations - god knows what else) what this nasty disease can do. i'll stress about it.
well, is there anyone here who hasn't 'tested' their loved ones' blood sugars after meals, just out of maybe concern or simple curiosity or their's? just do a test yourself; after he/she eats a high carb meal test their blood sugars.
hum, which CGM did you use? it can be inaccurate when first starting it. however, my dexcom is SO accurate...i almost feel like not even testing sometimes. actually, it is the high and low, the rise and fall which causes the nerve damage over time.
I'm as OCDiabetic as they come. I don't have a fully functional pancreas so staying on top of my BGs is a full time job.
I think we might be reading a bit more into the quote than the good doctor intended though. I don't think his intention is to tell us not to sweat the numbers. If we are going to be OCDiabetic, though, be more realistic about what a normal pancreas actually does and allows. If, despite all our attention to detail, we see a number above 140, it doesn't actually mean your organs are dissolving into goo.
Yeah, the average between 200 and 50 is 150, and way above what anybody would consider a safe average to have, but it's only two BGs. Blood sugar isn't a discreet measure and A1c depends a lot on time spent above and below your average BG.
That being said, even if normal BG profiles allow excursions above 200, with a broken pancreas, approximating the response of a healthy pancreas to bring a BG back into pre-meal range within an hour or two is problematic when you don't have a functioning pancreas.
I don't worry bout the 200, I worry about the roller coaster I'm going to ride for the next 5 hours because of the 200.
the 'don't stress about the numbers' comment wasn't even why i posted this or brought this to my attention. it was his comment about his CGM results (200's to 50's and supposedly non-diabetic). I've never had an endo tell me not to sweat BG's in the 50's...most endos freak out with 50 blood sugars for T1's (to a fault). They do tell me I'm a type 1 diabetic, it's the nature of the beast and I'm doing a great job. But yeah, FHS, it's never 'the number' for me, it's what I know I'll have to do to take care of it and get it back in range...the roller coaster as you say, in deed. Plus, those highs and lows feel awful for me, at least.
It's also important to keep in mind, for T2's at least, that metabolic syndrome is a lot more than just BG control issues.
I think it safe to, at least, assume there is greater sensitivity to glucotoxicity in a diabetic than in a "normal" person. After all, there is still a non-trivial incidence -- outside what would be seen randomly -- of diabetic complications in diabetics with exceptional control, and that incidence increases in lock step as control degrades from non-diabetic BG profiles.
Clearly more is going on here for diabetics than just abnormal BG levels. Diabetics have problems at BG levels that are completely harmless to non-diabetics.
Yeah, I think, like others have said, CGM data, in general, are problematic. Was he really 200? Was he really 50?
Still, I think his point is valid. BGs for people with perfectly normal pancreases are probably way more variable than those of us who are hyper-aware of our own BGs due to broken pancreases think they are, and I appreciate his perspective.
If I had a fully functional pancreas, I'd probably take his statement more to heart but, false standard or not, it doesn't mean I can approximate what a fully functional pancreas does on my best day, so I have to do what I have to do to minimize my chances at long term debilitating complications.
I have finger-stuck wife and kids, but no one's worn my CGM. This thread has me pondering putting it on one of my homies next change for a few days, maybe a week, to see what a "normal" person looks like.
Or maybe catch diabetes early in someone I love
Me too. Since I got the Omnipod and G4, it's really become sort of another hobby.
I love gadgets. My personality was made for being a diabetic in 2013. In fact, in the future when a truly perfect artificial pancreas is available, it would be less motivating as a diabetic (although, of course, I'd get one).
My Adorn laptop/business/diabetic bag was stolen out of my car last week, and I experienced what it was like to go back on MDI, keep records manually, etc. after 3 blissful months on the pod.
Not pretty.
He’s not saying don’t practice tight control, he’s just saying don’t compare your results to a false standard-- and that the notion that non diabetics don’t have substantial but temporary fluctuations in blood glucose after eating is false.
I'm quoting from Jenny Ruhl's website (link) below:
A Continuous Glucose Monitor Study Reveals Truly Normal Values
An illuminating research study was presented at the major annual European Diabetes conference in September, 2006. It reports on the daily pattern of blood sugars of a group of normal subjects as revealed by continuous blood sugar monitoring.
What is Normal Glucose? Continuous Glucose Monitoring Data from Healthy Subjects. Professor J.S. Christiansen, presented at the Annual Meeting of the EASD.
The whole presentation is well worth watching.
The main findings here, for those of you who don't have the high speed internet connection needed to listen to this presentation, are that in normal people the fasting blood glucose stays flat in the low 80 mg/dl (4.4 mmol/L) range throughout the night. After a high carb meal, normal people's blood sugar rises to about 125 mg/dl for a brief period, with the peak blood sugar being measured at 45 minutes after eating and then drops back under 100 mg/dl.
The chart at the top of this page is taken from this presentation.
This study also found that the same amount of carbohydrate eaten at a meal other than breakfast does not raise blood sugar anywhere near as high as it does at breakfast.
A Second CGMS Study Confirms This Range
A study of CGMS measurements taken in 74 normal people aged between 9 and 65 years old over a period of 3 to 7 days was published in June of 2010. It found the following:
Sensor glucose concentrations were 71-120 mg/dl for 91% of the day. Sensor values were less than or equal to 60 or >140 mg/dl for only 0.2% and 0.4% of the day, respectively
Overall only 5.6% of sensor readings were were over 140 mg/dl. (7.7 mmol/L) and these higher readings were more frequent in people under 25 years old. Only 4.4% of the readings of those over 45 were over 120 mg/dl.
Only .4% of all readings were over 140 mg/dl. But most significantly, this group was screened to ensure they had all off the following: A1Cs less than 6.0%, fasting blood glucose 70 to 99 mg/dl, 2-h oral glucose tolerance test (OGTT) levels below 140 mg/dl and no antibodies characteristic of autoimmune diabetes. After all these tests, all 17 people over age 45 who met the screening criteria had NO CGMS readings over 140 mg/dl at all.
This is probably because by the age of 45 people with the underlying genetic conditions that lead to diabetes, whose blood sugars would have been normal at younger ages, but who would have been getting higher than true normal readings after meals, would have progressed to where they failed the screening test. So it is a good bet that the people in the 45 and older age group in this study are truly, physiologically normal. With that in mind we are safe saying that normal people do not go over 140 mg/dl ever and are only rarely (4.4% of the time in this study) over 120 mg/dl--no matter what they eat.
Variation of Interstitial Glucose Measurements Assessed by Continuous Glucose Monitors in Healthy, Nondiabetic Individuals/ Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Diabetes Care June 2010 vol. 33 no. 6 1297-1299. doi: 10.2337/dc09-1971
--she has a lot of useful information on her website!
Best wishes to all!
marty1492
The data table is interesting. Most subjects had higher bg at the half hour vs 1 hour mark which comes as a surprise to me. Overall, I didn't realize non-pwd's ever spike much above 140 but apparently they do (but for a much shorter time).
Couple of important things to note about the studies cited:
The data presented are averages of all 72 participants and further groups them by age. The study does not claim that normal BGs never exceed 140 or fall below 60.
That's an important point to make since the the anecdotal CGM presented and the table I posted are not, actually, in conflict.
The .4% of all CGM data is an average of all age groups. The highest of all age groups was actually 1.3%. That's not a terribly high percentage, granted, but must be emphasized, again, that it's an average. The study does not present either the high or low BG attained, or a table of BGs for any individuals in the study. While it's not a huge amount of time, 1.3% of the time means the group still spends roughly 20 minutes out of the day over 140 mg/dl.
Really, by presenting only averages and omitting any data for individuals, it, unbderstandably, deemphasizes the variability that is found among the 72 individuals.
I mean, nobody is trying to argue that if you have a fully functional, healthy, pancreas, you're not tightly controlling your BG within a narrow range most of the time, or that diabetics shouldn't be trying to control their BG as tightly as possible
However, the the metronome like numbers often quoted simply do not represent the amount of variability that's in the healthy general population and if you take the time to read through the citations on the BS 101 site, there's plenty of reason to question the conclusions reached by Jenny Ruhl.
I don't think too many people do realize how variable BGs can be, which is the point of the quote.
well, do your own experiment...test a family member, friend, partner or whomever, etc...after they eat...see what you come up with? I'd imagine we can debate all different facts, data on here all day long and roam the internet to find/support something which fits into any of our individual opinions, too. I'm not at all a fan of Jenny Ruhl but some are. Again, just test someone who supposedly has a fully functioning pancreas...see the 'results' for yourself. I have NEVER seen a non diabetic go to 200 after eating, never. Nor do they fall into a true hypoglycemic area without something (med, insulin) to push them there.
I'd actually like to see a CGM on a non-diabetic and what happens to them during sleeping, night time hours; to see if he/she goes up during the DP stages or timeframe.
Sarah I used the dexcom. I wasn't able to tolerate having the sensor in me, allergic reaction, pain and swelling, even it had been accurate it wouldn't be usable for me. I have heard other people say also, total lack of accuracy and they hated it. I also don't want something beeping at me constantly. I need non invasive means of cgm and pump- hopefully the biohub will turn out to be something that can really work for us. By fluctuations I meant highs and lows… I think there are many things that cause damage with diabetes, fluctuations and highs are just the main ones probably.