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What Do My Lab Test Results Indicate?

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Posted on Fri, 22 Apr 2016
Question: I already mentioned this once here but wanted to get an opinion after offering more detail.

I've been monitoring blood sugar when i noticed i had a fasting glucose of around
120 -130 on several different days.
I went to doctor and he did an A1c and it was 5.6. i did an A1c at home 2 - 3 weeks later and it was 5.1
We are currently without insurance for 15 more days due to wifes switching jobs, so I'm wondering why the high morning glucose. My doctor said felt certain it's not due to diabetes or pre-diabetes, he said its because of my diet/ sleep pattern.
I have no symptoms or anything causing concern other than seeing those higher FBG.
i'm a fireman/ medic and work 24 hour shifts. I don't eat breakfast very often and my diet consists of morning coffee and around 3 sodas per day while running calls. I eat one large meal at dinner (around 8-9 o'clock), almost always heavy carb with a desert ( carbs and sugars are probably 200-300g for this meal) and I usually fall asleep within 15 min. We make calls during night so I average about 5 - 6 hours of sleep per night.
I already got the talk from my doctor about my current diet and how it isn't good, so I can change this for the future but due to job this is how its been thus far. Just being honest and I already am making adjustments.
i have checked my glucose levels quite a bit at home and my response to carbs sugars, even at higher levels seems normal.
my average daily random glucose level ranges between 80-115( normally around 105).
While fasting has been sometimes high my evenings before meal are almost always no higher than 85.
my average postprandials are normally between 110-130

because my doctor said I was okay and seeing my response to sugars is pretty normal, I've done a few self tests because I'm very curious about morning high BG. Plus I can't get true glucose tolerance by a doctor right now and not sure if I even want to because of pre-diabetes diagnosing trend that we've seen in the field for the last few years when getting patient HX on calls.

I listed them below

TEST 1:
fasting - 118
preprandial - 108
consumed - (70-80 grams of carbs/ breads within 5-7 min)
postprandial 1 hour - 134
postprandial 2 hour - 113
postprandial 3 hour - 96

TEST 2

fasting - 124
preprandial - 93
drank large morning soda within 5 min ( 80 grams of sugar)
postprandial 30 min - 189
postprandial 1 hr - 170
post prandial 1.5 hr - 133
post prandial 2 hour - 93
postprandial 2.5 hour - 78
postprandial 3 hour - 77

I know these are different sugars thus the different tests.
The only test that shot my sugar up was the soda test which I expected.
does my insulin response look normal?
thanks for response.


doctor
Answered by Dr. Ivo Ditah (46 minutes later)
Brief Answer:
INsulin respons eis normal..Questioning the fasting!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this concern about your sugars. For sure, the insulin response looks perfect. However, your fasting sugar is in the pre-diabetes range. When do you take measures for the fasting sugars? Early hours of the morning after the heavy diets?......

Well, you are definitely not diabetic and this is further confirmed by the HBA1c measures which are way below the threshold for making the diagnosis of diabetes. As you already know, your eating pattern is not the best and would be in your interest to address this. Am aware of the changes you mentioned but they are largely insufficient at this time.

I hope this helps. I wish you well. Thanks for using our services and do feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ivo Ditah (40 minutes later)
Thanks for response. Im wondering if the fasting glucose is high because of eating such high carbs going straight to sleep, plus sleep pattern.
First question is " could very large carb load cause higher morning sugar"
2nd "If i am experiencing "dawn phenomenon" type highs, could my sleep be causing that"?
Or a combination of both?
doctor
Answered by Dr. Ivo Ditah (11 minutes later)
Brief Answer:
Probably linked to high cabs diet!

Detailed Answer:
Hi,

I think this high FBS are related to the high carbs diet. I will not want to link this to the XXXXXXX phenomenon because you are not diabetic and there is certainly no room for hypoglycemias.

I hope this helps. I wish you well and let me know what your immediate thoughts are.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ivo Ditah (44 minutes later)
Yes, i dont think its XXXXXXX phenom either.
I have noticed when i eat a normal evening meal containg around 60-70 grams of carbs and wait at least 1 hour before sleep, my fasting glucose is in the low 80's regularly. Ive only tried this a handful of days but all of the days i have followed that mentioned above, my FBG is in the 80's.
Not sure if that tells you anything.
My insulin response does appear to be solid though.
doctor
Answered by Dr. Ivo Ditah (15 minutes later)
Brief Answer:
Your response is solid!

Detailed Answer:
Hi,

Your response is solid. Monit0r only and report future numbers to me. Keep physically active and adjust the diet to further better prevent diabetes.

I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ivo Ditah (15 minutes later)
Sorry to ask another question.
So does it seem im indeed not prediabetic either?
I understand being healthier but when you say "to prevent diabetes" do you think my readings indicate im fine and id best be served getting healthy or i look like im very early on in blood sugar issues?
Ive read that while A1c and fasting blood glucose are used as markers to check for blood sugar priblems, the insuline response is the standard to actually see how the body trulyhandles insulin.
doctor
Answered by Dr. Ivo Ditah (8 hours later)
Brief Answer:
You are not diabetic.....Your numbers do not suggest that...Not prediabetes

Detailed Answer:
Hi,

Your numbers do not suggest pre-diabetes or diabetes. When we say prevent a disease condition, it means you do not have it yet. Just like we will talk to all healthy persons to control weight diet, exercise often etc. to prevent diabetes irrespective of what the numbers are. Please, do not mistaken this for a possible diabetes.

Your numbers are good. Keep up with a healthy diet, regular exercise and lifestyle changes which will enhance better health.

I wish you well and hope this helps.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ivo Ditah

Internal Medicine Specialist

Practicing since :2002

Answered : 3984 Questions

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What Do My Lab Test Results Indicate?

Brief Answer: INsulin respons eis normal..Questioning the fasting! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this concern about your sugars. For sure, the insulin response looks perfect. However, your fasting sugar is in the pre-diabetes range. When do you take measures for the fasting sugars? Early hours of the morning after the heavy diets?...... Well, you are definitely not diabetic and this is further confirmed by the HBA1c measures which are way below the threshold for making the diagnosis of diabetes. As you already know, your eating pattern is not the best and would be in your interest to address this. Am aware of the changes you mentioned but they are largely insufficient at this time. I hope this helps. I wish you well. Thanks for using our services and do feel free to ask for more information and clarifications if need be.