diabetes question

[asscherisme]

I got a call from my doctor that a fasting blood sugar was high (127) and that it might indicate I have diabetes. IT really shocks me because there is no history in my family. He did say that it would need to be confirmed by a second fasting blood sugar.

My question is, the day before the test, I baked cookies with my kids and I ate way too many of them. And the night before the test, I went out to dinner - chinese food buffet and ate way more than I normally do. So over all the day before, my diet was way out of whack with what I normally eat. Way too many cookies, chinese food and lots, and I even drank a large coke at dinner and I rarely drink soda. I have not been to a buffet in years, its definately not a regular thing.

I had finished eating around 10pm and the blood test was at 9am. I did not realize the doctor would do the test. It was just a routine physical.

Is there a change it was a false reading due to the amount of food I ate? Could my body just have gone so haywire from the extra carbs/sugar thats whyt he level was high?

I am just going to eat my normal way and make sure the day before the test to not overeat or over due it and hopefully the second test will be normal (under 100).

Am I fooling myself and I probably have type II diabetes? Or is there a chance I don't have it and I just screwed up the results with my day before eating?

I am really panicking and this is something that has thrown me for a loop. I have not told anyone but have been crying a lot about it in private.

 

[justjulia]

Hey,

That same thing happened to me. I had a banana milkshake the evening before and I blame that. I was thrown for a loop, like you. The doctor had it retested on another day and you can be sure I ate no carbs or sugar the week before and then ran on the treadmill for 20 mins before going for the test, to burn up any sugar floating around in my bloodstream, lol. It came out fine. It has been fine since, and this was 2 yrs ago.

So, odds are good it was exactly what you said. Don''t worry!

 

[Maisie]

I also had the same problem. I ate some chocolate the evening before my test (which was also unexpected). My levels were silly high. I had a second test with fasting and I made sure not to eat anything fattening for 24 hours beforehand, and my results were the high end of normal.. but normal nonetheless!

 

[icekid]

asscher- As your doctor mentioned, you do need two fasting glucose levels to diagnose diabetes.

The problem is this- even though you ate beyond your ordinary diet the day before, your body should be able to make enough insulin to make up for the fact that more sugar was coming in. In turn, our body should then be able to respond to the increased insulin and take up the extra glucose and store it.

Really, you were fasting for plenty of time to get an accurate level. I''d say it is unlikely that your repeat will be less than 100, but hey- there is some error in all lab tests in addition to your diet being a little off the prior day.

I hope the repeat comes back much lower!

 

[asscherisme]

And to add insult to injury on the test, I usually work out a lot and that particular week I had hurt my back and had not gotten any workouts in. You know when you are running out to the store and you look like crap and thats when you run into someone? And you don't normally look as bad as you do at that moment and you feel embarrased? Well thats how I feel about the test. I feel like if I knew it would be done I would have not eaten about 6 cookies the night before and draank a full sugar coke and had 2 plates of chinese food!!!

I'm still really really worried though. I have my plate full with my kids needs and just don't have the energy to deal with this.

I am going back in 2 weeks for a retest.

If I did in fact have type II diabetes, woudn't my fasting blood sugar have been way higher after what I ate the night before? Like over 200 or something?

Julia and Maise, do you remember what your fasting blood sugar level was that was "off"? Your experience made me feel a bit better.

icekid, thats what I'm worried about, my body should have been able to compensate?

 

[icekid]

To the two prior posters who modified their diets added exercise before the test- I would say if that is not the way you normally eat, then you''re kind of deluding yourself. Obviously, you don''t want to have diabetes. But! If you only change your diet for the purpose of passing the test, then why test at all? To fool your doctor? Diabetes is a serious disease.

 

[asscherisme]

icekid, thats why I am going to do what i normally do. Which is eat fairly healthy but not perfect. But no where not even close to what I ate the night before the test. And normally I workout a lot.

So basically my normal routine because I want an accurate picture.

So now I''m confused. Is it a good possiblity that the test was wrong?

Even if the next test comes back as I am hoping, its still a wake up call about the effects of overeating!

 

[icekid]

Date: 5/31/2009 6:15:01 PM
Author: asscherisme

If I did in fact have type II diabetes, woudn''t my fasting blood sugar have been way higher after what I ate the night before? Like over 200 or something?



icekid, thats what I''m worried about, my body should have been able to compensate?

asscher- If possible with your back injury, I would return to your normal level of activity and diet before testing again. I think the combination of decreased activity plus the poor diet surely did not help. However, your sugar would be WAY WAY out of control to have a fasting 200 in the morning.

And yes, your body should be able to compensate. This was a bad eating day for you, but there are plenty of people out there who eat like that daily and their body is able to crank out the insulin (and then respond to it) and not have a high glucose.

 

[strmrdr]

one high test is meaningless.

You can have a problem dealing with sugar/carb overload like that and not have diabetes as such on a day to day basis and it may never develop into it.

Eat normally until the next test and follow the directions to a T and await the results.

I would however recommend avoiding that much overdoing in the future.

The test could have been wrong or a dozen other things also.

 

[asscherisme]

Karl, I agree with not overdoing it like that. Hopefully I don''t have it but the test is still a big wakeup call about the effects of overdoing it. I''m hoping my body was just shocked at the amount of carbs/sugar I ate.

Test doctor visit was about 10 days ago and I just got the call Friday. The good news is that last wed. I started my regular work outs again. So I guess I''ll just continue that and eat normally. I am going back 2 weeks from tommorow.

And I am going to worry until then.

 

[strmrdr]

Date: 5/31/2009 6:34:48 PM
Author: asscherisme
Karl, I agree with not overdoing it like that. Hopefully I don''t have it but the test is still a big wakeup call about the effects of overdoing it. I''m hoping my body was just shocked at the amount of carbs/sugar I ate.


Test doctor visit was about 10 days ago and I just got the call Friday. The good news is that last wed. I started my regular work outs again. So I guess I''ll just continue that and eat normally. I am going back 2 weeks from tommorow.


And I am going to worry until then.

Its only 1 point into the diabetes territory so not terribly high to start with.
126 is the start point for diagnosis.
So yes take it as a wake up call not to overdue but don''t worry to much!

 

[asscherisme]

Thanks for the calm down talk.

And absolutely wake up call taken for sure.

 

[icekid]

Date: 5/31/2009 6:40:34 PM
Author: strmrdr

Its only 1 point into the diabetes territory so not terribly high to start with.

126 is the start point for diagnosis.

So yes take it as a wake up call not to overdue but don''t worry to much!

storm- you are right about the diagnosis "starting" at 126, but that number has continued to trend down over the years actually. Being insulin resistant with numbers heading toward diabetic should not be ignored either.

 

[asscherisme]

From what my doctor told me, being 100-125 is considered "Pre-diabetic" so even that is a walk up call to watch my eating more carefully.

Interesting though, so diagnosis use to be higher than 126?

 

[strmrdr]

Date: 5/31/2009 6:55:18 PM
Author: icekid

storm- you are right about the diagnosis ''starting'' at 126, but that number has continued to trend down over the years actually. Being insulin resistant with numbers heading toward diabetic should not be ignored either.

true enough but one reading of 127 is not diagnostic and my main point was to calm down and not get overly worried and stressed at this point.
I think you would agree?

 

[strmrdr]

Date: 5/31/2009 6:57:38 PM
Author: asscherisme
From what my doctor told me, being 100-125 is considered ''Pre-diabetic'' so even that is a walk up call to watch my eating more carefully.


Interesting though, so diagnosis use to be higher than 126?

100-125 is check it a couple times a year and keep an eye on it territory with some lifestyle changes as needed I know people that have been in that range their entire life and it never got worse.
Here is a run down of the official standards:

http://diabetes.webmd.com/blood-glucose?page=3

I get checked every once in a while because it runs in my family.
All of my grandparents had it and some aunts and uncles.
My parents never did but had an occasional high reading then the next one would be fine.

 

[icekid]

Date: 5/31/2009 7:01:01 PM
Author: strmrdr

Date: 5/31/2009 6:55:18 PM

Author: icekid


storm- you are right about the diagnosis ''starting'' at 126, but that number has continued to trend down over the years actually. Being insulin resistant with numbers heading toward diabetic should not be ignored either.

true enough but one reading of 127 is not diagnostic and my main point was to calm down and not get overly worried and stressed at this point.

I think you would agree?

I do agree

I really hope your next one is back in range, asscher. And yes, they used to have a higher cutoff to diagnose diabetes.

 

[justjulia]

Personally, I think that doctors are afraid to tell you not to worry because they are afraid of litigation.
The thing for me was that I haven''t hadn''t had a milkshake in 3 years and had also had 2 doughnuts earlier, too. I was borderline. I agree that it is a wake up call to watch diet overall but I do not think that doctors have any business scaring people to death. I think medicine has swung WAY too far the other way just because of law suits.

I get so tired of being scared by tests only to find out there was not need to be scared. It has been that way with an amnioscentesis and mammograms. You get sort of immune to all of the business of doctors cya, if you know what I mean.

 

[icekid]

Date: 5/31/2009 9:44:15 PM
Author: justjulia

The thing for me was that I haven''t hadn''t had a milkshake in 3 years and had also had 2 doughnuts earlier, too. I was borderline. I agree that it is a wake up call to watch diet overall but I do not think that doctors have any business scaring people to death. I think medicine has swung WAY too far the other way just because of law suits.
.

There is a whole lot of CYA in medicine, but I''m not sure what it has to do with a blood test for diabetes

 

[justjulia]

Also, my husband had his physical this year and didn''t do anything differently and his was 125 first round and 2 weeks later it was 89. The doctor said it was probably what he ate the day before, the first time and just shrugged it off. I think textbook numbers are all very concrete but you really have to look at the whole picture.

And I wasn''t not trying to "trick" my doctor at all. I was just freaked out and wanted to see if I could control it. And I did. If my body was unable to increase the insulin sufficiently, it wouldn''t have mattered what I ate or did prior to the second test.

So, forgive me Icekid if I sound kind of steamed, but really I think you have to consider many things and consider bedside manner. The tone of a doctor can mean the world to someone who is worried.

 

[MichelleCarmen]

Instead of another fasting test, ask your doctor to give you a A1C test that checks how your blood sugar levels have been over the last few months. Basically, you'll gain a better insight on what the diet you generally eat is doing to your blood sugar levels.

Aside from the A1C test, I would suggest you buy a home meter that you can regularily test your main dietary foods and see if anything in particular is making your blood sugars raise up.

 

[mochi]

I'm a diabetic (T2) and my fasting blood sugar goes up/down depending on the food I ate the night before. The more indicative test is the A1c test. It will let you know your average blood sugar for the last 3 months.

ETA: You can get a glucose meter free on the net. Right now, One Touch Ultra is giving out free meters for diabetics.

 

[justjulia]

Date: 5/31/2009 9:52:47 PM
Author: icekid

Date: 5/31/2009 9:44:15 PM
Author: justjulia

The thing for me was that I haven't hadn't had a milkshake in 3 years and had also had 2 doughnuts earlier, too. I was borderline. I agree that it is a wake up call to watch diet overall but I do not think that doctors have any business scaring people to death. I think medicine has swung WAY too far the other way just because of law suits.
.

There is a whole lot of CYA in medicine, but I'm not sure what it has to do with a blood test for diabetes

The doctor should have put her at ease. I can only imagine the info was delivered in a sterile non emotional manner. Drs dare not play cool or patients might not take it seriously enough to change their lifestyle. That and if diabetes does develop, the patient won't sue them later. My view; your milage may vary.

 

[icekid]

Date: 5/31/2009 9:55:31 PM
Author: justjulia

And I wasn''t not trying to ''trick'' my doctor at all. I was just freaked out and wanted to see if I could control it. And I did. If my body was unable to increase the insulin sufficiently, it wouldn''t have mattered what I ate or did prior to the second test.


So, forgive me Icekid if I sound kind of steamed, but really I think you have to consider many things and consider bedside manner. The tone of a doctor can mean the world to someone who is worried.

I agree there is a lot of importance in the delivery of "bad news." I''m sorry you were unhappy with your physician.

Just an FYI- the fact that you could "control" your glucose through diet and exercise is not a shock. However, it''s not really a truthful representation of the glucose you walk around having if that is not your usual diet/activity level (though fantastic if you made a lifestyle change!). Many (most) diabetics CAN have normal numbers without medication through diet/exercise, especially early in the course of their disease.

 

[justjulia]

Date: 5/31/2009 10:03:57 PM
Author: icekid

Date: 5/31/2009 9:55:31 PM
Author: justjulia

And I wasn''t not trying to ''trick'' my doctor at all. I was just freaked out and wanted to see if I could control it. And I did. If my body was unable to increase the insulin sufficiently, it wouldn''t have mattered what I ate or did prior to the second test.


So, forgive me Icekid if I sound kind of steamed, but really I think you have to consider many things and consider bedside manner. The tone of a doctor can mean the world to someone who is worried.

I agree there is a lot of importance in the delivery of ''bad news.'' I''m sorry you were unhappy with your physician.

Just an FYI- the fact that you could ''control'' your glucose through diet and exercise is not a shock. However, it''s not really a truthful representation of the glucose you walk around having if that is not your usual diet/activity level (though fantastic if you made a lifestyle change!). Many (most) diabetics CAN have normal numbers without medication through diet/exercise, especially early in the course of their disease.

I had not had a milkshake in 3 years. It was a fluke. A ridiculous fluke. Doctors should tell their patients that if they go and consume massive amounts of sugar the night before, this could happen.

Again, my husband''s doctor laughed it off. It has to be a common occurance.

I think that doctors with more experience temper their interpretation of the test.

 

[icekid]

justjulia- Shrug... not trying to argue with you. There is a reason, clearly, that two tests are required to make the diagnosis. I''m sorry you have a problem with young doctors.

 

[perry]

For starters... I have type II diabetes; and was "Pre-diabetic" for years prior to that.

The test results you report raises a question. The fact that you ate a large amount the day before should not have affected it. All it normally takes is 8 hours of fasting after your last meal to get a good read on where your blood sugars are.

The fact that you routinely exercise makes it more of a concern. People who routinely exercise usually have better blood sugar levels. One of the keys to gain control of Type II diabetes is to start a routine exercise program.

However, if you were feeling ill (flue - cold - etc) that often raises blood sugar. I am not sure that a back injury does that (and I''ve seen no correlation to back problems and blood sugar in my case).

People who report extensive fasting and even exercise prior to the test are fooling themselves and may not have a valid test.

It is far better to find out you have problems in the "pre-diabetic" stage and take care of those problems than to let it develop to full diabetes. I sure wish I had taken proper action then.

So, just eat a normal diet (for you) the day before - fast overnight, don''t eat anything before the blood test (no coffee with sugar, no soda, etc). I tend to take an apple with me so that I can start eating something as soon as I can after the blood test.

The A1C test is a far better indicator - and I suggest that you request to have that test run as well.

One of the reasons that the numbers have trended down on when the Dr''s raise the alarm is that there is overwhelming evidence that if you take proper action when the blood sugar levels are in the pre-diabetic stage that you can prevent diabetes from ever occuring; and there are many major health effects that are very hard to avoid once you develop diabetes.

While on test at that level is not an indication by itself - Please take this issue seriously.

One thing I did at the prediabetic stage was to purchase a good blood glucose meter and test how I reacted during the day (sometimes up to 10 times a day). What was my blood sugar before eating, 1 hour after eating, 2 hours after eating, etc - and for different foods. The results closely match what is reported in the "glycemic" index for foods.

You may find that just by switching to lower glycemic index foods and limiting your intake of higher glycemic index foods that you can control your blood sugar soley by that if you are in a pre-diabetic stage.

I wish you the best with this; and I sure wish I had taken much more seriously my situation 5 years ago before I develope full fledge Type II diabetes.

Perry

 

[:)]

I stopped by quickly for a little break from work and saw this...

Had you had anything to drink the morning of? Often people 'forget' about things like OJ or coffee with milk/creamer/sugar in it as they only think of solid food when they think fasting.

Currently the diagnosis of diabetes is made on two separate random blood glucose values. The values are established as a part of a continuum from normal to diabetic, designed to diagnose early enough to enable interventions to prevent long term complications (eyes, kidney, etc, etc).

In about 3 months from now there will be a radical change in the way diabetes is diagnosed - at that time the hemoglobin a1c (hgba1c) will become the standard test to diagnose (currently it is not used to diagnose diabetes, but is used to follow people already diagnosed with diabetes.) The interesting thing is that at that time, people with blood glucoses in the current range for a new diagnosis of diabetes (say a couple of values like 127, 12, but with an a1c below 6.5 will no longer be called diabetic! Again, cutoffs are established (and over the years have been lowered to encompass more people) due to potential for long term complications from the disease that can be prevented/lessened with early diagnosis and intervention/control of glucose levels.

Most insurance companies will only currently cover the hgba1c blood test on diabetics, as it is currently not standardized as a way to diagnose diabetes. I personally would thus not specifically seek out this test in case it affects your insurance submissions (at least until the new guidelines are formally published) and would also not seek out any type of form or forms that would have to be filled out to have a diagnosis of diabetes placed on them (such as putting the icd9 code for diabetes down on a form for a free meter, etc) unless you actually have diabetes.

It is not unusual to get people with a normal blood glucose on repeat - it is more common that the repeat is in the impaired fasting glucose range than entirely normal, but a repeat value can be normal.

The best thing about this is it can serve as a wake up call to improve your diet (and get back to good cardio exercise!), even if the repeat value is normal. (or in the impaired range) The initial treatment/intervention is diet and exercise and, as Perry mentioned, early intervention and modification of diet and exercise is important. What you want to do is prevent lthe ong term serious complications as Icekid mentioned.

You can get your a1c in a few months when the guidelines change.

HTH.

 

[lyra]

I''m diabetic. I would never want to sit through the actual fasting glucose tolerance test, where you have to sit in the clinic for hours. No, I''d insist on the A1C test instead, even if I had to pay for it myself. I don''t know if it is considered the definitive test, but who wouldn''t rather have one simple blood test which gives you your average blood glucose level over the last 2-3 months than sit in a clinic for possibly nothing. If the A1C proved to be high, okay, then you''d have to force yourself to do the GTT I suppose. Hope that helps a bit. BTW, I have excellent glucose control, but mornings are always my high time, usually 108-120 no matter what. Good luck.

 

[:)]

Date: 6/1/2009 12:15:12 PM
Author: lyra
I''m diabetic. I would never want to sit through the actual fasting glucose tolerance test, where you have to sit in the clinic for hours. No, I''d insist on the A1C test instead, even if I had to pay for it myself. I don''t know if it is considered the definitive test, but who wouldn''t rather have one simple blood test which gives you your average blood glucose level over the last 2-3 months than sit in a clinic for possibly nothing. If the A1C proved to be high, okay, then you''d have to force yourself to do the GTT I suppose. Hope that helps a bit. BTW, I have excellent glucose control, but mornings are always my high time, usually 108-120 no matter what. Good luck.

Hi Lyra, the fasted glucose test only entails fasting and walking into the lab for a blood sample, no waiting - similar to a fasted lipid panel.
Currently the diagnosis of diabetes is not based on an a1c. You diagnose it based on two separate fasting blood glucose samples (or the randoms)

I believe you are thinking of the oral glucose tolerance test which does entail a couple of hours time and is not routinely done. It is useful in pregnancy where the blood glucose changes are too quick for an a1c to be helpful (if you waited for the a1c to change, you would be treating an old value long after the damage is done and the baby born - the value in the beginning would reflect the prior 3 months and so on)

Hope this clarifies.