When do postprandial bg's peak?

Discussion in 'Health and medical' started by Carterjp, Feb 23, 2004.

  1. Carterjp

    Carterjp Guest

    I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to 75
    minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).

    And while you are here, a couple of diet questions - what's with the squash family of vegetables? I
    ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes (simply
    microwaved and doused in some lemon juice by way of preparation) I thought they were supposed to be
    low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I also have erratic
    results with grapefruit. Had half a grapefruit one day to see bg go to 100 and then decline. The
    next day the same size serving from a fresh batch I excitedly bought from the grocers took it to 150
    without warning, (when right the day after one slice of whole wheat bread with sugarfree apricot jam
    only took me to 120 before declining). Could it be that different grapefruit varietals behave
    differently? Bizzare.

    T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    200)
     
    Tags:


  2. Alan

    Alan Guest

    On 23 Feb 2004 00:20:20 -0800, [email protected] (carterjp) wrote:

    >I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    >75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    >starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    >occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    >sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).
    >
    >And while you are here, a couple of diet questions - what's with the squash family of vegetables? I
    >ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes (simply
    >microwaved and doused in some lemon juice by way of preparation) I thought they were supposed to be
    >low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I also have
    >erratic results with grapefruit. Had half a grapefruit one day to see bg go to 100 and then
    >decline. The next day the same size serving from a fresh batch I excitedly bought from the grocers
    >took it to 150 without warning, (when right the day after one slice of whole wheat bread with
    >sugarfree apricot jam only took me to 120 before declining). Could it be that different grapefruit
    >varietals behave differently? Bizzare.
    >
    >T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    >200)

    I'm with you mate. I peak about the same time you do, unless there is a lot of oil in the meal - the
    "pizza effect". Don't sweat it - we're all a little different. I don't bother with the two-hour test
    unless my one-hour is unusual.

    The important thing is that you are testing and discovering things like this.

    On squash, grapefruit etc. Once again, we are all a little different. Believe your meter. If it's a
    favourite food, reduce the portion size and try again. If that soesn't work, try a different time
    of day. If that doesn't work, check if there are other vitamin or nutrition reasons to persist. If
    not, dump it.

    On eating the same thing with different results. Try again if the food is worth the effort; but
    remember there are also diurnal variations. I can't handle carbs of any sort before lunch, and only
    10-15 gm then. I can handle almost anything after mid-afternoon (in moderation:)

    Only your self-testing will eventually show you what and when you can eat. Keep at it - it's worth
    the effort. Maybe you can eat your grapefruit at bed-time.

    Cheers Alan, T2, Australia. dx May 2002 , A1C 8.2=>5.9, wt 117kg=>90kg, No diabetes meds.Diet and
    not enough exercise. I have no medical qualifications beyond my own experience. Choose your advisers
    carefully, because experience can be an expensive teacher.
    --
    Everything in Moderation - Except Laughter.
     
  3. markd

    markd Guest

    The 2 hr pp is usually used as the benchmark for testing food imppact on bg, the peak is often
    around 1 hr but varies with food and person. The 2 hr became the benchmark I speculate because it
    is/was used for same in the glucose load challendge test where a standard amount of glucose is given
    and the post intake results tested.

    As for the things you tested with varing results, one must first note the before intake number. Each
    item has x amount of impact usually which is in addition to the bg level with which you began. Test
    to get the responce difference to see what the food does. When you have stabilized your fbg and
    before meal bg these difference readings will be more helpful.

    >I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    >75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    >starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    >occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    >sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).
    >
    >And while you are here, a couple of diet questions - what's with the squash family of vegetables? I
    >ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes (simply
    >microwaved and doused in some lemon juice by way of preparation) I thought they were supposed to be
    >low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I also have
    >erratic results with grapefruit. Had half a grapefruit one day to see bg go to 100 and then
    >decline. The next day the same size serving from a fresh batch I excitedly bought from the grocers
    >took it to 150 without warning, (when right the day after one slice of whole wheat bread with
    >sugarfree apricot jam only took me to 120 before declining). Could it be that different grapefruit
    >varietals behave differently? Bizzare.
    >
    >T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    >200)
     
  4. Jennifer

    Jennifer Guest

    It's not a two hour peak...

    At two hours you would like to see yourself coming down.

    That's why the one hour goal is under 140 and the two hour goal is under
    120.

    Jennifer

    carterjp wrote:
    > I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    > 75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    > starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    > occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    > sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).
    >
    > And while you are here, a couple of diet questions - what's with the squash family of vegetables?
    > I ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes
    > (simply microwaved and doused in some lemon juice by way of preparation) I thought they were
    > supposed to be low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I
    > also have erratic results with grapefruit. Had half a grapefruit one day to see bg go to 100 and
    > then decline. The next day the same size serving from a fresh batch I excitedly bought from the
    > grocers took it to 150 without warning, (when right the day after one slice of whole wheat bread
    > with sugarfree apricot jam only took me to 120 before declining). Could it be that different
    > grapefruit varietals behave differently? Bizzare.
    >
    > T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    > 200)
     
  5. Al Hardy

    Al Hardy Guest

    Jennifer wrote:
    > It's not a two hour peak...
    >
    > At two hours you would like to see yourself coming down.
    >
    > That's why the one hour goal is under 140 and the two hour goal is under 120.
    >
    >
    > Jennifer
    >
    >
    > carterjp wrote:
    >> I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    >> 75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    >> starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    >> occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I
    >> see sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).
    >>
    >> And while you are here, a couple of diet questions - what's with the squash family of vegetables?
    >> I ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes
    >> (simply microwaved and doused in some lemon juice by way of preparation) I thought they were
    >> supposed to be low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I
    >> also have erratic results with grapefruit. Had half a grapefruit one day to see bg go to 100 and
    >> then decline. The next day the same size serving from a fresh batch I excitedly bought from the
    >> grocers took it to 150 without warning, (when right the day after one slice of whole wheat bread
    >> with sugarfree apricot jam only took me to 120 before declining). Could it be that different
    >> grapefruit varietals behave differently? Bizzare.
    >>
    >> T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    >> 200)

    With numbers over 200 IGT appears to be a wrong dx - you ARE t2. As for the spikes, they vary from
    person to person, from meal to meal, what you were doing before after and before the meal.

    It would be an easy thing to control DM if we were each the same every day, and all the same as
    everyone else. That is not the case, which at least keeps life interesting.
    --
    Now some people are cute and sweet
    and soft and kind and gentle,
    but I'm someone who's round the bend
    and marvellously mental!
     
  6. Ol' Bab

    Ol' Bab Guest

    carterjp wrote:
    > snip.... And while you are here, a couple of diet questions - what's with the squash family of
    > vegetables? I ate Chayote and it sent my bg rocketing. I experienced something similar with baby
    > squashes (simply microwaved and doused in some lemon juice by way of preparation) I thought they
    > were supposed to be low glycemic.

    There are two kinds of squash, summer and winter. The summer kinds are low starch. Watery. Rot
    easily. The winter kinds (keepers) are high starch. Ooops!, that's a generalization, maybe I'm
    in trouble.

    Anyway, don't know which Chayote is, and of coarse baby squashes could be anything.....

    Ol' Bab
     
  7. there is no hard and fast rule for bg peaks. Different foods will peak at different times. A high
    fat meal or pizza will have keep your bg's up for many hours. Simple carbs will leave your system
    rather quickly. The faster the rise, the quicker the fall.

    dave

    carterjp wrote:

    > I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    > 75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    > starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    > occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    > sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).
    >
    > And while you are here, a couple of diet questions - what's with the squash family of vegetables?
    > I ate Chayote and it sent my bg rocketing. I experienced something similar with baby squashes
    > (simply microwaved and doused in some lemon juice by way of preparation) I thought they were
    > supposed to be low glycemic. Is this a YMMV phenomenon? Another personal YMMV factoid perhaps - I
    > also have erratic results with grapefruit. Had half a grapefruit one day to see bg go to 100 and
    > then decline. The next day the same size serving from a fresh batch I excitedly bought from the
    > grocers took it to 150 without warning, (when right the day after one slice of whole wheat bread
    > with sugarfree apricot jam only took me to 120 before declining). Could it be that different
    > grapefruit varietals behave differently? Bizzare.
    >
    > T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    > 200)
     
  8. Carterjp

    Carterjp Guest

    I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89, HbA1C
    is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you cross 200,
    and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are T2. No meds for
    now. Diet and exercise like the T2 you are, or else you will face the consequences a T2 faces when
    they don't diet and exercise."

    My questions on that score are -->

    a) Should I be checked for retinopathy, kidney, heart and other damage?
    b) Is it common for this (relatively low fasting and OGTT, but clearly diabetic PP bgs) to happen?

    T2, dx Jan 2004, Male, 35 years, 5'11", 175lbs -> 165lbs

    "Al Hardy" <[email protected]> wrote in message news:<[email protected]
    berlin.de>...
    > >>
    > >> T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    > >> 200)
    >
    > With numbers over 200 IGT appears to be a wrong dx - you ARE t2. As for the spikes, they vary from
    > person to person, from meal to meal, what you were doing before after and before the meal.
     
  9. In article <[email protected]>,
    [email protected] (carterjp) wrote:

    > I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89, HbA1C
    > is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you cross 200,
    > and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are T2. No meds for
    > now. Diet and exercise like the T2 you are, or else you will face the consequences a T2 faces when
    > they don't diet and exercise."

    That sounds almost exactly like my endo, except he prescribed metformin for cardiac protection.

    > My questions on that score are -->
    >
    > a) Should I be checked for retinopathy, kidney, heart and other damage?

    I am.

    > b) Is it common for this (relatively low fasting and OGTT, but clearly diabetic PP bgs) to happen?

    I haven't had a GTT in decades, but these days I look non-diabetic until I eat a plate of
    linguine or a baked potato or any number of other foods I don't eat any more. AAMOF, my internist
    refused to believe I was diabetic because I was keeping my numbers so good just with diet and a
    little exercise.

    Priscilla
     
  10. Al Hardy

    Al Hardy Guest

    carterjp wrote:
    > I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89, HbA1C
    > is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you cross 200,
    > and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are T2. No meds for
    > now. Diet and exercise like the T2 you are, or else you will face the consequences a T2 faces when
    > they don't diet and exercise."
    >
    > My questions on that score are -->
    >
    > a) Should I be checked for retinopathy, kidney, heart and other damage?
    >
    Yes, I would definitely get those done, on an annual basis. And don't forget podiatry, please. I am
    in the UK, so I can't say whether your insurance would cover those costs fully or partly, but if you
    do have to pay, well, what price your health?

    > b) Is it common for this (relatively low fasting and OGTT, but clearly diabetic PP bgs) to happen?
    >
    I don't know as much about t2 as I ought to, but if not "common", it certainly does happen.

    Al.

    > T2, dx Jan 2004, Male, 35 years, 5'11", 175lbs -> 165lbs
    >
    > "Al Hardy" <[email protected]> wrote in message news:<[email protected]
    > berlin.de>...
    >>>>
    >>>> T2 detected Jan 23, 2004 (doc and OGTT say IGT, but pp bg can cross
    >>>> 200)
    >>
    >> With numbers over 200 IGT appears to be a wrong dx - you ARE t2. As for the spikes, they vary
    >> from person to person, from meal to meal, what you were doing before after and before the meal.
     
  11. Frank Roy

    Frank Roy Guest

    carterjp wrote:

    > My questions on that score are -->
    >
    > a) Should I be checked for retinopathy, kidney, heart and other damage?

    There may be damage to basement level membranes in some organs, but this sort of damage is not
    easily detected. At your age (35), your glucose/insulin problems have probably been found early. You
    are also on the lean side. Type 2 diabetics usually have lost some of their early or first phase
    insulin secretion (secretion within about 15 minutes of eating).

    > b) Is it common for this (relatively low fasting and OGTT, but clearly diabetic PP bgs) to happen?

    It is more frequent than many people realize. A person could go on for years and not be diagnosed
    until they were frankly diabetic.

    You should buy yourself a cheap glucose meter (ReliOn) and strips at WalMart. Then start to test
    yourself PP for different foods and proportions. By process of elimination, you can regain better PP
    BG control. Glucose intolerance can even vary by time of day, so consider that as a factor in your
    food choices.

    Frank
     
  12. Herman Rubin

    Herman Rubin Guest

    In article <[email protected]>,
    carterjp <[email protected]> wrote:
    >I see everyone talking about 2 hour peaks, but I've been measuring peaks usually at 45 minutes to
    >75 minutes (1 hour 15 minutes). What's going on? Fyi, my meals do tend to be lower in grains and
    >starches (potatoes and such) - but my understanding is that these time-delay (not advance) the
    >occurance of peaks. Can there be two peaks? I haven't seen this (2 peaks) happen yet, though I see
    >sustained highs (lasting ~45 mins) when I experiment with some foods (I'm still learning).

    Nobody really knows; it depends when the foods are digested, when the pancreas responds (for Type
    2), when the liver dumps glucose, when the medications take effect, etc.

    There is little or no response to what is in the stomach; the pancreas and liver only know what is
    in the blood stream, which is in a not too quick equilibrium with the much larger interstitial
    fluid. For someone with a steady bg of 100 (1 gram per liter), the blood has about 20 calories of
    glucose, and the interstitial fluid about 90. Low glycemic index foods will certainly move the peaks
    later, and are likely to flatten them even to not showing up as peaks. I can see no reason why there
    cannot be many peaks, or why they cannot change from one day to the next.
    --
    This address is for information only. I do not claim that these views are those of the Statistics
    Department or of Purdue University. Herman Rubin, Department of Statistics, Purdue University
    [email protected] Phone: (765)494-6054 FAX: (765)494-0558
     
  13. On Mon, 23 Feb 2004 09:18:08 -0800, Jennifer
    <[email protected]> wrote:

    >It's not a two hour peak...
    >
    >At two hours you would like to see yourself coming down.
    >
    >That's why the one hour goal is under 140 and the two hour goal is under
    >120.

    For those of us on insulin, the time of the peak depends very much on the type of food eaten and the
    type of insulin used. I once injected novolog, at pizza, and saw low 50's at 1 hour, then 130 at 3
    hours after eating. Clearly, the insulin "outran" the food in that case.

    >
    >
    >Jennifer
     
  14. On Mon, 23 Feb 2004 20:48:30 GMT, Bay Area Dave <[email protected]> wrote:

    >there is no hard and fast rule for bg peaks. Different foods will peak at different times. A high
    >fat meal or pizza will have keep your bg's up for many hours. Simple carbs will leave your system
    >rather quickly. The faster the rise, the quicker the fall.
    >

    Only if you've injected enough insulin. If not, it will just go up fast and stay up until you
    correct it in the next meal.
     
  15. Carterjp

    Carterjp Guest

    Frank Roy <[email protected]> wrote ...
    > >
    > > a) Should I be checked for retinopathy, kidney, heart and other damage?
    >
    > There may be damage to basement level membranes in some organs, but this sort of damage is not
    > easily detected. At your age (35), your glucose/insulin problems have probably been found early.
    > You are also on the lean side. Type 2 diabetics usually have lost some of their early or first
    > phase insulin secretion (secretion within about 15 minutes of eating).
    >

    Is there any way to find out what this damage is? I imagine that the fact I can peak so high if I
    eat the wrong things (e.g. 2 plateheaps of Pasta) means that I have some pancreatic damage because
    my first phase insulin secretion has been lost. But how do I find basement-level membrane damage?
    What does this mean for my future health?

    Also, should I specifically ask my doctor for metformin? Since I am somewhat young at 35 and have a
    ton of time to develop complications, which seem to develop in part due to IR, and not the BG, which
    is one side effect of IR (thanks to senior resident engineer OldAl for his knowledge and MedScape
    references!). Seems like I can control my BG all I want, but the underlying IR will still be at work
    giving me CVD and related issues. OTOH, the young-ish initiation into diabetes also gives me more
    time to develop dangerous drug side-effects (like messing-up my liver) from long-term medication,
    doesn't it?

    I have bought a blood-pressure meter from Walgreens for $60 and measure occassionally. I'm trying to
    figure out how to measure leg-bp as well (haven't yet).

    > > b) Is it common for this (relatively low fasting and OGTT, but clearly diabetic PP bgs) to
    > > happen?
    >
    > It is more frequent than many people realize. A person could go on for years and not be diagnosed
    > until they were frankly diabetic.

    I have been doing this. To date, the only data in the world showing that my bg exceeds 140/150 with
    a carb-oriented meal and can go up to
    190/200 with a high-glycemic carb-oriented meal is my meter (I have two of them - an older one and a
    newer one for cross check). That has convinced my doctor, even though my OGTT and HbA1C would
    probably have had them send me packing as a non-diabetic, and a hypochondriac to boot. I have
    owned the older meter for years, but checked only sporadically (big mistake - I had not checked
    PP readings in the last couple of years). My mother is a diabetic who shared the sense of risk
    with me, so I have always suspected this could happen. I caught the diabetic bg's quite
    randomly, when I found my meter and did a PP check.

    > You should buy yourself a cheap glucose meter (ReliOn) and strips at WalMart. Then start to test
    > yourself PP for different foods and proportions. By process of elimination, you can regain better
    > PP BG control.

    I am doing this quite painstakingly. Needless to say, I am burning cash in the process. Cheaper
    strips would be fantastic. Are the cheaper meters as reliable? I mainly use J&J's LIfescan OneTouch
    Ultra currently.

    > Glucose intolerance can even vary by time of day, so consider that as a factor in your food
    > choices.

    You are absolutely right - my readings absolutely indicate this.

    T2, dx Jan 2004, Male, 35, 5'11", 175->165->headed to 160 Typical bp 117/72 Typical PP bg 120-145 at
    1 hr, 100-120 at 2 hrs; 140-160 at 1hr with overeating Typical morning and pre-dinner fasting bg 77-
    85 40 mins aerobics daily, low-ish carb meals, trying to add resistance training
     
  16. Carterjp

    Carterjp Guest

    Priscilla,

    > > I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89,
    > > HbA1C is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you
    > > cross 200, and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are
    > > T2. No meds for now. Diet and exercise like the T2 you are, or else you will face the
    > > consequences a T2 faces when they don't diet and exercise."
    >
    > That sounds almost exactly like my endo, except he prescribed metformin for cardiac protection.

    It's GREAT to have some company. How was your t2 dx'd? Also on a random pp test on a home-meter? How
    did you weigh your options in terms of getting officially classified as a t2 in the insurance system
    versus staying an official IGT and actual t2 under your PCP's care?
     
  17. Gman99

    Gman99 Guest

    [email protected] (carterjp) wrote:
    > Priscilla,
    >
    > > > I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89,
    > > > HbA1C is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you
    > > > cross 200, and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are
    > > > T2. No meds for now. Diet and exercise like the T2 you are, or else you will face the
    > > > consequences a T2 faces when they don't diet and exercise."
    > >
    > > That sounds almost exactly like my endo, except he prescribed metformin for cardiac protection.
    >
    > It's GREAT to have some company. How was your t2 dx'd? Also on a random pp test on a home-meter?
    > How did you weigh your options in terms of getting officially classified as a t2 in the insurance
    > system versus staying an official IGT and actual t2 under your PCP's care?

    Whoa...when was the last time someone was Dx'd with a meter. A meter is NOT a diagnostic tool. It's
    debateable whether you're even IGT. Did you take your meter with you when you had your OGT, did you
    compare results and calibrate your meter ??
     
  18. carterjp <[email protected]> quoth:
    >Priscilla,
    >> > I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89,
    >> > HbA1C is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you
    >> > cross 200, and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are
    >> > T2. No meds for now. Diet and exercise like the T2 you are, or else you will face the
    >> > consequences a T2 faces when they don't diet and exercise."
    >> That sounds almost exactly like my endo, except he prescribed metformin for cardiac protection.

    >It's GREAT to have some company. How was your t2 dx'd? Also on a random pp test on a home-meter?
    >How did you weigh your options in terms of getting officially classified as a t2 in the insurance
    >system versus staying an official IGT and actual t2 under your PCP's care?

    Not my PCP, my endocrinologist. Whole different kettle of fish! ;-)

    Last January, my regular internist (PCP) was out on maternity leave, and the physician assistant
    filling in for her did my annual checkup. She ordered the first fasting BG test I'd ever had. (I'd
    had a GTT years ago and been told I was "borderline diabetic" but no-one ever followed up with me
    about it, and I didn't know anything at that time.) The fasting test came in at 130, and the
    letter in which I was told this said my "sugar was a little high," and they wanted me in for a
    retest. They seemed more interested in my triglycerides of 248 and my cholesterol (total just
    under 200, HDL low).

    It was the FBG that I focussed on, though, since I knew type 2 diabetes ran in my family. I got
    really scared and started educating myself. Luckily, a poster in this newsgroup, Susan Fein, was a
    poster in another newsgroup I inhabited, and she clued me into carbohydrates and blood glucose and
    pointed me to some resources. I read up and started low-carbing. I waited two weeks to go in for the
    second FBG (which I knew by then would be the one that would confirm a diagnosis of diabetes -- or
    not). When I got it, I was at 103! At that time, 103 was within the normal range. Woo hoo! As far as
    I was concerned, that proved out low-carbing as the treatment for my diabetes. That was just over a
    year ago. (Oh, and the low-carbing fixed up my triglycerides and raised my HDL, too.)

    Unfortunately, my internist, when she returned, and her physician assistant decided that the 103
    meant I didn't have diabetes, despite my telling them over and over again how stringently I was low-
    carbing and how high my BG would go when I indulged. I'd learned here that metformin was important
    for cardiac protection, since insulin resistance can do a lot of damage regardless of how tightly
    one controls one's BG, and I explained that to my internist, but she refused to prescribe it for me.

    So I found an endocrinologist. I got an appointment with the endo of a woman I knew, but that MD
    moved out of the country before the time of my appointment came along, and I was given some dude I'd
    never heard of before. Turns out he is exactly the right doctor for me. He thinks that how I treat
    my diabetes is exactly how he wishes all his patients did and says that in 10 years low-carbing will
    be the established recommended treatment. (It probably didn't hurt my case that I'd written out a
    time line of lab results and how I'd been treating my condition with diet, etc.) This guy's also
    very personable and has nice crisp boundaries, while also being touchy-feely. A difficult
    combination to maintain, but he seems to do so.

    This endo was very clear when he typed his notes into the computer. He said that he was officially
    diagnosing me with "impaired glucose tolerance" because of how difficult a diagnosis of DM can be
    when trying to get insurance in the future (and because I'd never had a confirmatory high number
    needed technically for the diagnosis), but he then turned to me, looked me in the eye and said, "I
    need you to be very clear that I *do* understand that you have diabetes!" Finally! I was understood!
    He was also aware of the same information I was about metformin and prescribed it for me. I'm still
    ramping up on dosage and strugging with side-effects at 1500mg/day.

    It does feel a little odd, but it's a deception made necessary by problems not of my making. I keep
    good control and am in better general health than I was 1.5 years ago. Denial of coverage because of
    a diagnosis is unfair. I'm probably in better health than many people who've never been identified
    as diabetic but who may well be, people who would be taken on for insurance. I've been at my current
    employer for 23 years, and anticipate remaining here until I retire in 15 years, so I don't expect
    I'd need to apply for health insurance before I switch to Medicare, but since anything can happen,
    my doctor's "innocent deception" may end up being necessary.

    Hope this helps.

    Priscilla
     
  19. Darryl

    Darryl Guest

    [email protected] (carterjp) wrote in message news:<[email protected]>...
    > phenomenon? Another personal YMMV factoid perhaps - I also have erratic results with grapefruit.
    > Had half a grapefruit one day to see bg go to 100 and then decline. The next day the same size
    > serving from a fresh batch I excitedly bought from the grocers took it to 150 without warning,
    > (when right the day after one slice of whole wheat bread with sugarfree apricot jam only took me
    > to 120 before declining). Could it be that different grapefruit varietals behave differently?
    > Bizzare.

    No one has yet mentioned that grapefruit is one of the side-effect foods with some blood pressure &
    cholesterol medications; I know it is with Lipitor. Perhaps this is throwing off the readings.
     
  20. Oldal4865

    Oldal4865 Guest

    carterjp wrote in message ...
    >> You should buy yourself a cheap glucose meter (ReliOn) and strips at WalMart. Then start to test
    >> yourself PP for different foods and proportions. By process of elimination, you can regain better
    >> PP BG control.
    >
    >I am doing this quite painstakingly. Needless to say, I am burning cash in the process. Cheaper
    >strips would be fantastic. Are the cheaper meters as reliable? I mainly use J&J's LIfescan OneTouch
    >Ultra currently.
    >

    I trust my Relion more than my Ultra at higher bG. My Relion, my Ultra and my Accu-Chek
    Advantage are in good agreement at any sugar below 150 mg/dL.

    I am very satisfied with the service and prices for mail order strips from Hocks though they
    seem to no longer offer their best deals. Their old product list was unbeatable for the
    premium strips.

    http://hocks.com/

    Regards
     
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