I Am A 43 Year Old Caucasian Female Diagnosed With Type 2 Diabetes About A Month Ago My Blood Glucose Was 128 Mg/dl Five Hours After The Last Time I Ate So My Doctor Later Ordered An A1c Which Was 53 Im Now Taking Metformin And Am Scheduled For Another A1c In A Couple Of Months Im Confused About My Diagnosis Because I Am Thin Very Active Have A Good Diet Am Asymptomatic And Have No Family History Of Diabetes My Blood Pressure Cholesterol And Triglycerides Are Normal I Wondered About Lada But Both Gad And Ica Antibodies Were Negative Which My Family Practice Doctor Says Means I Have Type 2 Could I Still Have Type 1 Does It Matter Is It Worth Re
I do not see that you have met the criteria for diabetes. The criterion for diabetes is a fasting glucose of greater than or equal to 126 mg/dl on more than one occasion . The A1c studies have all been normal. The antibody tests are superfluous if you do not have diabetes. If you were to have diabetes, the antibodies are helpful, if they are positive. They do not rule out type 1 diabetes if they are negative. I would strongly challenge the diagnosis. You do not want to have diabetes on your medical record if you really do not have it. It is all an insurance company needs to discriminate against you and charge unbelievable premiums.
Normal Waking Blood Sugar
After a night of sleep, and without any recently digested food in the system, the bodys glucose level tends to settle down to a healthy, normal level.
In the context of diabetes, this doesnt happen naturally, but it can be achieved with the proper use of insulin and other glucose-lowering medications. Ideally, everyone with diabetes will wake up with blood sugars in the normal range.
However, many people experience what is called the dawn phenomenon. As the body prepares to wake and start moving, it releases stored sugar from the liver into the blood. This can cause a moderate spike in blood sugar. You can read How to Fix High Morning Blood Sugars for tips on how to improve these numbers.
To confirm if this is happening to you, you can wake up in the middle of the night and check your blood sugar. If its in the normal range then, but higher after waking, this is probably the cause. If the spike is small and goes away quickly, then its likely nothing to worry about . The spike from dawn phenomenon is often less pronounced than one you would get from eating a typical meal.
Rising Blood Sugar: How To Turn It Around
Rising blood sugar signals a need for weight loss and more exercise.
Whenever you have routine blood tests at a physical exam, chances are one of the numbers will be a measurement of your glucose, or blood sugar. A normal blood sugar level is less than 100 milligrams per deciliter of blood after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher. But between those two numbers lie many opportunities for action.
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- Research health conditions
- Prepare for a doctor’s visit or test
- Find the best treatments and procedures for you
- Explore options for better nutrition and exercise
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Who Should Do The Test
According to the American Diabetes Association, screening for diabetes is recommended in people over 45 , or at any age if you have certain risk factors, including :
- Being overweight, obese, or physically inactive
- Having a close relative with diabetes
- Belonging to a certain race/ethnic group
- Having signs of insulin resistance or conditions associated with insulin resistance, such as high blood pressure , low good cholesterol and/or high triglycerides , and polycystic ovary syndrome
- Having had diabetes in pregnancy
What If I Have Trouble Getting To My Blood Sugar Goals
There may be times when you have trouble reaching your blood sugar goals. This does not mean that you have failed. It means that you and your health care team should see if changes are needed. Call your health care team if your blood sugar is often too high or too low. Taking action will help you be healthy today and in the future.
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A Note About Accuracy
In the USA, a blood glucose meter can be approved for sale so long as the results are consistently within 20% of the accurate value. That means that if your blood sugar is 180 mg/dL or 10 mmol/L, your meter may display a result of 216 mg/dL or 144 mg/dL . In practice, most meters are more accurate than that, but even an expensive hospital blood test using calibrated equipment has a 10% margin of error.
So dont panic if you check your blood sugar and its 140 mg/dL and a few minutes later, its 150 mg/dL . This may just be the normal discrepancy in the measurements. Look for trends over time to truly understand whats happening.
Similarly, CGM measurements also have a margin of error , and varies slightly depending on the specific system.
What The Science Says
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost . I will say, however, most of these diets are NOT keto and are simply lower carb . Also, long-term effects are not often studied due to budgetary constraints, so interpret results as you wish.
Verdict: A keto diet is not inherently better for weight loss than other diets but can be very effective if it:
- Helps you manage your blood sugar better than other diets
- Is easier for you to follow than other diets
- Works for your general lifestyle
As with most other diets, the main criteria for success is whether or not you can follow the diet for the long term. If you like the keto lifestyle, the diet works great. If you hate it, it probably wont work for you.
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How Difficult Is A Keto Diet To Follow
This is the most important, but also most subjective, question about any diet. If you dont feel physically and mentally well on a diet, it wont lead to long-term results, because you wont adhere to it.
The keto diet is probably one of the post polarizing diets when it comes to peoples opinion on how easy it is to follow. Some people love it almost from day one while others experience major food cravings and even physical discomfort.
This is what my experience with a keto diet was like. Yours may be different:
Create A Plan For Your Diabetes Management
Now that you have a better idea of what your pain points are, you can start making changes to your diabetes management.
If youre insulin dependent and consistently have high blood sugars in the morning, getting your blood sugar fluctuations and A1c down might be as simple as adjusting your nighttime basal insulin. Or, if you run high every day after meals, your carb-to-insulin ratio might be off and adjusting that could be what sets you on a path of a lower A1c. Until you collect the data and do the analysis, you have no way of knowing this.
I want to make an important point here: increasing your diabetes medication is not a sign of failure! Its often the best way to control your blood sugar and bring down your A1c.
I adjust my insulin up and down all the time when I change my diet or exercise routine. Adjusting your medication is an important tool in your diabetes toolbox and something you should always discuss with your medical team.
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Check Your Blood Sugar Level
Routine blood sugar checks are an important part of managing your diabetes. Checking your blood sugar at bedtime will help you and your doctor know whether your medicine and other treatments are adequately controlling your blood sugar levels overnight. Your blood sugar goal at bedtime should be in the range of 90 to 150 milligrams per deciliter .
Translating Your A1c To A Blood Sugar Level
Using this easy calculator from the ADA, you can translate your most recent A1C result to an eAG or estimate average glucose level.
You can also use this translation when working to improve your A1c and achieving closer to normal blood sugar levels. If you know an A1c of 6.5 is an average blood sugar level of 126 mg/dL or a range of 100 to 152 mg/dL, then you can look at your current blood sugar results on your CGM and meter and pinpoint which time of day youre frequently higher than this range.12% = 298 mg/dL or range of 240 347 11% = 269 mg/dL or range of 217 31410% = 240 mg/dL or range of 193 2829% = 212 mg/dL or range of 170 2498% = 183 mg/dL or range of 147 2177% = 154 mg/dL or range of 123 1856% = 126 mg/dL or range of 100 1525% = 97 mg/dL or range of 76 120
Normal blood sugar levels in a person without diabetes can result in an A1c as low as 4.6 or 4.7 percent and as high as 5.6 percent.
Just a decade or two ago, it was rare for a person with type 1 diabetes to achieve an A1c result below 6 percent. Thanks to new and improved insulin and better technology like continuous glucose monitors and smarter insulin pumps, more people with diabetes are able to safely achieve A1c levels in the higher 5 percent range.
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Keto Adaptation Is Rough
It takes a while to become what is known as keto adapted, which is your bodys way of saying hey, I got this, Im ready to mainly burn fat!
According to keto expert Ariel Warren, RD, CD, the exact length of the adaption period usually depends on how many carbohydrates you are used to eating. Around 2 weeks if you have eaten a relatively low-carb diet previously, 2-4 weeks for a more moderate-carb diet, and 4+ weeks for high-carbohydrate diet.
At the start of the adaption period, your body is rebooting what it has known for pretty much your entire life. Your brain is used to running on glucose and suddenly it doesnt have it. Now, it CRAVES it. Youre in glucose WITHDRAWAL.
Some describe this phenomenon as the keto flu, where you basically feel the opposite of everything promised sick, fatigued, nauseous, mental cloudiness, etc. its not very pleasant.
Oh, and I should probably also mention that low carb means low fiber pooping could be an issue. Its often recommended to add extra magnesium, potassium & sodium to your diet to help help your digestion elimination process.
However, if we look positively, it also means youre doing something right if you experience this, butwho wants to self-inflict that kind of discomfort? I did, and it was not fun. On this note
What Are Target Blood Sugar Levels For People With Diabetes
A target is something that you aim for or try to reach. Your health care team may also use the term goal. People with diabetes have blood sugar targets that they try to reach at different times of the day. These targets are:
- Right before your meal: 80 to 130
- Two hours after the start of the meal: Below 180
Talk with your health care team about what blood sugar numbers are right for you.
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What Should I Do If My Blood Sugar Gets Too Low
Low blood sugar is also called hypoglycemia . It means your blood sugar level drops below 70. Having low blood sugar is dangerous and needs to be treated right away. Anyone with diabetes can have low blood sugar. You have a greater chance of having low blood sugar if you take insulin or certain pills for diabetes.
Carry supplies for treating low blood sugar with you. If you feel shaky, sweaty, or very hungry, check your blood sugar. Even if you feel none of these things, but think you may have low blood sugar, check it.
If your meter shows that your blood sugar is lower than 70, do one of the following things right away:
- chew 4 glucose tablets
- drink 4 ounces of fruit juice
- drink 4 ounces of regular soda, not diet soda or
- chew 4 pieces of hard candy
After taking one of these treatments, wait for 15 minutes, then check your blood sugar again. Repeat these steps until your blood sugar is 70 or above. After your blood sugar gets back up to 70 or more, eat a snack if your next meal is 1 hour or more away.
If you often have low blood sugar, check your blood sugar before driving and treat it if it is low.
Several Factors May Cause A Persons Postprandial Blood Sugar To Remain Elevated
Smoking after the meal: Studies show that smoking raises blood sugar levels in people with diabetes. Extreme stress: Stress produces the bodys fight-or-flight response triggering the release of stress hormones such as cortisol. These hormones cause the body to release the glucose it has previously stored for energy. Eating or drinking after the meal and before testing the blood sugar: Continuing to eat will keep blood sugars closer to their immediate post-meal levels.
Studies show that 15 to 20 minutes of moderate exercise, such as walking, shortly after a meal may improve glucose metabolism and reduce postprandial glucose levels.
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Other Reasons For High Morning Blood Sugar Levels
If you continuously wake up with high blood sugar levels and haven’t eaten a bedtime snack the night before, your doctor may need to prescribe you more basal insulin , says Dr. Spratt.
However, if you typically eat a snack that contains carbohydrates before going to bed and don’t counteract it with rapid-acting insulin, your blood sugar levels may be higher in the morning as a result. Switch to a snack that won’t raise your blood sugar levels for example, a pairing of ham and cheese or a few bites of non-sweetened peanut butter, she says.
Lastly, if your blood sugar levels dip too low in the middle of the night, your body may release hormones that “rescue” you from dangerously low levels, according to the Cleveland Clinic. The result is that your liver releases stored glucose, causing your blood sugar levels to be higher than usual in the morning. This is called the Somogyi effect.
If you’re experiencing low blood sugar in the four to six hours after a meal, that’s a sign that your basal insulin dose is too high, says Dr. Spratt.
“A lot of people have lows of which they are not aware of,” she says. “They wake up and their blood sugar is high and assume they must need more insulin at night.” But, she explains, it’s important to check your blood sugar at 2 a.m. or 3 a.m. to make sure you aren’t experiencing a drop in glucose levels.
Long Acting Insulin Not Working For The Entire 24 Hours
THIS WAS THE CULPRIT FOR ME! I would normally go to sleep with a blood sugar of between 6.5 mmol/L and 7.5 mmol/L. Between 3:00 a.m and 4:00 a.m I would have a reading of between 12 mmol/L and 16 mmol/L. I normally took my basal insulin in the morning around 7:00 a.m. Lantus is supposed to be active for 24 hours controlling your blood sugar levels when you are not eating. However, in some individuals like myself, it only lasts about 18 to 20 hours. During long periods of time when we are not eating , the liver releases glucose to fuel the body. In my case, there was no long acting insulin in my body to handle this glucose, resulting in my high fasting blood sugars.
Also note that not eating will not help the issue. One may tend to not want to eat if they have a high fasting blood sugar. Eating and taking insulin will signal to the body that the fasting period is over and there is no need for the liver to release glucose into the bloodstream.
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Risk Factors For Developing Diabetes During Pregnancy
There is an increased risk of diabetes during pregnancy if:
- The woman is overweight
- The woman is a smoker or around smokers more than average
- The woman is older
- There is a family history of diabetes
- The woman is from an ethnic minority
- There is previous history of the birth of a large baby
There is a routine antenatal test used to measure glucose levels in urine however it has been noted it is relatively unreliable for diagnosing diabetes.
Therefore blood sugar levels are checked between 26 and 30 weeks of gestation. This is done of two separate occasions using one of two tests, either the fasting glucose test or the random glucose test. In addition to this if there are any abnormal results of these tests or there is a family history of diabetes, or a woman is regarded as obese she will be offered a glucose tolerance test.
Often with gestational diabetes, the woman is advised to take a number of steps to change their diet and exercise habits to ensure the best possible pregnancy.
It is reportedly advisable to increase participation in low-impact activities such as walking, swimming, yoga and pilates. In addition to this it is advisable to eat regular meals watching the amount of fat being eaten, remembering it is controlling the amount of fat not cutting it out of the diet completely.
Also reducing the amount of salt in the diet and ensuring that plenty of fruit and vegetables are included in the diet.