A question for diabetics

[buffettgirl]

Thanks for the tip about alternating sides and fingers. Would never have occurred to me. LOL

And thank you for the advice about testing before and after eating. I will have to get in the habit.

My machine says I can test on the forearm. Is that as accurate? How painful is that?

The spike that bothered me, I had eaten a Jimmy Dean sausage, egg, and cheese croissant thing. No idea why they are in the house since I don't usually buy processed crap. Anyway, that was the 140 3 hours later. Chicken soup (homemade) was 88 2 hours after. Today I had a grilled chicken wrap (ceasar dressing, iceburg lettuce, 2 slices of a small tomato, some red onion, and a home grilled chicken breast pieces on a burrito size tortilla) and 2 hours later my sugar was at 209. It just seems really really high to me.

Ok, on the first, that was a fat spike. It's totally normal. The fat slows down the digestion of carbs and even a perfectly healthy person will have a fluctuation like that.
The 209 is high, but make sure you're washing and drying your fingers completely before testing. Any residue left on your fingers will alter your results.

I am not really sure. I think type 2. They were all insulin dependent. And by lots I mean grandmothers on both sides, mother, father is borderline, plenty of aunts and uncles, and at least one first cousin that I know of. My mother was my age when she was first diagnosed which I think has a lot to do with my paranoia about it. She also did not take care of it and let it kill her before she was even 50 years old. I am trying my best to not walk in their footsteps. My uncle recently lost a toe to diabetes. I have seen the worst that it can do and I don't wish for it to happen to me. I am trying to be as proactive as I can be.

Should I not be concerned about numbers? What is normal after a meal? I was at 150 after dinner tonight. I guess I just tend to think that your numbers should always be between 80-110 and anything over 120 is bad. Is that wrong?

If you have had all these people who are younger, and all who are insulin dependent at an early age, you might want to investigate the possibly that your family has something called LADA. It's an autoimmune form of diabetes (like type1) which manifests itself like type 2. There are also many different genetic types of diabetes that mimic type 2 as well. But I"d look at LADA first.

Here is one study that shows how variable "normal" blood sugar can be http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892065/
(you can convert the blood sugars from mmol/l to mg/dl here http://www.childrenwithdiabetes.com/converter.htm

and this is a very interesting presentation:
http://www.diabetes-symposium.org/index.php?menu=view&id=322

So that's not to say that you don't have a problem brewing, but it might not be as drastic as you think.

 

[suemom2kay]

OP is your Primary Care Physician also an endocrinologist? I know many doctors that have no clue about treating diabetes and do a terrible job at managing this disease. I would make an appt with an endocrinologist. Many are also PCP's.

 

[JLTraveling]

Okay, I am not a doctor. My dad has type 2 diabetes which he controls with metformin, diet and exercise. I agree with those who say that everyone is different, but I personally have never heard of a post-meal 150 being problematic at all.

For my dad, his doctor wants to see an A1c under 7. Dad's has been running around 6.6-6.8 for the past couple of years, and the doc is happy. He has it tested every three months.

As far as daily spikes and lows, Dad was told that morning (fasting) blood sugar should be under 120--normal (no diabetes) people usually run 80-110, but up to 120 or so is fine. Pre-meal should be around the same, but if he's really hungry, he'll eat something low-carb even if his sugar is up to 140ish.

Dad was told to expect a post-meal spike, that it's a normal part of the digestion process. So he tests three hours after meals. The spike, for Dad, (not necessarily true for everyone) should be somewhere around 170. That's because his sugar drops around 15 points per hour and he's supposed to eat every five hours. If it didn't go up that much, there wouldn't be room for it to drop properly before eating. His numbers also go haywire, generally high, when he's sick.

So fluctuations are normal and expected. Dad was told that as long as he doesn't go above 200 he's not doing damage to his body, and that even the occasional "just over 200" mark isn't bad as long as his A1c's don't go high. Again, the precise numbers will vary by individual, and not all doctor recommendations are the same. I agree with tracking for a week or so, and then approaching your doctor with the results. Good luck!

 

[tvguy]

As far as daily spikes and lows, Dad was told that morning (fasting) blood sugar should be under 120--normal (no diabetes) people usually run 80-110, but up to 120 or so is fine. Pre-meal should be around the same, but if he's really hungry, he'll eat something low-carb even if his sugar is up to 140ish.

That fasting blood sugar level is what confused me. Mine was 108, which is at which point my Doctor said I was pre-diabetic. I went to the American Diabetes Association website, and they list 120 as the threshhold. I asked my Doctor and he said each lab has it's own threshhold, and the lab he uses says 100 is the pre-diabetic threshold for fasting blood sugar.

 

[zurgswife]

That fasting blood sugar level is what confused me. Mine was 108, which is at which point my Doctor said I was pre-diabetic. I went to the American Diabetes Association website, and they list 120 as the threshhold. I asked my Doctor and he said each lab has it's own threshhold, and the lab he uses says 100 is the pre-diabetic threshold for fasting blood sugar.

I've always used the 120. But with a home meter that number could actually be somewhere between 108 and 132 as there is a 20% error factor. So, if the blood was from a lab I do get they have their own thresholds but 100 sounds kinda low to me to say someone is pre-diabetic.

 

[kbeverina]

Thanks for the tip about alternating sides and fingers. Would never have occurred to me. LOL

And thank you for the advice about testing before and after eating. I will have to get in the habit.

My machine says I can test on the forearm. Is that as accurate? How painful is that?

The spike that bothered me, I had eaten a Jimmy Dean sausage, egg, and cheese croissant thing. No idea why they are in the house since I don't usually buy processed crap. Anyway, that was the 140 3 hours later. Chicken soup (homemade) was 88 2 hours after. Today I had a grilled chicken wrap (ceasar dressing, iceburg lettuce, 2 slices of a small tomato, some red onion, and a home grilled chicken breast pieces on a burrito size tortilla) and 2 hours later my sugar was at 209. It just seems really really high to me.

That would definitely concern me. I would guess that to be about 40 carbs (not knowing what kind of tortilla). I think you should be testing more often to see where the trend is, i.e., was that a 209 going up or a 209 coming down. If you had numbers at 1, 2 and 3 hours we could probably get a better picture of what's going on.

I think the forearm testing is just as accurate and less painful, but you do need to draw more blood, in my experience. Use the clear cap, prick the forearm and push down to force more blood out before moving the lancet device.

 

[manning]

For my dad, his doctor wants to see an A1c under 7. Dad's has been running around 6.6-6.8 for the past couple of years, and the doc is happy. He has it tested every three months.

As far as daily spikes and lows, Dad was told that morning (fasting) blood sugar should be under 120--normal (no diabetes) people usually run 80-110, but up to 120 or so is fine. Pre-meal should be around the same, but if he's really hungry, he'll eat something low-carb even if his sugar is up to 140ish.

!

A1C over 7 can lead to organ damage.

 

[worm761]

Thank you everyone for all of the advice. I have been tracking all day today and will continue to do so.

 

[zurgswife]

A1C over 7 can lead to organ damage.

As a parent of a Type 1 who battles and battles to keep numbers good that is comment is a not totally true. There are Type 1's who's BS numbers during the 1940's, 50's, 60's, 70's and into the 80's who don't have organ damage and I guarantee their A1Cs averaged in the 9s or higher....They didn't have the ability to test and correct like we do today. So to say a mear 7 can causes organ damage is wrong.

 

[buffettgirl]

oh and forearm testing, I find it incredibly painful for me. I bruise every time I try it there. The last time I was showing my son, "look sweetie, we can do this on your arm. Watch mommy try it." (doing my best mommy voice for a 12 year old hahah) and as soon as the lancet hit my skin a started seeing a bruise form right under the cap. My son was like "yeah, no way I'm doing that mom."

 

[Sadie22]

I have Type 2. I use a meter which can be used to test on alternate sites other than the fingers. I test on my forearm. My lancet device is adjustable for different depths, and also there is a different tip to put on the end of it for fingertip testing versus alternative-site testing. My fingertips are more sensitive than my forearms, so lancing my fingertips would always hurt, but forearm-testing is something I usually do not even feel. Plus I type for a living, so I don't want to have to deal with sore fingers.

The forearm reading tends to be about 15 points higher for me than a fingertip reading. I don't need to track rapid changes or to titrate insulin dosages, so alternative-site testing is fine for me.

The current state of the research seems to be that we want to keep our A1c under 7, and even better if it is under 6, if we want to avoid complications. The disease can progress despite our best efforts, but this is what we can do to try to live the healthiest lives possible.

 

[manning]

As a parent of a Type 1 who battles and battles to keep numbers good that is comment is a not totally true. There are Type 1's who's BS numbers during the 1940's, 50's, 60's, 70's and into the 80's who don't have organ damage and I guarantee their A1Cs averaged in the 9s or higher....They didn't have the ability to test and correct like we do today. So to say a mear 7 can causes organ damage is wrong.

You and your doctor will decide what your target A1C should be. For most people with diabetes, the American Diabetes Association recommends an A1C of less than 7%. Another group of experts, the American Association of Clinical Endocrinologists, recommends an even lower A1C of 6.5% or less.

I think I will go with the experts.

 

[zurgswife]

You and your doctor will decide what your target A1C should be. For most people with diabetes, the American Diabetes Association recommends an A1C of less than 7%. Another group of experts, the American Association of Clinical Endocrinologists, recommends an even lower A1C of 6.5% or less.

I think I will go with the experts.

A target A1C and saying that if you are over 7 it can cause organ damage are two different things. Just because you are over 7, 8 or even 9 doesn't automatically me you will suffer organ damage. I agree that any target A1C should be between patient and doctor but to scare a person that is trying to figure out what is going on with over 7 can cause organ damage is a bit overwhelming.

 

[buffettgirl]

A target A1C and saying that if you are over 7 it can cause organ damage are two different things. Just because you are over 7, 8 or even 9 doesn't automatically me you will suffer organ damage. I agree that any target A1C should be between patient and doctor but to scare a person that is trying to figure out what is going on with over 7 can cause organ damage is a bit overwhelming.

amen.

 

[manning]

Sometimes scaring can save a life or......limbs.

Something I heard once. What you don't know can, not necessarily will, kill you. I should know, being scared to go to a doctor almost dropped me in my tracks. Had I gone when I suspected something would have saved me a lot of grief.

OP, do yourself a favor and have a long talk with your doctor. He/she knows you the best. And you will find out one of two things. Something is or is not wrong with you.

 

[Sadie22]

The term we could use is complications, rather than organ damage. New research is showing that some of the complications may be reversed if the blood glucose fluctuations are brought under control, and that the disease may not be inevitably progressive as was once assumed. We can only do the best we can to each manage our own diet and exercise, take medicine as prescribed, and stay as well-educated on the disease as we possibly can.

 

[PatsMom]

OP - you have got some great advice here! The only thing I have to add is to make sure to test at different times of day. My morning blood sugars always stink. Doesn't matter what I do - snack before bed, no snack before bed. My endo and I were going to try some long acting insulin at bedtime to see if that would help but now things are on hold because I am getting ready to start chemo. The "dawn phenomenon" is pretty well known. If your morning numbers are high and the rest of the day better, try tracking what you eat in the evening. If you don't have enough long lasting carbs to carry you through the night, your body will make glucose to get you through.

I have tried alternate site testing and have to agree with what some others have said - to me it hurts more than stabbing a finger tip. I just make sure to alternate fingers and sides of fingers. That seems to help me a lot.

 

[worm761]

OP, do yourself a favor and have a long talk with your doctor. He/she knows you the best. And you will find out one of two things. Something is or is not wrong with you.

I actually have. We did the A1C last summer and it was normal. I am just a little paranoid and want to know what to watch for. I already have the classic signs due to other things. So I test my sugar just not as regularly as I should. My goal is to never become diabetic if I can help it. I am hoping that with diet and exercise I won't ever be.

 

[zurgswife]

I actually have. We did the A1C last summer and it was normal. I am just a little paranoid and want to know what to watch for. I already have the classic signs due to other things. So I test my sugar just not as regularly as I should. My goal is to never become diabetic if I can help it. I am hoping that with diet and exercise I won't ever be.

Good plan. And knowing what your BS is will help you try to attain these non medical interventions if possible. Good Luck as you continue.

 

[manning]

I actually have. We did the A1C last summer and it was normal. I am just a little paranoid and want to know what to watch for. I already have the classic signs due to other things. So I test my sugar just not as regularly as I should. My goal is to never become diabetic if I can help it. I am hoping that with diet and exercise I won't ever be.

Good direction.

Just be aware it may be possible to get it. All you can do is minimize your chances. In one of my orientations it was mentioned that what triggers it is not really known. People of all shapes and sizes get it. My dad was normal weight and got it. One of his sisters was known as the good year blimp and never got it. Go figure. History of it in the family increases you're chance.