help me figure this out

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help me figure this out


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Old 10-18-2019, 21:16   #1
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I don't have diabetes (yet) but something is not right and I can't figure it out.

Here is the timeline:

- in my mid-30s my fasting bg was in the upper 70s/low 80s. My diet was really crappy.

- at age 51 my fasting bg was 95, highest ever. Diet still crappy.

- for the next several years my fasting bg was upper 80s then low 90s. Diet is very good (gluten/dairy free, moderate carb intake).

- about six years ago my a1c was 4.8, just about perfect.

- four months ago my a1c was 5.5. Not happy. True, I had become somewhat overweight but my diet was still good. I also had my C-peptide level checked. It was 0.63, below normal (bottom of normal range is 0.8). This came as a shock since I had assumed I was teetering toward T2D (= relatively high C-peptide).

And so I decided to lose weight, which I did (15 lbs gone, BMI is now 25). I rechecked my a1c and ... it is 5.4. Basically no change. Fasting bg 90, which is consistent with prior readings.

So my questions to you guys:

- wouldn't a fasting bg of 90 ordinarily correspond to an a1c of 5.0 or so? It seems that my bg might be spiking after meals. I will be using a glucose meter to check on this.

- is there anything else I could or should do? I will get antibodies tested (due to low C-peptide) should my a1c get to the pre-diabetes level.

I am quite disappointed that my a1c didn't drop despite losing weight, which involved cutting my carb intake by 20% (to about 100 grams/day). I'm baffled as to why my a1c was so good several years ago and now it is merely "meh".

Thanks for your help.


_Lazza


FYI - I am a 63 y.o. male, fit, and with no significant health issues (no meds either). Very limited diabetes in my family although 23andme suggests I have a genetic predisposition for T2D.

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Old 10-19-2019, 04:50   #2
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When I was 62 my fasting BG was in the 80s and A1C was 4.5.

When I was 63 my fasting was 170 and A1C near 6.

The progression from "normal" to diabetic isn't the same for each of us. Some are very slow, some quite sudden. There are way too many factors to generalize.

The best thing you can do is to get a glucose meter (as you said you are) and test at pre-meal, 1hr after first bite, and 2hr after first bite. And calculate the carb count for the meal, as well. This will give you more meaningful data to track your glucose metabolism.

You don't need to do this for every meal or even every day. You'd just be "keeping an eye on it". Unless your BG level goes above 140, in which case you might want to lower carb even more and see if that helps.

Seems your doctor is proactive about your blood sugar. Most just assume T2 and don't test even C-peptide, let alone the antibodies test.

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Old 10-19-2019, 06:06   #3
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My insulin levels are usually low or below range, but eating very low carb, I'm usually giving my beta cells little reason to make up a bunch of insulin (along with the corresponding C-peptide)

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Old 10-19-2019, 13:33   #4
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Quote:
Originally Posted by VeeJay View Post
When I was 62 my fasting BG was in the 80s and A1C was 4.5.

When I was 63 my fasting was 170 and A1C near 6.

The progression from "normal" to diabetic isn't the same for each of us. Some are very slow, some quite sudden. There are way too many factors to generalize.

The best thing you can do is to get a glucose meter (as you said you are) and test at pre-meal, 1hr after first bite, and 2hr after first bite. And calculate the carb count for the meal, as well. This will give you more meaningful data to track your glucose metabolism.

You don't need to do this for every meal or even every day. You'd just be "keeping an eye on it". Unless your BG level goes above 140, in which case you might want to lower carb even more and see if that helps.

Seems your doctor is proactive about your blood sugar. Most just assume T2 and don't test even C-peptide, let alone the antibodies test.
I hate to over think this but I am concerned when I look at the disparity between fasting bg and a1c. When my fasting bg was 86 my estimated average bg, based on an a1c of 4.8, was 93. Only a 7 point difference. But now with a fasting bg of 90 and an a1c of 5.4 (average bg 113) the difference is now 23. The disparity has increased by a three fold. Obviously my body less able to cope with doling out insulin quick enough in response to the food I eat, which happens to be of moderate carb content.

Your case is much different. When you were 62 your average bg and fasting bg were about the same (in the 80s). But when you were 63 your fasting bg was MUCH higher than your average bg. Perhaps yours is more consistent with someone having T2D and mine is something else?

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Old 10-19-2019, 13:36   #5
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Quote:
Originally Posted by mbuster View Post
My insulin levels are usually low or below range, but eating very low carb, I'm usually giving my beta cells little reason to make up a bunch of insulin (along with the corresponding C-peptide)
My carb intake isn't really very low (100-ish grams/day) but I do make an effort to eat carbs with a lower glycemic index. So it really can't explain why my C-peptide level is so low. Regardless, I will try to cut my carb intake further.

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