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Discussion Starter · #1 ·
Hi,

I'm male, late 40's, 5'6", 90 kg's, non-smoker, non-drinker, ... hmm, why is this sounding like a dating profile already?

Oh yeah, I have had hypertension since 43.

Ok, just recently got "diagnosed" with diabetes and I have my doubts.

Some further background info:

Of course, over the festive season I eated a bit more than I should. And as a bit of a recluse, with a rich life on the internet, food was comforting.

Not too unhealthy. Plenty of breads, grilled lamb chops, discounted roast chooks, tonnes of vegies and fruits, coffee's, teas, cereals, sweets, soft drinks, etc.

On the night leading up to the OGTT test I ate half a bowl (500 grams) of macadamia & brazil nuts with ginger beer and lemon & lime soft drink [soda pops]. Yes, I was watching a movie leading up to midnight.

Following day, 27'th of December, around midday I woke up. Decided to call the pathologists and get that test out of the way. And the lady on the phone said, if I hadn't eaten or drank anything since I woke up, I was good to go.

So I rocked up for the OGTT around 1pm, and it took 2 hrs. You all know the drill. Also note that that according to Wikipedia:

"Usually the OGTT is scheduled to begin in the morning (0700-0800) as glucose tolerance exhibits a diurnal rhythm with a significant decrease in the afternoon."

That is, my glucose tolerance would be it's poorest in the afternoon!

On January the 4'th I got a call from the nurse at my clinic who gave me the "good news", saying I have confirmed diabetes, and could I make an appointment to see the doc.

Ok, so following day I saw the doc. To him it seemed like an open and shut case. He was already making plans for the ophthalmologist, dietician, podiatrist, another hba1c test, etc, etc. But I had my doubts.

Here's what the OGTT test results were btw;

Fasting 6.1 mmol/L
1 hrly 14.4 mmol/L
2 hrly 14.6 mmol/L (that's not a typo. Yes, the 2 hrly went up from the 1 hrly according to the pathology report I have)

I mean, over the last ten years my fasting blood sugar test levels had been vacillating between 5.6 mmol/L to as high as 7.1 mmol/L. Prior to this I never got an OGTT, and whilst some docs noticed my fasting glucose levels creeping up, and knew that my dad had diabetes and all, they never said I was diabetic.

If anything, about 5 years ago one doc said I may be heading towards pre-diabetic, but wasn't there yet.

So up till Jan 4, I was under the impression that I was still below pre-diabetic, and that even if I became pre-diabetic things were reversible, and no alarm bells were going off in my head. I personally hold the ADA Expert Committee responsible for this mis-perception, and missed opportunity.

Ok, back on the topic.

I'm still reading up on this but it seems odd to me that;

1) The Fasting Glucose is borderline normal (6.1 mmol/L),
2) The 1 hrly and 2 hrly almost seem like a measurement error,
I mean from what I have read, with such a high glucose level I should have been confused, or disoriented. Yet I was calmly sitting down reading a maths text book, waiting for the next hrly jab.​

I'm wondering about other possibilities like insulin resistance, as some of the symptoms, intestinal bloating, sleepiness, weight gain, increased blood pressure, and depression have been around for nearly a decade.

At this stage there could even be other explanations for the OGTT 1 hrly and 2hrly being so high. That is, if human error, or systematic errors were not the sole reasons, and that the figures were somewhat accurate. These other reasons could be related to diabetes, but not necessarily diabetes. Eg the fact that in 2000 I experimented with HGH. I'm wondering if such experimentation led to internal organ enlargement, or even upsetting the regularity of the insulin like growth factor (igf)?

I will go for the hba1c test as soon as I can, but a urine microalbumin is also called for and that requires regular sleeping patterns. Unfortunately once again my sleeping patterns have gone to pieces again, and I have two sleeps a day, with an overall forward drifting circadian rhythm.

Anybody else get such weird results, or heard of such numbers for an OGTT [6.1 to 14.6]? Anyone with any ideas?

Thanks.
 

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Welcome to Diabetes Forum! Those numbers do look rather suspicious but I will not comment further. I was diagnosed in 1945 and i don't think the OGTT existed then. I am not familiar what kind of results one should expect form an OGGT. I hope you will find the answers to your questions soon. Good luck to you!

Richard
 

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Discussion Starter · #3 ·
Welcome to Diabetes Forum! Those numbers do look rather suspicious but I will not comment further. I was diagnosed in 1945 and i don't think the OGTT existed then. I am not familiar what kind of results one should expect form an OGGT. I hope you will find the answers to your questions soon. Good luck to you!

Richard
Thank you for the welcome Richard!

For new readers who are not familiar with the OGTT (Oral Glucose Tolerance Test), it is a test one is supposed to turn up to having fasted for between 8 hrs and 12 hrs [a nights rest], and usually 3 blood samples are taken.

1) - The baseline, or fasting blood sample,
1.1) A solution containing 75 grams of glucose is given to be drunk within 5 minutes, and then,
2) - Another blood sample taken 1 hr after the oral glucose,
3) - Final blood sample taken at the 2 hr point after glucose.

Sometimes step 2 is skipped.

Objective is to quantify how the body reacts to consuming a pure sugar solution [glucose], as well as Glucose Tolerance tests at 1 and 2 hrly points after ingesting 75 grams of the glucose solution.

There is an intravenous version too, called an IVGTT.

For the OGTT, the fasting glucose blood test [step number 1], should be less than 6.1 for Normal, should be between 6.1 and 7.0 for Impaired Fasting Glycaemia, and less than 7 for Impaired Glucose Tolerance, and greater than 7 for Diabetes Mellitus.

My fasting glucose was 6.1 mmol/L [equivalent to 110 mg/DL], therefore fasting glucose indicates NOT diabetic.

However my 1 hr and 2 hr glucose results were well above Diabetes minimums of 11.1 mmol/L [200 mg/DL]. My result was 14.4, and 14.6 mmol/L [~ 263 mg/DL]. But as stated in the OP, I have my suspicions about the validity, accuracy, and interpretation of the 1 hrly and 2 hrly test results.

I guess I really have to go get that hb1ac test, AND depending on the outcome of that, maybe even redo the OGTT, or even see a Diabetes or Endocrinologist specialist.

Today my raw vegie meal of crushed soaked beans, crushed raw almonds, and crushed walnut kernels, with capsicum, celery sticks, bananas, and pears felt like a cold wet pile of cement in my tummy. I went for a walk, but there still seemed to be no digestion going on. I felt bloated, so I broke two eggs in a pan, no butter, no margarine, no oil, and sliced one tomato into it. I felt much better afterwards, and I am enjoying the rumblings in my belly :) Though I have little idea how bad it was to eat those.

I guess I will have to buy a decent kitchen scales, a notice board with common foods I eat, and their sugar, fibre, cholesterol, GI, and carbo content, my netbook, and start recording. Oh, better buy a glucose meter and strips too I guess. Test, measure, test, record! Only way I'm going to get ontop of this. Whether I have the big D or not.
 

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I have had a C-peptide test done three times in the past. Your C-peptide determines how much insulin your body is producing. You might ask your doctor to add that to your list of blood tests.

Your new battle plan sounds very good. Let us know how it goes!

Richard
 

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I guess I will have to buy a decent kitchen scales, a notice board with common foods I eat, and their sugar, fibre, cholesterol, GI, and carbo content, my netbook, and start recording. Oh, better buy a glucose meter and strips too I guess. Test, measure, test, record! Only way I'm going to get ontop of this. Whether I have the big D or not.
Welcome aboard, Noumenon. I agree with Richard - your battle plan sounds solid to me!

Take a look at the journal site being built by isisagate . . . I've started using it to log everything - http://www.diabetesforum.com/diabetes-forum-lounge/1817-diabetic-journal-free-life.html#post7565 - and it really helps when you're writing everything down, especially at first. It's just too easy for me to forget what I've eaten if I don't log it.

Good luck to you & I hope you'll stay with us . . . we can help each other SO much!
 

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I don't know about the OGTT sounds borderline subjective to me. What if your diabetes or body have stage fright and decide not to perform for that test, or other variables are introduced such as stress or contaminants. Reminds me of scollville units and measuring hotness by how much sugar water it takes to negate the effect. Let's just say I can't tell the difference so you wouldn't want to ask me to rate it. ;)

Yeah get a second opinion just to be safe but if you have a family history of diabetes it wouldn't hurt to watch out and start investing in a more diabetes friendly lifestyle.
 

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Discussion Starter · #7 ·
I don't know about the OGTT sounds borderline subjective to me. What if your diabetes or body have stage fright and decide not to perform for that test, or other variables are introduced such as stress or contaminants. Reminds me of scollville units and measuring hotness by how much sugar water it takes to negate the effect. Let's just say I can't tell the difference so you wouldn't want to ask me to rate it. ;)

Yeah get a second opinion just to be safe but if you have a family history of diabetes it wouldn't hurt to watch out and start investing in a more diabetes friendly lifestyle.
In the document "Diabetes management in general practice" available at (Sorry not allowed to post links yet)

under diagnosis

it says

"The diagnosis of diabetes is made in one of the following three ways but each must be confirmed on a subsequent day unless unequivocal hyperglycaemia with acute metabolic decompensation or obvious symptoms are present:
• Symptoms of diabetes and a random (non fasting) blood glucose > 11 mmol/L
• Fasting plasma glucose ≥ 7.0 mmol/L
• 2-hour plasma glucose > 11 mmol/L during an oral glucose tolerance
test (OGTT)
"

In my case the first two are negative.

The symptoms of diabetes are:

"The symptoms of diabetes include:

* Thirst --------- N/A
* Frequent urination ------------- N/A
* Tiredness or lack of energy ------ No more than other people
* Blurred vision ------------- Myopia from 2003 onwards
* Infections (eg. Thrush) --------- N/A
* Weight loss (in type 1 diabetes) --------- N/A
"

And for the OGTT I got 14.6 mmol/L (greater than 11 mmol/L). However the document states "each must be confirmed on a subsequent day". So I'm kinda concerned why the doctor assigned me as "Known diabetic" without a confirmatory test, or check.

Meanwhile, I'm still on the raw diet, and have dropped to 87.4 kg's. That's 5.1 kg's down from Jan 4'th's 92.5 kg's. Though I'm hearing that the first 6 kilograms of weight loss is usually fluids. So the hard yards of weight loss will come after the loss of the first 6 kg's.

I've also gone and purchased a breville ikon kitchen scales, and my Accu-chek Performa is in the mail. Additional strips, cal's, lancer tips, etc, I can get from Aus ndss (Sorry not allowed to post links yet).

I haven't been able to get around to get that urine and that hb1ac blood test yet as I can't seem to regulate my sleeping hours. That is, I don't sleep long enough a period for the morning mid-stream collection.

Once I do, I'll go see the doc for the results, the next few steps, including the management appointments of the disease, and I will ask him about c-peptide measurements too. Or a referral to an endocrinologist, or a retest of the OGTT.

Thanks for your support Isisagate, Shanny, and Richard.
 

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Discussion Starter · #8 · (Edited)
Ok, I got impatient with the endocrinologist. I wont get to see her for results until mid June, so what I did was try and replicate the OGTT test myself at home.

To do this I first tried 681 mL of apple juice (11 grams of sugar per 100 mL of apple Juice, therefore equivalent to 75 grams of sugar in 681 mL of apple Juice), and then tried to make multiple bg measurements at zero, 1, and 2 hrs. The multiple bg measurements using my home bg meter were to reduce uncertainties from the default uncertainty of 20%.

I mentioned what I was doing to my GP and he said "No need to do that, lets re-do the OGTT through a pathology lab". Which is what I wanted to hear :)

Before I went for the second OGTT test I found out about Glucodin. A product sold here in Aus in most pharmacies and some large supermarkets. Glucodin is a powder which claims to be 100% glucose. Unlike apple juice, or other substitutes, it is not sugar. Sugar (sucrose) is as you all know comprised of glucose and fructose. The glucose is readily absorbed in the body, but the fructose has to be converted by the liver before the body can utilise it. So best substitute is something which has 100% glucose. As glucodin is.

About 2 days before the lab administered OGTT I mixed 80 grams of glucodin powder with plain water, mixed well, and consumed this within 5 minutes on a fasting stomach. Before I did that I took several fasting bg measurements. Then one hour after the consumption of the glucose mixture I again took several bg measurements, and repeated those measurements at the 2 hr mark. I made sure I rested, and avoided getting up and about.

My home administered test results were:

Fasting average: 5.8 mmol/L (104 mg/Dl)
One hr after 80 gr of glucose drink, average: 9.3 mmol/L (167.4 mg/Dl)
Two hrs after 80 gr of glucose drink, average: 5.45 mmol/L (98.1 mg/Dl)

So they looked good.

2 Days later I went for the pathology lab administered OGTT. This time I made sure the appointment was in the morning, And I also took my own glucose meter with me to take and record simultaneous measurements.

My measurements were:

Fasting: 4.6 mmol/L (82.8) (The nurse also used a gluco-stix: ~7)
1 Hr: 8.8 mmol/L (158.4 mg/Dl)
2 Hr: 7.3 mmol/L (131.4 mg/Dl)

And today the official results of the OGTT were given to me by my GP:

Fasting: 3.8 mmol/L (68.4 mg/Dl)
1 Hr: 7.3 mmol/L (131.4 mg/Dl)
2 hrs: 6.2 mmol/L (111.6 mg/Dl).

In my opinion, they indicate that the first OGTT done in December (in the afternoon) was done incorrectly, and led to a misdiagnosis. These recent results are not indicative of Diabetes. The doctor however, whilst congratulatory, was reluctant to dismiss the December measurements as a misdiagnosis. Even though literature states that the OGTT should not have been carried out in the afternoon, as the December test was.

I also had a HBA1C test done on April 22 as well, and that came back 5.6%. Not as low as I would have liked, but climbing down from 6.2% of January's, and I'm sure it will continue to go lower over the next 3 months.

My weight was 67.9 kgms when the April tests were conducted.
 

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That's great news! glad it all worked out ok. One of the most troubling things is when you think there is a medical problem. I had some cheat pains a while back went to the ER had a full set of work done including a nuclear stress test to find out it was Acid Reflux. Piece of mind is invaluable. So I'm glad you got some. =)
 

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I am very much impressed with your posts and your knowledge of diabetes, even though you may not be a diabetic at this time. Your home administered testing is something I have never heard anyone doing before. If you actually do have diabetes, it is obvious that you will use very tight control and have stable blood sugar levels. That will certainly enable you to have good health in the years ahead. Please keep us updated on further testing and your diagnosis.

Richard
 

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Glad to see you back, Noumenon . . . and what good news too! Please do keep us updated now & then. It's good to know your GP jumped in on your behalf - what's up with that endo being so obtuse?! My goodness! :rolleyes:

And isisagate? Good to hear your update too - are you treating the reflux now? Keep us posted!
 
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