Beating a Glucose Tolerance Test?

[madaboutchooks]

Does anyone know if it is possible for a reformed diabetic to beat a glucose tolerance test? My GP has been very supportive of a low carb diet and I have been sharing information with him about keto. I wonder if now it is possible to test as non-diabetic when taking the test? I have documented evidence of my drop in HbA1c from 9.8 (made a mistake when I posted in the Facebook page that it was 9.7) to 5.5 over a period of four months. I fully expect my next test to be lower still as I am averaging about 5.4 in blood glucose (Australian measurements) at the moment, and am about to start fasting.

Has anyone done this?

[Donna]

I haven’t had one in years, but my A1C is currently 4.9%. I don’t doubt I’d pass. I’d probably refuse to take it to avoid the glucose load.

[madaboutchooks]

That’s the sort of A1C that I am dreaming of! Well done.

[Erick]

They talked about it in the latest 2 keto dudes episode. @kimhowerton and @richard mentioned that you would have to stop keto for 2 weeks in order to do the test. My HbA1c used to be 12 (Australian measurements) six months ago (before keto) and last week was 4.7 so I rather stay on keto than pause it for a couple of weeks and drink a bottle of sugar. But I’m with you on this. I’m very curious to know if I could pass the test.

Let us know if you end up going through with it.

[richard]

#Wow check out the nice HbA1c on @Erick

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My numbers are 11.2% to 5.2% … so we’re not too different.

Yeah if you are keto your Kraft test will show that you are not using much insulin - so you will look like a Type 1 diabetic kraft pattern. But you are just sparing glucose for your glucose dependant tissue.

What you may be able to do is take a Fasting glucose and a fasting insulin and the HOMA:IR formula will give you a rough guide of how your insulin resistance/sensitivity is tracking.

HOMA:IR = Fasting Insulin x Fasting glucose / 22.5

a Normal subject under 35 yo, with 100% β-cell function will be 1.0

Mine was 4.8 before I started regular monthly extended fasting, and 2.9 after. Mine has gone backward during my last 3 months as I went off metformin as an experiment (and that affected my insulin sensitivity but not my glucose control)

[richard]

I was able to keep my glucose in control (5.2% HbA1c) for 4 months without any medication which is the official benchmark for being non diabetic.

However I went back on metformin because it was helping me be more insulin sensitive.

[madaboutchooks]

I should have finished listening to the podcast! I took a break to get a few things done. I’m curious because my GP has been very supportive of my efforts and has been talking about my results when he meets with other medical professionals. If it were possible to sit through a GTT and obtain non-diabetic results it would give him even more ammunition. I am not keen to come off keto to ace it but I would be prepared to try for the greater good.

[madaboutchooks]

I’ve managed to get my HbA1c from 9.8 to 5.5 without medication. Three more months and I can make the same claim. Metformin does not agree with me at all. I am hoping to reduce the HbA1C even lower this time round (I had a few higher glucose readings as I had pneumonia during this period), and I haven’t fasted with any regularity yet. Thanks to all the advice in the podcasts I have just had blood drawn for a fasting insulin level to see what I’m dealing with. That should give me a better indication of what I might be able to achieve.

[Donna]

Omg… mine is 4.9. This is war, Erick! Haha.

[richard]

I suspect that my 5.2% and @Donna’s 4.9% and @Erick’s 4.7% are all the same thing. We all have red blood cells that live for slightly different durations from 90 days to 130 days , and HbA1c is how glycated your RBCs are over their short lives… so there is a natural variation involved in the measurement.

When I went off Metformin for 4 months, mine stayed at 5.2%, but my insulin increased. What does that mean? Well let’s say 5.2% is my physiological low point, the point which my body defends by making new glucose. My insulin increased because without the benefit of metformin I was a little more IR so had to make a little more to use glucose … but I evidently had excess insulin capacity (and by that I mean ability to clear glucose) to keep my glucose at my low point.

Metformin doesn’t lower existing glucose it slows the rate that I make new glucose but that apparently was not rate limiting. So the only effect we saw was metformin’s second benefit of attenuating insulin resistance.

At least that’s my theory

[paddy0761]

So for an old timer like me (55) a HOMA:IR of 1.92 is OK?
Normal range is quoted as <2.0 in adults, but is “normal” healthy?

[richard]

Yeah that’s very good. We all become more insulin resistant as we age. 1.9 at 55 is great.

[larry]

but my insulin increased.

What is the test that measured this, and what we the on and off metformin numbers?

[richard]

Fasting Insulin

20.3 Not fasting, taking metformin
13.7 3 months of monthly EFs
19.8 4 months monthly EFs + off metformin

Feb just before Breck we’ll find out if Fasting + metformin takes be back to around 14

[Cat1hi]

About beating a glucose tolerance test. So I would start with an at home glucose tolerance, as in a candy bar that has the 75 grams of sugar and then measure your glucose with a meter.

[Frezzash]

When first diagnosed my fasting insulin was 3 and my fasting glucose was 157. So what does that mean? I did the formula above and got 3 times 157 divided by 22.5= 27.9. If correct, I’m sure that not good! I since have brought fasting glucose to around 110, lower if I’ve exercised the day before. Still a high number of 14. I am possibly a MODY diabetic, testing is still being done. Would metformin be helpful with a lower insulin level? I’d give it another try if it would help fasting numbers.

[richard]

Oh sorry that is glucose in mmol/l for mass units

##HOMA-IR = (Glucose x Insulin) /405

#Your HOMA:IR = 1.16

If you were testing for insulin resistance I would say Congrats. You are almost as insulin resistant as a healthy person with 100% beta cell function under 35.

But yes your insulin is very very low, and probably not because you are sensitive but because you are not making enough.

The other formula from homeostatic model is HOMA:β

###HOMA: β = (20 * Insulin) / (Glucose (mmol/l) -3.5)
and in mass units

HOMA: β = (360 * Insulin) / (Glucose(mg/dl) -63)

your β function = 11.4%

Mine for comparison as a 51 yo who is very insulin resistant is 188% (I’m making 1.88x the amount of insulin of a healthy 35 yo)

Metformin will reduce glucose production in the live and increase insulin sensitivity in the rest of the body.

In your circumstance I would go as hard core keto as I could to preserve your production of insulin for as long as you can. But talk to your doctor about it.

[Frezzash]

Thanks!! I was a bit worried! Just having trouble with my fasting glucose, the rest of the day no huge spikes due to keto/intermittent fasting. I’ll go to bed with blood glucose if 90/95 and wake up with higher numbers. Just frustrating. And the higher fasting start to my day kind sets a baseline level for me. No spikes but just run a bit higher from my fasting being high. Hope that made sense😀

[BaconNectar]

My FBG were hovering in the low 110s a little higher than the reading i took the night before, probably because of the dawn effect. I did my first 3 day EF last month and my fbg is less than 100 almost every morning unless i eat a very late meal.

[madaboutchooks]

I used to get very high FBGs even when I had good glucose control. It’s only now I have been following a ketogenic diet for about five months that they are starting to improve(I had to cut out a lot of dairy to achieve this as well). They are now down to between 4.8 and 5.2 (78 and 84) and I hope that they will continue to lower.