Failing glucose test

(Ursula wagner) #1

I’m in the process of getting an 2 hr oral glucose test and it seems I’m failing it miserably. I’m 1 1/2 hours in and my glucose is so high. It’s like I have no insulin at all. My HOMA-IR is .6. But my A1C is at 6. This will guarantee that my dr will say I’m diabetic. I’m wondering if keto is the best way to go. This is quite scary for me.

(Bob M) #2

Did you also get insulin done for the test?

(Ursula wagner) #3

Not for this test but I had a fasting insulin test done about 1 1/2 weeks ago.

#4

Yes, if you have been on a low carb diet for a while, you have to prime your pancreas for a day or two before the oral glucose test. Our pancrease doesn’t hold insulin in reserve for a quick release anymore, as it did when we were high carb eaters. I don’t remember where I heard/read this, but I’ve seen it discussed often in low carb circles.

(Ursula wagner) #5

I did increase it a bit for about 3 days but the numbers went up to 18.5 mmol. I was freaking out seeing these crazy high numbers. I know I’m not diabetic because my other metabolic numbers are really good but my Dr is going to say I’m diabetic for sure. I don’t know how long or how much glucose I should have primed with but it obviously wasn’t enough

(Bob M) #6

This was my result:

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Can’t tell how high it got, as the only time I get a value was when I took data. I did this Saturday morning, and couldn’t keep my eyes open. I wanted to take blood sugar an hour into it, but didn’t.

I did this keto, never ate carbs beforehand.

I’d look at the duration of the curve, not the height.

And it’s too bad they didn’t take insulin, which would give you a Kraft curve.

But the test is partly based on time:

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https://www.mayoclinic.org/tests-procedures/glucose-tolerance-test/about/pac-20394296

If you’re below 140 after 2 hours, you’re pronounced good. (My glucose was below 140 2 hours after.)

Actually, found a better picture:

image

Edit: to convert units, multiply or divide by 18. So my 7.5 = 135 in US units (7.5*18 = 135).

#7

Really makes zero difference if he says you’re diabetic or not, it’s up to you how you proceed, not him.

What was your fasting glucose and where were you at the 1.5hr mark?

A1C’s aren’t perfect, but neither are the other tests. Just like most, HOMA-IR is a calculation, while it’s saying that you’re in the sensitive range, if your “so high” at the 1.5hr mark, that pretty much proves otherwise. Averaging 6 would mean you’re diabetic. Given that you’re asking if keto is the best way to go, are you eating that way now? Because if you are, you WILL fail a GTT in most cases from that alone.

Literally nothing to be scared about as a 6 is only an average of around 125 glucose, not ideal, but far from terrible. Do you work out? Track what you eat? Do you have excess fat to lose? All of that will drop that significantly.

Worst case he throws some Metformin at you and you break the cycle, become more efficient with your insulin, and that’ll have positive downstream effects that’ll let you hit your goal. Or you can play the mental game people do where you pretend all drugs are evil and you spend 5x as much on Dihydroberberine and almost pull of the same thing while convincing yourself it’s better because it’s natural… but why? Diabetes is an easy fix, nothing to get rattled about.

(Ursula wagner) #8

It wasn’t down in two hours. But when it did come down it crashed down. I just feel that there’s something else going on. My average sugars range from 4.8 mmol to 5.4 mmol depending on the day. My sugars were higher for about 3 days because I increased the carbs a bit. Going into the test it showed 5.9 mmol which is high for me and it went way past 18 mmol. I have to figure out what I need to do or find out why my A1C is as high as it is. It doesn’t match my numbers. It’s frustrating because the Dr’s don’t know and there’s so little info out there.

(Ursula wagner) #9

I’ve worked extremely hard to get off all the meds. I’m not about to go back on. Normally my fasting glucose is in the 4’s but today it was 5.5 and by the time I had the test it was at 5.9 ( very high for me). I’m actually quite strict with my diet. I’m still doing keto and I do a lot of intermittent fasting. Most days I’m doing OMAD. Sometimes I have a small snack right after work. I don’t have to lose anymore weight; I may be too thin now. I power walk 2-3 times a day (approx 2 1/2 - 3 hours a day) It keeps my sugars low. I was expecting the number to be high with this test but I was not expecting it to go up that high. I need to know where I can further research for what all the possibilities are. Why is my A1C so high when everything else is doing do well. I feel like I’m doing mostly everything right but I’m going the wrong direction now. I’m extremely frustrated

#10

You may have mentioned and if so, I missed it. How long have you been eating strict Keto? You say you have been quite strict. How many carbs do you average? Dr. Cywes, in a few of his YT videos says that in some who have been very strict and very low carb for a long time, he has them drink a glass of whole milk in the morning and then in the evening to trigger a little insulin response.

(Mike W.) #11

What was the purpose of the test?

(You've tried everything else; why not try bacon?) #12

Benjamin Bikman explains that the “problem” with keto is that with time on the diet, the pancreas dispenses with its insulin store. This means there is no first-phase insulin response, because the pancreas has to secrete all the needed insulin, instead of relying on a reserve. The real problem is that, for historical reasons, our understanding of diabetes is glucose-centric instead of insulin-centric. There is probably a better way than an OGTT to test insulin in ketotic people.

By the way, Prof. Bikman says that it only takes the pancreas about 24 hours to respond to a return to carbohydrate intake and build up its first-phase reserve again. For future reference, all you’d have to do in a similar situation is to eat carbs for a couple of days before the OGTT.

(You've tried everything else; why not try bacon?) #13

As Prof. Bikman explains, the fundamental limitation of the HbA1C is the underlying assumption that erythrocytes (red blood corpuscles) live for exactly 90 days, no more, no less. If you are unhealthy, and your red blood corpuscles aren’t making it for the full 90 days, then your HbA1C is going to be falsely lower than it really is. And if you are so healthy that they are living longer than 90 days, then your reading is going to be falsely higher than it really is. This makes the test noticeably less accurate than people assume it to be.

(Ursula wagner) #14

It was done because my A1C is now at 6.

(Ursula wagner) #15

Do you know how to find out how long my erythrocytes are living? I was wondering if doing a reticulocyte count would be helpful. But added to that I had a Fructosamine test done and if you convert it to match A1C, it came back as 6 as well. How can this be when my insulin is low, my triglycerides are low, my HDL is high, my liver enzymes came back within range, and my blood pressure is low? All these other markers to indicate insulin resistance are great but the A1C just keeps going up. I was prepared to have a somewhat higher A1C but this seems too high; and I may be wrong on that. I wish there was more studies or research to provide better insight for us who are keto

(Ursula wagner) #16

I did increase my carbs for about 3 days but maybe not enough

(Ursula wagner) #17

I’ve been doing keto since 2017. I’m not sure what my macros are. I don’t track them anymore. Maybe I need to do that to see if there is some carb creep that I’m unaware of.

(Mike W.) #18

So your Dr just wanted to say you’re diabetic now and treat you as such? What are your daily BG numbers? The only time I’ve heard of a OGT is when someone is pregnant and they’re testing for gestational diabetes.

(You've tried everything else; why not try bacon?) #19

Perhaps, then, you should listen to them, and not to HbA1C?

By the way, Amber O’Hearn’s hypothesis is that some people might see their HbA1C go up because they are not eating enough fat and are therefore depriving their bodies of needed energy.

(Peter - Don't Fear the Fat ) #20

I can see you are really concerned. I’m a terrible worrier and would be just like you. I don’t mean to belittle your concern, we’re all here for good health after all. But This thread is fascinating to me.

This seems astute to me. We’re looking for markers, for predictions, but which one do you preference?
May I ask how you feel? Without any of these tests would you feel well?
General health? Sorry I know little about you.