Glucose/Insulin 3-hour test result

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Glucose/Insulin 3-hour test result

Postby Hubbs » Tue Apr 05, 2016 12:11 am

I finally got the test result today - is it Kraft's Pattern 5: Insulinopenic? Type 1 diabetic? Hypoglycemic? Anxious to hear any insight here :?

Glucose tolerance test
Fasting 98, 1hr 185, 2hr 113, 3hr 45

Insuline tolerance test
Fasting 1.3, 1hr 17, 2hr 19, 3hr 2.0

A1c 5.6 (didn't change much at all after 2 months super restrictive diet)

My appointment with an endocrinologist is till 5 weeks out. So primary care doctor ordered additional lab tests including antibody and C-peptide. She thought glucose dropped to 45 at 3hr is concerning.
E3/E4
MTHFR compound heterozygous (C677T and A1298C)
A1c5.7/LDL-P1602
All advices appreciated :)

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Stavia
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Re: Glucose/Insulin 3-hour test result

Postby Stavia » Tue Apr 05, 2016 2:39 am

Its not diabetic. But you have some reactive hypoglycaemia. 2.5 mmol is low. Probably a lag effect from the 2hr insulin spike but you had an appropriate insulin response to the low glucose.

I looked at the Kraft patterns and dunno if you fit any of them. You're certainly producing insulin appropriately - even enough to push you hypoglycaemic.

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Re: Glucose/Insulin 3-hour test result

Postby Tincup » Tue Apr 05, 2016 7:37 am

Did you carb up (150g/day for 3 days) before test?
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Re: Glucose/Insulin 3-hour test result

Postby Hubbs » Tue Apr 05, 2016 9:52 am

Thanks Stavia. What to do with reactive hypoglycemic? What about all the post meal BG spikes I get frequently 160-200, 250 accationally, even with great sugar/carb restriction?

George, I did carb load for 3 days but range 120-150/day. Is that not enough for the 75g sugar drink challenge? It's surprising to see that 75g of sugar only raised blood sugar to 185, because a slice of gluten-free bread following 40 minutes intense hike sent my BG to 200.

I have been having dazzy spells, very low blood pressure, mild pain below ribs area, nightly leg cramping. I also wonder if taking too many suppliments (currently Berberine Bergomat Pantethine Tri Sugar Shield among many others) long term could cause problems?
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MTHFR compound heterozygous (C677T and A1298C)
A1c5.7/LDL-P1602
All advices appreciated :)

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Stavia
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Re: Glucose/Insulin 3-hour test result

Postby Stavia » Tue Apr 05, 2016 1:13 pm

Honey as far as I know its about limiting glucose spikes by all the usual means. Only ever has a couple patients with it

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Re: Glucose/Insulin 3-hour test result

Postby Stavia » Tue Apr 05, 2016 1:25 pm

Oh! Arent you supposed to carb load at 300grams a day pre the GTT? Maybe its as simple as that

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Re: Glucose/Insulin 3-hour test result

Postby Tincup » Tue Apr 05, 2016 10:02 pm

Stavia wrote:Oh! Arent you supposed to carb load at 300grams a day pre the GTT? Maybe its as simple as that


Most references I've seen say 150g/day minimum for 3 days. Dr. Eades (Protein Power) has them do it for 5.

Hubbs, loks to be pattern 5 to me. Whether because of LC diet or T1, hard to say. The antibody test should be useful.
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Re: Glucose/Insulin 3-hour test result

Postby Hubbs » Wed Apr 06, 2016 12:48 am

Regarding carb back load before test - does the amount change for body weight and total calorie intake? I eat 1200 calories/day and my weight 112lb.

I thought my result looks like Kraft's pattern 5, except my glucose didn't go over 200.

Reading up on reactive hypoglycemic, saw most advices point toward eating small meals frequently to prevent the lows. Is it necessary to give up my current morning fasting? And which condition do I have - insulin sensitive or insulin resistance?

Anxious to see test result on antibody GAD, and c-peptide (no fasting, wrong??)
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MTHFR compound heterozygous (C677T and A1298C)
A1c5.7/LDL-P1602
All advices appreciated :)

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Re: Glucose/Insulin 3-hour test result

Postby Stavia » Wed Apr 06, 2016 2:23 am

Dunno Hubbs.
You did have an insulin spike (with resultant drop of glucose afterwards) to a glucose load you wouldn't eat normally. So it was an unusual situation. If you dont drop so low with your normal diet then its not an issue surely?

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Re: Glucose/Insulin 3-hour test result

Postby LanceS » Wed Apr 06, 2016 7:40 am

Seems like you are making good progress. Be happy with that and continue experimenting with things that make sense.

I'm not sure you have enough information to make any sort of radical deviations on your current path. You'll have more information soon, and maybe that will help inform you as to better next steps. Speculation about what could be can induce alot of stress, but to be prepared for doctor discussions, you kind of have to engage in some background research. Try not to let it stress you out. Approach it in a way that is engaging and hopeful that you can find more things to continue helping you live your life to the fullest.

When I look at your response, a couple things occurred to me:
1) I am not substitute for an endocrinologist or any other doctor for that matter
2) Looks a little normal, just too high BG, maybe too low insulin (I couldn't tell the units and make them comparable to Kraft units, so I wasn't sure)... almost pointing toward insulin resistance initially, perhaps with some beta cell insufficiency, followed by insulin sensitivity as you went hypo. This could happen because of your diet (low carb diets often induce insulin resistance), genetics, or some combination of both.
3) Also looks like five as it seemed your insulin was too low and glucose too high.

With your hypo reading and dizzy spells, I would consider lightening up on supplements (like Berberine?) that reduce blood glucose. I'd put them on a list of questions to ask your doctor. If the dizzy spells don't go away, then perhaps you add the supplements back depending on doctor's advice.

Hubbs wrote:Reading up on reactive hypoglycemic, saw most advices point toward eating small meals frequently to prevent the lows. Is it necessary to give up my current morning fasting? And which condition do I have - insulin sensitive or insulin resistance?


My first thought would be that ONLY for meals that you think will provide challenging postprandial glucose levels, maybe you eat about 25% of your meal an hour (or a bit more) earlier (that 25% number is just a guess). That way the glucose from the 75% portion may find its way into cells more quickly (because insulin from the 25% is already in your system) and hopefully the 25% doesn't drive your blood glucose too high (if it does, then you would eat less than 25%, if it doesn't drive it high enough, than more than 25%). But I think you have to be careful, because IF your Beta Cells are in dysfunction, this seems like it might stress them out even more. The recommendation to eat small meals certainly seems to me to put Beta Cells under more stress. So if a 25% plan works for glucose causing meals shouldn't be taken for a license to eat alot of those types of meals. Some of this debate is currently ongoing in the Type I community and can ironically be found:

https://www.facebook.com/AmericanDiabet ... catino=ufi

The ADA is accepting of dietary advice that accepts carbs. These folks on the ADA's own forums are rebelling and sharing their anecdotes and stories about how they are living life more fully (low / ultra low carb zealots). I JUST WANT TO EMPHASIZE, I DON'T THINK YOU HAVE THE DATA TO ASSUME YOU ARE A TYPE 1 DIABETIC. Also I am a bit of a practicing low carb zealot, just fyi full disclosure. But I think you have to remember there are many many more people out there with the ADA approach to carbs than the ultra low carb approach. These two approaches are somewhat diametrically opposed. I can't tell you which one is right or wrong for you. But IF you end up finding that you have Beta Cell dysfunction, you probably have to ensure that whatever meal strategy you end up with that it doesn't continue to stress out the Beta Cells. It seems that having some fruits helps make your diet manageable... I think there would hopefully be a middle ground between carb up whenever and ultra low carb approaches that will allow for this. I think there are some stories of folks who went ultra low carb and gave their beta cells a rest and then later went back to a lowish carb diet and found their beta cells were functioning better.

Lastly, some folks think that GLUT4 transporters can come out and soak up glucose during and after resistance training. Because females are smaller and lift less weight some folks think this effect is not all that realizable in women. I don't know enough about it, but I know some have found success. Perhaps weightlifting or some form of high intensity interval training would allow for "glucose excursion meals" afterwards? Might help in your management, also might be something to ask your doc about.


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