lurker question
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| Sun, 11-11-2007 - 5:02pm |
Hi All...
I'm a lurker on this board and have a question. I was diagnosed as gestational diabetes during my recent pregnancy (my son was born 9/4). Nobody bothered telling me what my levels were for either my 1-hour or 3-hour tolerance tests back then. After my son was born, my OB/GYN wanted me to have a follow-up 3-hour tolerance test to make sure things were back to normal. When I talked to my nurse about the results she said that after 1 hour my blood glucose level was 191 when it should have been 180. Because of this she said my OB/GYN assumed that I was probably pre-diabetic and that I should go back to following a strict diabetic diet and checking my blood sugar 4 times a day (fasting and after every meal). They told me that my fasting levels should be below 100 and below 140 after meals. Are those normal targets?
First of all, this all seemed a little extreme to me. My grandfather has type 2 and doesn't even have to follow such stringent rules.
Anyway, I went ahead and have been testing rather often mainly out of curiosity and because I tend to be obsessive about health problems. For the past few day my fasting levels have been somewhat high (anywhere from 102-112), but my levels after breakfast (even totally carb breakfasts) are under 100. Yesterday all of my levels were below 100 except for after supper when it was 120-something. I decided to test during the night to see what was happening then and around 20 til 2 AM my levels were below 100.
All of this sounds normal to me except for the fasting levels, but I've read something about "dawn phenomenon." Do non-diabetic people experience that sometimes? I'm wondering if my 3-hour tolerance test results were a fluke of some kind. My OB/GYN tends to be somewhat of an alarmist, so her response didn't really surprise me, but I'd sure like to be able to not totally restrict myself to the extent she'd like for me to.
Thanks in advance for your advice to a confused lurker :-)
Megan

Well, the levels they indicate for pre and post meal are not 'extreme', those are standard glucose levels for those timeframes.
1 - you have a family history of diabetes (grandpa and maybe others not mentioned)
2 - you had gestational diabetes
3 - you tested high in your lab work
All of those do put you at risk. Being very proactive about nipping it right here and now is a great way to keep it from progressing - watching carbs, watching weight, getting exercise are all good things. My totally unmedical guess is that when you go back for a follow up visit with the dr, they'll check your daily results plus do some other testing - they might do an A1C which gives the 'average' of the glucose over the last 3 months, a broader panoramic view of things where the daily metering is a snapshot of right at that time. It's possible to have okay readings the 4 times you test and have things out of whack at other times of the day.
--Deb
Hi Megan,
A fasting blood sugar above 100 is called pre-diabetes by most doctors nowadays. It isn't that they want more people on the diabetes team but rather to prevent the complications of diabetes which start from day one. I do hope that your ob-gyn was strict about how much weight that you gained during your pregnancy as research is showing that it effects you and your baby more than was realized previously.
The two goals that she gave you are accepted goals of the American Academy of Clinical Endocrinologists. They are the strictest set of goals and absolutely will help prevent complications. Do you test two hours after eating? In non-diabetics the blood sugar rises with eating but comes back down to normal two hours after eating. In diabetics it doesn't start to come down until after three hours. So that is the reason for the two hour test.
In all of us our bodies start getting ready for a busy day about 4 am. In non-diabetics they are able to balance the amount of increased blood sugar and the amount of insulin secreted. It is in diabetics where these numbers get out of wack.
I hope that I have answered some of your questions. Please feel free to ask anymore that you have.
One comment about your grandfather. I am sure that you have read or heard about the elderly that have lost control of their cars and hit and injured or killed innocent people. The one thing that has been in the newspaper that all of these accidents had in common was uncontrolled diabetes. As a long time diabetic this certainly frightened me. Your GF needs to control his diabetes. Some doctors don't believe that this control needs to be as tight as when the diabetic was younger. We shall see if this theory holds up.