Lowering HBA1C

Fasted, that's a good number.

With diabetes they say check after 2 hours, but that is for insulin dosage and looking for serious warning signs and 2 hours alone won't give you the whole picture.

If you want an accurate assessment, to see your peaks, you can check every 30 minutes for two to two and a half hours. It's a lot of finger pokes, if you're eating four to five meals a day, but that would be best for a day or two of stable eating. So yeah, in an ideal situation, considering how often you eat, I would test every half hour from the time I got up, until two and a half hours after my last meal, or bedtime, whichever came last.

This is why the CGM is so ideal. You get to see the area under the graph, with all the peaks and valleys. For a full two weeks.

Also, I noticed someone recommended testing somewhere other than your fingertip and I wouldn't recommend that for accurate readings. The strips are calibrated for fingertips. You BG doesn't stay the same, but gets used up as you move through the body farther away from your core, and the strips compensate for that and are calibrated for fingertip. I don't know how much the difference is, but I had the same question when I went to the diabetes clinic, and I asked if I could use my leg because I'm paralyzed and can't feel my legs, so that would be ideal for me. They said no, and explained why.

Also, they mentioned that if I'm doing more than one test in short order, to use different fingertips, as swelling and inflammation in one fingertip may change the readings. And of course they also mentioned at the diabetes clinic to make sure my fingers were reasonably clean of sweats, oils, and of course sugars before doing the poke. I use an alcohol swab.

The good news is that I don't have to poke myself a hundred times a day forever, just a day or two when I'm eating as normal to get a baseline and then after that, whenever I go off your normal diet and "cheat", just to check if I'm safe. Because I'm eating less than 25 grams of carbs on a regular day, I stay around five to seven and a bit, and am always back down to around five and a bit two hours after my one big meal a day.

If I only tested at the recommended two hours I would never have known that my BG goes up to seven and a half around the hour mark.

When you do keto, your body will use proteins and glycerol's to make a few sugars in a process called, Gluconeogenesis.

Sorry for writing so long. I take my diabetes seriously now. It almost killed me when I was seriously food addicted. Two surgeries and almost a year in the hospital.
That was me that suggested it.

I ran an experiment and dud finger and knee right after each other, multiple different times and really found no difference, maybe .1 of a difference if any at all.

But I am not diabetic and wasn’t checking becayse my health depended on it.
 
How much do you guys think lifestyle factors could play into it? I take my sleep and recovery extremely seriously and try to mitigate stress as much as possible. I'm a shift worker though so my circadian rhythm is absolutely out the window. Do you think this could play a substantial role?
 
How much do you guys think lifestyle factors could play into it? I take my sleep and recovery extremely seriously and try to mitigate stress as much as possible. I'm a shift worker though so my circadian rhythm is absolutely out the window. Do you think this could play a substantial role?
I’m still thinking gh. Have you stopped using it to see?
 
That was me that suggested it.

I ran an experiment and dud finger and knee right after each other, multiple different times and really found no difference, maybe .1 of a difference if any at all.

But I am not diabetic and wasn’t checking becayse my health depended on it.
I think I'm going to try a few times, fasted and eating. It would be nice to stop pricking my baby finger and point one is well within the tolerances of the test strips.

I don't know why I didn't just try it myself instead of taking the diabetic nurse's words as gospel.
 
I’m still thinking gh. Have you stopped using it to see?
I don't have a ton of exposure to GH at this point. I used it for about 6 weeks, discontinued it while I was cruising for 12 weeks, and have been back on it for about 6 weeks now. Would that be enough exposure to significantly impact my a1c?
 
I don't have a ton of exposure to GH at this point. I used it for about 6 weeks, discontinued it while I was cruising for 12 weeks, and have been back on it for about 6 weeks now. Would that be enough exposure to significantly impact my a1c?
A1c is basically a measure of your average blood glucose over the previous 3 month history.
 
He's very young, and his bodyweight is in the normal-ish range, and he's on metformin, and he's supplementing that with insulin, and his A1C's are a little high and still rising.

With Metformin, and insulin, and he's in his 20's his A1C's should be in the 3's. He should be pale and ready to faint from low blood sugar.

Might not be the worst thing in the world to be at least a little concerned, given the circumstances.
I get where you're coming from but if his insulin and metformin use is what it should be then he shouldn't ever be low. I'm actually pretty impressed it's not low but your comment has me really thinking I don't have enough information.

Now I want to know his total daily dose of insulin. How much is long and how much is rapid acting bolus and basal timing and what types?
Fasted bg
Metformin dose
Insulin to carb ratio
Other supplements used
Family history of diabetes?
Have you ever experienced hypoglycemia?
 
I get where you're coming from but if his insulin and metformin use is what it should be then he shouldn't ever be low. I'm actually pretty impressed it's not low but your comment has me really thinking I don't have enough information.

Now I want to know his total daily dose of insulin. How much is long and how much is rapid acting bolus and basal timing and what types?
Fasted bg
Metformin dose
Insulin to carb ratio
Other supplements used
Family history of diabetes?
Have you ever experienced hypoglycemia?
I'm not convinced my doses are where they should be considering the amount of food I'm eating and combined with GH. The insulin doses are pretty moderate.

Now I want to know his total daily dose of insulin. How much is long and how much is rapid acting bolus and basal timing and what types?
So im using insulin only 3x a week paired with my high carb days. The dosing is as followed - 10iu lantus upon waking, 5iu Humalog pre and post workout, 5iu Humalog with one other meal on that day. So 25iu total.

Fasted bg
Recently anywhere between 4.7-5.5

Metformin dose
500mg daily (with last meal)

Insulin to carb ratio
900g of carbs to 25iu of insulin on those high carb days

Other supplements used
Berberine 500mg 2x a day

Family history of diabetes?
Father had diabetes but it came on after a major operation he had. I believe it was induced by the therapy afterwards.
Have you ever experienced hypoglycemia?
Yes in the past, but not recently. Happened before when on really low carbs
 
That was me that suggested it.

I ran an experiment and dud finger and knee right after each other, multiple different times and really found no difference, maybe .1 of a difference if any at all.

But I am not diabetic and wasn’t checking becayse my health depended on it.
Well, I thought tonight would be a good time to try it as I was celebrating a birthday with my best bud and had some bread and cake, so my sugars were significantly higher than normal.

I had different results.

I tested with Bayer contour next strips and a contour next EZ meter, left baby fingertip was 7.7 mmols, and right kneecap was 6.8 mmols.

Both strips were from the same lot and bottle.
Not a wildly different reading but statistically significant, especially if I was calculating a bolus of insulin, which I don't take.

I did at first try to test right thigh, but even with the lancet turned up to five I couldn't get a large drop of blood, I'm guessing that's why you do the kneecap, because of thinner skin?

I'm going to try again tomorrow fasted (if I remember before I eat) and see if I still see a difference, and report back.
 
Well, I thought tonight would be a good time to try it as I was celebrating a birthday with my best bud and had some bread and cake, so my sugars were significantly higher than normal.

I had different results.

I tested with Bayer contour next strips and a contour next EZ meter, left baby fingertip was 7.7 mmols, and right kneecap was 6.8 mmols.

Both strips were from the same lot and bottle.
Not a wildly different reading but statistically significant, especially if I was calculating a bolus of insulin, which I don't take.

I did at first try to test right thigh, but even with the lancet turned up to five I couldn't get a large drop of blood, I'm guessing that's why you do the kneecap, because of thinner skin?

I'm going to try again tomorrow fasted (if I remember before I eat) and see if I still see a difference, and report back.
Maybe it was different because you don't use your legs? So less blood flow? Less blood flow, then the sugars in the blood reduces more? Just spitballing. With you I would keep doing the finger. Too bad the leg didn't workout for you. There would be zero pain then.

Anyhow I don't do the knee cap, but the teardrop muscle up and inside to the knee cap. Did you massage the area before poking? Try that to get some blood flow going, massage up and down your leg.
 
My trt doc just told me he doesn't even care about my fasted bg or ha1c. He says If he's ever worried he will check c-peptide. Just mentioning it because it's the first time I've heard of this test.
 
Your insulin use seems pretty moderate and probably helps on those ultra high carb days. My father also developed type 1 diabetes as an adult from complications but not from a surgery. You could be developing insulin resistance from this high of carb intake but I couldn't say for sure I'd imagine a doctor would recommend not taking metformin or insulin for 3 months and check a1c but I'm not a doctor.
 
what is your post meal glucose at the 90 min mark ? also what is your fasting insulin?
i've been testing over the past few days anywhere between 60-120 mins after a meal and ive gotten reading anywhere between 6.0-8.5.
i don't believe ive ever had my fasting insulin tested, atleast not recently.
 
Your insulin use seems pretty moderate and probably helps on those ultra high carb days. My father also developed type 1 diabetes as an adult from complications but not from a surgery. You could be developing insulin resistance from this high of carb intake but I couldn't say for sure I'd imagine a doctor would recommend not taking metformin or insulin for 3 months and check a1c but I'm not a doctor.
no doubt in my mind that a doctor would require me to come off steroids and all other associated drugs before making any assessment. I'm in too deep lol
 
I tested with Bayer contour next strips and a contour next EZ meter
I use the same meter and strips. The strips are expensive as hell. Do you think its worth it to keep going with them in my situation? or would a cheaper option be reliable enough considering my life isnt depending on them?
 
I just took a reading, about 60 mins after a meal and it rang in at 6.8.
the meal consisted of 140g chicken, 350g rice, 90g banana. No insulin. but took Lantus in the AM, and Humalog with my two previous meals.
 
I use the same meter and strips. The strips are expensive as hell. Do you think its worth it to keep going with them in my situation? or would a cheaper option be reliable enough considering my life isnt depending on them?

All good quality test strips are pretty expensive.

I know you're not diabetic, but I'll discuss things from a diabetes viewpoint and you can apply it to yourself as needed.

Unlike type one diabetes, which can kill you in twenty minutes flat, type two and generally insulin resistance is a slow killer, it come on slowly,it gets worse slowly, and harms you fairly slowly, until it gets quite bad. It's terrible for you, don't get me wrong, but it moves fairly slowly in most people until late stages, then it gets really bad really fast.

So, if your diet is stable, and your medication is stable, it's fairly safe to just keep everything normal for a few days, test the hell out of yourself for a full day of eating and medication, and then stop testing for 3-6 months then repeat.

Unless you do something out of the ordinary like eat a bunch more or less carbs than normal. Then you should test a few times just to be safe.

The only real danger with type 2 is that unlike getting worse, it can improve very quickly, so if you are taking insulin, and if you eat a lot healthier for a few days, (less carbs) your standard dose of insulin could become lethal.

And you are taking insulin, so if you decide to stop eating all that rice you probably want to start testing again while you stabilize yourself to a new setpoint, but if you don't make changes and keep the same food, at the same times, and the same bolus of insulin, you can probably stop testing for a few months at least, and then do another full day of testing and see if anything's changed, and if it has, it will probably only have changed a bit, and you can readjust, and go back to testing sporadically.

So yeah, you don't have to test constantly if you are in a groove, and don't change anything.

The warning signs for full blown type two diabetes are hungry, thirsty, sleepy, and pissing like a racehorse, and they come on slowly too. At my worst I had blood sugars in the 30's and didn't actually feel bad, just thirsty and kind of pleasantly sleepy, and I thought I was pissing so much because I was thirsty and drinking so much fluids.

I have two other things to mention. Someone mentioned Fasting insulin tests. Testing insulin directly would be a great thing if we could do a finger prick for a dollar like BG but no, we can't it's much more expensive and difficult and we can't. A fasting insulin test will figure out pre-diabetes five or ten years before an A1C will show it.

I'm not sure it will be helpful for you, because of the Metformin, insulin and berberine you're already on, those seem like confounding factors.

Also, you mentioned you have a history of diabetes in your family, and your Dad got diabetes after a surgery, and you think his treatment gave it to him?

Respectfully, I disagree, that's not likely, it would be like saying he ate bacon five times in the last month and that's probably why he got a heart attack. Like Atherosclerosis, Type 2 diabetes takes a long time to develop.

There are only a few drugs that can push you over the edge to insulin resistance, (Olanzapine, and other anti-psychotics is the one big class that is common and does it) but even that takes years to go from completely normal to full blown diabetic.

More likely he was on the edge or already diabetic, and the tests before or after surgery just caught it. Catching diabetes in a blood test is a good thing, not knowing and letting it ravage your body while you walk around feeling fine is the nightmare.
 
All good quality test strips are pretty expensive.

I know you're not diabetic, but I'll discuss things from a diabetes viewpoint and you can apply it to yourself as needed.

Unlike type one diabetes, which can kill you in twenty minutes flat, type two and generally insulin resistance is a slow killer, it come on slowly,it gets worse slowly, and harms you fairly slowly, until it gets quite bad. It's terrible for you, don't get me wrong, but it moves fairly slowly in most people until late stages, then it gets really bad really fast.

So, if your diet is stable, and your medication is stable, it's fairly safe to just keep everything normal for a few days, test the hell out of yourself for a full day of eating and medication, and then stop testing for 3-6 months then repeat.

Unless you do something out of the ordinary like eat a bunch more or less carbs than normal. Then you should test a few times just to be safe.

The only real danger with type 2 is that unlike getting worse, it can improve very quickly, so if you are taking insulin, and if you eat a lot healthier for a few days, (less carbs) your standard dose of insulin could become lethal.

And you are taking insulin, so if you decide to stop eating all that rice you probably want to start testing again while you stabilize yourself to a new setpoint, but if you don't make changes and keep the same food, at the same times, and the same bolus of insulin, you can probably stop testing for a few months at least, and then do another full day of testing and see if anything's changed, and if it has, it will probably only have changed a bit, and you can readjust, and go back to testing sporadically.

So yeah, you don't have to test constantly if you are in a groove, and don't change anything.

The warning signs for full blown type two diabetes are hungry, thirsty, sleepy, and pissing like a racehorse, and they come on slowly too. At my worst I had blood sugars in the 30's and didn't actually feel bad, just thirsty and kind of pleasantly sleepy, and I thought I was pissing so much because I was thirsty and drinking so much fluids.

I have two other things to mention. Someone mentioned Fasting insulin tests. Testing insulin directly would be a great thing if we could do a finger prick for a dollar like BG but no, we can't it's much more expensive and difficult and we can't. A fasting insulin test will figure out pre-diabetes five or ten years before an A1C will show it.

I'm not sure it will be helpful for you, because of the Metformin, insulin and berberine you're already on, those seem like confounding factors.

Also, you mentioned you have a history of diabetes in your family, and your Dad got diabetes after a surgery, and you think his treatment gave it to him?

Respectfully, I disagree, that's not likely, it would be like saying he ate bacon five times in the last month and that's probably why he got a heart attack. Like Atherosclerosis, Type 2 diabetes takes a long time to develop.

There are only a few drugs that can push you over the edge to insulin resistance, (Olanzapine, and other anti-psychotics is the one big class that is common and does it) but even that takes years to go from completely normal to full blown diabetic.

More likely he was on the edge or already diabetic, and the tests before or after surgery just caught it. Catching diabetes in a blood test is a good thing, not knowing and letting it ravage your body while you walk around feeling fine is the nightmare.
Great info.

So in my original post I stated that I believe the increase in A1C is transient due to my current caloric intake. This caloric intake is temporary and food will come back down, likely Q1 or 2 of 2024. When food comes back down to get in shape, the insulin/metformin will be adjusted accordingly based on BG readings and A1C which I test every 12 weeks.

Insulin testing is definitely something I'll inquire about getting tested on my next check up.

As for the T2 diabetes symptoms, I do experience hunger, thirst and frequent urination but not to an extreme by any means. I always just chalked it up as being due to my energy output/activity and drinking a gallon and half of water per day.

Lastly, you hit the nail on the head on my dad's situation. There's no denying his diet was crap and he was overweight. The steroids and other meds he was put on just further pushed that needle. My point is, that diabetes doesn't run in my family genetically per say. I believe my grandfather (on my mom's side) was pre diabetic, but again, influenced by poor diet and lifestyle more than anything else.
 
I wonder if some people can be healthy with higher blood sugar. Like are these average numbers statistically that might not show the entire picture. I have a gene that makes me high risk for high blood sugar but another gene that makes me low risk for diabetes. Weird.....
 
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