Fasting for PET scan type 2

[Rolysatch]

Hi, not sure if anyone can help. My mum has unfortunately been diagnosed with cancer, they think it hasn't spread and she can have surgery if it hasn't and this is her only realistic chance of a cure so we are pretty desperate and it's essential she can have the scan which is thursday at 2.30pm. To have the pet scan her blood glucose needs to be between 4 and 8, she's type 2 diet controlled. I've bought her a glucose monitor but getting a few strange results. For example we did a test run and she ate at 8pm and fasted through till 2.30pm the next day (the time of her scan) her level in the morning at 7am was 4.5, but strangely this started to rise as the morning went on without eating or drinking.

We did a test run again last night she ate at 8pm and had breakfast this morning at 7.15am (just some shreddies no sugar and a cup of tea) before breakfast it was 4.5 but Rose to just below 7 at 2.30, she then had kippers for a late lunch and it went to 8.4 which freaked her out a bit.

The info from the hospital just says to fast for 6 hours.

With a scan at 2.30pm in the afternoon does anyone have any suggestions as to the optimal strategy for fasting to ensure her blood glucose is going to be as low as possible at that time in the afternoon, should she have a carb free breakfast on the day of the scan or go right through from 8pm the night before, she's happy to do that but worried it could have the opposite effect? Any advice really appreciated!

Thanks in advance

Roland

 

[ColinUK]

Hi Roland,

How long before the scan is scheduled?

I’m asking because the longer she has to be able to monitor the impact of various patterns and foods the better she’ll be able to coerce the right sort of figure from the meter.

Personally I’d probably aim for something like a breakfast of eggs perhaps with some cheese or avocado to boost the fat content a little and track that at 2, 4 and 6 hours. For me I’d expect to see almost no change after two hours, a slight rise after four and eased down after six but were all different and each day is different so it’s guesswork to a degree.

If I’m fasting and am active then it’s not unusual to see my BG rise over the course of 4 or 6 hours before easing off again.

What’s the sort of level she’s seeing first thing in the morning?

Just a thought but have you or her spoken with anyone on the helpline number or even with someone at Macmillan as it’s cancer specific?

Hopefully the scan shows that it’s not metastasised and that your mum can be operated on with a high likelihood of success.

Please keep us informed how she’s doing.

Colin

 

[EmmaL76]

Sorry Roland I wrote you a massive long message this morning with lots of wonderful advice but non of which took into consideration the fasting for 6 hours (it was very early and hadn’t read your message properly) I’m so sorry you and your mum are going through this. These morning rises with or without food are very common, unfortunately with the scan on Thursday you don’t have to much time to figure it out and only have 2 days of experimentation. I would echo Colin above and go for something like eggs, protein etc at around 9 am, we don’t want her starving by the time of the scan or the body may unhelpfully start dumping glucose on her for energy. A light walk if your mum is physically active can be beneficial and lower sugars for several hours, however If the body sees this as a stressor it can temporarily raise sugars, so maybe that’s worth a trial today/tomorrow. Keep her hydrated, water is best. Now the one thing you have little control over is the anxiety/stress these things cause, try to keep your mum occupied and relaxed in the run up to the scan it’s hard I know but some mindful relaxation may help… are you able to go with her? I have a hospital appointment this afternoon and have been told I have to go alone which I wasn’t expecting, it’s just I find not being alone keeps me calmer. Please pop back let us know how you and your mum are getting on

 

[Rolysatch]

Hi Roland,

How long before the scan is scheduled?

I’m asking because the longer she has to be able to monitor the impact of various patterns and foods the better she’ll be able to coerce the right sort of figure from the meter.

Personally I’d probably aim for something like a breakfast of eggs perhaps with some cheese or avocado to boost the fat content a little and track that at 2, 4 and 6 hours. For me I’d expect to see almost no change after two hours, a slight rise after four and eased down after six but were all different and each day is different so it’s guesswork to a degree.

If I’m fasting and am active then it’s not unusual to see my BG rise over the course of 4 or 6 hours before easing off again.

What’s the sort of level she’s seeing first thing in the morning?

Just a thought but have you or her spoken with anyone on the helpline number or even with someone at Macmillan as it’s cancer specific?

Hopefully the scan shows that it’s not metastasised and that your mum can be operated on with a high likelihood of success.

Please keep us informed how she’s doing.

Colin

Hi Colin thanks for the reply. The scan is on Thursday at 2.30pm. It would have been better if it was first thing in the morning i think, but grateful just to get one so quickly.

To he honest she's always floated between pre diabetes and diabetes for years, she's always been really good at controlling it just with diet. She spent 2 weeks in hospital with what was initially thought to be gallstones which was then found to be a klatskin tumor, they inserted some stents in her bile duct which reversed the jaundice and she got her appetite back a bit, but had lost a lot of weight. She was slim anyway as she has a low fat diet for her heart. I wanted to build her up a bit and put some weight on in case they refused surgery or chemo because because she was too frail. I've been taking lots of "taste the difference" ready meals and puddings round to her to put a bit of weight back on rapidly - food she wouldnt normally have - which has done the trick. For the sake of a couple of weeks i thought that building her strength.back up was more pressing, but didnt know they wanted a pet scan at that point and that the scan required low blood sugar. But I just hope I haven't messed things up with that. She's been on a more sensible diet the last week since finding out and she's generally under the required 8 but we wany to be sure as thecscan will be delayed if she's not.

Thanks again I'll report back

Roland

 

[Rolysatch]

Sorry Roland I wrote you a massive long message this morning with lots of wonderful advice but non of which took into consideration the fasting for 6 hours (it was very early and hadn’t read your message properly) I’m so sorry you and your mum are going through this. These morning rises with or without food are very common, unfortunately with the scan on Thursday you don’t have to much time to figure it out and only have 2 days of experimentation. I would echo Colin above and go for something like eggs, protein etc at around 9 am, we don’t want her starving by the time of the scan or the body may unhelpfully start dumping glucose on her for energy. A light walk if your mum is physically active can be beneficial and lower sugars for several hours, however If the body sees this as a stressor it can temporarily raise sugars, so maybe that’s worth a trial today/tomorrow. Keep her hydrated, water is best. Now the one thing you have little control over is the anxiety/stress these things cause, try to keep your mum occupied and relaxed in the run up to the scan it’s hard I know but some mindful relaxation may help… are you able to go with her? I have a hospital appointment this afternoon and have been told I have to go alone which I wasn’t expecting, it’s just I find not being alone keeps me calmer. Please pop back let us know how you and your mum are getting on

Hi Emma thanks for taking the time to reply. Yes we were shocked about the rises. We've never used a monitor before, as she manages it well generally when she goes to her annual check up.

As far as excersise unfortunately she isn't allowed any physical exertion for 24 hours before the scan, they inject a radioactive sugar for the scan and for her cells to absorb it and glucose levels has to be low. Otherwise that would have been a great idea.

I didn't realise stress had an impact - I'm realising what a minefield it is - she's a worrier at the best of times so you can imagine what's he's like currently. So I'll let her know about that thanks.

I think we'll try a light no carb breakfast as you both suggest ratgerbthan going right through for 18 hours.

I can't go in to the scan with her but will be taking her there, so will be doi g my best to keep her calm.

Thanks again!

Roland

 

[Proud to be erratic]

Hi Emma thanks for taking the time to reply. Yes we were shocked about the rises. We've never used a monitor before, as she manages it well generally when she goes to her annual check up.

As far as excersise unfortunately she isn't allowed any physical exertion for 24 hours before the scan, they inject a radioactive sugar for the scan and for her cells to absorb it and glucose levels has to be low. Otherwise that would have been a great idea.

I didn't realise stress had an impact - I'm realising what a minefield it is - she's a worrier at the best of times so you can imagine what's he's like currently. So I'll let her know about that thanks.

I think we'll try a light no carb breakfast as you both suggest ratgerbthan going right through for 18 hours.

I can't go in to the scan with her but will be taking her there, so will be doi g my best to keep her calm.

Thanks again!

Roland

As Emma said earlier, staying hydrated is essential. When even just a little dehydrated, dispersal of glucose from normal metabolism can become very compromised. So plenty of fluid (yes ideally just water, or hot water with a slice of lemon) to help your Mum keep her BG lower. Good luck (from another Roland).