I don't understand my test!

[Mary.M]

Hello all, I am confused by a blood screening I had recently to try to diagnose an annoying rash, nothing showed up except blood glucose 7.2mmol/L, with a message from the lab: 'DM cannot be excluded, follow-up recommended'. I wasn't asked to fast so I'd eaten twice that morning, second time about an hour before the test. Because of the lab message my GP has asked for a fasting blood test next week. What I don't understand is the lab range is 3-11 so I'm well within that, and also well within the numbers on your site except for fasting tests. I'm worried why the lab and my GP think I'm at risk of developing diabetes, I'm not overweight, take lots of exercise, drink one glass of wine a day. Anyone have any ideas or advice? Thank you!

 

[mikeyB]

Hi Mary.M, welcome to the forum.🙂

Depending on what you ate an hour before your test, that could be an entirely normal reading, so you aren’t really at risk of diabetes just yet.

When you have the fasting test ask them to do an HbA1c test (they may well be doing that anyway) which will tell them what your blood glucose has been doing for last three months or so. If that is normal, no worries.

There isn’t anything you can do between now and the test to change that, so carry on in blissful ignorance for now.

Let us know what happens🙂

 

[trophywench]

For interest I just looked at the ref ranges on my surgery website (you can only do it if you've had a test for that) and 3 - 5 ish = normal and anything above up to whatever = impaired glucose tolerance and anything above = most likely diabetic BUT this is ONLY for 'fasting' blood tests, not random ones.

Yours was random - hence they're simply looking after you, just in case - that's all - and I can only applaud that !

 

[Mary.M]

ok, I'm getting to grips with this, thanks for the help! the reasons I'm asking questions are:

1. I'm a scientist so I question anything I don't understand that has numbers, and no biomedical/chemistry knowledge so need help in this area

2. I've been hyperthyroid for 6 years and familiar with thyroid tests which only ring alarm bells if they are outside the ref range, this is different and more complex

3. I joined a thyroid forum when I was diagnosed, it's helped so much talking to people who've been through it & learning from their experience

so, I didn't know that 'post prandial' doesn't mean after eating just anything, it means you've been given 75g glucose and tested after

that's a LOT of sugar/carb for me and I wouldn't have eaten anything near that before the test

and I didn't know that while being over the top of the range means 'most likely diabetic', being under the top doesn't automatically mean you're ok

yes, they are indeed looking after me, I have the most fantastic GP and just wanted to understand why the lab had flagged my results, never had a glucose test before so nothing to compare it with and would find it hard to cope with another disorder on top of thyroid, fingers crossed for a good fasting result next week!

 

[trophywench]

If post prandial blood tests have to be done after 75g carb then I can never test mine nor can anyone else since I doubt if I could cram that amount of carb in for one meal very comfortably. Post prandial to me (Latin O level, failed) ONLY means 'after eating' with no caveats re what you ate.

On the other hand an OGTT blood test - Oral Glucose Tolerance Test - does have to be done before and after 75g of Glucose.

 

[Madeline]

How much?😱

 

[Madeline]

Low carb, no carb. I am sick to death of cabbage.

I dreamt about a great big gooey jam n cream doughnut last night. Probably the saddest dream I’ve ever had, dreaming about food ffs. Had to up my steroids to 40mg because pollen, and OMG is my body whinging and craving because of it. Brain is insane.

 

[AndBreathe]

@Mary.M - as I understand things, there would need to be a minimum of 2 randomly tested blood glucose results above 11, before medics usually get too bothered.

That you already have a thyroid condition could have peeked up the interest, as it's fairly common for a person to have dysregulation in both their thyroid and relating to diabetes - especially if the thyroid disorder is auto-immune, which you haven't shared.

Personally, at this stage, I'd like to think in your shoes, I could go along with the thought my GP is just discounting diabetes.

Regarding the term, postprandial, I consider that to be after eating, not necessarily any given amount of carbohydrate or sugar. The diagnostic test using a fixed amount of glucose to assess our body's ability to metabolise if efficiently is called an Oral Glucose Tolerance Test (OGTT).

These days, although they still do OGTTs, they're only usually used to diagnose gestational diabetes. More often for T2, it's an HbA1c test (that looks at the last couple of months averages). For T1, it can be a number of things, but more often than not it involves alarmingly high blood glucose levels.

For now, I'd urge you not to become too concerned. Should the next test come back feel, you can discount diabetes, for now. If it comes back less great, then you seem up for tackling it.

Just as an aside, not at the T2s are overweight at the time of diagnosis, although that's less usual.

Good luck with the next test, and let us know how it turns out?

 

[Mary.M]

well, I don't know! so much good logic going on here!

I passed O-level Latin and yes, I thought 'post prandial' meant after eating and I knew I'd eaten before the test, so I thought the 7.2 reading being flagged up was a bit OTT

my pre-test 'elevenses', after walking the dog for at least an hour, was probably one piece of wholemeal toast, equivalent to around half a teaspoon of sugar, with cheese or eggs to keep me going for the rest of the morning, plus a bucket of coffee with half a teaspoon of sugar, total less than 10g

then I found the 75g glucose thing here: https://www.diabetes.co.uk/diabetes_care/postprandial-plasma-glucose-test.html and yes, I thought 'gaaaahh!!! that's nearly 3 ounces (for those of us who still cook with old money)

for the record, my thyroid disorder is Graves Disease which is indeed auto-immune, and my doctor took me off the meds for a month in case the rash was a drug reaction so my thyroxine was high when I had the glucose test

GP said the rash was angioedema & urticaria, no idea why and she said they often never find the cause, good news is after 4 months of intermittent flaming red sore face episodes and violent itching, it hasn't come back for a month now

wasn't a drug reaction so back on thyroid meds for 6 weeks and levels should be back down again, phew!

couldn't face having thyroid, unexplained hideous facial volcanic eruptions AND suspected diabetes …. will find out next week and thanks to everyone here for the inspiration, wishing everyone a good day

 

[mikeyB]

For what it’s worth, Mary, your elevenses would stick my BG up to around 10, maybe more, without any insulin to cover it. Of course, I’m T1 with a decrepit pancreas, but it does demonstrate my original point about what’s normal🙂

 

[trophywench]

The slice of toast - and it doesn't matter what colour the flour was that went into the bread dough - is 15g of carbohydrate whereas one teaspoon of sugar, is 4g of carb according to the bag thereof in my kitchen cupboard. So, half a tsp is 2g of carb.

Each 10g of carb increases my BG by 3.0 on a BG meter so a slice of white toast increases it by 4.5 - but a lot of brown bread is nearer 18g carb per slice anyway, so more. Half a tsp of white granulated would increase my meter reading by 0.6.

I hope you ain't diabetic Mary!! You'd come unstuck pretty soon making erroneous assumptions like that! LOL

Always read the packet!

 

[silentsquirrel]

I think you may have looked at the "sugars" info on the label, rather than the total carb figure, which is the one you need - all carbs turn to glucose! Easy mistake to make.

 

[TheClockworkDodo]

Yes, do look at the total carbs, not the sugars, it's all carbs which are the problem for people with diabetes. And if I were you I'd ask your GP to do an HbA1c rather than random tests, it will give a much clearer idea of what your blood sugar's doing in the longer term.

Unlike Mike and Jenny, if I had a small slice of toast and a large drink with half a teaspoon of sugar (say 20g carbs in total) and then went for an hour's walk the amount of insulin I'd need to cover it would be precisely zero - the walking would counteract the carbs to the extent that I might even need a biscuit when I got back from the walk to stop my blood sugar going too low. So it just goes to show that we are all different!

 

[Mary.M]

I dunno, sugars? carbs? I know carbs turn to sugar but no idea what the conversion rate is, I was trying to relate my morning intake to the 75g glucose they dish out for the controlled post-prandial

depends what you read how many grams in a slice of bread, I make my own and a slice can be bigger than supermarket bread, 1 tablespoon of sugar in a 400g flour loaf, prob get about 10 slices off it, so 40g flour plus one tenth of a tbsp of sugar

so, let's see what people think: I eat around 7 most evenings and nothing after that

usual morning is breakfast around 6 (legacy of having to walk dog before work all those years): glass of OJ (175ml, just measured it but no idea how much fruit sugar) some plain yogurt & a bit of fruit (varies depending on what's in the shops) with a dollop of ricotta, and one slice of toast, a bucket of coffee with half a tsp sugar

walk dog around 7.30 for an hour or so then another bucket of coffee with half a tsp sugar and another slice of bread with some protein, usual time 9.30-10

the day of the test I left home after that, at around 10, and the blood was drawn at 11

what does anyone think about a plasma glucose reading of 7.2 on that background? 'normal'??? who, me???

 

[Madeline]

Fruit juice is pretty high octane stuff for sugar.

 

[silentsquirrel]

So 40g of bread flour would be about 24 - 28g of carbs.
The OJ is very high carb, and you would want to cut it out if you were diabetic - but because that would spike very quickly, I doubt if it would still be having an effect after nearly 5 hours.
7.2 sounds pretty normal to me!
I hope you have a conclusive result with an HbA1c test.

 

[TheClockworkDodo]

Anything you buy (apart from things like loose fruit & veg) should have a chart on it telling you the total no. of carbs in it, and/or the no. of carbs in a portion or in 100g of it or something similar, so it should be easy to work out the total carbs you're eating. Don't worry about trying to work out the conversion to sugar - if you're diabetic you just need to limit carbs (or inject for the carbs you eat if you're type 1).

We make bread too, and my slices are about 40g bread, which is about 20g carbs. Bread's easy to work out - just weigh what you're eating and half the weight is the no. of g of carbs.

But I don't really think you need to worry about carbs at the moment, only if it turns out your HbA1c is high - as others have said 7.2 sounds pretty normal for a one-off test!

 

[AdeV]

Low carb, no carb. I am sick to death of cabbage.

Have you tried frying it in butter? (I think the technical term is sauted, but frying works for me) IMHO that is the answer to ANY green vegetable problem. No carbs either

 

[Madeline]

Have you tried frying it in butter? (I think the technical term is sauted, but frying works for me) IMHO that is the answer to ANY green vegetable problem. No carbs either

Yep! I’m just so bored with it, blasted brassicas lol. How would we cope without lovely butter, and maybe some bacon chopped into it.

 

[AdeV]

Yep! I’m just so bored with it, blasted brassicas lol. How would we cope without lovely butter, and maybe some bacon chopped into it.

Then covered in melted cheddar or maybe a bit of Stilton to bolden it up...

When did you last have asparagus?