OGTT

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mandan

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Type 2
My OGTT 60' is too high, 180' is too low, but 0' and 120' is normal.
Hba1c is 5.8% 39 mmol/mol.
Glukose 0' 5.7 mmol/l (reference 3.7-6.0), 60' 14.0 mmol/l, 120' 7.6 mmol/l (reference -7.8), 180' 2.1 mmol/l
Insulin 0' 7.6 mIU/l (reference 3-25), 60' 73.5 mIU/l, 120' 106.4 mIU/l, 180' 7.2 mIU/l
HOMA-IR 1.92 (reference 0-2)

What should I do? Should I get some insulin? I think I have more than enough insulin but it is not fast and efficient enough, to avoid the highs and lows. I am doing Yoga, Tai Chi, Feldenkrais (2*3 hours per month) ice skating (1*2 hours per week) and in the summer swimming. I am going to my two piano teachers weekly as well.

I started to take medicine 05.2022. First a half year long I took metformin, after that for one year metformin+jansitin (sitagliptin), I took also from 10.2022 for 2 month rosuvastatin and after that for 10 month atorvastatin 1*10 mg. Last October I decided to stop all medicines. My genetician for mody told me, the doctors should control bilirubin, if it rises too high they should stop the medicine, but my diabetes doctor didn't care about it, if there is no control, there is no sense to take the medicine, I was considering. Now I am just on diet and exercise and my daily blood sugar values are usually still good.
 
mandan said:
My OGTT 60' is too high, 180' is too low, but 0' and 120' is normal.
Hba1c is 5.8% 39 mmol/mol.
Glukose 0' 5.7 mmol/l (reference 3.7-6.0), 60' 14.0 mmol/l, 120' 7.6 mmol/l (reference -7.8), 180' 2.1 mmol/l
Insulin 0' 7.6 mIU/l (reference 3-25), 60' 73.5 mIU/l, 120' 106.4 mIU/l, 180' 7.2 mIU/l
HOMA-IR 1.92 (reference 0-2)

What should I do? Should I get some insulin? I think I have more than enough insulin but it is not fast and efficient enough, to avoid the highs and lows. I am doing Yoga, Tai Chi, Feldenkrais (2*3 hours per month) ice skating (1*2 hours per week) and in the summer swimming. I am going to my two piano teachers weekly as well.

I started to take medicine 05.2022. First a half year long I took metformin, after that for one year metformin+jansitin (sitagliptin), I took also from 10.2022 for 2 month rosuvastatin and after that for 10 month atorvastatin 1*10 mg. Last October I decided to stop all medicines. My genetician for mody told me, the doctors should control bilirubin, if it rises too high they should stop the medicine, but my diabetes doctor didn't care about it, if there is no control, there is no sense to take the medicine, I was considering. Now I am just on diet and exercise and my daily blood sugar values are usually still good.
Click to expand...
Welcome to the forum, I suspect you are not in the UK as some of the test you quote would not normally be done here.
The one that is looked at is the HbA1C result which is normal at 39mmol/mol. You would not be diagnosed as diabetic unless it was over 47mmol/mol but I assume that you must previously have had that diagnosis to be put on the diabetic oral medications.
From the result you now have I think just doing what you are doing now and keep an eye on your blood glucose daily readings and have regular HbA1C tests. If things change then discuss your options with your doctor.
 
Thank you for your kind words and encouragement.
Yes I am not from the UK, I am from Hungary, Budapest.

My first OGTT had worse results in 05.2022. Now I am producing much more insulin in the first hour, but it is somehow not enough, or not efficient to get so fast in the first hour the blood sugar down, the result for glucose for 60' was almost the same, but the result for 120' is much better, so it is working, and I have insulin, which is good news for me:
Glucose 0' 6.5, 60' 14.5, 120' 12.2 mmol/l
Insulin 0' 6.5, 60' 42.3, 120' 119.5 mIU/l

C-peptid
03.2023 1.42 (reference 0.48-5.05)

fasting glucose
01.2024 5.7 mmol/l
12.2023 6.8 mmol/l
09.2023 5.2 mmol/l
04.2023 6.0 mmol/l
03.2023 5.8 mmol/l
10.2022 6.3 mmol/l
06.2022 6.5 mmol/l
02.2022 7.3 mmol/l
09.2020 5.9 mmol/l
08.2020 6.8 mmol/l
08.2020 7.4 mmol/l

ICA, GAD, Insulin, IA2, ZnT8A negative
MODY negative
t-TG, IgA, IgG, aTPO, anti-Tg GEN2, TRAK negative

HbA1c
12.2023 5.8% 39 mmol/mol
09.2023 5.74% 38.65 mmol/mol
03.2023 5.9% 41 mmol/mol
10.2022 5.4% 35 mmol/mol
 
mandan said:
Thank you for your kind words and encouragement.
Yes I am not from the UK, I am from Hungary, Budapest.

My first OGTT had worse results in 05.2022. Now I am producing much more insulin in the first hour, but it is somehow not enough, or not efficient to get so fast in the first hour the blood sugar down, the result for glucose for 60' was almost the same, but the result for 120' is much better, so it is working, and I have insulin, which is good news for me:
Glucose 0' 6.5, 60' 14.5, 120' 12.2 mmol/l
Insulin 0' 6.5, 60' 42.3, 120' 119.5 mIU/l

C-peptid
03.2023 1.42 (reference 0.48-5.05)

fasting glucose
01.2024 5.7 mmol/l
12.2023 6.8 mmol/l
09.2023 5.2 mmol/l
04.2023 6.0 mmol/l
03.2023 5.8 mmol/l
10.2022 6.3 mmol/l
06.2022 6.5 mmol/l
02.2022 7.3 mmol/l
09.2020 5.9 mmol/l
08.2020 6.8 mmol/l
08.2020 7.4 mmol/l

ICA, GAD, Insulin, IA2, ZnT8A negative
MODY negative
t-TG, IgA, IgG, aTPO, anti-Tg GEN2, TRAK negative

HbA1c
12.2023 5.8% 39 mmol/mol
09.2023 5.74% 38.65 mmol/mol
03.2023 5.9% 41 mmol/mol
10.2022 5.4% 35 mmol/mol
Click to expand...
According to the criteria we use in the UK you would not be considered to be diabetic or even in the 'at risk' or prediabetic.
Many of those other tests are ones that would not routinely be done here (at least not without a fight)
What exactly is your worry?
 
My second diabetes doctor told me what you thought. There isn't any metabolism disease at the moment, and there will nothing happen in the next 12 month. After 1 year there will be control with 0' and 120' OGTT. I have to be on diet, exercise, go to my psychologist biweekly and measure my daily blood sugar and blood pressure. If all the values were bad I could visit him again, or make a routin test.

I had so many examination since May 2022 and I had to pay for all of them, because our public health is with long waiting lists and many doctors left for abroad. I was last november at a cardiologist and he discovered at heart ultrasound a left chamber insufficieny with echo EF=43%, but the heart MRI was all right. My second diabetes doctor and my cardiologist think that all of my problems are psychosomatic and maybe I am a little bit hypochondriac.
 
We don’t use the word ‘hypochondriac’ anymore @mandan We say a person has health anxiety 🙂 To me, it certainly sounds like you’re very anxious. All the obsessive detail you’ve written can be a sign of anxiety. If you’re already seeing a psychologist, perhaps you could get advice from them about things like CBT to help you deal with your anxiety.
 
Thank you @Inka for your idea. I would like to ask my psychologist about the possibility of CBT at my next visit. The only person who could really help me is my psychologist, who I am visiting since last September. But I don't think that I am worrying about my health. I am just doing what my doctors were asking for.

The first diabetes doctor thought that I have some rare type of diabetes and this is why he was asking for so many examinations. I thank him that he encouraged me to be on diet and exercise a lot. But he would like some high impact cardio exercises (weight lifting, crawl swimming), while I looked for low impact cardio exercises (Tai Chi, Yoga, Feldenkrais). I got twice COVID (2020 and 2022), and at my heart MRI the doctor told me cardio is not good for me. But my second diabetes doctor is the opposite, he think that I am just examining myself for fun, but it is also not true. He is not interested in my examinations, just what he is asking for.

I am considering to do the quarterly diabetes control labor for the next year with Hba1c. But my cardiologist was asking for a methabolic panel as well, which would be also interesting.
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Cukor kontroll csomag - SYNLAB

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Comprehensive Metabolic Panel (CMP): MedlinePlus Medical Test

A comprehensive metabolic panel (CMP) measures 14 substances in your blood. It's often part of a routine checkup and can help diagnose certain conditions. Learn more.
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Basic Metabolic Panel (BMP): MedlinePlus Medical Test

A basic metabolic panel (BMP) measures eight different substances in the blood. It's used to provide information about your body's electrolyte balance, kidney health, and metabolism. Learn more.
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The UK has stopped using OGTT for routine diagnostic purposes several years ago.

I was diagnosed via an OGTT more than 30 years ago, but I think some of the anomalies you are seeing may be part of the reasoning why OGTT is no longer used?

The fact that your HbA1c is on target suggests that your metabolism is coping well with your actual meals and food. As long as you aren’t planning to start eating lots of high glucose meals, the results of your OGTT seem less relevant to me?

You may also find it reassuring to see the results from this CGM study into the glucose responses of healthy individuals without diabetes. Some higher readings are perfectly normal.

 
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