Very unsure if I have diabetes or not, after a recent scare

[FruitLion]

So let me preface by saying we know I have a HBa1c score within normal parameters. Only just though! However because we know I have reactive hypoglycaemia, this doesn't mean much.

Recently I tried to see an Endocrinology specialist with a pair of blood glucose meters, giving very different results. One is an Accu Chek Performa Nano, the other is a Kinetik Wellbeing monitor. The Nano claims I'm not a diabetic, the Kinetik claims I am! Sometimes the differences are way above the 15% threshold. Since all my measurements were too confusing for the specialist to decipher, I was bounce back to my GP, and now I have a serious level of anxiety in wondering what is happening to my body. To give a few examples.

Fasting:

Nano = 4.9 - 5.6 mmol
Kinetik = 5.9 - 6.9 mmol

2 hours after eating:

Nano = 6.4 - 7.2 mmol
Kinetik = 8.5 - 10.3 mmol

Obviously there's a huge difference here. One monitor claims I'm perfectly normal, or on the low end of prediabetic. The other claims I'm above normal for any diabetic. Combined with the low blood sugar reading my doctors once caught from a vein blood test, and a fruity taste that sometimes sticks in my mouth that many say is due to way too high sugar and ketones, and you can imagine I've been left paranoid and worried about what could be happening to my body.

 

[Inka]

Hi @FruitLion 🙂

Have you had an official diagnosis of Reactive Hypoglycaemia? How low was the reading the doctor once got from your vein?

Even if the Kinetik was reading correctly after meals (when your blood sugar would be at its highest probably) being around 10 wouldn’t give you ketones or the diabetic fruity breath. I was diagnosed with ketones and a blood sugar approaching 30.

One thing you could try with your meters after meals is to test someone else to compare their and your readings, but blood glucose meters aren’t meant for diagnostic purposes.

Edited to add - what was your recent scare? Did you actually see the Endo (I was a little confused because you’d written “tried to”)?

If you can answer the above questions, you’ll get more individual input @FruitLion

 

[everydayupsanddowns]

Welcome to the forum @FruitLion

Sorry to hear about the anxiety you are experiencing around your blood glucose levels, and I can completely understand how different measurements from machines which are supposedly doing the same job would only make things more difficult for you

As @Inka says, home BG meters are not really intended for diagnostic purposes for exactly these reasons. And because of the inevitable (and permitted) variation from lab results that you mention.

Of the two brands you mention, I’ve never heard of Kinetik, but Accu-Chek is one of the most established and reputable brands whose meters often come towards the top of accuracy rankings, so I would be inclined to think that the Accu-Chek was more likely to be giving you reliable results.

If possible I would try not to worry, and to use the lab results and HbA1c values when it comes to monitoring your risk of diabetes.

Reducing the proportion of carbohydrates (not just sugars) in your meals will help to reduce rapid rises in BG after eating, and I believe this should help reduce any potential reactive hypoglycaemia?

Hope your anxiety reduces. Let us know how you get on 🙂

 

[FruitLion]

Hi @FruitLion 🙂

Have you had an official diagnosis of Reactive Hypoglycaemia? How low was the reading the doctor once got from your vein?

Even if the Kinetik was reading correctly after meals (when your blood sugar would be at its highest probably) being around 10 wouldn’t give you ketones or the diabetic fruity breath. I was diagnosed with ketones and a blood sugar approaching 30.

One thing you could try with your meters after meals is to test someone else to compare their and your readings, but blood glucose meters aren’t meant for diagnostic purposes.

Edited to add - what was your recent scare? Did you actually see the Endo (I was a little confused because you’d written “tried to”)?

If you can answer the above questions, you’ll get more individual input @FruitLion

I was referred to see the Endo specialist because my low blood sugar was caught in the act, as well as some ketones in my urine at a separate point. I had a phone consultation with them, but they based everything on my HBA1C score, rather than my symptoms, how I react to foods and my low/lingering high sugar moments.

My scare was when I had the low blood sugar. I passed out briefly and was taken to A&E, and all I had to drink was Innocent apple juice at the time.

 

[Inka]

Could you work out any possible cause of the low blood sugar @FruitLion and how low was it? By ‘cause’, I mean eg had you not eaten for a few hours or had a few days of just grabbing bits and pieces of food - that kind of thing?

It is possible for people without diabetes to drop low, especially if theyve not been eating well/frequently. In that case there’d probably be what are called ‘starvation ketones’ in their urine. Some people are more susceptible to missed or late meals than others. When I was at Uni, it happened to a couple of people I knew of - fainting and shaking. One had additional issues that explained it, one had just had a hard period of study and a somewhat disrupted eating schedule. So it can happen, but is obviously scary when it does.

It’s good you’ve had the reassurance of speaking to an Endo. Your normal HbA1C should be a reassurance too as it shows you’re unlikely to be going high. If I was you, I’d ask for a repeat in 6 or 12 months just so you can make sure it’s still ok and get that reassurance.

I agree with Mike above that I’d trust the Accu Chek meter above your other meter. I have one (a different model) and have had various meters from them over the years. They all seem accurate and reliable.

 

[FruitLion]

Could you work out any possible cause of the low blood sugar @FruitLion and how low was it? By ‘cause’, I mean eg had you not eaten for a few hours or had a few days of just grabbing bits and pieces of food - that kind of thing?

It is possible for people without diabetes to drop low, especially if theyve not been eating well/frequently. In that case there’d probably be what are called ‘starvation ketones’ in their urine. Some people are more susceptible to missed or late meals than others. When I was at Uni, it happened to a couple of people I knew of - fainting and shaking. One had additional issues that explained it, one had just had a hard period of study and a somewhat disrupted eating schedule. So it can happen, but is obviously scary when it does.

It’s good you’ve had the reassurance of speaking to an Endo. Your normal HbA1C should be a reassurance too as it shows you’re unlikely to be going high. If I was you, I’d ask for a repeat in 6 or 12 months just so you can make sure it’s still ok and get that reassurance.

I agree with Mike above that I’d trust the Accu Chek meter above your other meter. I have one (a different model) and have had various meters from them over the years. They all seem accurate and reliable.

My fasting sugar seems good too at 5.7. Sometimes, if the food waa fatty, my sugar stays elevated after 2 hours, but the lowest I've ever seen it dip is 3.1 mmol. Apple juice is a huge trigger for me, as are some sweet treats like cake. Otherwise the only specific thing thay triggers drops is having anything to drink with my meals, be it water, milk or juice.

 

[Inka]

Unfortunately, i think some people are just more sensitive to foods and certain eating patterns than others. If you find that apple juice doesn’t work for you, then I’d just avoid it to save the worry.

You might also find certain foods or eating schedules (ie what time you have your meals, if you need snacks, etc) suit you better than others, so you could take a general look at your diet and try a few things to see what works best for you as an individual.

You haven’t mentioned if you have any risk factors for Type 2 diabetes or any family history, or your BMI, but aiming for a weight in the normal range - neither too high nor too low - is sensible.

You’ve had your HbA1C checked (do you remember what it was exactly?) and that was sensible. You say it was normal so that should reassure you. If it was me, I’d keep the meter for occasional blood sugar checks and not worry about diabetes. If you have any risk factors, you could get another HbA1C in 6/12 months just to see how things are going. I can understand why it caused you anxiety but just keep it at the back of your mind and don’t let it overshadow your life. Getting a way of eating that suits you would be my priority and hopefully that will keep your blood sugar ok.

 

[helli]

Regarding the difference in your meters, have you checked them with a test solution?
The manufacturers should be able to provide this test solution which may go some way to give you more confidence in on of them.

 

[FruitLion]

Unfortunately, i think some people are just more sensitive to foods and certain eating patterns than others. If you find that apple juice doesn’t work for you, then I’d just avoid it to save the worry.

You might also find certain foods or eating schedules (ie what time you have your meals, if you need snacks, etc) suit you better than others, so you could take a general look at your diet and try a few things to see what works best for you as an individual.

You haven’t mentioned if you have any risk factors for Type 2 diabetes or any family history, or your BMI, but aiming for a weight in the normal range - neither too high nor too low - is sensible.

You’ve had your HbA1C checked (do you remember what it was exactly?) and that was sensible. You say it was normal so that should reassure you. If it was me, I’d keep the meter for occasional blood sugar checks and not worry about diabetes. If you have any risk factors, you could get another HbA1C in 6/12 months just to see how things are going. I can understand why it caused you anxiety but just keep it at the back of your mind and don’t let it overshadow your life. Getting a way of eating that suits you would be my priority and hopefully that will keep your blood sugar ok.

I seem to be the first to have diabetes of any kind, but I'm also the first with heart palpitations, asthma and LPR reflux. Very unlucky genes it seems! I'm almost underweight at 70kg and very skinny no matter how much I eat at age 30.

Sometimes my sugar is high after meals, sort of. Sometimes at the 1-1.5 hour mark after eating, my sugar is perfectly normal, between 6-7.5 mmol. Then suddenly at 2-3 hours, it rockets up again at least 10 mmol. There's no pattern in the foods that do this, once happened from a single buttered bread roll. Until my GP has an answer for me, they gave me the preliminary diagnosis of T2, but I hope to help solve the mystery as to why it happens as soon as possible.