I have borderline type 2 diabetes and used to take Sitagliptin. Now my doctor wants me to try a period without it.
Sometimes the blood glucose value taken one hour after a meal RISES when measured two hours after a meal. I eat no food of any sort after the meal.
Can anyone explain what is happening?
The following are typical values I have seen several times:
One hour after meal: 8.5 mmol/L (150 mg/dL). Sometimes a bit lower.
Two hours after meal: 10.3 mmol/L (190 mg/dL).
Your liver has a primary role in keeping your blood sugar up between meals (that is, when no glucose at all would be arriving from your small intestine) and it does this by either recycling some glycogen, or synthesizing it from lactate, glycerol (from triglycerides), or certain amino acids. Your kidneys can do something similar, although their contribution is relatively less important.
The reason your blood sugar is rising out of the usual hysteresis band is that
(a) your liver is not switching off glycogenolysis/gluconeogenesis when it ought to (it 'believes' your blood sugar is lower than it actually is)
(b) your pancreas is redlining its insulin output and
(c) the rest of your body is not able to accept the too-high glucose correction from your liver.
In other words, you're still deeply insulin resistant.
Your doctor is right to get you off the drugs, but you need to do your part by getting your diet right in order to reverse the underlying problem.
TheAwfulToad Thank you for your reply. I didn't see it until now. What you write is very interesting.
Could your points tie in with liver damage from medication? I took a "sartan" blood pressure medication for 5 years and was exceedingly ill throughout. I'm now recovering from presumed liver (and perhaps also kidney) damage, which I will get investigated.
This medication damage is non-specific and so are the many symptoms. So any observations can only generalise but there have been many metabolic processes which have not been working properly.
Can you offer any observations, no matter how tentative or speculative about the effects on diabetes?
I know that's a vague request and thank you for any information.
Sorry for the delay in replying.
Before eating a meal I have a reading of approx 4.5 to 5.0 (80 to 90 mg/dL)
The meal is medium-small. Usually a small pie with vegetables and rice. Not a lot of carbs. I got the following readings after eating.
One hour after meal: 8.5 mmol/L (150 mg/dL). Sometimes a bit lower.
Two hours after meal: 10.3 mmol/L (190 mg/dL).
I haven't been diagnosed but need some reassuring from people who actually have the problem
High reading which GP ignores