Queries on my latest blood test

[barani19]

I did my blood test last week. These are the numbers.

FBS: 124 mg/dL (My Glucometer reading: 113 mg/dL)

PPBS: 79 mg/dL(My Glucometer reading: 104 mg/dL)

HbA1C - 6.7 (Estimated Avg Glucose[eAG]= 146 mg/dL). 3 months ago, it was 6.9 mg/dL

Fasting serum insulin- 14.37 mu/mL . 3 months ago, it was 13.63 mu/mL.

My queries:

1) Why there is a lot of deviation from my glucometer(i use accu check active) readings? Particularly PPBS.

2) Even though my HbA

1C has slightly improved, fasting serum insulin has increased. It means my Insulin Resistance has increased. How can this be possible?

Please provide your inferences and suggestions.

Thanks

[Praveen55 Moderator]

barani19

Thanks for posting your blood test results.

1. Home Glucometer Vs Lab test reults: The accuracy of home Glucometer is not as good as lab test. If you read the technical specs of home Glucometer, you will find the accuracy is specified to be + - 15 %, though in practice it is much better than that. This is the reason why home GM should be used to see trend in blood sugar values and not rely entirely on its reading to diagnose a medical condition. Lab tests results are considered generally accurate within + - 2%. Hence you find variations. There is other reason also which is related to the method used in lab test that is different from home GM.

2. Insulin resistance calculation requires fasting blood glucose and fasting serum insulin level. For example, your current FBG of 124 and Serum insulin of 14.37 gives HOMA - IR of

4.4 using the calculator below:

thebloodcode.com/homa-ir-ca...

In order to find your past insulin resistance, you have to provide FBG value also. Then you can compare. You can not conclude insulin resistance has gone higher based on just insulin level.

Are you on medications?

Hope above is helpful.

[barani19 Administrator in reply to Praveen55]

Thanks for your response on the Glucometer Vs Lab tests. It is pretty helpful.

My HOMA-IR value(using the link provided by you) was 3.7 last time. This time it is 4.4.

I'm not on any medications.

When it comes to my diet, I take Emmer wheat meal two times a day and LCHF one time adding to almost 1 hour walk/work out daily.

Is my condition improving because of Long wheat? Please let me know your thoughts

[Praveen55 Moderator in reply to barani19]

What was your FBG three months ago?

[Praveen55 Moderator in reply to Praveen55]

OK, it must be 110 based on IR of 3.7

[barani19 Administrator in reply to Praveen55]

It was 111 mg/dL

[Praveen55 Moderator in reply to barani19]

There is some improvement in your HbA1c value. However, it is really difficult to pin point that this is due to long wheat. As I understand, long wheat is supposed to improve FBG value with time. In your case, your FBG level shows increase in three months period.When did you start long wheat diet?

When you take FBG readings at home, do you find it varying widely on-day-to-day basis?

[barani19 Administrator in reply to Praveen55]

I started full fledged long wheat 9 months ago. 6 months ago, i had long wheat in the mornings & afternoon and had LCHF for dinner. My HbA1c was 7.5.

Three months ago, i changed my diet to LCHF in the morning and emmer wheat meal in the afternoon and for dinner, my HbA1C reduced to 6.9.

I continued with the same diet for the last months. The only new introduction is the Vitamin C tablet (500 mg) .

I take FBS almost daily and i found it to be consistent between 100-115 mg/dL.

[Praveen55 Moderator in reply to barani19]

Now you have provided the full information. Based on these information, there is consistent improvements in your HbA1c on introducing long wheat in your diet, therefore it has definitely helped. When your HbA1c was 7.5, what was your FBG?

How much long wheat do you consume per meal? Is it 60 gm? What is your weight and BMI?

[barani19 Administrator in reply to Praveen55]

Thanks for analyzing the results in detail. Appreciate the same.

My FBS was 125, Fasting Serum Insulin was 19.50 mu/ml when my HbA1C in was 7.5 (on 30 Nov 2018).

I typically consume around 80-90 grams of long wheat per meal.

My weight is 86.1 kgs now (gained around 3 kgs in the last 4-5 months or so) . BMI is 28.

[Praveen55 Moderator in reply to barani19]

There is considerable improvements in IR and HbA1c levels. In my opinion, you may benefit further by losing some body fat which will result in improved insulin sensitivity and hence lower HbA1c. Make some plan to lose weight and maintain your BMI < 24 over long term. You may consider reducing long wheat to 65 - 70 gm per meal.

[barani19 Administrator in reply to Praveen55]

Sure Praveen55 . Thanks for the inputs again. Let me focus on reducing my weight for next 3 months.

I feel hungry if i eat less. Anyways, let me plan to substitute Ghee for the amount of long wheat i reduce per meal.

I will keep you posted once my next blood test results are out in next 3 months.

Cheers.

[Praveen55 Moderator in reply to barani19]

Yes, you can add some other low carb items. Ghee is good, may be some cheese/paneer/nuts/seeds. wish you all the best.

[seemap in reply to barani19]

Great!!! I also have experienced good results when on long wheat. Pls keep all here updated so it benefits each in the struggle to maintain good control on the levels. Why don't you try and add salads to your meals. Believe me you will see much better results. Requsst to pls keep us all updated.

[barani19 Administrator in reply to seemap]

Thanks for your suggestion. Sure. i will keep you all updated on the various research i do with T2D.

[nyonyo]

Though your fbs is 124 and ppbs 79, your A1c (the average blood sugar) is 146, this means that there must be some bs spikes at other times, check your bs after lunch and especially dinner, logically thinking, how could the average be much higher than fbs and ppbs?

[barani19 Administrator in reply to nyonyo]

I've been trying to find out this answer for a long time. I've been taking BS spike readings after 60 minutes, 70 minutes and 90 minutes after lunch and dinner and you will be surprised to know that the average of all these readings for a week to 10 days is 126 mg/dL. It does not match with the average blood glucose value at all.

The only other reason can be that my HBA1C was 14+ a year ago when i was diagnosed T2D. Can this have any impact on average blood glucose?

[nyonyo in reply to barani19]

Check after 30 minutes then, the difference between ppbs (2hrpp?) and after meal is, we don't have to fast for at least 8 hr before, so the carb/sugar has NOT been drained out and get accumulated

I don't think your past 1 year A1c can have any impact on your current A1c, because the life of hemoglobin is only 2-3 months

[barani19 Administrator in reply to nyonyo]

I did a 30 minute check after afternoon and dinner meal as well. BS level ranges from 100-120 mg/dL. It eventually spikes to around 140-150 (sometimes 160 mg/dL) in 60-80 minutes. Stays there for next 30 minutes- 45 minutes or so and then drops and settles down at around 100-115 mg/dL. All the above readings are from my glucometer.

Thanks for the clarification on the impact of my current HbA1c.

[Godfrey]

I have used Emmer wheat for more than 3 years. There was very slight improvement in HbA1c .from 7 Use Emmer wheat also in LCHF keep about 75gms of Carb all put together per day.

Now my HbA1c is 5.7

[Praveen55 Moderator in reply to Godfrey]

That is excellent result - HbA1c from 7 to 5.7, that is from full blown diabetes to non-diabetes assuming you are not taking medications.

I found that Emmer wheat does give lower post-meal blood sugar rise than the standard wheat. It makes sense to include it as part of LCHF diet where carb is limited to less than 100 gm. I could not include LW in my LCHF because my carb limit is 30 gm or less.

[barani19 Administrator in reply to Godfrey]

Thanks for sharing your experience. Are you on any medication?

[Godfrey in reply to barani19]

Yes I was taking Gluformin G2. Now I have reduced it to Gluformin G1

[barani19 Administrator in reply to Godfrey]

Thanks for your response