Blood Fasting Sugar tests , hb1ac, triglyce... - Diabetes India

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Blood Fasting Sugar tests , hb1ac, triglycerides,vldl. Different labs different results, hard to understand

Confused about blood fasting sugar status, hb1ac, triglycerides.

I have been keeping a track of my bloodwork for last 9 months or so. And my trigylcerides are sky high. When I consciously walk everyday as much as I can they do come down but still very high.September 2018- 680, October - 285 (with the help of fibrate but that also messed my liver and fasting sugar levels i.e. 112) January- 460, April 566, June 385 .Vldl is usually double the normal limit. LDL and total chol is normal always. This was induced due to corticosteriod use which i was given without telling me, basically unethically. It's not genetic in my case ,Hypertriglyceridemia.

I went for Hb1ac - 4.7 (it was 5.7 two years ago ),C- peptide- 1.05 , Blood fasting glucose in 3 labs on 3 consecutive days : 111, 94, 89. I don't know which one to trust. glucometer readings are 110, 112,116 and even go upto 131 on different fingers in the same minute, 109, 116. Also the levels are different based on 8 hour 10 hour and 12 hour fasting time periods. Doctors say that they do not rely on glucometers for diagnoses and hb1ac was 4.7 so no way i have sugar but i have high triglycerides. I really do not want to take medicines and just modify my life style. I work a 9 to 5 , travel by car. The different lab results confused me as well, 89,94, 111. And post meal my result was 106 from the lab that showed 89 fasting.

I know there are mnay variables but i have stiff feet in morning, some dark patches on my chest and stomach, little 3-4 wart like things, had sweet taste in my teeth which went away on salt gargles and comes back too. Doctors are not helpful at all. Went to like 9 docotrs

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To give you some suggestion on your TG , if you could let us know the following details:

What all food you take in a day-

Breakfast , lunch , Dinner, ???

Have you kept track of overall Calori intake/ day ?

What is your BMI?

What is your exercise frequency and duration every day ?

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My food used to consist of wheat chapatis 12 in a day, pulses, very few veggies and curd. I recently changed it to only 2 chapatis in a day , and eat chickpea flour chapati ( I know it has 57 gm carbs and 11 gm sugar ) but for some reason everyone says they are better than grains. I eat pulses every day and make a point to eat veggies in every meal. my bmi is 23.5 , i weigh 83 kg now and I used to be 91 to 98kgs but that was all due to corticosteriods. My family has no history of any disease except my father having heart attacks but his lipids are perfect for a long time. I find it hard to keep a track of calorie intake because of different data on many foods such as curd, low fat milk, cottage cheese. Many sites claim curd has 10 gm protein per 100 gm while i see 3.6 gram on actual containers etc. so it is confusing, who to trust.

right now , i know my carb intake is still major portion of the meals but i have reduced grains to the minimum. the problem is i come from a family of vegetarians so i can only do dairy low fat but then i have seen so much conflicting info on everything, it has made me nauseated, Some MD doctors say full fat is good for healthy insulin response, someone says opposite etc Some claim dairy is bad for insulin or blood sugar. Now how do i control my carbs without the help of dairy ?

There is so much controversy on saturated fat as well and lately it has been claimed it is not bad. Then what about everyday recommendation of protein. It makes me really confused, if god intended us to be living normally why would every food be filled with huge portion of carbs as science says carbs are bad. i know there are different forms of carbs, fat and proteins , but really is there no other option than eating meat to control carbs ? Do we even have to control carbs or just the source of carbs ?

I walk 10 kms a day and used to go to gym for an hour everyday before i got so stressed with these blood results.

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My Dear LostBoy

Don't worry !

Everything would be fine !

(1) Your health conditions are not so bad that you can not control it...

(2) Agree with you that sometimes the information you get in internet is conflicting. But one needs to have some fundamental understanding of his own health condition and should have his own intelligence what to accept and what to reject.

For example a curd/ plain yogurt can have protein 3.5 gm to 10 gm per 100 gm depending upon the source of milk and it's processing if any. Greek yoghurt nowadays available everywhere can have protein upto 10 gm/100 gm which is a result of straining and minimising carbs and maximising protein. Similarly Curd can have Fat varying from 0% to 6.5% depending upon to what extent the milk is skimmed- single toned / double toned / Full fat!

(3) Having said that, You are in the right place now where people exchange their views based upon their practical experience and everybody is here for learning and sharing.

(4) For your condition, I suggest you minimise Carbs and maximise Fat and moderate protein. TG is formed b1 molecules of glycerol and 3 molecules of fatty acid .

It is definitely essential that you limit your daily calories- 1 gm Carbs/ protein gives you 4 calories where as 1 gm fat gives you 9 calories and it is possible to follow Low carb high fat diet with any food style once you have basic knowledge of food and nutrition.

Nowadays , a lot of android apps are available in Google Play Store free of cost which will help you to track your daily calories. If you are living in India, then there are Apps on indian food specific dishes with calories count available. A couple of popular apps I know are 'Healthify me" , 'Indian food Calori chart" and there are many more and whatever you find comfortable , please select. Our members can also suggest some better apps.

(5) Exercise should be an integral part of your lifestyle 2 times a day if you are otherwise active . Or else if it is a sedentary lifestyle, you may even exercise 3 times, keeping in mind calories you burn , your BMR and Calori intake !

(6) I would also recommend you to do a basic certificate course on Nutrition called CFN where you can learn fundamentals. I presume you live in India - then you can do a course through IGNOU- the course fees is Rs 500, you will get course material some 4-5 books/ available in their website which you can down load all free. You can attend week end classes at their study centre which is optional. After 6 months duration , you will appear for an exam and get your certificate- it is exciting ! 😊 There is also a diploma course of 1 year duration on food & nutrition called DNHE. You get a lot of study material and it is very interesting to learn. Afterall, it would be useful for your own health and help others too and then it may help you to understand Google search results better and interpret! 😊

Best of luck!πŸ‘

Best regards

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Thanks. Quite useful info but I am basically confused about lentils, legumes and beans. they also have carbs and if i limit them as well, wouldn't it jeopardize my protein intake ? I have been suspecting the recommended protein guidelines anyways but doc told me go for 150 gms of protien a day as i am 83 kgs .. i have moral issues with eating chicken but even if i do eat chicken , ican't do it daily and the place where they give boiled chicken breast they give minimum 250 gms with brocolli. My main question is about dairy I can go for double toned as it has less saturated fat but a few questions, how do i find out saturated fat content of cottage cheese made from double toned milk at home as if yo ucheck the values of amul or mother dairy packed full cream paneers they are quite high in sat fat. second, is dairy bad for blood glucose or insulin response ? And is chicken bad for insulin response. One dr eckberg said that full fat dairy is better than low fat dairy as he considers low fat as processed dairy and fat is essential for slowing insulin response. But my doc said that if i have full fat dairy it will have more saturated fat.

I know i have to establish few simple , basic and easy to remember rules but the conflict occurs in meeting protein demands, various claims on vegan, meat and dairy food items and what they do to our body.

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Dear Lostboy

You are in the right place where you can learn a lot. you must spend at least one hour a day with HU. There are many other communities such as LCHF , Healthy eating etc under HU and there is a wealth of information posted by the members .

To answer some of your concerns :

As Praveen said, you do'nt seem to have T2. However you need to be careful.

Yes, Your high TG and low HDL is not a surprise , though it is a concern. TG and HDL are inversely proportional and the ratio of TG/ HDL could be an indicator of CV health. TG is bad and hdl is good. If you bring down your TG, HDL will go up and there are ways to reduce your TG with diet and exercise... Which you can...

With regards to your protein , the recommended amount is very clear and consistent in all literature/ articles and there is no confusion . It is 0.8 gm per kg of body weight. It may go up to 1-1.2 gm/ kg body weight for athletes. If you eat excessive protein, it would result into more nitrogenous waste like urea which would put more load on your kidney.

On protein, this article is informative:

health.harvard.edu/blog/how...

On fats, the healthy fats are the saturated fats which helped me to keep my TG under 100 and my HDL went up to 60-70.

Pulses, legumes are definitely high in carbs and you should limit.

My staple diet is full cream mother dairy paneer with 25% SFA and 20% protein. Then almonds 50% fat with 20% protein. No veg oil is used anywhere in my dishes. It is either butter or ghee or coconut oil. I eat a lot of green vegetables (non starchy) at least 2 servings with each meal. My fruits are Capsicum, cherry tomato, Avocado and ... Sometimes cherry with my meal. Greek yogurt in the morning along with Free range Egg omellete topped up with parmesan cheese, capsicum , corriander leaves along with lightly roasted almond is a standard fitment with me in the morning which I enjoy and never get bored.

I maintain my BMI @20-21 and my lipids are in perfect conditions and my blood glucose is under control.

I exercise post meal and I don't miss it at any cost !

Find out you BMR from the apps. And your overall calories should not exceed your BMR. (Take in to account calories you burn during your exercise )

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There is no confusion for guidelines but if i add the calories and compare them with the protein those foods have, something doesn't addup. Here is an example of a vegan who cites studies showing dairy and meat are bad for lipids

The trouble is , there are many such videos claiming the opposite (LCHF) with other set of studies. The 0.8 to 1.2 gm of protein cannot be achieved on vegan food or even dairy without disturbing the balance of carbs or fats.

I may be simply overeating to be honest. But i have a huge appetite.

Veggies hardly have any protein to meet the daily needs so eliminating pulses, legumes, lentils , grains or reducing them creates the protein dilemma. On top of tha tthese dairy is dangerous videos and meat is bad.

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That is why I suggested you to do your own research and study and get some insight...

Yes I am aware...there are videos by each society - Vegan, vegetarian, Lacto vegetarian, egg-tarians, meat eaters. Dairy eaters , anti-dairy and so many classification ....I don't want to start a debate here. ....there will always be videos in favour and against any food style ...

You have a health condition... it is your body....do whatever suits you....you feel better, healthy and your lab parameters are ok.

You can always do your own experiment for a couple of months and check your lab parameters and your health conditions and then take your call....

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thanks , been trying for 10 months. doctors seem to be clueless and want to push statin or fibrates , hence the stress anyways , appreciate the replies.

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Statin anyway can not reduce TG much or increase HDL. Statin is used to lower overall cholesterol and LDL , which is again unethical practice.

You need cholesterol. Your liver makes cholesterol naturally. There is a huge requirement by the body. Samething true with Fibrate!

Both Statin and Fibrate are synthetic chemicals which could create more problems than any benefits as such.

You need to understand clearly what makes excessive triglyceride in your blood.

(1) 3- Carbs plus one fat molecule combine to form a triglyceride molecule. So excessive carbs are responsible .

(2) Your body fat can break in to TG to supply energy to your body , if you do a prolonged fasting !

(3) if you take excessive calories much more than your BMR, the excessive calories can get converted in to TG.

(4) leading a sedentary life and obesity without exercise can lead to increased TG

(5) Hypothyroid can also lead to High TG.

You need to figure out what is applicable to you and then take action .

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Everything makes sense in your reply but only one doubt, excessive fasting and overeating both can cause trigs rise as per point 2 and 3! wow, never knew the point 2 , so i guess the trick is just eat veggies , moderate dairy and not starve or overeat, got a challenge on my hands, i guess best way out is exercise. thanks

my throid has always been normal till now . sedentary ,well 9 to 5 job, travel by car i guess i have to make conscious effort to walk like 20000 steps , then only any difference will be visible

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(1) 3- Carbs plus one fat molecule combine to form a triglyceride molecule. So excessive carbs are responsible .

This is wrong. Carbs can form fat de novo. The glycerol part of comes from glycolysis. Triglycerides as their very nomenclature implies are one molecule of glycerol esterified with three molecules of fatty acids which may be of the same of different chain length. These fatty acids too can be synthesised from acetyl coA formed in the TCA cycle and transported out of the mitochondria. So, lipids as a whole can be formed from carbohydrates and fructose is a good raw material for that as it can be metabolized only in the liver! Since storage of energy as fats needs very little water and since it is also high energy the metabolic processes have evolved in such ways as to convert all extra energy as fat to be stored as triglycerides in the adipose tissue.

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Would it be possible to get an explanation to this statement "Carbs can form fat de novo"?

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You will have to study biochemistry for that- the metabolism of glucose and de novo synthesis of fatty acids in liver and fat metabolism in adipose tissue.

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Thank you, I understand IP address v4 and v6 !!

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Dear Mr Yenyen

I think we are on same page with regards to Carbs being the starting point for TG production, apart from the typo error with regards to Triglyceride. It is true that Triglyceride is formed by esterification of one molecule of Glycerol with 3 molecules of fatty acid.

Having said that , we must note that DNL (De novo Lipogenesis) not only occurs at Liver, but also at Adipocytes.

When one eats excess carbs, DNL

takes place at liver. Carbs gets converted to glycerol by Glycolysis at liver and finally gets converted to TG. TG is then packed in VLDL and is carried through the blood stream to the Adipocytes. The Adipocytes extracts the lipids from VLDL and then it is stored in the Adipose tissue for future. In this process, since TG is formed at liver , some TG also gets stored at liver. (NAFDL)

Now if one eats more of dietary fat , the fatty acid gets packed in chylomicrons and it is transported to Adipose tissue. Adipocytes extracts the lipid from chylomicrons and the lipid gets stored directly in the Adipose tissue.

From DNL at Liver and DNL at Adipocytes, which one should we prefer???

Now if one has a metabolic syndromes, Obesity, T2, the Adipocytes will show some resistance to extract the Lipid from both VLDL and chylomicrons , but comparatively, study indicates that it appears to be more sensitive to extract lipids from chylomicrons which is a direct exogenous source of dietary fat.

If the Adipocytes , don't extract the lipid- TG from VLDL, naturally, the TG in blood remains high.

I would rather prefer Fats to Carbs and try to minimse DNL at Liver. We would like to avoid fatty liver

(NAFDL) which is common to many T2's and also high risk of High TG level. DNL at Adipocytes is simpler form of storing energy for future days or during fasting. DNL at liver due to diatary carbs is a very complex process and not energy efficient.

I definitely need fat - all our cell membranes made of fat. Our cells have unlimited storage space for fat.

So do I need fat from an exogeneous source or an endogenous source is the point.

Finally, exercise is the most important of all for metabolic syndrome to ensure that the cells remain very active and sensitive and don't become lazy.

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Thanks, it seems very helpful but I took a few days and I guess I can say that : #Hemps seeds, chia seeds, walnuts, almonds, flaxseeds , cold pressed mustard oil would a be a good antidote to the assault of other forms of saturated fats and oils. It's a bit mind numbing how some sources claim certain oils to be bad and other sources list the same oils as good, for instance sesame oil, coconut oil ,canola oil etc.

#Now as far as carb theory is concerned, the best I can do is limit crabs from grains but have to consume lentils, beans, legumes and they have comparatively better ratio of carbs to protein compared to grains, even if it is still not ideal.

#As far as chicken is concerned, chicken breast has least saturated fat but it still has a high dietary cholestrol which is ONE point that confused me, as it has no carbs and only protein but wouldn't that cholestrol adversely effect trigs or vldl etc. ? Eggs, well complete protein but again varied claims, some say eat egg whites, some say eat it whole especially because the yellow part has cholestrol, funny thing same people forget that even white meat chicken has cholestrol! eggs also interfere in absorption of biotin upto 40 percent even when cooked.

Coming to the composition of trigs, I thank you for making me aware of this as no one else ever did but this link explains it as well : fediol.eu/web/chemical%20co...

# Free fatty acids are the unattached fatty acids present in a fat. Some unrefined oils may contain as much as several percent free fatty acids. The levels of free fatty acids are reduced in the refining process. Refined fats and oils ready for use as foods usually have a near to nil free fatty acid content.

Just a few pointers, it is not a long read, this link. please tell me if I am wrong, isn't cold pressed oil better than refined oils ? And what does the above point really mean ? ''free fatty acids are reduced in the refining process'' so is that good or bad ?

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I would never never take any veg oils wether it is refined, unrefined, cold pressed, or hot pressed, and even if with ideal omega 6/omega 3 ratio.. Not even whole seeds which contain high level of PUFA.

Yes, my logic is that all of these have PUFA which are Poly unsaturated and unstable compound. Would tend to get oxidised.

Yes , you may take PUFA if you want to reduce your cholesterol HDL, TC and LDL . Statin not required- PUFA can be used as a substitute for Statin....πŸ˜€

But I want to increase my all cholesterol level - HDL, LDL, TC by eating SFA and would not hesitate to take dietary cholesterol containing egg yolks etc.. even If I avoid dietary cholesterol, my liver anyway would make cholesterol for me since my body requires it..

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I have to concede, you do know a lot but they say hemp seeds, flax seeds, walnuts, almonds are great, as they have omega 3s! well I don't have to wait for long, i will get my bloodwork done soon , and I would know , let's see, if these seeds, mustard oil doesn't work, then butter it would be and dairy.

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lostboy3

Welcome to the DI forum. First of all, rest assured that your health issues are not as bad as you are thinking. Reading through your post, you seem to be having concerns about two main issues - blood glucose/diabetes and Triglyceride/lipid. Below are my thoughts:

BLOOD GLUCOSE/DIABETES

1. Variability in BG: Blood Glucose is not a constant number and it is not unusual to have different readings on different days. In particular, fasting blood sugar number can vary depending on conditions like - sleep quality and duration, stress level. Your lab results 111, 94 and 89 on three consecutive days are perfectly okay. Please be assured that there is nothing to be concerned about this variability. It is normal.

2. Your post-meal rise in BG of 17 points ( 106 - 89) is excellent.

3. Your HbA1c of 4.7 is also excellent. Not many healthy individuals have this low number.

4. Home Gucometer Readings and observed variability: It is normal and it is not the fault of the meter. Read below:

You may get difference in readings from the two samples from the same finger also.

a} Our capillary blood sample which is easy to obtain just with a prick is not homogenised and so it is highly unlikely to give same readings from two samples. Meter is okay.

b). BG level is a dynamic value because sugar is being transported from the blood stream to various cells.

c). The accuracy of home glucose meter is not as high as the lab tests. If you look at the data sheet, variation can be up to 15 % and still acceptable. Practically, error is generally better than that. Agencies are working towards a tighter specs.

Despite all these limitations, home glucometer is an excellent tool to monitor trends in our blood sugar levels at a low cost. It is not a replacement for lab tests.

Lab tests collect much larger sample of blood and then it goes through a centrifuge, a process which makes the sample near homogenised before testing to get consistent results. Their accuracy is very good, 2% variation max.

Sorry for the long explanations.I hope his gives you some reassurance.

5. Conclusion On BG: YOUR BG LEVELS ARE PERFECT AS PER LATEST RESULTS!

6. C- peptide- 1.05: First of all, you have to include more details about this number e.g. Fasting blood sample or PP blood sample, unit used. BG number for the same sample.

C-peptide can give information about insulin resistance and can predict probability of diabetes in future. One can take suitable actions to avoid that from happening.

The reference range fasting C-peptide in healthy individuals according to my information is : 0.11 - 0.61 nmol/L. The range may vary according to the lab. Please talk to your Doctor also if you have any insulin resistance based on C-peptide result. I do suspect you may have insulin resistance but it is better to comment on this after full information is available.

TRIGLYCERIDE/LIPID

Your triglyceride level is definitely very high. Could you post other lipid numbers please- TC, HDL, LDL ..

Corticosteroids are powerful medications that can sometimes have a wide range of side effects. Now that you have discontinued that, your condition should improve.

Before I suggest anything on this issue, I would like to know your full lipid profile. I am sure you would be able to resolve this with diet and lifestyle changes. You do not have to turn to non-vegetarian unless you want to. There are good options in vegetarian diets also.

Losing some more weight will be helpful.

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Thanks. Iforgot to mention my c- peptide tests is not in mmol units, it is in ng/ml units where reference range is 0.81 to 3.85. And it was fasting sample. BG as far as i remember below 95 as per ''that lab'' if i were to just see results from dr lal path, i shouldn't be worried about blood glucose but it is one particular lab which alway shows high numbers. Today i tested 3 labs in one day 12-13 hour fasting glucose, 99(submitted at 9.50 a.m), 93 (submitted at 9.40 a.m.) , 103(submitted at 9.20 a.m)

My HDL hovers around 34 mg/dl. Ldl always below 100, right now 86. VLDL 61, goes to 91 even, double triple the range. trigs i already mentioned, non hdl is 147, sometimes it's normal, at others slighlty elevated. total cholestrol is 182, alays remains in limit, 172 etc. I must add I have always been an individual with high anixety and usualy my vitamind d levels plummet low if i don't take supplements , also vit b12 is in range 312 etc but as per my own research, labs/doctors are lagging in updating their info, it should be at least over 500. My personal grudge is that i am tall and if i lose more weight i will look very skinny ;/ And i have been tensed for far tool ong, i guess i should eat pizza at least once in 2 months !

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I think you are unnecessarily taking stress about your results. Relax and enjoy life. We live only one life...no more confusion. Just eat as per your choice...it's not eating meat will solve the sugar or lipid problem and I would recommend vegetarian diet is best...just do one thing...get HbA1c tests done every three months plus lipid profile for health management ....and follow the results if in range no problem...why to worry so much? Hope you come out of so much confusion soon!

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You do not have to lose weight. Lose excess fat and put on more muscles by doing some strength training e.g weight lifting. You do not have to waste time in running/walking 10 kms a day.

Stop worrying about variation in lab results. Your focus should be your health. Your BG is excellent as evident from HbA1c which is average of three months. HbA1c of 4.7 % means your estimated average blood glucose over the previous 2 - 3 months has been 88 mg/dL. This is a dream number for many. What more do you expect.

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Your BMI 23.5, your weight is 83kg.

What is your height? over 6 ft?

What age group are you in?

what is is your waist to height ratio? this more important than BMI!!

18.5 to 25 is a healthy BMI

Healthy weight is 63kg to 83 kg.

You can work towards losing weight!! This mat be different to other response!

What is important is watching out for hidden and free sugar, regular exercise and healthy eating simple small portion and lots of water.

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Just measured, waist is 35 inches, height well, 185 cms so, 6'1 or 6 feet , sugar as far as natural in foods is concerned , there's a lot in dairy, vegetarian food , and even vegetables but i do not consume any added suagrs, excpet any that may be in multivitmains, vitmain c base etc

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You can do exercise, can loose to get to the middle of BMI range if you can but enjoy one life!

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Where and how do you get your VLDl measured?

Is it calculated?

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yes in lab tests , should be below 30, i have usually 90, 70, 60

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is it measured or calculated?

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measured, also i am surprised my hb1ac is 5.2 today while it was 4.7 a month ago, been eating more pulses, besan chapati (not sur if i should or not in place of wheat

),less execise but more walking, trigs lowered 182 but hdl still low 32.9 .

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