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What do the following blood sugar levels indicate?

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Posted on Wed, 20 Jul 2016
Question: Ive asked several bloodsugar questions on here pertaining to something i noticed while checking my wifes fasting glucose. I noticed mine could be high in the morning.
I was alarmed and went to dr and he checked my sugar in the afternoon and it was 89. He asked when the last time i ate was and i said i hadnt eaten in a while but had drank a large soda about an hour and a half before D-stick. He assured me i wasnt diabetic.
I took an A1C and it was 5.3
Over the last months ive done several things.
I checked my oral glucose tolerance
And i was pretty normal.
1 hour post prandial 157
2 hour post prandial 110

Ive been checking my sugar a lot. I also have noticed that my sugar at early morning around 3:00 am is normal but around 6:00am to 7:00am is when my liver dumps sugar and it will be high for a short burst, normally less than an hour ranging Between 89 but sometimes up over 140. My sugar then drops pretty fast back down to 100 or less within 45 min without consuming anything. The even weirder thing is if i do eat or drink sugar when my sugar is in the dumping period it will drop even faster down to normal range 80-100 within 30-45 min.
Ive taken 3 A1c tests over 5 months and they all are between 5.5 one time and others were 5.3.
My question is, hypoglecemia runs in my family, could my evening glucose readings that are always in lower 70's cause my liver to store up more sugar at evening meal which is a very large meal, produce a larger dump for that short window in the morning?
Ive done a fasting glucose at an 8:00am dr appointment during these months and it was 101. Dr said its 1 point out of range and again said i should quit checking sugar so much. He said maybe some resistance but very little and everyones liver dumps sugar in the morning. The doctor is a primary and not an indocrinologist.
How do i make sense of all this?
doctor
Answered by Dr. Saumya Mittal (40 minutes later)
Brief Answer:
Are you on medicines

Detailed Answer:
Hi,
I am Dr Mittal.
I have read your message.
I think I can help you.
I would need to know if you are on any medicines?
Let me know.
Best of luck. Dr Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (14 minutes later)
Tylenol, dexilant, clonazepam.
When this concerned me i had a full blood panel run. Doctor said everything looked normal. No weight loss or outward signs or symptoms. I thought it was 5 months but more like 7 says paper work.
doctor
Answered by Dr. Saumya Mittal (1 minute later)
Brief Answer:
How much was the sugar

Detailed Answer:
Ok
When you say your sugars were alarmingly high, how much was the sugar?
Was it fasting or after meal?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (7 minutes later)
The morning is fasting and normally 100-119
doctor
Answered by Dr. Saumya Mittal (7 minutes later)
Brief Answer:
Mild IGT

Detailed Answer:
Hi
Thanks for your response.
I think I can say you hAve mild impaired glucose tolerance. As of now, you need not worry.
First, your sugars are above normal in fasting state. This is usually due to a prolonged overnight fasting leading to secretion of glucagon and thus release of sugars by liver in morning. You may try to take a small snack at night.
Second , your sugars come down after food because body starts secreting insulin when you eat. But the food has not yet reached the stomach on half hour. So you have sugars on lower side of normal. It's expected.
Third , your post 1 hour and 2 hour sugars are fine. No need to worry too much there.
I would suggest watching your diet and regular exercise as the only treatment regimen for now. Monitor sugars regularly. Ideally 6 monthly is enough.
Best of luck. Dr Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (20 minutes later)
I undertand but If i have impared glucose response, why do i respond so strongly to soda or even a sweet coffee. Seriosly, my sugar will drop a lot even if its 140 if i drink something sweet.
I have wondered if this is related to how i eat my meals. I eat only 1 big mesl per day at night.
I drink sugar during the day multiple times and ehen i monitor 6-7 times during day, my sugar stays 80-110 ( normally under 100 and for sure under 100 after 1:00pm and keeps getting lower until i eat dinner).
No one in my family is diabetic but my mother, brothers, grandfather all have hypogycemia.
Mother and grandfather have it worst and get shaky when they sugar crash.
I also notice if i drink diet soda during the day my numbers are pretty much guaranteed lower on fasting glucose. That poses my other question. If i take a fasting glucose reading after 8:00am my numbers look normal because that sugar rise and fall in the early morning lasts only for about an hour then drops quickly. I feel like my body is storing sugar during the day and the amount of sugar consumption determines the severety of the morning dump.
The A1c results are also confusing.
Your thoughts?
doctor
Answered by Dr. Saumya Mittal (5 hours later)
Brief Answer:
Suggestions

Detailed Answer:
Hi,
I have already mentioned that glucagon is secreted after overnight fasting. so your morning sugars may be higher.
When you eat something insulin is secreted that lowers sugars before food reaches stomach and is absorbed.
Plus if you have taken diet soda, it's not fasting sugar anyways. It's called diet soda for that reason.
I hope that this explains why you have those reading.
And Hba1c of 5.3 is normal. No confusion there.
Best of luck. Dr Mittal.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (4 hours later)
No diet soda.
I missed that "morning sugars may be higher".
I have regular sodas 2-3 times per day, so my A1c should technically still be higher because my daily sugar intake is high throughout the day.
I said that i do notice if i switch to diet soda i notice my fasting number will be around 110 the next day. If i do this a few days in a row, my morning glucose will be around 90.
This is why i said it seems like my liver is storing the sugar.
Like i said, i have around 1 hour of higher sugar readings in the morning at around 7:00am but by 8:00am its down and it stays normal all day even when consuming sugary drinks.
So if i get fasting readings over 140 sometimes, and i have impaired fasting glucose, why doesnt my sugar go back up after insulin realease at 1 hour?
Im trying to understand thi
I know diabetics and none of them

s
doctor
Answered by Dr. Saumya Mittal (8 minutes later)
Brief Answer:
Explained

Detailed Answer:
Hi.
In your case, it is not that the insulin is deficient.
So despite your regular sugar intake, daily sugars and Hba1c remains normal.
As I said before , prolonged overnight fasting causes the glucagon to get released. This hormone raises the sugars. So your sugar is high in morning.
However, when you drink or eat something, the insulin starts getting secreted and glucagon stop working leading your sugars to fall before the food reaches your tummy.
Once you start eating, sugars and insulin gets balanced.
And yes , you are right. Liver does store glucose which is the first source of energy.
Best of luck. Dr Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (4 hours later)
My only concern was when i saw the pattern of 4::30am glucose 115
5:30am glucose 110
7:00 am glucose 148
8:00am glucose 118

No food is taken during these readings. They are all morning readings.
The only time i see readings over 140 have been when i consumed a high amount of carbs the daysbefore. Lower carbs the prior day equals lower fasting glucose.
doctor
Answered by Dr. Saumya Mittal (8 minutes later)
Brief Answer:
its obvious

Detailed Answer:
Good observation.
I hope you realize, high carb intake leads to high sugars, and vice versa.
Its obvious.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Saumya Mittal

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Practicing since :2004

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What do the following blood sugar levels indicate?

Brief Answer: Are you on medicines Detailed Answer: Hi, I am Dr Mittal. I have read your message. I think I can help you. I would need to know if you are on any medicines? Let me know. Best of luck. Dr Mittal