Went in to My Oral Glucose Test Today Results Were Not I was Expecting.

[MikeO]

Did the three hour test. And to be honest i am not sure if blood sugars are a dysautonomia issue. We were expecting the test to show hypoglycemia but dang if it did not go the other direction.

Post blood draw was 108

1 hr draw was 308

2 hr draw was 315

3 hr draw was 131

Doctors notes below.

Patient has quite high blood sugars after the glucose load I think would be reasonable to speak with endocrinology, would also be reasonable to follow back up at Madison with a specialist.

Zachary J. Baeseman, MD, FAAFP
 

 

[Pistol]

So sorry @MikeO! Dysautonomia definitely has an impact on blood glucose levels. Many patients with ANS dysfunction suffer from hypoglycemia, myself included. But it CAN also go the other direction, here is a link  Influence of Autonomic Nervous System Dysfunction on the Development of Type 2 Diabetes | Diabetes Care | American Diabetes Association (diabetesjournals.org)

CONCLUSIONS—Autonomic dysfunction, in combination with poor physical fitness, may be a mechanism associated with early glucose dysmetabolism and the development of diabetes

[DADofPotsSon]

My late father who had dysautonomia also had blood sugar problems.  He reduced his weight from 230 to 190 lbs, reduced his carbs, took 2000 mg of ceylon cinnamon morning and night, and took a daily walk even up to age 83 and his blood sugars were about 110 both morning and night,  he switched to a stationary bicycle at age 83, and eventually a resistance pedaling device at age 85 that he could use from his chair.  If his evening blood sugar reading was above 115 he would say darn it and drink a low carb beer, which sometimes I think he always wished for higher reading!  This would lower his BS readings real fast, though one has to keep and eye on it so it don't go too low, his never went too low.  The cinnamon method works on some people and not so well on others,  I do not get the benefits of cinnamon like my dad did, a little but not enough.

DADofPotsSon

[MikeO]

2 hours ago, DADofPotsSon said:

If his evening blood sugar reading was above 115 he would say darn it and drink a low carb beer, which sometimes I think he always wished for higher reading!

Haha I could see doing the same.

@PistolThank You for sharing the link. It is helpful. I am sure this has a hand in why food seems to be such a hurdle for me.

[MikeO]

8 minutes ago, DysautonmiaMatt said:

There are supplements like berberine and drugs like metformin that can help along with of course diet changes.  Did they by chance test your fasting glucose along with fasting insulin?  Also cortisol levels also can influence glucose. Below is some info from an Endo:

https://www.goodhormonehealth.com/2020/02/03/3ss-2/

Well i am not going the supplement route outside of some of the spices i use for cooking, i am not going to go out of my way to take them. Metformin comes with a black box warning so i am not willing to do that as well. there is one other drug that my PCP brought up but he did mention side effects were a bit to manage.

Diet is my first defense. My fasting numbers are ok but just not with sugars or carbs. if this does not work i am sure i will end up with insulin.

Yes blood draws is with fasting (3hr test) the test did include insulin. My thyroid tests have came back stellar so that is not a concern

[MikeO]

Well i went back into UM today. The nutritionist that ordered the glucose test was not expecting the test results (sigh). By all means we did discuss A1C's as well as fasting blood sugar numbers and more than likely the spike in the numbers would have never been caught without the sugar load test. Seems to me i still have an angel on my back.

She did cite in her opinion the test results are atypical and does agree that being seen by a endocrinologist is not out of the question. She in her mind does question if the blood sugar spikes are linked to my orthostasis. I did present at the office today.

I did put a request to be seen at UW.   

[MikeO]

On 10/7/2022 at 6:19 PM, DysautonmiaMatt said:

There is nothing typical about our health issues

No there is not. I heard i have a disorder Haha.

 

On 10/7/2022 at 6:19 PM, DysautonmiaMatt said:

My endo generally goes by A1C and fasting glucose to detect sugar problems.

I did have this conversation with the dietitian. She did look at my AIC's and fasting glucose and in her option my abnormal glucose response would have never been picked up on with these tests. Only reason we discovered it was due to the 3hr glucose test. she was suspecting hypoglycemia and was surprised i went in the other direction.

We did also discuss what i was feeling during the OGTT test (i did become symptomatic) and she said they were classic traits of high blood sugar (feeling really ill in the first 15 min, sudden blurry vision, feeling tired and weak ect..) That was like a light coming on for me (same symptoms i get at home after a meal). We did also talk about extreme hunger attacks. She said this is a hormonal response due to the body not being able to process glucose in the the cells. For her this does just strengthen the need to see an edno.

For now the diet outline has not changed. Keep a watchful eye out for sugars, keep my meals small and more frequent and always pair a carb with a protein ie...piece of whole grain toast with peanut butter works for me. Piece of toast with a hard boiled egg and sugary yogurt with a glass of milk will couch me for 3hrs with the same symptoms as i have with the OGTT test.

On 10/7/2022 at 6:19 PM, DysautonmiaMatt said:

It would be interesting to see what your cortisol and glucose are when you have a BP drop. 

Yeah would be interesting but for now i can wait. I am getting a handle on what works and does not just based on symptoms. Will see what the endo wants to do.

 

On 10/7/2022 at 6:19 PM, DysautonmiaMatt said:

I cheated and had some pretzels on an empty stomach and about 45 mins after eating them my glucose was 117

I would not stress over a 117 number. that is normal. I had a 168 a while back (forgot to fast) ate a half bagel with cream cheese 3 hrs before the blood draw. was not considered abnormal. My 2 hr 315 is bad.

With my recent confirmation of asthma is going to throw out a log to stumble over (will be in the same boat as @RecipeForDisaster) I did lookup up metformin and it effects on the parasympathetic NS is not good for asthmatics similar to pyridostigmine  . Misspoke on the metformin but pyridostigmine stimulates the parasympathetic NS which in turn vasoconstricts the airways. 

[MikeO]

12 hours ago, DysautonmiaMatt said:

Did not know that. Good catch. Do you have any links to where you found that info?

Misspoke on the metformin but pyridostigmine stimulates the parasympathetic NS which vasoconstricts the airways which is bad for asthma.

[JennKay]

@MikeO -- wow, such an interesting thread and set of observations. I also suspect my symptoms flare from chnages in blood sugar. I connected it to my blood sugar when I was pregnant and had to do the OGTT, except mine was hypoglycemic as you suspected yours would be. I apparently get nauseous, lightheaded, and flushed when my sugar drops into the 60s. 

I'm still trying to connect it to my situation now though. I have been taking florinef for almost 2 months now and it has made such an improvement in my quality of life. I still get PVCs, but they are much less frequent and I'm sleeping a little better. Little is the key word there, but every bit counts, right? 😆 Then yesterday I was at a baby shower and had some pudding pie dessert thing that was delicious, but about 10-15 mins after my chest got tight and the PVCs when crazy. Now, I suspect sugar must be kicking my sympathetic side into over drive. Will be avoiding sugar as much as possible for the next 2 weeks to see if this helps any. It will be sad to give up sugar, but I will gladly compromise if it makes the PVCs better! I feel like I am still paying the price for that sugar bomb today...

[Pistol]

@JennKay I definitely get symptoms from sugar! It is a stimulant ( remember kids and a sugar rush? ), so it can cause PVC's, tremors, tachycardia etc. But when I become hypoglycemic ( usually after a high glucose food, like pancakes and syrup, which I avoid at all costs ) I experience tremors, sweating, weakness and hunger. This is the glucose intolerance part. The body produces insulin but the sugar gets metabolized so quickly that the insulin is still active and the blood sugar drops. When this happens I have to eat grapes or drink orange juice combined with a protein, like peanut butter or cheese. The protein helps for the sugar to last in the blood stream. 

I have been able to minimize the episodes of hypoglycemia greatly by avoiding all concentrated sweets and eating snacks all day long. 

[MikeO]

@JennKayGlad to hear you are sponding to the florinef. Your pudding pie experience sounds like me when would would eat ice cream. While back i started reading the nutrition labels of the foods i would buy but was only looking for trans fats and sodium. now that i am sugar aware you would be surprised in how much sugar is included in various products.  

[DADofPotsSon]

MikeO, You might try Ceylon Cinnamon Gummies about 2000 MG with 100 MCG chromium.  I have been using this for several months and it has really lowered my blood sugar/A1C readings, nearly like metformin.  It takes about a month to start working real good.  It has many other benefits too!  I would suggest you do some research on it.  I did and now I am very pleased with the results.

DADofPotsSon

[Pistol]

@MikeO @DADofPotsSon I am aware of the beneficial properties of cinnamon for diabetics and general blood glucose control. I second that it is a good option to research!

[MikeO]

3 hours ago, Pistol said:

@MikeO @DADofPotsSon I am aware of the beneficial properties of cinnamon for diabetics and general blood glucose control. I second that it is a good option to research!

@Pistol @DADofPotsSonwonder if this was why i was intuitively adding cinnamon to my sugar laden instant oatmeal? I did look this up and looks promising. I do have concerns that the cinnamon is processed thru the liver (most my drugs are) albeit seems to be very little reported issues.

[DADofPotsSon]

@MikeO, From what have researched  CEYLON CINNAMON  does not effect the liver and works the best on blood sugar control.  Apparently Cassia Cinnamon can cause liver problems due to coumarin content.  Scientists say Ceylon cinnamon is likely safer in very high doses than supermarket cinnamon. Ceylon cinnamon is the only true cinnamon and the Cassia (Chinese) cinnamon sold in stores is merely a cheap impostor and even dangerous to consume, according to what I have read. Here is a really good article on cinnamon:  https://diabetestalk.net/blood-sugar/which-type-of-cinnamon-is-best-for-diabetes 

DADofPotsSon

[MikeO]

Update: what an adventure getting a diagnosis. 4 tries with endocrinology and 2 months later before they got why i was referred to them in the first place ((frustrating)) and then they just pass the buck back to my PCP. ((())).

Notes from the endo:

The glucose abnormality does not explain his syncopal episodes

- These glucose values are consistent with diabetes; I don't see his A1cs but if they were normal, there is a disconnect and A1c may not be reliable

- For this newly diagnosed diabetes, I would recommend connecting with PCP to decide on initial plans

[MikeO]

Well my Doc is finally getting up to speed i was referred over to Diabetes training which is run my the same RN's that run the cardio rehab (I feel we are a tight family after being in and out of there the last several years)

My Dr wants to put me on Metformin but i did bring up my concerns of a drug interaction so she called and yes there is a valid concern so not sure where this is going to end up at. I know i am not willing going to stop my Ranolazine.  

[MikeO]

Well the plan is MyChart was updated to me having type 2 diabetes. This opens up me to get training and monitoring supplies as well as additional testing paid by the insurance.

For now before i start the metformin we are going to slap on a Dexcom G6 for 14 days to get more diagnostics done and go from there.  

[Sarah Tee]

@MikeO, I hope the Dexcom monitor gives you some useful information. I hear they can be very helpful.

[MikeO]

On 12/11/2022 at 6:30 AM, Sarah Tee said:

@MikeO, I hope the Dexcom monitor gives you some useful information. I hear they can be very helpful.

Thanks! I am so geared up to give the monitor a try. I also am now a big believer in big data (many readings to show a pattern).

Surprisingly what got me here is that i bought a new BP monitor that is bluetooth enabled. I also installed a app on my smartphone that captured the readings and notes and sends them to a web portal. So then for a month or so i took many blood pressure readings i.e just getting out of bed, when i took meds, when i ate (about every hour or two) etc...

This did show a distinct pattern over time that my blood pressure drops significantly after eating so, i sent in the reports off the web portal to my specialist (she could not ignore the data) and at least acknowledged postprandial hypotension which then got me a referral to a nutritionist.

So after talking with nutrition the gal suspected some type of blood sugar issue (hypoglycemia) and ordered the 3hr oral glucose test which by surprise showed postprandial hyperglycemia. 

To be honest i don't think i would have ever been diagnosed if it were not for me collecting a lot of readings. Know one would have guessed just by looking at my fasting blood sugars.

I did install the sister glucose app on my phone an the plan is to capture blood pressure readings like i did before along with the glucose readings at the time i take my bp. I will be able to merry up the results to show a bigger picture. I am chopping at the big to see what this shows!

  

 

[Birdlady]

I believe there is a connection to POTS/dysautonomia with glucose issues. There was a thread started last year about it.

Sorry to hear that the endo was not helpful. I really just don't understand why they would just refer you back to the PCP. I agree that we have to collect data ourselves on apps and programs that they cannot deny. Sadly my EP would actually use it against me as another clue that I'm just a neurotic female who needs to exercise. 

I haven't been checking my blood sugars again because it never made any sense. It seemed like mine would go high at times despite what I was eating. My A1Cs are all very normal, so instead my doctors just pooh-poohed the numbers I test at home. Have they sent me to do a formal OGTT? Of course not. I still wonder what magical age I'll have to be when  doctors start caring about the health of POTS/dysautonomia patients. They didn't care in my 20's and still don't seem to care in my 30's. Maybe 50's will be the magical time if I make it there lol? 😉

[MikeO]

22 hours ago, Birdlady said:

I believe there is a connection to POTS/dysautonomia with glucose issues. There was a thread started last year about it.

Sorry to hear that the endo was not helpful. I really just don't understand why they would just refer you back to the PCP. I agree that we have to collect data ourselves on apps and programs that they cannot deny. Sadly my EP would actually use it against me as another clue that I'm just a neurotic female who needs to exercise. 

I haven't been checking my blood sugars again because it never made any sense. It seemed like mine would go high at times despite what I was eating. My A1Cs are all very normal, so instead my doctors just pooh-poohed the numbers I test at home. Have they sent me to do a formal OGTT? Of course not. I still wonder what magical age I'll have to be when  doctors start caring about the health of POTS/dysautonomia patients. They didn't care in my 20's and still don't seem to care in my 30's. Maybe 50's will be the magical time if I make it there lol? 😉

Good timing with your post. I was just about to post a new thread asking about just this. Link is very helpful thank you! 

The whole run around with my faint team and the endo goes beyond me. I did have to take a deep breath just so i don't burn any bridges. At least the endo that referred back to my PCP did mention that any of my A1C's based on the OGTT would not be accurate.

I am glad that i am getting a CGM put on, it should be harder to rebuke clinic data vs patient data.

I just wonder if i had some Insulin resistance years before my dysautonomia started snowballing or the other way around. I did find an paper (Cardio bias) that talks about neuropathy as a possible stressor of autonomic dysfunction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668070/

  

[MikeO]

Well sucks to be me. I did get the CGM put on today. Not sure what this means but my glucose tanked when i went to bed (40 Alerts were set to 70) when i did get up to validate the readings i could not get the manual finger prick reading. Pretty sure there is a threshold were the device will not work

to show anything but an error.

Screen shot below.

 

[Pistol]

@MikeO if the drop in glucose level at bedtime is correct you may want to consider eating a protein-rich snack before bed time? 

I know that manual glucometer readings can show an error message if the glucose level is too low - so that may be the reason you could not get the fingerstick reading?

[MikeO]

2 hours ago, Pistol said:

@MikeO if the drop in glucose level at bedtime is correct you may want to consider eating a protein-rich snack before bed time? 

I know that manual glucometer readings can show an error message if the glucose level is too low - so that may be the reason you could not get the fingerstick reading?

Pretty sure the RN said the manual glucosmeter would error out at some point (like usual i never remember what is talked about at my encounters) i will be calling the clinic today.

The readings do look like my blood pressure patterns. I did tank a few more times while sleeping, sure this would explain my nighttime hot flashes (male menopause)