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Blood glucose always slightly too high

Answered on May 30, 2014
Created May 26, 2014 at 11:43 AM

Hi everybody,

I have a friend with strange blood glucose readings. My friend is eating Paleo (or better say Primal) for a long time. She is eating a moderate carb Primal version. She is doing a lot of endurance sport. Daily cycling/jogging/yoga. On holidays she is speed cycling the mountains and that kind of heavy stuff. She is very thin and muscular. She has never been overweight or a couch potato and was always eating "healthy" (she ate grains in the past but never processed/sugary crap).

All this doesn't sound like diabetes candidate to me. Anyhow she has a quite high fasting blood glucose of 100-120mg/dl. Her HbA1c is 6.6%. But her C-peptide is at the low range of normal (0.79mcg/l).

Whatever she is doing her blood glucose does not go under 100mg/dl. But her blood glucose does not spike up after carb meals either. The blood glucose raises after carbs 10-20mg/dl and is back to "normal" at the 2 hours mark. Exercise does not lower her blood glucose level.

Her diabetes doctor is overstrained...of course! The doctor gave her Metformin which did nothing despite of digestive problems.

For me this doesn't look like diabetes or insulin resistance. But it doesn't look healthy either. Does anyone have related articles/studies or ideas?

Thank you...

96440612cf0fcf366bf5ad8f776fca84

(19413)

on May 27, 2014
at 10:20 AM

The other thing is to look at is this book:

Paleo Diet for Athletes: http://www.amazon.com/The-Paleo-Diet-Athletes-Nut... Here's a quick summary of it: http://home.trainingpeaks.com/blog/article/a-quic...

91d78e1cab685c6ca95b98480f7602c7

(0)

on May 27, 2014
at 07:08 AM

Thanks for that idea. I think she might want to try that.

91d78e1cab685c6ca95b98480f7602c7

(0)

on May 27, 2014
at 07:07 AM

Thanks everyone for the answers. The overtraining was my first thought as well. Unfortunately she is not willing to change anything about her training. I will further try to convince her to train less and differently.

3491e51730101b18724dc57c86601173

(8395)

on May 27, 2014
at 12:01 AM

Or LADA (Latent Autoimmune Diabetes of Adults). The high fasting and A1c with a fairly low C-Peptide indicate she's not making much insulin. This will look a lot more like Type I (thin) than Type II. She needs to see a good endocrinologist who is familiar with late onset autoimmune diabetes. Some won't diagnose problems like that until they are pretty far along.

96440612cf0fcf366bf5ad8f776fca84

(19413)

on May 26, 2014
at 01:30 PM

Also, I would suggest that she eat a lot more protein (from good quality meats of course). If her blood sugar is high while fasting either she's insulin resistant, or possibly in a lot of stress from the workouts - this raises cortisol, which signals gluconeogenesis to create more sugar. In the long term, she should work out far less, like 1x a week and do more weight training and less cardio - i.e. sprints instead of jogging, or HIIT instead of long bike drives. The workout I mentioned above shouldn't be done often, just once a week is enough.

96440612cf0fcf366bf5ad8f776fca84

(19413)

on May 26, 2014
at 01:28 PM

I would suggest doing a long strenuous work out (both cardio and strength training) while fasted early to late morning, waiting an hour or two, then eating a carb rich meal (safe carbs, not grains of course - stuff like sweet potatoes, carrots, etc. at best, or white rice at worst). What this will do is deplete the muscles and liver of glucose, creating a drop in sugar levels, then after the carb refeed, it presents a higher sugar state, so her cells see both low and high sugar.

91d78e1cab685c6ca95b98480f7602c7

(0)

on May 26, 2014
at 12:42 PM

I'm with you about the chronic cardio. But cycling is very important to her.

She eats no grains. She also tried VLC which didn't change her blood glucose levels. Not the fasting ones and neither the postprandial ones.

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4 Answers

0
Medium avatar

(167)

on May 30, 2014
at 06:37 AM

This article talks about how insulin resistance is on the rise in young, slender women who do not even remotely fit the diabetes stereotype. http://www.womenshealthmag.com/health/type-2-diabe...

Metformin sucks! The gastrointestinal problems don't always go away, and I found that starchy meals including bread and rice were the only thing that combatted the intense nausea when I was on it. I finally stopped when I almost crashed my car due to crazy fatigue and a headache that was so bad my eyes wouldn't focus. My recommendation - find another way.

One thing for her to keep in mind - she hasn't necessarily done anything wrong to cause this. The first thing a lot of ladies do after a diabetes or pre-diabetes diagnosis is blame themselves and try to figure out what they should have done differently. Unfortunately, we live in a world where even if you do everything "the right way," there are so many hidden contributors that it can't always be prevented. Luckily for her, she already lives a super-healthy lifestyle, and she's already got a diet and exercise regime that's healthier than what a doctor would tell a diabetic person to implement. She sounds like a fantastic lady with a lot of drive - if she just keeps doing what she's doing, she'll stay pretty healthy.

0
32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on May 26, 2014
at 11:14 PM

That HbA1c alone is diagnostic for it. "Thin" makes one think of Type 1 diabetes, or at least some amount of T1D is a factor.

3491e51730101b18724dc57c86601173

(8395)

on May 27, 2014
at 12:01 AM

Or LADA (Latent Autoimmune Diabetes of Adults). The high fasting and A1c with a fairly low C-Peptide indicate she's not making much insulin. This will look a lot more like Type I (thin) than Type II. She needs to see a good endocrinologist who is familiar with late onset autoimmune diabetes. Some won't diagnose problems like that until they are pretty far along.

0
F291857fa12a0291688ea994343156dc

(720)

on May 26, 2014
at 07:20 PM

Everything @raydawg brings up is "spot on"... Before I read his responses my impression was "your friend is way over training."

How old is she? How long as she been doing this level of effort? Maybe it's finally catching up with her.

0
96440612cf0fcf366bf5ad8f776fca84

(19413)

on May 26, 2014
at 12:27 PM

That A1C is pretty high, and that fasting blood sugar is indeed very high. She might be pre-diabetic. Of course all that constant chronic cardio doesn't help the situation - if anything it can cause irreversible heart damage.

Remember, skinny doesn't necessarily mean healthy. At least in obese diabetics, they have the ability to dispose of glucose to fat cells, your friend can only burn them off, but obviously, her fasting blood sugar is high, so this is likely not happening, which is a dangerous situation in the long term. It can cause all sorts of damage to nerve and blood vessels tissues, including eyes, and even kidneys once it gets high enough.

Someone in this situation should be eating a very low carb diet, and no grains.

91d78e1cab685c6ca95b98480f7602c7

(0)

on May 26, 2014
at 12:42 PM

I'm with you about the chronic cardio. But cycling is very important to her.

She eats no grains. She also tried VLC which didn't change her blood glucose levels. Not the fasting ones and neither the postprandial ones.

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