My 2010 Glucose Tolerance Test – Have I Goofed?

This entry is part 4 of 6 in the series My 2-Hour Glucose Tolerance Tests
Blood Vials from today's Blood Draw

Blood Vials from today's Blood Draw

I may have goofed today, getting a two-hour glucose tolerance test after a weekend bout of  flu.  There’s a chance that fighting off bugs over the weekend will mean that icky, super sweet sugar drink will boost my blood sugars artificially high, when my hope had been to have those blood sugars be as low and just as “passing the grade” as they were last year when I did this test.  Passing a glucose tolerance test last year, after five years ago failing two in a row . . . that got the attention of my endocrinologist.  He’s intrigued, because that kind of success is almost unheard of.  Especially for someone who doesn’t have much insulin in her pancreas.  It was motivating to see my endocrinologist be surprised by the unexpected IMPROVEMENT of my supposedly incurable condition.  It was affirming to me that he’s a pretty good human being, and that in addition to being surprised by my success, he also seemed delighted about it.  So you’d think I’d go out of my way to be sure my lab tests this year would be just as good.  And then that darned flu-ey kind of thing hit.  On the week where my  annual physical had been scheduled months ago, and for months, I’d had in mind to do the labs right after my annual physical. And besides, my sugars while sick had been pretty good.  In the 70s mainly.  But then, I wasn’t eating much at all.  Just resting more than usual throughout the weekend and drinking broth and water.  It didn’t occur to me that a sugar test a day after a fever might throw my body for a major loop.  Now that I’m worried about my results, there are dozens of warning bells that should have sounded off.  Here are some of the obvious ones:

1) Stress can lead the body to make more sugar on its own, out of our little stores of body sugar, plus if the body deems it’s needed, out of our muscles and the proteins in our bones.  Both being sick and taking a big jolt of sugar count as stressors to the body, which can up the stress hormones that lead the body to make more sugar.

2) When we’re sick, the body uses insulin to allocate resources to help fight the bugs, and so despite having fairly low blood sugars while I’ve been sick, it’s possible my little, hardworking pancreas has been working extra hard, churning out bits and parts of extra insulin.  And so it might not have a good reserve.

3) Those are reasons that, if I wanted a “stand up tall and give a toss of your head” kind of victory test result, I should have been careful about getting this test while sick.  And then there are health reasons.  You see, if I’ve got a stressed pancreas that’s been getting better slowly, slowly, then why add stress at a time when my body’s getting over being sick?  Why stress it further?  That’d be like jumping up and down on a broken bone that’s on the mend .  . . and even worse, jumping up and down on it right after someone’s taken a whack at it.  Oh, sure, there’s new science on bone healing that indicates a certain amount of mild pressure and use can actually increase the speed of healing.  But the operative word there is “mild,” and today, by drinking a triple-sweet hit of orange crush soda, in one big, cringing gulp . . . well, that’s two or three times more carbs than I usually consume in a single day.  And all that happened in less than a minute.  How’s that for NOT being nice to my pancreas?

Those are the hindsight reasons why it may have been dumb, dumb, dumb to take this test today.  To make matters worse, it was an expensive test.  I had decided that, as my once-a-year check, it’d be good to check all the “Well, but you didn’t check this” things that different medical experts have brought up to me in recent years.  So in addition to checking my blood sugars, I had my insulin levels checked.  And my C-Peptides, since physicians are divided about which measure they really trust.  I snuck in a fasting proinsulin test, since I have a baseline measure of that from six years ago, and it’s another window into how the pancreas is functioning.  All those tests and insights, but given that I’ve been sick, I figure I’ve blown the value of those tests, since I had them done at a time when the results might end up being a little wonky.

So, dumb, dumb, dumb.  Plus lots of clues since swallowing that vile 75 grams of sugar in 10 ounces (note that a regular soda has about 25 grams of sugar in 10 ounces, so that’s literally a three times sweetened soda in that glucose tolerance test).  The clues that this might have been a bad idea came within the first hour, when I didn’t feel shaky, but I did feel kind of groggy and weak.  I didn’t need to pee very badly, and I took that as a good sign, since if levels of sugar go too high, then the sugar spills into the urine where the kidneys work hard to filter it out from there.  Oh, people are often so oblivious to what a poison sugars can be!  We only have about a teaspoon circulating at any time within all our blood . . . that is, if we’re healthy.  More sugar than that wreaks enough havoc, that the body works hard to get it out of the blood.  But I didn’t need to pee a lot throughout the test, and I wasn’t really feeling very thirsty either.  Good signs, or signs of sluggishness based on high blood sugars?  I don’t know the answer, but I’m worrying.

Bad sign number two is that I was so nonchalant about doing a glucose tolerance test.  That kind of hubris is exactly when Fate decides to teach me a lesson in humility or just “I told you so.  You see, I’m FATE!!!!”

I was so nonchalant, I didn’t bother to bring along my glucometer to get a sneak preview of how my blood sugars might end up throughout the test.  I was so nonchalant, I went straight from the two hour glucose tolerance test to helping out at a local middle school, where I stayed two extra hours helping students edit their radio pieces, before I finally went home and thought, well, gee, maybe I should see where my blood sugars are, now that it’s been five hours since the glucose tolerance test.

As a perspective on what they might have been.  When I woke up at 5:00 AM this morning, my sugars were 77.  At 10:10 when the lab actually started the test, my still-fasting sugars were at 83 (I suspect the rise from the morning level was either because my liver was doing a better wake-up job of clearing out stale insulin from my body, or else because the stress of getting ready for a glucose tolerance test, and especially when I’d been sick, meant my body was doing the stressy thing of making sugar on its own)  But anyway, sugars of 83 upon starting the test.

Last year, with similar fasting blood sugars before the glucose tolerance test began, instead of going up to 220 after two hours, the way my sugars did four years ago, by the end of two hours, my blood sugars were down below 130.  Which means, I had passed the glucose tolerance test with a normal result instead of a “confirmed diabetic”!  This year, I was thinking, as I sat in the exam room for the two hour test , that obviously, since I had that kind of good result LAST year, it’s what I should expect from THIS year too.  But it’s not looking like it can work out that way.  Because if my sugars had gone down to around 120 two hours after the test this year, you’d expect them to be back around 83 again FIVE hours after such a test.  That’s how I was thinking, when I finally came home at 3 PM, poked my finger and drew out that little garnett-colored bead of blood.  BEEP! when the glucometer.  The little hour-glass twirled like a stylized roll of dice, and then the number:  101.

Yikes.  Fives hours after drinking that sugar drink.  With that icky sweet orange tangy stuff the only “food” I’ve had in nearly 20 hours.  And my sugars, which generally would be in the 70s or 8os, are still up over 100.

Bad, bad sign.

Followed by a puzzling sign.  You see, in disappointment, and also hunger, I then ate about two ounces of fatty short ribs plus roughly three tablespoons of butter.  I know that’s awfully decadent, but for me?  Hey, much better than drowning my sorrows in ice cream.  Besides, since I’m basically a fat burner these days, there’s a pretty good argument to be made that when my body needs calories, it doesn’t matter whether the fats are mono- poly- or saturated.  If I don’t overeat fats, my body’s going to burn them.  In the last two weeks, I’ve had two leading experts tell me that this is probably the case, and that a high-fat diet is beneficial in this way.  High fat may be very dangerous when it’s done in wiffle-waffle fashion, with a few days of high fat, then a weekend of cutting loose and having bread and sweets and higher carb foods.  But that’s not generally how I do high fat.  I eat so few carbs in the typical month, my whole month’s tally wouldn’t add up to enough to serve a typical, single meal to for a foursome of ADA nutritionists who are . . . well . . . out to lunch.  Me?  I generally eat probably less than 50 grams of carbs a day, and probably on many days, more like 30 grams.

So anyway, I ate that breaking of my fast, that meat and butter, at about 3:30 then thought, oh, why not?  I’ll check my sugars again.  Now they were down at 89.

Hmm, I wondered.  What if I go out and take our dog for a walk?  And I did, and felt a little more focused after that.  But didn’t check my blood sugars.  I’m a little blood sugar shy at the moment.  I wanted to see them go way down, but was afraid they had gone way up.  (Exercise can sometimes do that to me, and I HAD been running a bit with our dog)

It’s all a phobia right now, as I wait to see the results of my latest 2 hour glucose tolerance test.

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