Fasting BG & A1c

[skb]

OK. So I have managed to copy posts from the Fasting thread to a new topic devoted to Fasting BG & A1c.

[walkerwally1]

Honestly I'm not sure why we put emphasis on fasting bg, maybe it's because Doctors do.  In the 23 years since I was diagnosed I have had several Doctors and they all were pretty much the same.  They looked at fasting bg and A1c and made all of their decisions based on that.  I have taken a print out of my daily testing to my doctors more than once and it was ignored.  One of the reasons I fired my last Doctor.  On my lab report it shows the normal range for fasting glucose is 82-115, and that it for non-diabetics.  When I first decided to take charge of my blood sugar control and forget the doctor my goal was to try and stay below 140 mg/dl at all times as that was where organ damage was supposed to start.  After a while I found that I could stay below 120 at all times so that became my new goal.  I think that is more important, and bg after meals is probably the most telling.  Anyway I don't think it's worth beating yourself up over, just try to do the best you can and that works for me.

[Shanny]

I completely agree, Wally. And furthermore, there's no reason diabetics shouldn't aspire to non-diabetic numbers. We know how to control our blood sugar levels - it makes no sense at all to add some imaginary buffer zone, just because we've already been diagnosed wish diabetes. Whether we can do it with diet only, or using diet and meds combined, we can control our blood sugar, and we need to DO IT if we want to live long healthy lives free of complications.

[Grammabear]

I agree with Wally and Shanny.  What annoys me to no end is to have a doctor tell me that I should eat more carbs so that my A1C will be 7% or just below.  Don't they realize that it is those of us with diabetes that suffer from uncontrolled numbers?  The doctor who originally diagnosed me told me that the pain I had in my  feet was nerves that were in the process of dying, and once they died that I would not have pain ever again.  What a dolt  because he lied.  I have neuropathy because of uncontrolled diabetes in the beginning and I will probably always have it to some degree.

[bigskygal]

I agree too about the over emphasis on fbg/A1c by doctors. Though I don't often test around meals any more, unless it is a new food.  My goal is to always be below 120. I have tested so thoroughly around the foods I eat that I know they are safe.  I do fasting and bedtime just as a snapshot of my day.

[skb]

I think this discussion on FBG / A1c deserves its own space away from the fasting thread.

Personally, for me, the fasting number is important because it indicates my glycogen status. That is because I understand my own system very well. It may not be relevant to someone else. I think of A1c only as a very general indicator of BG profile as I think there are a number of other factors that influence that number, probably some of these are yet unknown.

[Carbcrazydog]

I agree with skb. My post meal numbers are usually around 140 and i am trying to eat to keep them under 120. But my fasting number has a direct relationship over how i have been eating since the past few days. If i eat low(er) carb, at the right time, exercise enough etc, they usually start trending down. Higher fasting number is a wake up call that i need to jump back on the wagon ASAP.

I am super happy. My mom suddenly planned a visit and is coming on Saturday. Will be home for 15 days. I am on a 2 week vacation and my only plans are to listen to her constant lecture over how awesome my kids are and i should not endlessly complain over any hard time they give me. And that our generation has so less patience etc etc. I love her. Having lost my dad early, every minute i can spend with her and see her happy means so much more.

[Grammabear]

For me the fasting numbers tell me how well my basal insulin program is working on my insulin pump.  It helps me to be able to see what my numbers have been for the past twelve hours by looking at the screen of the cgm and also by downloading the cgm to see a broader picture.

You would think that having this technology at my disposal would ensure that all fasting numbers are perfect - but sadly they are not.  I downloaded the cgm just before my last lab visit to the doctor and the cgm and the converter system on this forum indicated my A1C would be in the high 5s.  It was not, but instead it was 6%.  That is good enough for me and I'm hoping the Endocrinologist agrees.

[walkerwally1]

And by all means I don't mean that fasting bg has no relevance but I do believe that it is only part of the picture.  For me it really shows what my evening meal was like, higher after dinner bg means higher fasting.  I have not really been bothered by DP for quite some time.  I guess my main thing was that people should not get upset if fasting bg is not double digits, your overall bg really is what's important and I do think that most doctors place too much importance on fasting bg and ignore bg at other times.

[skb]

I guess my main thing was that people should not get upset if fasting bg is not double digits, your overall bg really is what's important and I do think that most doctors place too much importance on fasting bg and ignore bg at other times.

I agree completely. That DP is not bothering you, only means that you are running on a near depleted glycogen store. In this state the morning fasting will be proportionate to the bedtime number. But if the glycogen levels are any higher then number of fasting hours, physical activity, all come into play.

[rocky]

Very good discussion. These are the threads that I learn most from.
I think DP does affect me. My pre dinner numbers are usually in the low 80s. Theoretically, after a 12+ hour fasting the morning number should be lower than that or thereabouts, but it is 10+ points higher.
As far as doctors are concerned, I think they should follow this

http://www.diabetic.pub/Diagnosis%20and%20Classification.htm

[walkerwally1]

I guess my main thing was that people should not get upset if fasting bg is not double digits, your overall bg really is what's important and I do think that most doctors place too much importance on fasting bg and ignore bg at other times.

I agree completely. That DP is not bothering you, only means that you are running on a near depleted glycogen store. In this state the morning fasting will be proportionate to the bedtime number. But if the glycogen levels are any higher then number of fasting hours, physical activity, all come into play.

Good point and actually it just dawned on me (no pun intended) that DP has not been a factor.  When I first started LCHF a bit over 3 years ago it was a major factor in my fasting numbers.  Just shows that the learning process never stops.   

[rocky]

But if the glycogen levels are any higher then number of fasting hours, physical activity, all come into play.

I understand that the number of hours fasted impacts the morning number. I've seen my BG begin to go up if I check later than usual, but what is your (all of you) experience if the fasting hours continued some more. I've never checked for that, but if you have, what has been your experience ?

[skb]

Believe it or not, I've tested BG for 100s of variables, but never for pure fasting beyond the usual 12 hours. Tell you what, I'll be doing this sometime soon & will let you know how it goes.

[walkerwally1]

I haven't really tested the effect of fasting but I have observed my blood sugar when fasting for testing or for a procedure.  When I have gone 20-24 hours with nothing but water my blood sugar runs in the mid 70's to low 80's.  The next couple of days after returning to eating normally I have noticed my bg runs lower than it did before the fast leading me to believe that it is probably a good thing to do.  I know Dr. Jason Fung views it as a treatment for Diabetes and Obesity :
https://www.youtube.com/watch?v=tIuj-oMN-Fk

I have listened to his presentation and it does make some sense but I have not really put it into practice but I do think it may be worth looking into.