Why Such a High Baseline Glucose?

[sandyt]

How can it be? Pre-diabetes?
After wearing a cgm I got a surprise. My fasting glucose seems to hover between 100 and 110! Postprandial spikes are mostly around 140 with only a couple going to 150. That is only a delta of only around 30 which doesn’t seem horrible. But the high baseline has me stumped.

I also did a few finger sticks with a glucometer which read consistently lower (by 6 to 30 points).
I exercise for an hour each morning. I also take a 25 min walk after dinner almost daily. I get around 7 ½ hours of sleep each night. My diet consists of mostly whole foods…similar to a Weston A. Price diet. I severely limit processed food and avoid seed oils and added sugars. I DO EAT CARBS…between 100 and 150 g per day. So I am not keto. I fast between 6:30 pm and 9:30 am six days a week. I am at a perfect weight and body composition.

Within the last year my hba1c spiked from 5.3 to 5.7 and my fasting glucose at Labcorp was 100. So I believe that the cgm values could be accurate. (The cgm predicted a 5.9 hba1c for me.) My insulin tested (Labcorp) at 3.5 a few months ago, but has also gone up to 6.8 this year.

I have done a lot of research and can’t find anything that speaks to my situation. Could a 100-110 glucose just be normal for me? Or is there something I should be doing differently? Any suggestions/advice appreciated.

[Tincup]

I have done a lot of research and can’t find anything that speaks to my situation. Could a 100-110 glucose just be normal for me? Or is there something I should be doing differently? Any suggestions/advice appreciated.

I don't have any certain answers, but perhaps some things to explore.

First, on a CGM. What has been explained to me is that the analogy is a roller coaster. A lab blood draw is the front car of the coaster, a finger stick is a middle car and the CGM is the last car. So if your glucose is changing the CGM will be the last to change.

On insulin, Catherine Crofts did her PhD thesis using the late Joseph Kraft MD's data. She told me that insulin is very pulsatile, so fasting insulin values can vary even over short periods of time. She's more in favor of a "stress test" where you test exactly 2 hours after your carbiest meal. Insulin levels > 50 are bad < 30 are good and in between needs more testing. We have links to her work as well as Kraft's on posts if you search.

You might read through some of the info I linked on Marty Kendall's program here. Marty's wife is a T1 diabetic and through her data he found that dietary fat has an impact on basal insulin levels. In the low carb/keto communities it is thought that fat has no or very little impact on insulin. This may be true in an acute sense, but not over the course of the day and "area under the curve."

In Marty's Data Driven Fasting program, he gets people to use their glucometer as a fuel gauge and delay eating till their glucose has dropped. In a very brief summary (he has an app to automate this), he has people eat without changing anything for three days initially. Recording their glucose prior to eating. Then computing an average. After this, he sets an initial "target" glucose slightly below the average. Then asks you not to eat till your glucose is below that trigger. Once you are consistently below the trigger, then the trigger is lowered some more. Rinse and repeat. He's found that once people get a trigger lower (say around 80 mg/dL), that things like fasting glucose tend to clear up.

[sandyt]

That is soooo interesting. I can't wait to dig in and do some research. Thanks!

[Tincup]

That is soooo interesting. I can't wait to dig in and do some research. Thanks!

I happened to write a post on Kraft's work just now in another group.

This is Joseph Kraft MD's original paper on the OGTT (oral glucose tolerance test) with insulin assay. A search for more info on Kraft's work.

Catherine Crofts did her PhD dissertation using Kraft's data, here is a search on her work.

[mike]

I have done a lot of research and can’t find anything that speaks to my situation. Could a 100-110 glucose just be normal for me? Or is there something I should be doing differently? Any suggestions/advice appreciated.

Kind of obvious, but I thought I would ask - are you putting the CGM in the correct spot? They only work in the underarm from what I was told.

100-110 fasting would indicate that the BBB has become a bit glucose resistant. Usually that would happen if your peaks are too high for the brain, and glucose receptors become fewer. The brain chooses slow starvation instead of quick burnout. If you are not having large BG swings, then you should be okay, since your ketones would likely be enough to supplement the low glucose. If you had big swings, then you would not be able to meet your fuel needs and neurons start to have problems.

[sandyt]

Kind of obvious, but I thought I would ask - are you putting the CGM in the correct spot? They only work in the underarm from what I was told.

I was wearing it on the back of my upper arm...top of the tricep muscle.
My glucose swings aren't huge (30-40 points). In fact, if you took my whole curve and moved it down 20 points it would look marvelous

[mike]

Kind of obvious, but I thought I would ask - are you putting the CGM in the correct spot? They only work in the underarm from what I was told.

I was wearing it on the back of my upper arm...top of the tricep muscle.
My glucose swings aren't huge (30-40 points). In fact, if you took my whole curve and moved it down 20 points it would look marvelous

That doesn't sound like the right spot, at least for my FreeStyle Libre 2. I would ask your doctor or check your packaging. When I was told how to put it on, they emphasized that it was only tested (?) in the underarm - the loose area when you hold your arm level...a few inches away from your armpit.

[sandyt]

Kind of obvious, but I thought I would ask - are you putting the CGM in the correct spot? They only work in the underarm from what I was told.

I was wearing it on the back of my upper arm...top of the tricep muscle.
My glucose swings aren't huge (30-40 points). In fact, if you took my whole curve and moved it down 20 points it would look marvelous

That doesn't sound like the right spot, at least for my FreeStyle Libre 2. I would ask your doctor or check your packaging. When I was told how to put it on, they emphasized that it was only tested (?) in the underarm - the loose area when you hold your arm level...a few inches away from your armpit.

I will check. It would be nice if that were the problem!!! (But the average glucose value from the cgm did match my Hba1c, so that gives me pause.)

[TheresaB]

How can it be? Pre-diabetes?
After wearing a cgm I got a surprise. My fasting glucose seems to hover between 100 and 110! Postprandial spikes are mostly around 140 with only a couple going to 150. That is only a delta of only around 30 which doesn’t seem horrible. But the high baseline has me stumped.

I also did a few finger sticks with a glucometer which read consistently lower (by 6 to 30 points).
I exercise for an hour each morning. I also take a 25 min walk after dinner almost daily. I get around 7 ½ hours of sleep each night. My diet consists of mostly whole foods…similar to a Weston A. Price diet. I severely limit processed food and avoid seed oils and added sugars. I DO EAT CARBS…between 100 and 150 g per day. So I am not keto. I fast between 6:30 pm and 9:30 am six days a week. I am at a perfect weight and body composition.

Within the last year my hba1c spiked from 5.3 to 5.7 and my fasting glucose at Labcorp was 100. So I believe that the cgm values could be accurate. (The cgm predicted a 5.9 hba1c for me.) My insulin tested (Labcorp) at 3.5 a few months ago, but has also gone up to 6.8 this year.

I have done a lot of research and can’t find anything that speaks to my situation. Could a 100-110 glucose just be normal for me? Or is there something I should be doing differently? Any suggestions/advice appreciated.

There are many things that contribute to blood glucose levels, many are not even food related. Have you read our wiki https://wiki.apoe4.info/wiki/Blood_Sugar]Blood Sugar

[sandyt]

How can it be? Pre-diabetes?
After wearing a cgm I got a surprise. My fasting glucose seems to hover between 100 and 110! Postprandial spikes are mostly around 140 with only a couple going to 150. That is only a delta of only around 30 which doesn’t seem horrible. But the high baseline has me stumped.

I also did a few finger sticks with a glucometer which read consistently lower (by 6 to 30 points).
I exercise for an hour each morning. I also take a 25 min walk after dinner almost daily. I get around 7 ½ hours of sleep each night. My diet consists of mostly whole foods…similar to a Weston A. Price diet. I severely limit processed food and avoid seed oils and added sugars. I DO EAT CARBS…between 100 and 150 g per day. So I am not keto. I fast between 6:30 pm and 9:30 am six days a week. I am at a perfect weight and body composition.

Within the last year my hba1c spiked from 5.3 to 5.7 and my fasting glucose at Labcorp was 100. So I believe that the cgm values could be accurate. (The cgm predicted a 5.9 hba1c for me.) My insulin tested (Labcorp) at 3.5 a few months ago, but has also gone up to 6.8 this year.

I have done a lot of research and can’t find anything that speaks to my situation. Could a 100-110 glucose just be normal for me? Or is there something I should be doing differently? Any suggestions/advice appreciated.

There are many things that contribute to blood glucose levels, many are not even food related. Have you read our wiki https://wiki.apoe4.info/wiki/Blood_Sugar]Blood Sugar

I have read it but it has been awhile so I will re-read. I am currently in a deep dive on Kraft, Crofts, and Bikman There is soooo much to learn!
Bikman did mention, just as a side note, that he wasn't sure a moderately high fasting glucose was a problem if the fasting insulin was good and postprandial excursions were low. This gives me hope