Day to day variations in blood glucose

@bitsygirl
I, too, have struggled with Type 2 for many years. For anyone in this forum to come up with an exact cause would be doubtful since we are not doctors. The key to this may be your A1C levels and finding a trend. Blood sugar can go up and down quickly and there can be several reasons. You talk solely about meals a day and a dietitian can help you immensely from those spikes. For day to day care, the Libre 2 or 3 or something similar will help check your levels throughout the day, but more importantly, it checks the desired range you should be in for a good A1C result. Exercise can also make the difference to lower those higher levels. I, personally now, have stayed in the near 100% target range daily after having an A1C of 8.0 for so long and now down to near 6.0. Carbs and sweets will also cause the spikes. I no longer take diabetic medication other than Ozempic, but what works for me may not necessarily work for you. If possible, a dietitian is like going to physical therapy for a bad strain, but you can heal and benefit from this process.

@bitsygirl welcome to Mayo Clinic Connect. After reading your initial post in this discussion I’m a bit confused. Hoping you can clarify. You said that you have started monitoring your blood sugars in an effort to figure out why you have so much calcification in your coronary arteries. I’m not sure I understand the connection. I can respond to the topic of variations in blood glucose. Blood glucose is not a one and done lab. It is constantly changing throughout the day and is affected by so many things (what & when you ate, other health conditions, stress & emotions …..even the seasons and weather!) It is completely normal. As @collegeprof mentioned looking at trends and patterns can be more helpful in understanding if blood sugar is ok or if there is a problem. There are other types of testing and labs to do this. Are you interested in that sort of thing?

@collegeprof and @cehunt57: Thanks for your replies! I did not explain the motivation behind watching my blood sugar very well. A few months ago I got a very high Agatston score which was very unexpected. The Agatston score measures calcium in the coronary arteries. I started reading on heart attack prevention and it sounded to me like there is an association with diabetes, or at least there is a higher risk of a coronary event in people with calcification if they also have diabetes. When I started monitoring my blood glucose, I saw very high numbers. The last two days or so, the peaks are much smaller and I have more time in the 50’s. It’s a little like the peaks all were truncated and the entire curve was shifted down a few points. Of course I am very happy if the recent numbers reflect my glucose response, but I am confused by the change.

@bitsygirl
@cehunt57

Thank you for the clarification. It sounds like you are saying that you have not been diagnosed as a diabetic, but now your blood sugar values indicate highs (above 200) and lows (below 70). I am no doc of any kind, but it sounds like there is an underlying condition with your heart and Agatston Score affecting blood sugar levels and perhaps other areas, but I believe a cardiologist would be more suited to answer why these and other problems you may have exist. If you live near a Mayo Clinic or heart health hospital, perhaps this hospital can give you multiple tests to find the underlying cause. Your (temporary) glucose values show highs and lows which can be dangerous, but a good heart surgeon can really help. Perhaps, @cehunt57 can add more to this message as well. The question I have is why did you take an Agatston in the first place? This is not routine to my knowledge. If you are or have been diagnosed as a diabetic, why are you starting to monitor your glucose now? What do previous A1C results show?

My PCP suggested the cardiac calcium test. I think it was because she saw calcium in my iliac arteries during a hip x-ray taken as part of the PMR diagnosis.

I have not been diagnosed as a diabetic. I have diabetes in my family and also heart disease. My A1C is borderline prediabetic/normal. I am trying to stay ahead of potential problems; I learned my lesson from the unexpected Agatston score. I should have done more before my score was so high.

I have a cluster of seemingly inexplicable problems given that I have always exercised regularly and eaten a relatively healthy diet: osteopenia, high blood pressure, and a high Agatston score. No doctor seems very concerned about figuring out a root cause. Probably because I am still pretty “healthy”. I am not sure a root cause could be found or what could be done anyways. I read the book “Best the heart attack gene” and it suggested to check blood sugar because of its association with CVD.

Just got a reading of 200, so I guess the old behavior has returned. Just appreciative of the technology available to keep track and the research to know it’s important!1

@bitsygirl
@cehunt57

My final advice to you is 1) see an endocrinologist and get an A1C lab test done and 2) see a cardiac professional to discuss your irregularities with your Agatson Scale. Other docs may not have the expertise in these 2 areas, but if this were me, I would be concerned. You should also continue to get your A1C lab tests checked for the next year. I would think it is time to nip this in the bud.

@bitsygirl
I agree that you should see an Endocrinologist for diagnosis and treatment.
This happened to me too. My internist started me on an oral medication to control the blood sugar levels. He also pointed out that diabetes is now considered a cardiovascular disease

Thanks for your advice @astaingegerdm and @collegeprof . I believe my PCP has entered a lab for an OGTT. She mentioned an endocrinologist referral, so I think I can see one based on the results of the OGTT. It’s all been through a messaging system and the messages are never directed to me … I just see the conversation between her and the nurse (I think).

@astaingegerdm - Would you be willing to tell more about your experience? Did you have CVD ? Start seeing high blood glucose numbers?

@bitsygirl
I think the fasting blood glucose slowly climbed to “pre-diabetes “ level. At that time I also was treated on and off with steroids for an autoimmune illness. Steroids also added weight.
The medication I started on-Januvia- worked well.
My father had diabetes and cv disease.
I decided to get a Calcium Score CT. It was not bad at all. I knew about calcifications in my major arteries- aorta, carotid etc.
on a previous chest CT there was calcification visible along one long coronary artery.
At this point I decided to lose weight. I lost 45 lbs over a year and didn’t need diabetes medication. However, my body wanted some of that weight back 18 lbs. Absolutely no reason. I think I had minor autoimmune flare ups after Covid vaccines.
Im back on Jenuvia, I have lost a couple of pounds.
This April I needed a new aortic valve. A cardiac catheterization was done before. Apparently, my coronary arteries are clean like an adolescent’s. The calcification seen before was outside the artery. Strange.
My goal now is to lose the extra weight.
My Internist definitely checks everything that could show at my age. Im 79.
I get carotid ultrasounds at regular intervals.
I have taken medication for cholesterol and blood for a few years too.

@astaingegerdm Thanks for sharing. It sounds like you have a good internist. I had not heard of calcium outside the artery before. That’s great luck. I have a little plaque in my carotid but it’s not a problem so far. The plaque is everywhere really. Only bad in the coronary arteries. Sounds like they can clean out the larger arteries if it were to become a problem. I am 61. Turns out my coronary arteries are 6 years older than you. ;). Glad the aortic valve replacement went well.

Good luck with the weight loss. Sounds like you have really stayed on top of your genetic predispositions.