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Dr Hive, my metabolic panel


Ginevra
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I had been to my oncologist last week who ordered a complete metabolic panel and CBC With Differential/Platelet. All the CBC factors look good, so - yay. I’ concerned, though, that my glucose level had a flag for high; it was just over the top end of the scale (102; top is 99). This was not a fasting test, though, so there’s that. Also, this past weekend, celebrating July 4th, I ate a lot of things I haven’t been that elevate glucose - bagels for breakfast, corn on the cob, some cookies, chips and mini Reese’s cups, and a few glasses of wine (although it was a red blend and was not sweet). 
 

Cause for concern? Or most likely due to my weekend eating off-the-wagon? (My doctor will call me re any flags, so I’m not taking Hive word for anything. Just benefitting from the ability to look at my lab results through the portal today.) 

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11 hours ago, Ginevra said:

that my glucose level had a flag for high; it was just over the top end of the scale (102; top is 99).

Mine trends higher than that for non fasting. It really depends on what you ate. My fasting glucose results are on the low end though. How about cholesterol? If that is high as well, my oncologist would nag.

How are your protein and your calcium results on the comprehensive metabolic panel? My oncologist would get anxious if my protein level is low normal.

ETA:

my highest reading was 122 and the upper limit of normal is 140 for non fasting 

Edited by Arcadia
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Just now, Grace Hopper said:

Seems like your A1C measure would be a better indicator, if that was measured. 

They didn’t do A1C. I think they require fasting to measure that (right?). It may be that when my doctor sees the flag, she might request follow up for A1C/fasting glucose level. 

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With it not being a fasting test, I wouldn't worry overly much. If it was two hours or more after eating, then I would just watch future bloodwork to be sure a pattern is not forming, but yes, holiday eating can throw things off for a bit.

Someone who knows more about this in the context of cancer or recovery (I am assuming from oncologist that it's in the picture), might have more information though.

When I was young, exercised regularly, stayed a healthy weight, etc. my FASTING blood sugar looked like this all the time; it's clearly a susceptibility for me vs. lifestyle only. It took another 20 some years (including with me trying to stay on top of diet, etc.) to push me into the prediabetes range (just one itty bitty toe over the line).

What I wish I had known much earlier, is that higher normal blood sugar that isn't yet to the prediabetes realm is still able to make you feel hungry, etc. if you don't stay on top of it. Staying on top of it is easier if you know your personal triggers--lots of people on here have talked about using a glucose meter to see what patterns you can find on your own. It's much easier to stay a healthy weight if you know how to time meals, combine food, and avoid triggers that send blood sugar up and down, creating constant hunger. 

An A1C is a better measure of your blood sugar stability over time, but creeping fasting blood sugars are also good to watch.

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6 minutes ago, Arcadia said:

How are your protein and your calcium results on the comprehensive metabolic panel? My oncologist would get anxious if my protein level is low normal.

Protein is normal, but low end of normal. Calcium looks okay mid-level. 

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1 minute ago, Ginevra said:

They didn’t do A1C. I think they require fasting to measure that (right?). It may be that when my doctor sees the flag, she might request follow up for A1C/fasting glucose level. 

FWIW, I have a very strong family history of diabetes and my A1C has never been tested. I've always assumed that's because my fasting glucose is always well within the normal reference range.

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Just now, Pawz4me said:

FWIW, I have a very strong family history of diabetes and my A1C has never been tested. I've always assumed that's because my fasting glucose is always well within the normal reference range.

I have a strong family history too and that disease scares me a lot. That’s what makes me nervous about it. Makes me wish I had gotten the labs *before* the holiday weekend. 

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4 minutes ago, kbutton said:

Staying on top of it is easier if you know your personal triggers--lots of people on here have talked about using a glucose meter to see what patterns you can find on your own.

I have been interested in getting a CGM in order to see these patterns. I do exercise, eat well and am at a healthy weight. 

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Just now, Ginevra said:

I have been interested in getting a CGM in order to see these patterns. I do exercise, eat well and am at a healthy weight. 

If you feel good with what you are doing, a monitor might just make you paranoid. 

I would not do it over one lab if you are content with your current management. 

If you were to develop a problem quickly, folks with your profile are increasingly identified as having adult onset autoimmune diabetes, and you would be having more obvious signs. If you have slow changes, you have PLENTY of time to get a monitor and fret about it. 😉

Things like being hungry all the time are soft signs to look for, and that's the only reason I mentioned it--I just wish I'd know that part. And even then, with constant hunger and not knowing my triggers, it took a long time to move into the prediabetes range.

It's unlikely that you need to worry.

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I'd be very surprised if a doctor ordered additional testing based on a very slightly elevated fasting blood glucose result on a test where the patient wasn't fasting. Unless there is some connection between non-fasting blood glucose and cancer recurrence, but I'm not aware that there is. DH often has blood work done right after lunch, so I'm sure his glucose is usually above the non-fasting reference range. His oncologist has never mentioned it.

Truly, I wouldn't worry about it.

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4 minutes ago, Pawz4me said:

I'd be very surprised if a doctor ordered additional testing based on a very slightly elevated fasting blood glucose result on a test where the patient wasn't fasting. Unless there is some connection between non-fasting blood glucose and cancer recurrence, but I'm not aware that there is. DH often has blood work done right after lunch, so I'm sure his glucose is usually above the non-fasting reference range. His oncologist has never mentioned it.

Truly, I wouldn't worry about it.

Thank you for that.

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A1C does not require fasting; it's not measuring current blood sugar. I think it shows basically the average over the last 4 months? 

I had a high (pre-diabetic) A1C once about 10 years ago. I cleaned up my eating a bit; after about 6 months they ran it again and it was fine. I've never had one since. 

 

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40 minutes ago, Ginevra said:

Protein is normal, but low end of normal. Calcium looks okay mid-level. 

Mine prefers me to have my protein level at the high end of normal.

My A1C was ordered with thyroid panel, celiac panel, iron panel just to check what could contribute to my osteoporosis. My oncologist was amiable to ordering any blood test I ask for as long as he has an excuse for insurance purposes.

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A 102 non fasting wouldn’t concern me at all. If you are concerned, ask for an A1C which is a score of all your glucose levels over the last 90 days and a fasting insulin test which predicts issues with diabetes a lot earlier than either fasting glucose or even A1C. 

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8 hours ago, Ginevra said:

it was just over the top end of the scale (102; top is 99).

On my bloodwork results it says for non fasting results,

”glucose, ser/plas (manual entry) see emr for details (70 - 140 mg/dl)”

From CDC https://www.cdc.gov/diabetes/basics/getting-tested.html

CDC_Diabetes_Social_Ad_Concept_A2_Facebo

Fasting Blood Sugar Test

This measures your blood sugar after an overnight fast (not eating). A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes.”

Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You can take this test at any time and don’t need to fast (not eat) first. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.”

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A1c is a better measure if you are worried about diabetes as it gives the range of blood sugar over 3 months- which is the average lifetime of red blood cells. I’ll do an A1c yearly instead of the glucose test which can be more manipulated by not eating. 

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56 minutes ago, Lilaclady said:

A1c is a better measure if you are worried about diabetes as it gives the range of blood sugar over 3 months- which is the average lifetime of red blood cells.

I just had mine done but didn't realize at the time that iron deficiency anemia can cause a false positive with A1C.  Mine was 5.8 (prediabetic) but I also have iron deficiency anemia so I don't know now how useful the test was for me.

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1 hour ago, Kassia said:

I just had mine done but didn't realize at the time that iron deficiency anemia can cause a false positive with A1C.  Mine was 5.8 (prediabetic) but I also have iron deficiency anemia so I don't know now how useful the test was for me.

I didn’t know that. My A1C was 5.6 while my fasting blood sugar was below 70, closer to 50 before my CT scan. I remembered because the nurse was shocked and worried I would faint (I was seated). I get hypoglycemia symptoms often so that makes sense to me.

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