I woke up thinking about first phase insulin response and oral glucose tolerance tests (OGTT). Does that ever happen to you?
This is on my mind because I went in for a blood test last week and the result of my HbA1c was so good – better than it’s been in years – that I actually thought to myself… maybe you don’t have diabetes anymore. It was the best thought I’ve had in a long time and I allowed myself to entertain it for a few hours.
But the scientist in me did not allow the lunatic in me to get too carried away. And so I realized that if I were to be the first person (aside from Halle Berrie) whose diabetes magically disappeared, I would need proof. I, therefore, decided to perform my very own OGTT.
Disclaimer: Unfortunately, I am not really a scientist, nor am I a doctor. I am a diabetes patient who has taken (and failed) a lot of OGTTs. Do not take this as medical advice. Do not take this seriously.
Jessica Apple’s Homemade OGTT:
3 Tablespoons of granola (oats, almond flour, white flour, butter, brown sugar, vanilla)
3 ounces of whole milk
Approximate carb count: 12 grams
I sat down to eat my very small portion of granola with the intention of having my beta cells secrete just the right amount of insulin to keep my blood sugar from going over 120. To encourage them to do their thing I cheered them on: Go Betas, Go Betas, Go Betas!
It was such a hopeful (albeit delusional) time for me. Of course, I know the facts: the GAD65 autoantibodies, and the low C-peptide mean only one thing. But the thought I was entertaining- that diabetes might be gone- was a magnificent feeling.
Much less magnificent was the feeling that I needed to put my head down on the table about thirty minutes after my delicious OGTT. I checked my blood sugar. 149.
What I have lost completely in the course of my thus far slow-progressing (knock on wood) case of autoimmune diabetes (LADA), is the first phase insulin response. My beta cells will still make some insulin after I eat, but it will arrive too late to help. In a situation like the small snack of granola, my blood sugar can easily go up to 200. Three or four hours after I’ve eaten, however, when there’s no granola in my stomach, my beta cells will secrete. Thanks, Betas. I appreciate your effort, however, you’re doing nothing but making me hypoglycemic.
At this stage of my diabetes, I prefer to think of my beta cells as sleeping, rather than dead, since eventually they do come through (and it’s less depressing). I’ve read a little bit about beta cell stress. And recently I came across this post: Do Beta Cells Need Secretory Respite? In my unprofessional opinion they do, which is why I eat a very low-carb diet. I don’t want to exhaust my beta cells. Some of them may be lost for good. I know this. But to those who aren’t I say, Hang in there little friends. Don’t die. Sleep your deep sleep now, like the poisoned Snow White. While you’re resting keep in mind, someday our prince will come.
I love reading this every year or so when I start to think maybe…
Oh my gosh. Jessica. I am so happy to be reading all of your posts. I was just diagnosed with Type 1 during TrialNet. My A1c is 4.7. I failed the OGTT (twice, royally), but seem to not have diabetes very much outside of an OGTT. I don’t know anything about first phase insulin/reactive hypoglycemia/anything. What you are describing is so familiar. These posts are exactly what I need to read. Thank you!
V Funny. I call those moments, “Yup, still diabetic!” I too have LADA. Are you aware of the Facebook LADA group?
i love that: “someday our prince will come!” good to have an A1C that makes you question your status though! :-)