Glucose intolerance
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Glucose intolerance
I have been an ATPL holder for some years, but recently took an extended hiatus for family reasons.
I reurned to flying RPT last year, and renewed my Australian Class I medical. Everything very normal, EXCEPT:
1. weight - 128 kg for 179cm height.
2. A GTT showed a VERY slight indication of IGT - I seem to recall my glucose reading at 5.7 mmol/L after the 2 hours. This was noted as being slight glucose intolerance, but not an indication of diabetes melitus. (the pathology, and the doctor DID say that ALL other blood factors etc were GOOD, just a slow return of glucose levels after the 2 hours. My INITIAL blood glucose level prior to the test was NORMAL)
Cholesterol etc were all normal (actually, VERY good. Should be worse for my weight problem, but there you go)
Australian CASA passed me, with a note that I should lower my weight, and this should have a direct effect on the glucose / insulin problem as well.
I put on a lot of weight after the medical, and only recently started a weight reduction and excercise plan (I walk 15 km a day, taking 1hr 45 to complete the "walk"). I also limit my carbohydrate intake significantly.
I renewed my Class 1 today. All VERY good again, but my urine test showed a VERY small percentage of glucose - aparently under 1%, but still present, so I have to do another GTT tomorrow. The AME wasn't concerned, as I discussed my weight loss etc with her (I was down to EXACTLY the weight I was at the medical last year, as luck has it!), and she restamped my medical cerificate. CASA won't pass on it until they get the GTT results.
Here is my scenario:
My sister is an insulin dependant diabetic. There is a history of diabetes throughout my family, mainly Type 2.
I am overweight, but reducing that as we speek. I have lost over 12 kg to date (3 weeks of work!), and several inches off my dimensions. I am sure a fair percentage of apparent non-weight loss is due to muscle gain from the physical activity.
I show a MILD intolerance to glucose, but not significant enough to be labelled as Diabetic.
My question is: how can I further reduce my blood glucose levels? Will my current regime of 2 hoiurs BRISK walking per day, coupled with a very sensible "diabetic type" diet help me to further lower the glucose intolerance, or am I definitely pre-disposed for at least T2 diabetes?
Any suggestions GREATFULLY received, as by god I do NOT want to EVER give up flying!
I am VERY concerned, and am PRAYING that my GTT result tomorrow is BETTER than last years.
Additionally, I MAY be attending an "Asian airline" interview within the next 3 months. I know I MUST reduce the weight to at least double digits (or suffer the Asiam mediocal examiner\'s "Triple digit death stroke"), but it concerns me that even a MILD intolerance will immediately rule me out with them (no questions asked)
I reurned to flying RPT last year, and renewed my Australian Class I medical. Everything very normal, EXCEPT:
1. weight - 128 kg for 179cm height.
2. A GTT showed a VERY slight indication of IGT - I seem to recall my glucose reading at 5.7 mmol/L after the 2 hours. This was noted as being slight glucose intolerance, but not an indication of diabetes melitus. (the pathology, and the doctor DID say that ALL other blood factors etc were GOOD, just a slow return of glucose levels after the 2 hours. My INITIAL blood glucose level prior to the test was NORMAL)
Cholesterol etc were all normal (actually, VERY good. Should be worse for my weight problem, but there you go)
Australian CASA passed me, with a note that I should lower my weight, and this should have a direct effect on the glucose / insulin problem as well.
I put on a lot of weight after the medical, and only recently started a weight reduction and excercise plan (I walk 15 km a day, taking 1hr 45 to complete the "walk"). I also limit my carbohydrate intake significantly.
I renewed my Class 1 today. All VERY good again, but my urine test showed a VERY small percentage of glucose - aparently under 1%, but still present, so I have to do another GTT tomorrow. The AME wasn't concerned, as I discussed my weight loss etc with her (I was down to EXACTLY the weight I was at the medical last year, as luck has it!), and she restamped my medical cerificate. CASA won't pass on it until they get the GTT results.
Here is my scenario:
My sister is an insulin dependant diabetic. There is a history of diabetes throughout my family, mainly Type 2.
I am overweight, but reducing that as we speek. I have lost over 12 kg to date (3 weeks of work!), and several inches off my dimensions. I am sure a fair percentage of apparent non-weight loss is due to muscle gain from the physical activity.
I show a MILD intolerance to glucose, but not significant enough to be labelled as Diabetic.
My question is: how can I further reduce my blood glucose levels? Will my current regime of 2 hoiurs BRISK walking per day, coupled with a very sensible "diabetic type" diet help me to further lower the glucose intolerance, or am I definitely pre-disposed for at least T2 diabetes?
Any suggestions GREATFULLY received, as by god I do NOT want to EVER give up flying!
I am VERY concerned, and am PRAYING that my GTT result tomorrow is BETTER than last years.
Additionally, I MAY be attending an "Asian airline" interview within the next 3 months. I know I MUST reduce the weight to at least double digits (or suffer the Asiam mediocal examiner\'s "Triple digit death stroke"), but it concerns me that even a MILD intolerance will immediately rule me out with them (no questions asked)
As you know it's a good idea to do plenty of exercise. Walking is great - but perhaps you might consider doing a little weight training to add some lean muscle mass. This is known to improve glucose tolerance and assist in fat loss.
And while walking is good - any chance you could add something a little more intense (e.g. some light jogging, cycling, swimming, rowing)?
And while walking is good - any chance you could add something a little more intense (e.g. some light jogging, cycling, swimming, rowing)?
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Though I hesitate to recommend any faddy diets, lowering your carbohydrate intake does help with symptoms of diabetes. Don't stop vegetables though and if you crave starch have porridge oats for brecky. This coupled with your increased excercise is a recipe for healthy flying. I was grounded with hypertension so I am taking my own advice.
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From the Daily Mail website:
There are two main groups of carbohydrates: simple sugars and complex starches. Simple sugars include glucose and fructose, found in fruit and vegetables, sucrose (sugar) found in sugar cane and beets and lactose, found in milk. With the exception of lactose, simple sugars have a high gylcaemic index which means they raise blood sugar levels quickly - giving a short, sharp, burst of energy - followed by a dip and cravings for more of the same. This is why you may find processed, sweetened foods, such as chocolate, cake and biscuits, so moreish.
Complex starches, found in cereals, beans, potatoes and wholemeal bread, provide slow-releasing energy which helps to keep blood sugar levels stable and cravings under control. It's a good idea to base your diet around complex carbohydrates because they are filling, often contain good levels of fibre (indigestible substances that help to keep cholesterol levels down and protect against bowel diseases), provide a slow release of energy and are relatively low in fat.
To help you calculate how much carbohydrate you should be eating in a day, take a look at our list of carbohydrate-rich foods below.
One slice wholemeal bread: 14.5g
Bowl of muesli : 71.1g
Bowl of porridge: 21.9g
Average serving of pasta : 33.3g
Average serving of brown rice: 48.1g
Jacket potato with skin: 63.4g
Average serving of lentils : 12.6g
Contrary to belief, carbohydrate foods are not high in fat, but you must watch how you cook and serve them.
Roast potatoes have more than double the calories of boiled potatoes, for example. Adding a cream, cheese or butter-based sauce to pasta will dramatically increase the more fat/calorie content when compared with, say, a tomato-based sauce
visit the health calculatorhere
There are two main groups of carbohydrates: simple sugars and complex starches. Simple sugars include glucose and fructose, found in fruit and vegetables, sucrose (sugar) found in sugar cane and beets and lactose, found in milk. With the exception of lactose, simple sugars have a high gylcaemic index which means they raise blood sugar levels quickly - giving a short, sharp, burst of energy - followed by a dip and cravings for more of the same. This is why you may find processed, sweetened foods, such as chocolate, cake and biscuits, so moreish.
Complex starches, found in cereals, beans, potatoes and wholemeal bread, provide slow-releasing energy which helps to keep blood sugar levels stable and cravings under control. It's a good idea to base your diet around complex carbohydrates because they are filling, often contain good levels of fibre (indigestible substances that help to keep cholesterol levels down and protect against bowel diseases), provide a slow release of energy and are relatively low in fat.
To help you calculate how much carbohydrate you should be eating in a day, take a look at our list of carbohydrate-rich foods below.
One slice wholemeal bread: 14.5g
Bowl of muesli : 71.1g
Bowl of porridge: 21.9g
Average serving of pasta : 33.3g
Average serving of brown rice: 48.1g
Jacket potato with skin: 63.4g
Average serving of lentils : 12.6g
Contrary to belief, carbohydrate foods are not high in fat, but you must watch how you cook and serve them.
Roast potatoes have more than double the calories of boiled potatoes, for example. Adding a cream, cheese or butter-based sauce to pasta will dramatically increase the more fat/calorie content when compared with, say, a tomato-based sauce
visit the health calculatorhere
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Thanks guys - much appreciated.
JUST finished the latest GTT. Urine results were negative gluc, negative ketones. Now to await the BGL's.
Good thing this time was I didn't once feel "hypo" after ingesting the 75gm Glucose solution (like drinking undiluted cordial - I asked for a six pack please
)
Anyway, time will tell.
JUST finished the latest GTT. Urine results were negative gluc, negative ketones. Now to await the BGL's.
Good thing this time was I didn't once feel "hypo" after ingesting the 75gm Glucose solution (like drinking undiluted cordial - I asked for a six pack please
)Anyway, time will tell.
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Pseudonym,
You mentioned concern for an up-coming Asian airline interview in the next 3 months. As chance would have it, I did my medical renewal yesterday in Singapore (which I think still counts as an Asian country) and engaged the medico in conversation with your post in mind. Two important points came out.
(1) The Singapore medical checks fasting glucose ONLY (where it seems you don't have a problem). A Glucose Tolerance Test is ONLY done if the fasting glucose results indicate a problem.
(2) "Triple Digit Death" - Yes, if your weight goes into 3 digits (in Kg) unless balanced against large skeletal size (BMI), then it is indeed Bye bye! Keep up the exercise programme!
Good Luck,
Old Smokey
You mentioned concern for an up-coming Asian airline interview in the next 3 months. As chance would have it, I did my medical renewal yesterday in Singapore (which I think still counts as an Asian country) and engaged the medico in conversation with your post in mind. Two important points came out.
(1) The Singapore medical checks fasting glucose ONLY (where it seems you don't have a problem). A Glucose Tolerance Test is ONLY done if the fasting glucose results indicate a problem.
(2) "Triple Digit Death" - Yes, if your weight goes into 3 digits (in Kg) unless balanced against large skeletal size (BMI), then it is indeed Bye bye! Keep up the exercise programme!
Good Luck,
Old Smokey
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Pseudonym,
If you like flying you best start losing weight now.
That family history and your personal weight do not bode well for keeping diabetes at bay.
Sorry to say it in words of one syllable but that is the way it is.
Best of luck.
FD
If you like flying you best start losing weight now.
That family history and your personal weight do not bode well for keeping diabetes at bay.
Sorry to say it in words of one syllable but that is the way it is.
Best of luck.
FD
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Yup, I know!
Well the results came back today, and it's all WONDERFUL news!
Totally NON-Diabetic, with no indication of diabetes at all - well within the normal level!
I returned negative all round, with blood gluc at normal levels after the 2 hour wait etc. Urine was neg gluc, neg ketone. After 2 hrs, the bgl was 7.4 mmol/L (below 7.7 is NORMAL)
But still reducing the weight and staying on a PROPER diet for LIFE!
Well the results came back today, and it's all WONDERFUL news!
Totally NON-Diabetic, with no indication of diabetes at all - well within the normal level!
I returned negative all round, with blood gluc at normal levels after the 2 hour wait etc. Urine was neg gluc, neg ketone. After 2 hrs, the bgl was 7.4 mmol/L (below 7.7 is NORMAL)
But still reducing the weight and staying on a PROPER diet for LIFE!
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If you are concerned about your blood sugar levels buy a glucometer, actually most companies will give you one free (the catch is the test strips are expensive) and monitor your blood sugars. Normal levels are between 4 and 7. Hyperglycemia takes days to manifest itself whereas hypoglycemia is rapid, they are both potentially lethal if left untreated.
You're doing the right thing by keeping your doctor in the loop.
You're doing the right thing by keeping your doctor in the loop.
