"Tell him he needs to buy a glucose monitor to begin testing at home. The most accurate is the Bayer Contour. I use the Next One personally. You can Google "glucometer accuracy study" for the data if interested. Strips can be costly. Best place to buy them is eBay. The Contour strips have been tested for accuracy I believe it was 2 years post expiration but without a doubt, they are good for 1 year post expire. So your best deal by far for frequent testing is to buy expired strips on eBay. You can also Google for the accuracy testing study. If you don't mind throwing money down the drain buy them wherever. Be very careful which monitor you use, many are next to useless for pre-diabetes. Personally, I would only use Bayer Contour.
A one time glucose reading doesn't tell the whole story, but he is definitely likely to have impaired glucose tolerance secondary to exogenous GH. It's something me and really almost everyone frankly who has used GH for any decent period of time at high enough dose has had to deal with. He could be experiencing a pronounced dawn effect which can be exacerbated by fasting and stimulants. This is what was happening to me. Google dawn effect if you don't know what I'm talking about. I find this is extremely common with GH. In my case, A1C was fine, postprandial glucose (1-2h post-meal) later in the day was also fine. Glucose was also fine upon waking 6-8h fasted, though higher vs no exogenous GH still under 100 or right at it. Fasting and stims would increase it to pre-diabetes levels (101-125). Research catecholamines and glucose if you don't know what I'm saying. Natural catecholamines are the reason for the dawn effect and it's exacerbated with caffeine, ephedrine, modafinil, etc. I wouldn't say this is the same as DMT2 in an obese sedentary person though it does meet the diagnostic criteria for DMT2. In my experience, it won't usually get worse than this.
But it is glucose intolerance and it does need to be addressed either through cessation of GH or use of metformin, insulin, berberine, gymnema and Cinsulin. In his particular case since he doesn't compete or even take AAS/T cessation is the only logical course. Once glucose has stabilized, he can resume at 2 IU qhs 5d qwk, increasing to a max of 4-5 IU qhs 5d qwk after adding metformin XR at 2gm qd if glucose levels allow. I'd also add berberine at 1200-1500 mg qd, gymnema at 400-500mg, Cinsulin at 500mg. I'd not resume the a.m. dose. The 2 days off GH should be on days off training. It's entirely possible that his glucose upon waking 8h fasted was much closer to 100, then he used GH, drank some coffee, fasted longer then his body dumped glucose from the liver because it felt like it needed glucose and had the catecholamines available to make it happen. Also worse if he didn't train the night before which he shouldn't be doing due to liver enzyme levels.
If you're a competitive bodybuilder and experiencing this and don't want to get off GH just use insulin. Anyone on GH I believe should have insulin on hand to manage glucose as needed. Go to Walmart and buy an NPH and an R for $25 each. If you want to waste your money on Lantus, Levemir, Humalog, etc that's your business. Studies shave shown clearly that NPH is equally or more efficacious as basal insulin as Lantus, Levemir, etc. Same for R vs log. If you have high fasting glucose secondary to GH on metformin, add NPH qhs on GH days starting at 10 iu and titrate to response, increasing by 5iu, measured by your Contour. Add R a.m. until you get your basal bedtime dose adjusted and thereafter preprandial as needed if postprandial glucose becomes an issue. You should not spike more than 140 postprandial. Using insulin to control glucose on GH is much better than allowing elevated glucose. If you fear it, GH use may not be for you. The same way people say have anti E on hand if needed for T/AAS, you should probably initiate metformin regardless if on GH and have insulin on hand with a Contour monitor that you use multiple times per day. This will allow you to assess the dawn effect, postprandial glucose, etc. If you're on GH at 4IU or greater qd and haven't had blood work 12h fasted on stims, don't monitor at home and are not on metformin, it is highly probable that you are no different than this guy with the 125 fasted x 12h. Also, this guy likely needs TRT and is just being stupid. LMK if you have questions.
Rex."
Great post, thanks. Although readability could be much improved by breaking the text up into paragraphs, as above.