New Advice From Dietician

[SJC]

I went to see the dietician today. I was diagnosed as prediabetic at HbA1c 44 and was told by my GP that 48 was the cut off point for a diabetes diagnosis.
After changing my diet on the principle of LCHF I brought my next Hb1 test down to 37 (in a few weeks).

The dietician has just surprised me. She said I am worrying unnecessarily and that I can pretty much eat wheat I want but leave out white starchy carbs. She says I wasn't even true prediabetic at 44!!!! She showed me a new chart that is being given to dieticians after recent new guidelines have been laid down, and according to her chart I think it was 47 or higher to be preidabetic. What??
She said I could have a piece of cake now again, a bit of pastry now and again because these foods have fat in them which slows down the sugar release. She even said a bar of chocolate now and again wouldn't do me any harm because it too has plenty of fat in it from the milk.

I have come away feeling more confused than ever. Do I take her advice I wonder or do I listen to other prediabetics and diabetics?

 

[Bluetit1802]

I was diagnosed diabetic, HbA1c was 53. My nurse also told me to avoid/reduce white starchy stuff, but that I could have a piece of cake or pastry if I wanted, as long as it wasn't every day, saying about the fat content. Not sure about the cake, but I am now successfully adding back a bit of pastry and it has slowed down the sugar release of the spuds in the pie. No massive spike now, but a constant small rise that lasts a lot longer.

I can't advise you what to do, but with your levels, and provided you keep an eye on your base levels, no harm in having a bit of what you fancy.

 

[lovinglife]

While I find her advice ok I think this is sometimes where this type of advice is a bit ambiguous, what does occasionally or now and again actually mean, to each person it will be different, some will interpret it as once a month some as once every couple of months and some as once a week, to me it means high days and holidays e.g. Twice or three times a year but there is nothing to say I am right either, clear as mud eh

 

[Avocado Sevenfold]

.....Do I take her advice I wonder or do I listen to other prediabetics and diabetics?

If I were you, I'd listen to my meter.

 

[SJC]

If I were you, I'd listen to my meter.

She told me there was no need to test with a meter as I am not even prediabetic now.

 

[Bluetit1802]

Well I hope you won't listen to her on that score or you may end up back where you started.

 

[zand]

Like Avocado Sevenfold said....I'd listen to my meter. It's your meter that has helped you get back below pre-diabetic scores, not your nurse.

 

[SJC]

She said scaring yourself about figures is not the way to go. I told her about bread and potatoes taking me into the sevens.That's only one round of burgen at a time and 2 very small new potatoes at a time. She says that's normal for most people and that as long as it comes down in two or three hours it's not a problem.

She said no one has a sugar problem that warrants being worried unless it always seems to go to double figures and tend to stay high. She said that a spike that comes down naturally over those 2 or 3 hours shows my body is coping with sugars fine.

 

[Bluetit1802]

She said scaring yourself about figures is not the way to go. I told her about bread and potatoes taking me into the sevens.That's only one round of burgen at a time and 2 very small new potatoes at a time. She says that's normal for most people and that as long as it comes down in two or three hours it's not a problem.

She said no one has a sugar problem that warrants being worried unless it always seems to go to double figures and tend to stay high. She said that a spike that comes down naturally over those 2 or 3 hours shows my body is coping with sugars fine.

She is right on that score. I'm happy if I spike to the low 7's but am back to base an hour later.

 

[SJC]

These are my average stats:

Fasting morning BG Always under 5.1 Usually between 4.4 and 4.8, thats with supper of 1 or 2 oatcakes or a good half slice of burgen by 9.30pm.

All other meals come down to a low of 5.3 within three hours sometimes two. Occasionally when I have bigger portions or a a bit more carbs, my BG can stay in the 6s for three hours but rarely goes over 7.2.

I do not test at one hour because I don;t think my figures warrant it.

 

[zand]

Yes I agree, but you still need to keep it that way. I would test sometimes to check that you are staying where you want to be, with normal BG's. You've done so well, it would be a shame to let things slip again.

 

[Bluetit1802]

My personal opinion is there is nothing at all wrong with your figures. They are normal, and your A1c confirms this. Why are you getting stressed about it? Just eat sensibly, and use your meter to keep an eye on things. You won't slip back if you use your meter, and it doesn't have to be every day.

 

[SJC]

That's the conclusion I have come to. I shall only test now and again in the mornings and have a couple of days off from testing a week now.
I am sure I am not alone when testing in that you look cautiously at that meter hoping it tells you what you want to see!
I have this going on. I have a lack of oxygen going to my heart and seeing a cardiologist soon about that. I have kidney problems. I am query M.E/CFS and waiting to see a specialist about that. To be honest I don't feel I can take much more on the health shock front

 

[Totto]

I went to see the dietician today. I was diagnosed as prediabetic at HbA1c 44 and was told by my GP that 48 was the cut off point for a diabetes diagnosis.
After changing my diet on the principle of LCHF I brought my next Hb1 test down to 37 (in a few weeks).

The dietician has just surprised me. She said I am worrying unnecessarily and that I can pretty much eat wheat I want but leave out white starchy carbs. She says I wasn't even true prediabetic at 44!!!! She showed me a new chart that is being given to dieticians after recent new guidelines have been laid down, and according to her chart I think it was 47 or higher to be preidabetic. What??
She said I could have a piece of cake now again, a bit of pastry now and again because these foods have fat in them which slows down the sugar release. She even said a bar of chocolate now and again wouldn't do me any harm because it too has plenty of fat in it from the milk.

I have come away feeling more confused than ever. Do I take her advice I wonder or do I listen to other prediabetics and diabetics?

She seems to be completely normal dietician giving the kind of advice you will want to disregard.

Obviously you are doing the right thing. You know what you can eat and what you should avoid as you test.

I was 46 at diagnosis, reduced it to 35 and try to keep it there, don't want to go higher. Was diagnosed by OGTT by the way, not HbA1c.

My DSN feels my control is too good. Can it be too good? No, of course not. Truly normal HbA1c means less risk of complications.

 

[Harpar]

I was under the impression that an a1c of 44 - 47 was pre-diabetic. Over 48 = diabetic. So have they upped the limit again, so you are not diabetic, only pre-diabetic at over 48?

 

[SJC]

I was under the impression that an a1c of 44 - 47 was pre-diabetic. Over 48 = diabetic. So have they upped the limit again, so you are not diabetic, only pre-diabetic at over 48?

She showed me a chart today and that's what it said. I think it said from 51 or 52 was prediabetic!

 

[andcol]

I was diagnosed diabetic, HbA1c was 53. My nurse also told me to avoid/reduce white starchy stuff, but that I could have a piece of cake or pastry if I wanted, as long as it wasn't every day, saying about the fat content. Not sure about the cake, but I am now successfully adding back a bit of pastry and it has slowed down the sugar release of the spuds in the pie. No massive spike now, but a constant small rise that lasts a lot longer.

I can't advise you what to do, but with your levels, and provided you keep an eye on your base levels, no harm in having a bit of what you fancy.

Yes @Bluetit1802 that is the same as I see; also icecream does the same but it means the peak is delayed by an hour so your post-prandial is at 3 hours or later.

I find pastry to be a bit harsher than cake/ice cream in that yes it is delayed but is then a big spike whereas the others are a continuous slow rise over a couple of hours.

 

[SJC]

Yes @Bluetit1802 that is the same as I see; also icecream does the same but it means the peak is delayed by an hour so your post-prandial is at 3 hours or later.

I find pastry to be a bit harsher than cake/ice cream in that yes it is delayed but is then a big spike whereas the others are a continuous slow rise over a couple of hours.

So have I been being a bit over the top and cruel to myself in your opinion. I haven't had one biscuit, piece of cake or any pastry since the day I was told I was prediabetic. The most I have is an Atkins bar every now again, like at most once a week.

 

[Harpar]

She showed me a chart today and that's what it said. I think it said from 51 or 52 was prediabetic!

Well I suppose thats one way to reduce the numbers of people being diagnosed ! ! ! Can't say I agree with that though, to me 48 to 52 (6.5-6.9%) is higher than I would want to be, and certainly high enough to start causing damage, 6.5% was considered as diabetic, when did it change, or have I missed something?

 

[andcol]

Cruel/over the top - I can't comment on that but you have taken control. It is your life and who are we to say yes/no. If you feel comfortable with the way you are eating (and it is healthy) then continue and don't let anyone tell you different