Should I be concerned?

Gardengnome

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Type of diabetes
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A year ago I was told by my dr that my HbA1c of 41 was prediabetic as it was the same as a year previously, with all the life style changes ,exercise taken etc had I NOT been prediabetic it should have dropped lower. Although I took notice of the dr and acted on his words, I did wonder if he was a 'glass half empty' sort of person as he was the same one who, when diagnosing me with hypertension, had said I wouldn't be able to do enough on my own to lower it. I just felt he wanted me on medication no matter what. [I am now on meds for hypertension].

I am now almost due for another A1c test so have been testing myself and wonder if anyone can throw light on these readings? Fasting early morning - 6.3; pre meal - 6.0 and post meal [2 hrs] 8.2. I wonder if they are higher than they should be and what to do if so. Thanks for the help.
 

sanguine

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Hi, welcome. If you were diabetic those numbers aren't bad, though higher than I would like. But they are just spot readings and their relationship with an HbA1c is a bit tenuous. What do you typically eat?
 
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Bluetit1802

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I agree with @sanguine. Your levels are indicating pre-diabetes (or even diabetes depending on what you are eating.) It looks like it is time to take some dietary control.
 
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Gardengnome

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Thank you Sanguine and Blue tit for your replies. I am a healthy BMI [<19] although 2 yrs ago when diagnosed with hypertension I was quite overweight and had borderline high cholesterol, but I was not classed as obese. I've been a yo-yo dieter as long as I can remember. It was 2 yrs ago that I first had an A1c of 41 and then the same a year later. I took control of my life style and ditched the Weight watcher/NHS diet with its high carb content and low fat. I do watch the carbs but don't actually count them, drink very little alcohol, don't smoke and walk briskly at least 2 miles daily. I do eat a LOT of vegetables and fruit, suspect too many carbs from fruit actually, and very little meat, plenty of fish and eggs though. My feeling is that I've done all that I can to reduce the possibility of prediabetes turning into type 2. I am waiting to be contacted for a follow up A1c which I'm thinking will still be classed as prediabetic, or worse. I am 72 yrs btw. Is there more I should be doing?

My dr said a year ago that you don't have to be overweight to get type 2. My grandmother had it latterly in life but did little exercise and wasn't overweight, but my mother didn't. Father I don't know about as he died early.

The dr said the A1c numbers would rise and when they reached close to 50 he would put me on Metformin. I did wonder if he was just scaremongering? Would he do that?
 

Bluetit1802

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I would wait for your next HbA1c before worrying about anything. Type 2 can be "inherited" through the family genes, and is not restricted to overweight people. There are plenty of skinny type 2's, so your doctor was right on that score. There is no reason why your HbA1c should rise if you are following a suitable diet, but perhaps you should start keeping a food diary along with the portion sizes, and start to count your carbs. You may be eating more than you think. Easy to do if you are just guessing. Use your meter to test before and 2 hours after a meal, and record these levels alongside your food.

If you wish, you could let us know a typical day's food and maybe we can help.
 
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Gardengnome

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Thanks Bluetit, you could be right about the quantities of food consumed. It all sounds rather a palava though to make a food diary but if the A1c has risen then that may be the time to start. I've never really sorted out the difference between carbs and calories although I am starting to take note!

What reading should a non diabetic person have before and 2hrs after eating? I have the feeling that my numbers are too high - are they?

You, on the other hand, have now had a T2 diagnosis for just a year and for all I can see you seem to have managed it all extremely well. :)I hope I'm not being too cheeky but may I ask your age, as I think that has a relevance to T2 doesn't it?
 

Bluetit1802

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Hi,

There is some dispute about the levels non-diabetics reach. They tend to rise at about an hour and come back down again by 2 hours, but much depends on what has been eaten.

This is one theory, and one I have adopted for my own personal targets::

All for non-diabetics:
Fasting under 5.5
One hour after meals 7.8
Two hours after meals 6.6
http://www.phlaunt.com/diabetes/14045524.php

The NICE guidelines are a little more generous
Fasting and before meals 4 to 5.9
Two hours after eating under 7.8

Keeping a food diary may seem like a palava, but as we tend to repeat meals over and over, it becomes easier as time goes on. I still keep one now, and doubt I could manage without it. I don't weigh everything anymore, just the odd thing, but I do note things like "2 potatoes" or "half a slice of bread" etc. That way I can eat to my meter. I know that if I have 3 potatoes I will go high, and I can look back and see patterns. I keep mine on an Excel spread sheet so its easy to move stuff about. If you are worried about rising levels, then in my opinion it is essential to learn about carbs, and how many grams of carbs there are in foods. Set yourself a target of so many grams a day. Some members on here are very strict. They have less than 20 grams a day. I couldn't sustain that, so I stick to up to 60g a day. You need to find a level that suits you personally, and one you can sustain without feeling deprived.

Not too cheeky at all. I will be 67 on Wednesday! I was diagnosed in January but didn't get a meter and start testing until April. It has all been trial and error, with lots of mistakes along the way, and I am not as hardcore as many on here, but my finger pricking levels are currently under the levels in that first set of targets above.
 
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Gardengnome

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Type of diabetes
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Thanks, that's really helpful. I really have to raise my game I think. I've been too complacent perhaps just thinking that keeping fit and exercising and not gaining weight was all I needed to do. That and the apology for doing an HFLC diet. No problem with the high fat in moderation of course - I just love butter and disregard any health person who tells me to eat polyunsaturated margarine. Obviously the low carb bit has let me down!

A typical day would start with half a grapefruit, a boiled egg and a slice of toast, butter and occasionally a little marmalade. Cup of coffee, milk, no sugar mid morning; home made vegetable soup for lunch, probably quite a generous portion, piece of fruit, apple, orange, whatever is to hand.; mid afternoon a cup of tea and more fruit. Dinner might be fish, chicken or a veggy option. Always cooked from scratch and served with plenty of vegetables. Might have some potatoes but never many and often none. Rarely have pudding due to the calorie factor but might opt for a natural Greek yogurt with sweetener and lemon or maybe some honey. I drink water and no fizzy drinks. Other than writing it all down in diary form and carb counting I would have said that was pretty good but you may disagree? Please feel free to say what you think. I do think that a post meal reading of 8.2 is way too high and I should be taking more care. For one thing I should probably take readings regularly which I tend not to do, I'm far too casual.

Have a nice birthday!
 
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sanguine

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Things I would stay away from in your typical day: grapefruit, toast, marmalade, orange, potatoes, honey. Get yourself a book called Carbs & Cals which contains photos of foods and meals with carb, calorie, protein and fat values. Try and stick to foods that have 10g or less carb per 100g.
 
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Bluetit1802

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Type 2 (in remission!)
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I agree with @sanguine. I think the fruit is letting you down. There is a lot of sugar in fruit. It is natural sugar, but nonetheless, sugar, and will raise your levels. This is especially so with the tropical fruits. Most of us try to stick to a few berries such as strawberries, raspberries etc. and eat them with cream or yogurt as part of a meal rather than as a snack. For your own information, have some fruit on its own as a snack then test before and at 1hr and 2hrs after and you will see what I mean. Some lucky people can manage better than others. My own levels can go haywire.

The Carbs and Cals book (Amazon) is excellent.
 
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Gardengnome

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124
Type of diabetes
Don't have diabetes
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Diet only
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going to a gym
Thank you both of you, Time I took control obviously and will certainly buy the carbs and cals book. I did have a small book of carbs but couldn't really make much sense of it all.
 
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beardie

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Messages
397
Type of diabetes
Type 2
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Diet only
Some fruits are much worse than others. It may seem to be a PALAVER, but keeping track of what you eat will make a huge difference if you also test.