Fit and Healthy but Prediabetic

BikeLife

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4
Hello, I have just been diagnoses as prediabetic. I have had two HbA1c tests 3 months apart. The first came back as 47 and the second as 46 - so that seems pretty conclusive!

It came as a surprise as I am a very fit active person with a good diet and healthy lifestyle. A recent health check up gave me a body fat percentage of 14% and all other criteria were good. But I guess that is just the way it is!

So, I have started to cut out snacks such as cakes, biscuits, etc. and cut out 'bad' carbs but I find I am hungry most of the time and am worried that I will lose weight and my energy levels will drop.

I have been looking in to the low carb and ketogenic diets but I am not sure if and how this will affect my training - I do a lot of cycling and cross training.

Does anyone have any thoughts, suggestions or experience of this?
 
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Guzzler

Master
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Type 2
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Diet only
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Poor grammar, bullying and drunks.
When you switch to a lower carb diet it is a bit of a shock to the body, the whole system needs time to settle in. Prof. Tim Noakes did trials with athletes and noted that at first performance was slightly worse but in the long run the athletes on low carb outperformed those on a 'normal' diet. Should you choose LCHF you must replace the carbs with fat and protein. The type of fat is your own choice be it olive oil or animal fats.
Like all new regimes it takes trial and error to get to where you want to be.
I do not know much about the Keto diet but the end result is the same, I think, i.e you go into ketosis so the body burns fat instead of carbs.
 
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BikeLife

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Thanks Guzzler. From my basic understanding of the ketogenic diet, the body adapts to burning fat for fuel instead of carbs, but does the same happen on the LCHF diet? I presume it must do so what is the benefit of the ketogenic diet?
 

bulkbiker

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19,575
Type of diabetes
Type 2
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Diet only
Thanks Guzzler. From my basic understanding of the ketogenic diet, the body adapts to burning fat for fuel instead of carbs, but does the same happen on the LCHF diet? I presume it must do so what is the benefit of the ketogenic diet?
The ketogenic diet means that you will run on fat all of the time (permanent ketosis).. depending how low carb you go then you may find yourself switching between running on glucose and running on fat depending on your consumption of carbs. If you are running in Low Carb mode you may still "bonk". Once you are running in keto mode "bonking" becomes a thing of the past. So for example keto marathon runners do not experience "the wall" .. at least that is what my reading on the subject has claimed. I'm neither a long distance cyclist nor marathon runner.. far too lazy for that.
 
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BikeLife

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Thanks bulkbiker, that makes a bit more sense now. I guess I have a bit more research to do before a decide on the best option for me.
 

AM1874

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Hi @BikeLife .. and welcome
You have certainly made a good move coming here. Since joining this forum, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

The key point to take on board now is that managing and controlling your diabetes through exercise, diet and testing your blood glucose seems to be the best way forward for many people. You have expressed interest in a keto diet which at 20 grams of carbs a day or less, is the logical extension of going Low Carb High Fat (LCHF). For me, committing to an LCHF / Keto lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I have tagged @daisy1 for you and I suggest that you read up on the valuable information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. together with the following Diet Doctor websites, which will give you all the info that you need on what and what not to eat ...
Low Carb Intro and Information , Low Carbs in 60 Seconds and a Keto Diet for Beginners

Unless you are prescribed one by your Doc or Nursie (unlikely), it is a top priority that you get yourself a test meter and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

The costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £29.49
10 packs x 50 use code: 975833 .. cost is £58.98
For the TEE 2, the strips are £7.75 for a pack of 50 .. but there are no discount codes currently available

I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I now know what my BG levels are .. and I can now manage them

Hope this helps
 
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daisy1

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@BikeLife

Hello BikeLife and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 250,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.
  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 

Christine McMillan

Well-Known Member
Messages
46
Type of diabetes
Type 2
Treatment type
Diet only
Hello, I have just been diagnoses as prediabetic. I have had two HbA1c tests 3 months apart. The first came back as 47 and the second as 46 - so that seems pretty conclusive!

It came as a surprise as I am a very fit active person with a good diet and healthy lifestyle. A recent health check up gave me a body fat percentage of 14% and all other criteria were good. But I guess that is just the way it is!

So, I have started to cut out snacks such as cakes, biscuits, etc. and cut out 'bad' carbs but I find I am hungry most of the time and am worried that I will lose weight and my energy levels will drop.

I have been looking in to the low carb and ketogenic diets but I am not sure if and how this will affect my training - I do a lot of cycling and cross training.

Does anyone have any thoughts, suggestions or experience of this?

Has your surgery suggested you join the XPert course? Best thing my husband ever did, I’ve been diet controlled T2 since 2006. I was told then as an overweight, nearly obese because of my petite body shape versus short height to follow the GI on carbs route and low fat. With a food XPert tutor you get to discuss the merits of all diets, v medications, insulins. You name it, they talk you through, and if like us you’re in a mixed group, you meet people with T1 and T2 in the same family, different cultures, plenty with comlex health conditions which affect diet, and a range of ages. The idea is by going to a neighbourhood group friendships might be struck up. As we can’t drive, this was not an option but certainly we could’ve made friendships in this way. There are other diabetic courses, DAFNE is another, HEIDI was a precursor of XPert if I remember. 6 x 2hr courses, free book included (and a cracker it is, its more than a booklet but not a book, we don’t have a word for it I’d say). Good luck.
 

melaskew

Newbie
Messages
3
You may be able to access a pre diabetes programme depending on the area you live in. I work in Cambridgeshire in the National Diabetes Prevention Programme and we use the xpert programme mentioned. Joining the scheme is based on your HBA1 c being between 42-47 and a referral from your GP.
 

Glink

Well-Known Member
Messages
252
Type of diabetes
Prediabetes
Treatment type
Tablets (oral)
Wow, seems like more and more thin & fit prediabetics here lately. I am also a biker and also a surprise diagnosis. I found that LCHF helped get my sugars under control (although I also take metformin now). I ended up going very low carb for the first year or two, and then adding some back in to help with exercise stamina, actually. I keep to under 100g/day, but I no longer do the 20g/day thing because I was just crashing with exhaustion after rides and losing weight t a disconcerting extent. Definitely get a metre and see how exercise affects your sugars also--I found this to be really different at different times of the day, but that strategic eating (not of carbs, just protein) helped mitigate it. Also weather during exercise affects me more now that before diabetes (heat, for example, makes the stress of a strenuous ride more and my sugars inevitably rise). It's a lot of trial and error! Also, if it hasn't already been raised, there's a chance you are early LADA, and it might be worth inquiring for a GAD antibody test or at least keeping an eye out for any sudden turns in your health.
 

Christine McMillan

Well-Known Member
Messages
46
Type of diabetes
Type 2
Treatment type
Diet only
Hello, I have just been diagnoses as prediabetic. I have had two HbA1c tests 3 months apart. The first came back as 47 and the second as 46 - so that seems pretty conclusive!

It came as a surprise as I am a very fit active person with a good diet and healthy lifestyle. A recent health check up gave me a body fat percentage of 14% and all other criteria were good. But I guess that is just the way it is!

So, I have started to cut out snacks such as cakes, biscuits, etc. and cut out 'bad' carbs but I find I am hungry most of the time and am worried that I will lose weight and my energy levels will drop.

I have been looking in to the low carb and ketogenic diets but I am not sure if and how this will affect my training - I do a lot of cycling and cross training.

Does anyone have any thoughts, suggestions or experience of this?

We didn't have to ask, our surgery is so on the ball, we were told about it. Mind you, it was also easy to get to speak to a dietician as well. Our surgery is very on the ball - and we have a dedicated GP on the subject too. For the past 2 years we've had our annual check up moved so that it falls within our birth month.
 

CoreyG

Newbie
Messages
4
Hello, I have just been diagnoses as prediabetic. I have had two HbA1c tests 3 months apart. The first came back as 47 and the second as 46 - so that seems pretty conclusive!

It came as a surprise as I am a very fit active person with a good diet and healthy lifestyle. A recent health check up gave me a body fat percentage of 14% and all other criteria were good. But I guess that is just the way it is!

So, I have started to cut out snacks such as cakes, biscuits, etc. and cut out 'bad' carbs but I find I am hungry most of the time and am worried that I will lose weight and my energy levels will drop.

I have been looking in to the low carb and ketogenic diets but I am not sure if and how this will affect my training - I do a lot of cycling and cross training.

Does anyone have any thoughts, suggestions or experience of this?
Check out the book by Steve Phinney and Jeff Volek The Art and Science of Low Carbohydrate Performance
 

BikeLife

Newbie
Messages
4
Thanks to everyone for taking your time to provide help and advice - and there is definitely a lot of it!

I'll book a follow up appointment with my GP regarding a test for LADA, and work my way through the rest of the info to try and get my head around what I need to do and what my work best for me.
 

masonap

Well-Known Member
Messages
74
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Celebrity pop stars, football.
Hello, I have just been diagnoses as prediabetic. I have had two HbA1c tests 3 months apart. The first came back as 47 and the second as 46 - so that seems pretty conclusive!

It came as a surprise as I am a very fit active person with a good diet and healthy lifestyle. A recent health check up gave me a body fat percentage of 14% and all other criteria were good. But I guess that is just the way it is!

So, I have started to cut out snacks such as cakes, biscuits, etc. and cut out 'bad' carbs but I find I am hungry most of the time and am worried that I will lose weight and my energy levels will drop.

I have been looking in to the low carb and ketogenic diets but I am not sure if and how this will affect my training - I do a lot of cycling and cross training.

Does anyone have any thoughts, suggestions or experience of this?

I'm type 2 and have been on tablets for a long time, and 18 months ago was also started on insulin.
I have cut as many carbs from my daily food intake as I can without being silly about it. Yes you're right to cut out the obvious bad carbs (cakes, biscuits, sweets, chocolate, fizzy drinks, etc.) but you also need to watch out for bread, pasta, rice & potatoes. I exercise every day by walking (mostly uphill) or cycling for an hour and whilst doing that I have snacks of fruit, cereal bar, a couple of squares of dark chocolate & mixed nuts and this helps me to keep up my energy levels without getting a hypo. As I've been doing this for about the last 6 months or so I don't feel hungry very often, except when it really is coming up to the next meal time - I try to keep my meal times at the same time each day. In my normal day I try to keep snacking down to just one item between meals (like a piece of fruit or some nuts) and as a result I'm heading towards losing a stone in weight.
Good luck on your personal journey, I hope that you can make changes and avoid the complications that Diabetes can lead to if not well controlled.
 

SimonCrox

Well-Known Member
Messages
317
It is odd that someone with a healthy lifestyle, diet and weight should get pre-diabetes; it is getting more common. Do you have other risk factors such as family history, non-white ethnic origin, vascular disease or features of metabolic syndrome? The suggestion of LADA is sensible (I would never be patronising). But other things raise the Hba1c, not just abnormal glucose levels; being Afro-caribbean, anaemic or having had your spleen removed all increase the HbA1c; if you are testing for LADA, with GAD antibodies, one could also run off a fasting glucose level.
Best wishes
 

Alexandra100

Well-Known Member
Messages
3,742
Type of diabetes
Prediabetes
Treatment type
Tablets (oral)
It is odd that someone with a healthy lifestyle, diet and weight should get pre-diabetes; it is getting more common. Do you have other risk factors such as family history, non-white ethnic origin, vascular disease or features of metabolic syndrome? The suggestion of LADA is sensible (I would never be patronising). But other things raise the Hba1c, not just abnormal glucose levels; being Afro-caribbean, anaemic or having had your spleen removed all increase the HbA1c; if you are testing for LADA, with GAD antibodies, one could also run off a fasting glucose level.
Best wishes
I am another example of this. In August, age 75, I got an A1c of 41, following on from 40 the year before and 37 before that. My GP would not have mentioned this to me, as I am still one point away from being officially pre-diabetic (in the UK). Luckily she wanted me to go on to statins to lower my LDL cholesterol, so sent me to the nurse, who dropped the bombshell. It was a very great surprise, as no-one in my family has had diabetes, though we all die of heart related problems. We are 100% English, with a smidgen of Scottish. I don't have any vascular disease, and with a BMI of 16.5 I don't have metabolic disease either, nor have I lost my spleen. I was eating the classic healthy diet and doing far more than average exercise. Given the fact that I have been gradually losing weight, I am wondering about LADA, but my GP doesn't want to do anything until I have achieved proper pre-diabetic status. I am testing my BG and weighing myself regularly, so if things start to accelerate I'll be back to the surgery at once.
 

Glink

Well-Known Member
Messages
252
Type of diabetes
Prediabetes
Treatment type
Tablets (oral)
I am beginning to suspect there may be a lot more of us thin/fit/good diet/no risk factor adult-onset folks than we realise out there. We just aren't screened regularly, so unless symptoms or complications arise we rarely find out our blood sugar status. I'm sure if I were heavyset my GP would have had me screened regularly, but as a thin athletic healthy-eating type with no apparent risk factors I never had a blood sugar test in my life until I became ill. Thankfully by following advice here I've been able to get mostly on top of it and adjust my expectations.
 
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