Hello in need to advice please

[maido277]

Hello all, I am a bit confused, worried and to be honest a bit angry. I went for a routine blood test like I do every year last week.

The results of my HBA1C came in at 42. The doctors text msg said pre diabetes. But the notes from the Dr that thenreceptionist had said borderline pre diabetes.

The reason I am confused and shocked is that I eat 90% clean, don't eat processed apart from pasta once a week. I do 12 to 14k steps a day and weight train 3 to 4 days a
Week. I drink alcohol once a month. That once is prob about 12 units.

I am 41, family history and of Indian descent.

I am not sure barring stopping eating pasta and bananas what else to do.

The only thing I have done is over the last 6 weeks I went on a holiday to vegas for a week and it was bit carnage and since got back 5 weeks ago haven't been as clean as I mention above. Could it be the test being last 3 month avg has picked this up.

Any advice much appreciated please.

 

[CatsFive]

Being of Indian descent unfortunately increases your chance of developing diabetes, I'm not sure what 'eating clean' means. I was shocked and in a flat spin for 2-e months at my diagnosis as I was eating plenty of fruit & veg, and cooking almost all my meals from scratch though I was nothing like as active as you!

Unfortunately some of us develop diabetes despite an apparently exemplary lifestyle.

Your holiday will have made a difference, but your HbA1c is in the pre-diabetic range. Hopefully you will get another one once the Vegas holiday has worked it's way through. It's measuring an average of your blood sugar for the lifespan of a red blood cell, which is about 12 weeks.

 

[Lakeslover]

Hi and welcome.

first of all this result is really borderline, and you should certainly be able to do something to change it.

eating pasta and bananas is very likely to cause an increase in blood sugar. This is true in diabetics and non diabetics. But it’s how your own body deals with it that is important. that’s what you need to find out.

Your holiday will have had some effect, as you say the test is roughly a three month average but also slightly weighted towards more recent weeks. I would assume you ended up eating more than usual, and maybe more junk food?

most carbs can raise blood sugar, so potatoes, cereal, rice, bread, beer, as well as most fruits other than berries.

to see what works for you it’s worth looking into buying a meter, and testing your blood sugars before and two hours after a meal. You are looking for your blood sugar to rise by a maximum of 2 points.

if you can give us a better idea of what you currently eat we can make some more relevant suggestions. I would say it’s likely that you only need to make small adjustments.

 

[MattInUSA]

As CatsFive said, your ethnicity is working against you. How is your weight? People of Asian heritage are much more prone to metabolic conditions and NAFLD at normal BMIs. Fasting insulin and glucose would be a good start to tell you what your insulin sensitivity is. Lakeslover's suggestion of buying a meter and testing after meals is also a good idea to see if you're spiking with all carbs, only certain carbs, and how much you're spiking.

 

[maido277]

Thank you for your help guys.
Appreciate the help.

Sample diet


Breakfast
Porridge oats
Blueberries
Banana
Oat milk
Peanut butter (vegan pure no palm oil sugar etc)
Dash of honey

Lunch
1 slice toast
Avocado
2 eggs

Nuts for snack (walnuts, almond)

Dinner
Salmon
Salad or Veg
2 piece garlic bread

Or salmon and egg noodles


Gym

Post workout

Protein shake
Cream of Rice

 

[Lakeslover]

There are certainly things there that I couldn’t eat. For example oats, banana, honey would all send my blood sugar soaring. Peanut butter I can have as long as it’s purely peanuts, no added sugar.

on a good day I can cope with a slice of garlic bread eaten with a full meal as the fats and protein slow the absorption of the bread. Unfortunately the same can’t be said of toast.

eggs and avocado, salmon, veg and salad are all great. Protein shake sounds ok as long as it doesn’t have sugar added. Most nuts are fine, good snack (peanuts are higher carb than others).

But I’m not you, and you may be different. A meter will Give you independent unbiased advice!

 

[maido277]

Guys I have just done the test 2 hrs after eating. My machine is an acute chek and I got a different reading on the index finger of each hand. One was 7.8 and the other was 7. Both done within 60 secs of each other.

Is this normal or is my machine dodgy?

 

[KennyA]

Guys I have just done the test 2 hrs after eating. My machine is an acute chek and I got a different reading on the index finger of each hand. One was 7.8 and the other was 7. Both done within 60 secs of each other.

Is this normal or is my machine dodgy?

This is perfectly normal. All meters are supposed to be accurate to a certain point, but there's an allowable error. From memory it's supposed to read within 20% of the 'true' reading, 95% of the time. So both your readings fall well within that 20% allowable error.

As an experiment I've done sucessive readings off the same drop of blood and got different results - but within allowable error.

This is why single fingerprick readings aren't all that informative, and it's simply not worth stressing over an odd one. It's looking at the trend over time of what certain foods reliably do to your BG - which is why you need a baseline reading before eating so you can judge what the two hours after reading actually signifies.

 

[MattInUSA]

Guys I have just done the test 2 hrs after eating. My machine is an acute chek and I got a different reading on the index finger of each hand. One was 7.8 and the other was 7. Both done within 60 secs of each other.

Is this normal or is my machine dodgy?

What was the meal? Being that high two hours after a slice of toast is concerning, but being that high after a big bowl of oats and fruit is probably to be expected even for non-diabetics. You'll learn what different meals do to your glucose and can make adjustments. And yeah, home meters have a lot of variability.

How is your fasting glucose?

 

[maido277]

What was the meal? Being that high two hours after a slice of toast is concerning, but being that high after a big bowl of oats and fruit is probably to be expected even for non-diabetics. You'll learn what different meals do to your glucose and can make adjustments. And yeah, home meters have a lot of variability.

How is your fasting glucose?

Hello Mattinusa

The meal was salmon, egg noodles stir fry and 2 couple of gherkins. I was at my mums and have read egg noodles are low glyacemix.

I have just done my first fasted reading at 7.15am and it came out at 5.3 which I think is semi okay.

 

[MattInUSA]

Hello Mattinusa

The meal was salmon, egg noodles stir fry and 2 couple of gherkins. I was at my mums and have read egg noodles are low glyacemix.

I have just done my first fasted reading at 7.15am and it came out at 5.3 which I think is semi okay.

Your fasting is within normal range, which indicates you'd have to spend a lot of time with elevated glucose after meals to achieve that A1C. The post-prandial reading is a little concerning (not super concerning, it could be far worse even taking the high end number), but realize that those glycemic indexes are a generalization and what's low glycemic for one person can be high glycemic for another (and vice versa). I think in your case it's not a bad idea to get a few more post-prandial readings (30 minutes, 1 hour, and 2 hours after) from different meals, along with fasting readings, and redo the A1C in 1-2 months. Perhaps Vegas is really skewing things, or you may have some meals you simply should avoid or minimize.

 

[maido277]

Your fasting is within normal range, which indicates you'd have to spend a lot of time with elevated glucose after meals to achieve that A1C. The post-prandial reading is a little concerning (not super concerning, it could be far worse even taking the high end number), but realize that those glycemic indexes are a generalization and what's low glycemic for one person can be high glycemic for another (and vice versa). I think in your case it's not a bad idea to get a few more post-prandial readings (30 minutes, 1 hour, and 2 hours after) from different meals, along with fasting readings, and redo the A1C in 1-2 months. Perhaps Vegas is really skewing things, or you may have some meals you simply should avoid or minimize.

Hi mattin

I tested today after all 3 meals

Breakfast bagel, yogurt with berries 2 hrs after was 5.7
Lunch quinoa chicken salad was 6.3
Dinner Salmon potato and salad after 1.5 hrs was 6

 

[MattInUSA]

Hi mattin

I tested today after all 3 meals

Breakfast bagel, yogurt with berries 2 hrs after was 5.7
Lunch quinoa chicken salad was 6.3
Dinner Salmon potato and salad after 1.5 hrs was 6

Those all seem like decent numbers to me. Maybe spot check if you ever go crazy with food a la Vegas to see what kind of numbers you're hitting, but the numbers you've provided are not indicative of the A1C you received (an average of almost 7). I'd try to keep it clean for the next month or two and check A1C again. Was your last A1C in the normal range?

 

[maido277]

Those all seem like decent numbers to me. Maybe spot check if you ever go crazy with food a la Vegas to see what kind of numbers you're hitting, but the numbers you've provided are not indicative of the A1C you received (an average of almost 7). I'd try to keep it clean for the next month or two and check A1C again. Was your last A1C in the normal range?

I had a A1C test a week ago which was 42 that's what brought me here. Previous to that I had a blood test in Apr 2022. I have no idea the result of that as the receptionist just said all is good.

The text msg I received last week from the doc post the A1c said " hello Mr.....your blood test have shown that your blood sugar has increased very slightly and are now in the pre diabetes range". So then I rang the receptionist to find out the actual reading and it was 42.

Anyways I will check randomnly after meals now. Keep an eye on the fasted one in the morning. And go for another A1c end of September.

Thank you for your help

 

[MattInUSA]

" hello Mr.....your blood test have shown that your blood sugar has increased very slightly and are now in the pre diabetes range"

It sounds like you may have been nearing pre-diabetes previously? I would just try to keep it pretty clean and retest the A1C in a few months. You may just be someone who can't have a bunch of cheat meals and get away with it. Also keep in mind that the A1C assay can be thrown off by some supplements, such as high dose biotin, so if you're using supplements then give them a 2-3 day break before retesting. It's great you're worrying about this now rather than waiting until you have full-blown diabetes, because it may be a relatively easy fix.

 

[maido277]

It sounds like you may have been nearing pre-diabetes previously? I would just try to keep it pretty clean and retest the A1C in a few months. You may just be someone who can't have a bunch of cheat meals and get away with it. Also keep in mind that the A1C assay can be thrown off by some supplements, such as high dose biotin, so if you're using supplements then give them a 2-3 day break before retesting. It's great you're worrying about this now rather than waiting until you have full-blown diabetes, because it may be a relatively easy fix.

Mattin

I lost my dad last year. He had diabetes at 40. I saw what he went through. He ended up with complications etc and a quadruple bypass. It has scared the living day lights out of me. My whole dad's side is type 2 and i am indian origin. I promised my dad I would look after myself and try and avoid it. So I am trying.

Can i just ask one last question.

What is the most important test when I do my glucose finger pricks at home. Is ir the fasted one in the morning? If that is good am I on the right path?

 

[MattInUSA]

Mattin

I lost my dad last year. He had diabetes at 40. I saw what he went through. He ended up with complications etc and a quadruple bypass. It has scared the living day lights out of me. My whole dad's side is type 2 and i am indian origin. I promised my dad I would look after myself and try and avoid it. So I am trying.

Can i just ask one last question.

What is the most important test when I do my glucose finger pricks at home. Is ir the fasted one in the morning? If that is good am I on the right path?

Oh wow, I'm sorry about your family history. Mine is much the same, so I understand the concern. As far as finger sticks go, I personally put more weight on the after meal tests. In my opinion, someone can have normal fasting numbers long before a diabetes diagnosis, when testing after meals would have revealed trouble handling carbohydrates far sooner. A1C is supposed to capture the entire picture, but it's not a perfect test either since terrible post-meal numbers combined with normal fasting numbers can give an A1C that's normal(ish). All three combined help to understand what's going on, along with some other tests. If I were you I wouldn't dig too much into the details unless you have another abnormal A1C in the next few months.

 

[ajbod]

In my opinion the best use of testing is just before eating, and 2 hours after the first bite. This will tell you A. How your body handled the carbohydrate content of the meal. 2. If your body is struggling to control your sugar levels.
From what you learn, you can adjust the carb content of the meal until it has no bad affect on your levels, this may meaning ditching that recipe altogether.
Your fasting level, is usually the very last to drop, so it could be very high, but throughout the day your levels could be excellent. so it's a guide to overall, but not an accurate picture.

 

[maido277]

In my opinion the best use of testing is just before eating, and 2 hours after the first bite. This will tell you A. How your body handled the carbohydrate content of the meal. 2. If your body is struggling to control your sugar levels.
From what you learn, you can adjust the carb content of the meal until it has no bad affect on your levels, this may meaning ditching that recipe altogether.
Your fasting level, is usually the very last to drop, so it could be very high, but throughout the day your levels could be excellent. so it's a guide to overall, but not an accurate picture.

Thanks guy for the help.


My before meals over the last few days is 5.3 to 5.5 average....my 2 hours post is averaging 6.3.

Thank you for all the help. I am waiting for the classes or the thing the nhs refers you to, to start. But I thought I get a head start.