Just told I have pre-diabetes (almost)

[MimT]

My GP called me in after a routine blood test and told me I am almost pre-diabetic, with a fasting blood glucose level of 6 (mmol/l presumably). I've since been scouring the internet to see what this means and it looks as though if I'd been in the US I'd fall into the prediabetic range (no "almost").

My GP was quite concerned and gave me advice about diet and exercise. I couldn't fully concentrate on what she was saying because her news came as a shock. I'm not overweight and nobody in my family that I know of has had diabetes. It is taking a while to get my head around everything.

I have to say that my immediate reaction was to be sceptical of what she was advising as a change of diet, thinking it sounded all wrong. Having read lots here and elsewhere, it turns out her advice is spot on. She advised me to eat oranges whole, not squeeze them for juice, to eat lentils, avoid breakfast cereal, potatoes etc. and increase exercise. I'm now doing some of that - more exercise, even cooking up some green lentil soup

I'm seeing her again in a few days. Now that I'm getting used to the notion, I'll be much more receptive to what she says and have more questions.

I don't really have a point to make, except to say it's really nice to find this community. I've not told any friends or family yet, so reading the experiences of all you good people here is very helpful, even comforting.

 

[JoKalsbeek]

My GP called me in after a routine blood test and told me I am almost pre-diabetic, with a fasting blood glucose level of 6 (mmol/l presumably). I've since been scouring the internet to see what this means and it looks as though if I'd been in the US I'd fall into the prediabetic range (no "almost").

My GP was quite concerned and gave me advice about diet and exercise. I couldn't fully concentrate on what she was saying because her news came as a shock. I'm not overweight and nobody in my family that I know of has had diabetes. It is taking a while to get my head around everything.

I have to say that my immediate reaction was to be sceptical of what she was advising as a change of diet, thinking it sounded all wrong. Having read lots here and elsewhere, it turns out her advice is spot on. She advised me to eat oranges whole, not squeeze them for juice, to eat lentils, avoid breakfast cereal, potatoes etc. and increase exercise. I'm now doing some of that - more exercise, even cooking up some green lentil soup

I'm seeing her again in a few days. Now that I'm getting used to the notion, I'll be much more receptive to what she says and have more questions.

I don't really have a point to make, except to say it's really nice to find this community. I've not told any friends or family yet, so reading the experiences of all you good people here is very helpful, even comforting.

Hi @MimT , and welcome,

While your doc does have some excellent ideas, (leaving cereals and potatoes etc, alone) some might not quite go far enough for many of us here. Yes, an orange is better when eaten whole, because the fibres slow down the blood glucose spike, and doesn't hit the system as hard as juice would. But when you consider an orange has 9 grams of carbs per 100 grams, and an average orange weighs 200 grams... That's still quite a bit. Lentils are starchy, so not always a good choice. But.... You're in the borderlands, so this is where it gets a little tricky. I'm quite thoroughly diabetic, and while I have improved my insulin resistance/sensitivity over the past years, I still can't get away with certain foods. You, however, probably could! That's why testing would help. You're not likely to get a meter and strips on the NHS, but the bulk of us here self fund if that is the case, to see what works wonders and what doesn't.
https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might help some when it comes to testing and the basics of low carbing. Keep in mind you might not have to go as far as described in the Thingy, but it does give something to base future choices off of, maybe. It's quite possible, you might be able to avoid a diabetes diagnosis all together!

Good luck! (And hold on to that doc, most don't know about low carb!)
Jo

 

[MissMuffett]

Welcome @MimT to the forum. You'll get lots of information and support here it’s a great place. Yep do lots of reading, most members here do low carb, it’s certainly helped me. Good luck

 

[MimT]

Thank you @JoKalsbeek and @MissMuffett for your support, Right now that's just what I need.

Apart from a couple of bad spells, my life till recently was pretty well free of illness and ailments and I felt healthy. It's mainly in the past couple of years that I've suddenly had to manage for nasties like heart disease (on statin and more) and osteoporosis (on denosumab). Now I've got to watch out for diabetes - ugh! This body of mine is deteriorating - it's old age .

My doctor is the best diagnostician - and a terrific person as well. I should clarify, she tried to tell me to have a low fruit intake of things like oranges (and bananas IIRC) - among other advice some of which went in one ear and out the other I'm sorry to say. I'll pay more attention when we meet again this week.

Your article is very helpful, Jo. Low carb diet it is from now on. I'm going to have to figure out what foods are good to keep glucose in check at the same time as keeping LDL and triglycerides in check (and trying to keep bones from getting too weak). Apart from a sweet tooth from time to time, my diet has been reasonable I think. I've always pretty well only had hi-fibre wholemeal bread (I know I have to cut that down or out). I eat lots of salads - cucumber, lettuce, tomato, avocado, veges, fish (mostly sardine, tuna etc), homegrown veges and herbs for soups and salads, olive oil, cardiac-friendly margarine etc. I'm hopeful I'll only need to tweak my diet rather than make drastic changes. I usually only have eggs once every one or two weeks (same with steak and chicken). I'll ask if it's safe to eat them more often.

I've been looking at glucose meters. There doesn't appear to be much to choose from where I live. I'm thinking of getting the Appu-chek Guide Me meter. Is that premature or not, given I'm relying on only one test result so far? (I hope getting a meter won't tip me into obsessive monitoring.)

 

[coby]

My GP called me in after a routine blood test and told me I am almost pre-diabetic, with a fasting blood glucose level of 6 (mmol/l presumably). I've since been scouring the internet to see what this means and it looks as though if I'd been in the US I'd fall into the prediabetic range (no "almost").

My GP was quite concerned and gave me advice about diet and exercise. I couldn't fully concentrate on what she was saying because her news came as a shock. I'm not overweight and nobody in my family that I know of has had diabetes. It is taking a while to get my head around everything.

I have to say that my immediate reaction was to be sceptical of what she was advising as a change of diet, thinking it sounded all wrong. Having read lots here and elsewhere, it turns out her advice is spot on. She advised me to eat oranges whole, not squeeze them for juice, to eat lentils, avoid breakfast cereal, potatoes etc. and increase exercise. I'm now doing some of that - more exercise, even cooking up some green lentil soup

I'm seeing her again in a few days. Now that I'm getting used to the notion, I'll be much more receptive to what she says and have more questions.

I don't really have a point to make, except to say it's really nice to find this community. I've not told any friends or family yet, so reading the experiences of all you good people here is very helpful, even comforting.

Hi @MimT and welcome
Your post particularly 'grabbed' my attention because, just like yourself, I too was shocked to be called in to see my GP and told this news and I too also had no weight issues or family members with the condition. It took me ages to realise that carbs were a problem for me from now on and it's as if we develop an allergy to them. Once we 'get' this then it's easy to see the path ahead and to adjust our eating. It sounds as if your GP is not too bad as some insist we need carbs! You are only just teetering on the edge of diabetes so you can do this before you fall into the pit as it were Wishing you well on your new journey x

 

[ianf0ster]

Hi @MimT and welcome to the forum.
Many of us find that BG meters are best used for testing the blood glucose reaction we get to food. The problem being that we are all different in genes, gut biome and culture etc. We can each react differently to the same quantity of the same food, there can be differences depending on whether we eat carbs with lots of fats or not, and even in some cases due to the time of day.

I see that you are in Australia so I don't know which meters are available there. Generally, we tend to look for ones with cheaper test strips (the major cost when testing meals) but having decent reviews.

I know that it's tricky trying to eat the best foods to manage both heart disease and diabetes, since the general advice (particularly on fats) is contradictory. I had a triple cardio bypass just a couple of years before my diagnosis with diabetes and gave up trying to eat for both, but since diabetes is a major heart disease risk I just concentrated on diabetes remission which I have achieved for nearly 4 years now.

 

[JoKalsbeek]

Thank you Jo and Miss Muffett for your support, Right now that's just what I need.


I've been looking at glucose meters. There doesn't appear to be much to choose from where I live. I'm thinking of getting the Appu-chek Guide Me meter. Is that premature or not, given I'm relying on only one test result so far? (I hope getting a meter won't tip me into obsessive monitoring.)

No idea on meters Down Under, sorry... Just check which one has the cheapest strips, as that is where the running costs are. And as for "old age", well... Statins can raise blood sugars, so it doesn't have to be an age thing. Some people are put on them who don't actually need them, (heading the need off, basically), but if there's heart trouble already, then those are here to stay. If you can't cut out the statins, which could be the reason your blood glucose is edging towards unpleasant levels where they weren't before, you tackle what you can, meaning a low carb diet and/or medication. And don't be too scared of eggs.... Most of the cholesterol that goes around our bodies we actually make ourselves, what we consume is just a smidge in comparison. When you start a low carb diet you might notice a change in your cholesterol for a bit, because it transports fats around, amongst other things... So when you start losing weight on a low carb diet, the cholesterol tends to rise for a little while, but that's because it's bringing fats to the exit. That'll come down again relatively soon, so don't panic, you're not clogging the works post haste. Steak is often lean, chicken can be if fats really bother you, so... I don't quite see why you'd need to cut those out, but with other things going on you might have your reasons and I am not exactly what you'd call qualified to put two cents in there. I mean, I know what's good for my diabetes, but I also know what doesn't mesh with my kidneystones, migraines and rheumatism, my wonky thyroid etc.... No idea about osteoperosis though. So while I can jammer on about all sorts of things, not all things, haha. (Though some here would probably raise an eyebrow at that statement, as I am a bit of a meddling busy body.... Somehow.).

Don't worry too much about obsessive monitoring. You're not likely to. If you know when to test effectively (before a meal and 2 hours after), there's no need to start poking yourself at random, to get numbers that don't add anything to your knowledge of what your body can handle. And once you've tested around a certain meal a couple of times, you already know what it does, so you can cut down on testing that, or eventually nix it entirely. Things like, oh I dunno... Do you get steroid shots in your joints sometimes? Those can up glucose for a while as well. For me, that lasts about a week, and I top out at 9.0 mmol/l, on a low carb/ketogenic diet. Same with a vaccination or a flu. It helps sometimes to know what's going on, but it's just, you know... Informative. Not something you're going to be checking every hour, on the hour. Have a little faith in yourself. And stop worrying about things going in one ear and out the other: getting any kind of diagnosis is terrifying and people tend to go into a traumatic state of being. In one ear, out the other, is absolutely common and to be expected, really. I know I barely knew which way way up right at the start, and then I started reading a bunch of books like The Diabetes Code, and went over them with my husband every evening at dinner, as I tend to process verbally sometimes... And I took notes which I sent to myself via e-mail. Because nothing actually stuck, right at the beginning. That's why The Nutritional Thingy is relatively simple. Because at first, you're floored, and just about everything'll go over your head. That's fine.

Read everything you can, ask any questions you have, as there's always someone around with answers, and take notes so you know what to ask your doc about. What your HbA1c is, etc. And hey, you could ask for a meter... You never know, they might be open to it.

You're on the right track here, you're curious and eager to tackle this. It'll be okay. For me, I have a whole lot of stuff going on, and diabetes is the only one I don't have to worry about. That one's sorted, done, dusted, not a problem. I wish all issues were this realtively easily solved. So breathe.... This one's the "easy" one.

Hugs,
Jo

 

[Antje77]

My GP called me in after a routine blood test and told me I am almost pre-diabetic, with a fasting blood glucose level of 6 (mmol/l presumably).

You can't really diagnose someone on a single fasting BG number (unless it's really, really high).
Have you had your hba1c tested as well?
That one tells you something about your BG levels over the past 3 months. If it were me, I'd want to know what my hba1c was before deciding a major overhaul of diet is necessary.

Good luck!

 

[MimT]

I'd want to know what my hba1c was before deciding a major overhaul of diet is necessary.

Thanks. I figured that would be the case and I'd like to have confirmation. The GP ordered some additional blood tests - I don't know whether it includes the HbA1c or not (I wasn't concentrating at the time). I'm seeing her this week to discuss the results of whatever they were.

 

[MimT]

Don't worry too much about obsessive monitoring. You're not likely to.

I'm not so sure. I've been obsessively reading up on prediabetes and T2 over the last few days - lol. I'll try to not get too carried away at this stage

 

[JoKalsbeek]

I'm not so sure. I've been obsessively reading up on prediabetes and T2 over the last few days - lol. I'll try to not get too carried away at this stage

Oh trust me.... The information hunger'll get sated in a few weeks/months, but right now you need to find out everything you can, because it brings comfort and gives you control of this thing; You can do something about it and it's empowering to find that you can, so that helps you get through this. That fades, when you get to a point where you can give people advice on T2 and prediabetes on a forum, haha.

 

[JoKalsbeek]

Thanks. I figured that would be the case and I'd like to have confirmation. The GP ordered some additional blood tests - I don't know whether it includes the HbA1c or not (I wasn't concentrating at the time). I'm seeing her this week to discuss the results of whatever they were.

They'll do a HbA1c at some point, might have done already, might have another to confirm or initially diagnose. They're not going to diagnose based on a single on-the-spot measurement alone, and a HbA1c is a 3-month average.... It's more telling, diagnostically. So it'll have been ordered, before or coming up. Always ask for an exact number, and write it down. You need to know where you're starting from, so you can see improvement along the way, and it helps to know where you stand. Just a "you're fine" or "You're prediabetic/diabetic/borderlinesomethingorother", isn't helpful in the long run.

 

[derekhansen]

Others have already posted some excellent advice so I will try not to repeat.
Like you my diagnosis came as a shock but luckily the nurse that gave me the bad news that my Hb1Ac was 49 and just into the T2 category, encouraged me try a low carb diet/lifestyle change rather than going straight on to Metformin tablets. She also pointed me towards this website which has been extremely helpful and supportive. After 3 months my Hb1Ac was down to 37 and in the normal range.
The appointment with your Doctor this week will hopefully make things clearer but if you do end up going down the low carb route, I would recommend books by Dr.Jason Fung (Diabetes Code) and by Dr Bernstein (Diabetes Solution). I might also try looking at some Youtube lectures and Interviews by Dr. David Unwin who is one of the pioneers of treating T2 diabetes using diet rather than medication.

 

[MimT]

Thank you everyone for your comments, help and experiences.

As an update, I saw my GP again yesterday. Regarding the "almost" pre-diebetes result, I asked about diet and further tests.

Re diet, I told her I'd just bought the latest CSIRO low carb book and she wholeheartedly endorsed it. She said she wouldn't recommend no or ultra-low carb in my case, however the low carb diet would be excellent for me.

Re further tests, I asked about HbA1c and she advised it was not indicated at this stage because my result was under the limit plus my tests from previous years were within the normal range. Previous years' fasting glucose results in mmol/l were: 2021: 5.2; 2022 5.2; 2023 5.4; 2024 6.0.

If I'd been over the pre-diabetes limit (6.1 mmol/l plus) she would than have requested the oral glucose tolerance test (OGGT) and, depending on the result, maybe the HbA1c. She offered another test for fasting blood glucose next month (implying it may not add any useful info), but I said next year as normal would be fine. (AFAIK Medicare in Australia has guidelines for what tests it will cover and when.) I didn't tell her I've bought a glucose meter. Honestly, I felt a bit embarrassed and that she'd think I was over-reacting.

As an aside, my serum lipid tests were all within target for the first time since 2020 - yippee! My iron/ferretin/transferrin sat test results were wacky/inconsistent again, as has happened in past years.

 

[aris]

Read up on glycemic index. And try to stick to foods low on that index. This is pretty much automatic if you are following a lower carb diet.