Newly diagnosed and confused

[tiredgirl91]

Hello.
I've been recently diagnosed with prediabetes. I've been checking my fasting blood glucose levels in the last few days and honestly, I'm scared because
While at some days the levels are in the prediabetic range (above 6mmol/l but not higher than 7), I'm getting some very bad readings as well.
For example, a couple of days ago it was 7.8 mmol/l
Two days later 8.8
And once it was as high as 10 mmol/l.

Please note that these are my fasting results. Nothing other than water at least 10 hours before the check.

What does this mean? Not asking for medical advise but for some guidance, because I feel lost and I'm thinking about making another appointment with my doctor to see what happens because to me this seems like a full blown diabetes.
Please help.

 

[JoKalsbeek]

Hello.
I've been recently diagnosed with prediabetes. I've been checking my fasting blood glucose levels in the last few days and honestly, I'm scared because
While at some days the levels are in the prediabetic range (above 6mmol/l but not higher than 7), I'm getting some very bad readings as well.
For example, a couple of days ago it was 7.8 mmol/l
Two days later 8.8
And once it was as high as 10 mmol/l.

Please note that these are my fasting results. Nothing other than water at least 10 hours before the check.

What does this mean? Not asking for medical advise but for some guidance, because I feel lost and I'm thinking about making another appointment with my doctor to see what happens because to me this seems like a full blown diabetes.
Please help.

First off, breathe.

Okay, so. When you wake in the morning, there's something called Dawn Phenomenon, which means your liver dumps glucose into your bloodstream. (Though I think you may already have read this). Thing is, the liver doesn't just do that upon waking. It does the same thing when you're stressed, when you have a restless night with nightmares or insomnia, when you wake up a few times to go to the loo, or the neighbour's dog's being loud... Maybe hormones are wreaking havoc. Maybe you had a cold. Anything can happen. There's so many reasons why the dump may be higher some mornings than others. And the fasting numbers are the last ones to go down, should you tackle the daytime (post-meal) numbers. You could have absolutely beautiful bloodsugars all day long, and still have a bit of a peak in the morning. So those numbers mean exactly nothing in terms of whether or not you're crossed the diabetic threshold, okay? Your HbA1c is much more meaningful far as that is concerned, and since your diagnosis is recent, I think they may have been done not too long ago? What was your HbA1c, do you happen to know, or can you look it up?

In any case, have a read here about the whole diabetes thing and how to get numbers down, but for the moment... No worries. You're not doomed or anything. You came to the right place to get your numbers down, whatever they are. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Hugs,
Jo

 

[JoKalsbeek]

Hello.
I've been recently diagnosed with prediabetes. I've been checking my fasting blood glucose levels in the last few days and honestly, I'm scared because
While at some days the levels are in the prediabetic range (above 6mmol/l but not higher than 7), I'm getting some very bad readings as well.
For example, a couple of days ago it was 7.8 mmol/l
Two days later 8.8
And once it was as high as 10 mmol/l.

Please note that these are my fasting results. Nothing other than water at least 10 hours before the check.

What does this mean? Not asking for medical advise but for some guidance, because I feel lost and I'm thinking about making another appointment with my doctor to see what happens because to me this seems like a full blown diabetes.
Please help.

https://josekalsbeek.blogspot.com/2...I5fWzLbuwnxIpF19blUd_93qI1PkesiKLzSS_HuBEEXVc is the same thing in Dutch, by the way. (Just noticed your location on your profile.)

 

[tiredgirl91]

@JoKalsbeek

Thank you for this very useful reply! I have read a lot about the dawn phenomenon and while I know it exists, it is usually connected to prediabetics and diabetics (from what I've read) and it is not as pronounced in healthy people.
A fasting blood sugar of 10mmol/l just seems really out of place to me... Idk.
My HbA1c was 5.9. I also had a 2 hour OGTT test and I did not do well on that... My fasting was just below the diabetic value, and the 2 hour value was in the prediabetic range

 

[JoKalsbeek]

@JoKalsbeek

Thank you for this very useful reply! I have read a lot about the dawn phenomenon and while I know it exists, it is usually connected to prediabetics and diabetics (from what I've read) and it is not as pronounced in healthy people.
A fasting blood sugar of 10mmol/l just seems really out of place to me... Idk.
My HbA1c was 5.9. I also had a 2 hour OGTT test and I did not do well on that... My fasting was just below the diabetic value, and the 2 hour value was in the prediabetic range

5.9, had to convert that to mmol/mol because it meant nothing to me at first glance, but that's at the prediabetic threshold. Cut carbs a little, you probably won't have to do much more than that to get better numbers for the time being. Keep an eye on things though. No-one bothered to tell me I was prediabetic, there's so much I could've prevented if I'd known. And keep in mind people without diabetes get dawn phenomenon too, so don't kick yourself around over it.

 

[tiredgirl91]

@JoKalsbeek

I'm really sorry that you weren't able to tackle your health issues much earlier. Which brings me to the fact that I'm actually grateful that I'm diagnosed with prediabetes now... I understand how much of a difference an early diagnosis (or even just a warning sign) can make.

That being said, my other issue is that I'm really skinny (actually underweight) and I don't know how the reduction of carbs would affect my weight. I actually need to gain weight based on BMI and bodyfat % (abnormally low).

I have another question though: What is the "golden standard" test which is used to diagnose diabetes? Is it Hb1AC, or does the fasting one and the OGTT have the same diagnostic value?

 

[JoKalsbeek]

@JoKalsbeek

I'm really sorry that you weren't able to tackle your health issues much earlier. Which brings me to the fact that I'm actually grateful that I'm diagnosed with prediabetes now... I understand how much of a difference an early diagnosis (or even just a warning sign) can make.

That being said, my other issue is that I'm really skinny (actually underweight) and I don't know how the reduction of carbs would affect my weight. I actually need to gain weight based on BMI and bodyfat % (abnormally low).

I have another question though: What is the "golden standard" test which is used to diagnose diabetes? Is it Hb1AC, or does the fasting one and the OGTT have the same diagnostic value?

Woa, hold up... You're underweight? Did you lose weight recently and unexpectedly, without trying? While there is such a thing as TOFI (Thin Outside, Fat Inside), if you're underweight that's not very likely. Sudden weight loss could be indicative of Type 1 rather than Type 2, but I'm not seeing numbers that would correspond with late onset T1... The HbA1c is the gold standard, as you put it BUT.... It can turn up higher than it should be when someone's aneamic. If you are underweight there's a chance you might be iron deficient (and deficient in a bunch of other things as well), so... That'd skew results. In that case, you wouldn't be diabetic or prediabetic at all. So very much worth checking whether your iron's up to par, if you don't know yet.

Why are they looking into diabetes? What was the reason you were being checked out in the first place? Because the symptoms of high blood sugars can also occur in a whopping load of other conditions. If they're barking up the wrong tree, you best find out sooner rather than later.

For the moment, no carb cutting. If you're underweight and the diagnosis is nowhere near solid, just keep eating until you're 100% certain on what's going on. You need to put weight on, so eat, don't start anything drastic. And be a dog with a bone with this, don't let it go!

 

[tiredgirl91]

@JoKalsbeek

I was just doing routine bloodwork because yes, I've noticed that I've lost some kgs recently without really trying. I have been thin my whole life, but now it just seemed too drastic for me. My clothes are falling off me. And I was feeling very fatigued as well.
My bloodwork did not show anything abnormal (iron levels are good as well), except high fasting blood sugar. It was 6.9 mmol/l. I was immediately sent for OGTT and... rest is history. I was diagnosed as prediabetic. I got a glucose monitor recently and I'm seeing some really high readings an hour and two hours after my usual meals.
I have other symptoms like getting up to urinate at night, more than 3 times a night. And increased urination during the day.

I've been looking into Type 1.5/ LADA, idk if that is a possibility...

 

[JoKalsbeek]

@JoKalsbeek

I was just doing routine bloodwork because yes, I've noticed that I've lost some kgs recently without really trying. I have been thin my whole life, but now it just seemed too drastic for me. My clothes are falling off me. And I was feeling very fatigued as well.
My bloodwork did not show anything abnormal (iron levels are good as well), except high fasting blood sugar. It was 6.9 mmol/l. I was immediately sent for OGTT and... rest is history. I was diagnosed as prediabetic. I got a glucose monitor recently and I'm seeing some really high readings an hour and two hours after my usual meals.
I have other symptoms like getting up to urinate at night, more than 3 times a night. And increased urination during the day.

I've been looking into Type 1.5/ LADA, idk if that is a possibility...

What do you call "really high" readings? If you're losing weight fast and you really are having high readings, you should request C-peptide and GAD tests, and do it soon-ish... As in, put in a call tomorrow and get those organised. There are various versions of Type 1, but for some reason a lot of doctors still think it only occurs in children, and don't look beyond T2. Adult onset, especially if you're losing weight fast and seeing high blood sugars, is a real option. And if that is the case, you do need to be very careful. If at any point you start feeling ill while having high blood sugars, you call for help, okay? Because if you are a T1 variant, things can turn ugly really fast. ( @Antje77 , I'm tagging you in here because I think you might be more useful than I could be. I'm out of my depth here, I think, and I might be overly worried when I shouldn't be.)

 

[tiredgirl91]

@JoKalsbeek

I'm frequently seeing around 10mmol/l an hour after eating
and 8 or 9 mmol/l, two to three hours after a meal
(and these days I have been more careful around carbs mind you), so eating only whole wheat, beans, small amounts of rice and potatoes etc, and always paired with fat and protein. So not a huge amount of food really.

Again, thank you for taking the time to reply in such an elaborate way. I think I really should request those test as soon as possible. I have an ugly '"gut feeling" somehow.

 

[Antje77]

Like @JoKalsbeek said, being thin doesn't rule out T2 at all, but it can be another reason to keep in mind you could be something else than T2.
However, there are more thin T2's/prediabetics on the forum, it's not conclusive at all.

I'm frequently seeing around 10mmol/l an hour after eating
and 8 or 9 mmol/l, two to three hours after a meal
(and these days I have been more careful around carbs mind you), so eating only whole wheat, beans, small amounts of rice and potatoes etc, and always paired with fat and protein. So not a huge amount of food really.

Those are definitely not levels to be alarmed by in a T1 emergency kind of way, especially because you are testing so you'll notice if you should suddenly see numbers in the high teens or twenties all the time.

You're saying you don't eat much food really, what about eating more without increasing the carbs if you're close to underweight already? Whole wheat, beans, small amounts of rice and potatoes etc do increase blood glucose in (pre)diabetics, but cheese, cream, mayonnaise, fatty meats like pork belly or chicken legs etc. do not.

 

[tiredgirl91]

@Antje77

And what I forgot to mention before (and I think is quite significant), I have a family of Type 2, however, and all of them are/were thin or pretty much at the lower end of normal weight. I'm really afraid that if it is determined by genetics, I can only slow down the progression but not prevent it, after all
However, I will continue to control my fasting and postprandial numbers. And I will have another Hb1AC done in a month.

The thing with low carb is that it just makes me lose even more weight (It may be subconscious as I don't find LCHF food really appetizing) and I just end up eating less.

 

[DJC3]

The thing with low carb is that it just makes me lose even more weight (It may be subconscious as I don't find LCHF food really appetizing) and I just end up eating less.

What sort of lc meals have you tried? Have you looked at many of the lc websites, maybe for higher protein meals rather than the high fat things? Try DietDoctor.com if you haven’t already
Can you maybe add calories without increasing carbs too much by eating more nuts or cheese?

 

[tiredgirl91]

@DJC3

Since getting my prediabetes diagnosis I've been experimenting with adding more fat and/or protein to my meals in the form of meat, fish, full fat dairy, nuts etc. and all it does it makes me feel very satiated very quickly (i.e. ending up in a calories deficit at the end of the day) as I try to limit snacks because I'm afraid of frequent spikes.
And on top of that, I feel really fatgued when I'm reducing my carbs.

On the other hand, I find it easier to eat carbs because I crave them. On the other hand, I don't seem to tolerate them well even though I've never been an "unhealthy" eater (I rarely eat fastfood, desserts, candies etc.)

I don't know... This situation is just so confusing to me, I feel like I can't win.

 

[Antje77]

And what I forgot to mention before (and I think is quite significant), I have a family of Type 2, however, and all of them are/were thin or pretty much at the lower end of normal weight.

Has any of your family members been tested for MODY diabetes that you know of?

 

[tiredgirl91]

Has any of your family members been tested for MODY diabetes that you know of?

As far as I know, no. They are all classified as Type 2.
I know something about LADA but MODY is a whole new concept to me... And it gets more and more confusing :/

 

[Antje77]

As far as I know, no. They are all classified as Type 2.
I know something about LADA but MODY is a whole new concept to me... And it gets more and more confusing :/

MODY is a type of diabetes that strongly runs in families, and it's very often misdiagnosed.
While T2 also tends to run in families, it's also associated statistically with being overweight. So if you have a family with many non overweight diabetics (who aren't T1) there may be something to find there.

Or it may just be coincidence and a strong tendency to T2 of course.

 

[tiredgirl91]

MODY is a type of diabetes that strongly runs in families, and it's very often misdiagnosed.
While T2 also tends to run in families, it's also associated statistically with being overweight. So if you have a family with many non overweight diabetics (who aren't T1) there may be something to find there.

Or it may just be coincidence and a strong tendency to T2 of course.

That's interesting. From what I've read, MODY stands for "Maturity-onset diabetes of the young" and it shows up at a relatively young age. Now, I'm (relatively) young (in my early 30s).
But in all of my family members, the diabetes appeared at an older age. I think, 50+ or even later.

 

[GDM06]

First off, breathe.

Okay, so. When you wake in the morning, there's something called Dawn Phenomenon, which means your liver dumps glucose into your bloodstream. (Though I think you may already have read this). Thing is, the liver doesn't just do that upon waking. It does the same thing when you're stressed, when you have a restless night with nightmares or insomnia, when you wake up a few times to go to the loo, or the neighbour's dog's being loud... Maybe hormones are wreaking havoc. Maybe you had a cold. Anything can happen. There's so many reasons why the dump may be higher some mornings than others. And the fasting numbers are the last ones to go down, should you tackle the daytime (post-meal) numbers. You could have absolutely beautiful bloodsugars all day long, and still have a bit of a peak in the morning. So those numbers mean exactly nothing in terms of whether or not you're crossed the diabetic threshold, okay? Your HbA1c is much more meaningful far as that is concerned, and since your diagnosis is recent, I think they may have been done not too long ago? What was your HbA1c, do you happen to know, or can you look it up?

In any case, have a read here about the whole diabetes thing and how to get numbers down, but for the moment... No worries. You're not doomed or anything. You came to the right place to get your numbers down, whatever they are. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Hugs,
Jo

Thanks for this Jo,
I have been thinking about this as I have always struggled with fasting glucose. Even during pregnancy, it was difficult to get my fasting blood glucose below 5.5, the just kept increasing basal insulin.
I can hardly get fasting BG below 6.5 generally 7, and I get a 1-2 units rise with meals, in fact, pre-evening meals I am 4.2 -5.6.
I bought a CGM and noticed from 4 am-4.30 am my BG starts rising from about 6-7
I am also fasting until 11 am and I am on a low carb diet (20-30g daily), I have never been a breakfast person, breakfast makes me feel uncomfortable I am slower and bloated with breakfast and it sometimes makes me nauseous.
I guess from your message as long as HBA1C is fine then I shouldn't worry too much about the fasting sugar!

 

[Musiecat]

@JoKalsbeek

I was just doing routine bloodwork because yes, I've noticed that I've lost some kgs recently without really trying. I have been thin my whole life, but now it just seemed too drastic for me. My clothes are falling off me. And I was feeling very fatigued as well.
My bloodwork did not show anything abnormal (iron levels are good as well), except high fasting blood sugar. It was 6.9 mmol/l. I was immediately sent for OGTT and... rest is history. I was diagnosed as prediabetic. I got a glucose monitor recently and I'm seeing some really high readings an hour and two hours after my usual meals.
I have other symptoms like getting up to urinate at night, more than 3 times a night. And increased urination during the day.

I've been looking into Type 1.5/ LADA, idk if that is a possibility...

Hi have they checked your thyroid