Prediabetes cured??

[DanW13]

Hi,

Background - diagnosed in September 2020 with prediabetes after putting on half a stone during Covid lockdown. HBA1C of 43.

Went low carb circa 50g a day of carbs, lost over 2 stone in 6 months, reduced A1C down to 37. Remained low carb ever since with steady annual A1C of 38 last 2 years.

Had latest test yesterday, was a bit nervous as turned 50 last month and had a few birthday celebrations (alcohol, several other carby treats), plus a week in Barbados where I fell victim to some iffy sugary cocktails. However latest HBA1C has come back as 33!

I’ve 2 thoughts on the result, 1) Could it be an outlier reading, read you can add/deduct 3 or 4 points to the reading during to variation of testing etc. So I could in fact be 36/37 still which would be closer to previous readings. Or 2) Could my mildly damaged pancreas have healed itself and after 3 years low carb it’s now functioning normally again, hence much lower reading?

Appreciate even if it is 2) it’s not a licence to go back to old ways as it’s more full remission, but it does at least mean hopefully I can relax a bit on holiday maybe and not stress if I have the odd ice cream or beer! I’ll stay low carb due to other health benefits also.

Thoughts?? Have others seen consistent A1C results followed by a sharp fall after a period of time on low carb/Keto diets?

cheers
Dan

p.s LDL & cholesterol were up a bit so did pay a bit of a price for the birthday celebrations & holiday! Know how to sort that out though & Trig/HDL was just 0.5 still sit too worried anyway. Blood pressure in ideal range also.

 

[ianf0ster]

Hi @DanW13 congrats on the low HbA1C test result.
You were only just in the pre-diabetic range in the first place, so I'm a bit doubtful as to whether you are a case of pre-diabetes being 'cured'.
But a drop from 43 (originally), to 33 now is no mean achievement.

Whether holidays and relaxing on the carb front have a noticeable effect on your HbA1C will depend upon when that is (in relation to when you are tested), how much higher carb you go and for how long you do so. I don't know of any medical studies that show long term improvement (lowering) of insulin resistance, but I don't know of any that rule it out altogether either!

 

[KennyA]

Hi,

Background - diagnosed in September 2020 with prediabetes after putting on half a stone during Covid lockdown. HBA1C of 43.

Went low carb circa 50g a day of carbs, lost over 2 stone in 6 months, reduced A1C down to 37. Remained low carb ever since with steady annual A1C of 38 last 2 years.

Had latest test yesterday, was a bit nervous as turned 50 last month and had a few birthday celebrations (alcohol, several other carby treats), plus a week in Barbados where I fell victim to some iffy sugary cocktails. However latest HBA1C has come back as 33!

I’ve 2 thoughts on the result, 1) Could it be an outlier reading, read you can add/deduct 3 or 4 points to the reading during to variation of testing etc. So I could in fact be 36/37 still which would be closer to previous readings. Or 2) Could my mildly damaged pancreas have healed itself and after 3 years low carb it’s now functioning normally again, hence much lower reading?

Appreciate even if it is 2) it’s not a licence to go back to old ways as it’s more full remission, but it does at least mean hopefully I can relax a bit on holiday maybe and not stress if I have the odd ice cream or beer! I’ll stay low carb due to other health benefits also.

Thoughts?? Have others seen consistent A1C results followed by a sharp fall after a period of time on low carb/Keto diets?

cheers
Dan

p.s LDL & cholesterol were up a bit so did pay a bit of a price for the birthday celebrations & holiday! Know how to sort that out though & Trig/HDL was just 0.5 still sit too worried anyway. Blood pressure in ideal range also.

Pre-diabetes isn't a disease so technically you can't be diagnosed with it. It's right to be concerned if your BG drifts up out of normal range, though. One reading of 43 (was it just the one?) is within the 5% allowable error (if it was a lab-test HbA1c) of a normal result. Your 33 is probably close enough - the result is certainly in the range of around 31.5 to 34.5.

Were you told that your pancreas was damaged? The more likely explanation for your higher reading is that you had developed a bit of insulin resistance - plenty of insulin, but your muscle cells weren't able to utilise it properly. Reducing the glucose load for a period tends to lower insulin levels, and give your systems a chance to regain a bit of sensitivity. If you've largely been keeping to the low-carb path since that would tend to confirm it.

It is much, much better to do what you've done rather than wait for formal diagnosis or symptoms to start. Yes, it's entirely possible to make very large reducations in BG quite quickly - there are a couple of accounts in the "Success Stories" section from people who reduced three figure A1cs to normal in a few months.

 

[DanW13]

Pre-diabetes isn't a disease so technically you can't be diagnosed with it. It's right to be concerned if your BG drifts up out of normal range, though. One reading of 43 (was it just the one?) is within the 5% allowable error (if it was a lab-test HbA1c) of a normal result. Your 33 is probably close enough - the result is certainly in the range of around 31.5 to 34.5.

Were you told that your pancreas was damaged? The more likely explanation for your higher reading is that you had developed a bit of insulin resistance - plenty of insulin, but your muscle cells weren't able to utilise it properly. Reducing the glucose load for a period tends to lower insulin levels, and give your systems a chance to regain a bit of sensitivity. If you've largely been keeping to the low-carb path since that would tend to confirm it.

It is much, much better to do what you've done rather than wait for formal diagnosis or symptoms to start. Yes, it's entirely possible to make very large reducations in BG quite quickly - there are a couple of accounts in the "Success Stories" section from people who reduced three figure A1cs to normal in a few months.

Sorry yes not explained myself well at all, no pancreas damage was referring to insulin resistance & pancreas thus producing more to compensate. Querying if that has now fully reversed due to being low carb for 3 years and only just putting a foot into the prediabetes range. It was just the one reading at 43.

Thanks
Dan

 

[KennyA]

Sorry yes not explained myself well at all, no pancreas damage was referring to insulin resistance & pancreas thus producing more to compensate. Querying if that has now fully reversed due to being low carb for 3 years and only just putting a foot into the prediabetes range. It was just the one reading at 43.

Thanks
Dan

That makes sense. The thing that tells you where you are is your A1c. If you've been having consistent results in the low to mid-30s it shows that your overall level of glucose intake isn't challenging your system. Yes, you may be having odd periods where carb/sugar intake rises but these are not having a long term effect. In my view that would tend to confirm that your insulin system is functioning as it should.

If you overloaded it for longer periods, though, it might well not cope they way it didn't cope before - and you'd see your A1c results steadily rising again. I'm always a bit uneasy about talking about "reversing" or "remission" as absolutes - I prefer to say that I'm managing or controlling my condition. "Remission" has recently been defined as simply two successive HbA1c results below 48, six months apart, without glucose lowering medication being used. I don't think this is particularly helpful.

 

[ianf0ster]

......................................... "Remission" has recently been defined as simply two successive HbA1c results below 48, six months apart, without glucose lowering medication being used. I don't think this is particularly helpful.

I don't see why you don't find it helpful. Remission (in cancer for example) isn't the same as cure and can be reversed - i.e. back to disease progression.
Diabetes is the same - somebody is only in T2D remission for as long as they continue to get 6 monthly HBa1C 's of below 48 without use of glucose lowering medication. Basically, once in remission you are in it until you aren't!

If your GP only tests each year, then you don't know if you are in remission or not (I'm in that situation currently since last HbA1C more than 6 months ago), but the presumption is that since my BG control has not changed, then I'm still in remission pending evidence to the contrary.

 

[KennyA]

I don't see why you don't find it helpful. Remission (in cancer for example) isn't the same as cure and can be reversed - i.e. back to disease progression.
Diabetes is the same - somebody is only in T2D remission for as long as they continue to get 6 monthly HBa1C 's of below 48 without use of glucose lowering medication. Basically, once in remission you are in it until you aren't!

If your GP only tests each year, then you don't know if you are in remission or not (I'm in that situation currently since last HbA1C more than 6 months ago), but the presumption is that since my BG control has not changed, then I'm still in remission pending evidence to the contrary.

Because I don't think having two A1cs of 47 is a good definition of remission. I had a range of nasty diabetic symptoms at much lower BG levels.

That definition enables a payment trigger to be set, but it completely overlooks the experience of the individual with diabetes.

 

[catinahat]

If I were you I wouldn't look at it as reversed , remission, cured or anything else.
Your excesses during covid merely highlighted that you are becoming resistant to your insulin.
Plenty of people, in fact most people did exactly the same as you throughout the pandemic without becoming pre diabetic. Their lack of exercise and poor diet didn't cause them to become insulin resistant, why would it cause you to be.
So you didn't cause your pre D, and by eating less carbs you haven't cured it either, just controlled it.