Hbac1 Not Playing Ball

[Sunnysarah 2]

Hello

I am 67 years old, generally healthily had kneee replacement, on statins and low bp medication. I am 65kg and very active, I ride a bike 30-60min each day and swim twice a week.

My diet I would say is healthy, in the last year or 2 I have had much mire fruit and veg in my diet.

I randomly got a result of 41 on my HbA1c and was shocked as nothing has ever come up before, I watched my sugar intake and was very good with it, cut out sugar in my drinks, cut out chocolate all together and the retest a few months later came back 42. So, confused I carried on but still lived my life without sugar and it came back 44 this time.

I have a machine at home which my daughter bought me and I generally do it first thing in the morning without having had anything to eat or drink and my readings are between 5-6.5.

My brother is diabetic and has been since he was 20 (insulin).

Am I trying to fight a loosing battle here by trying to diet control this? Nothing seems to be working and I 100% know I can't cut anything else out as I am eating the right things.

Everyone says prediabieties is reversible with diet and excersise but I already do the right things and am not overweight so how can I help myself?

Appreciate you reading and any replies x

 

[EllieM]

Everyone says prediabieties is reversible with diet and excersise but I already do the right things and am not overweight so how can I help myself?

Prediabetes is often reversible if it's T2. But you've got a family history of T1, so it''s possible you're LADA, which is likely to (slowly) progress to insulin.
On the other hand, does cutting out sugar include cutting out carbs in general (eg bread, pasta, rice, potatoes), because if it doesn't you've got considerable scope for cutting out additional carbs. Have you sat down and counted all the carbs you have in a day?

You've got a healthy diet and lifestyle, so you can still be healthy even if (worst case scenario) you have to go onto insulin.

 

[Guzzler]

Hello and welcome to the forum. Tag for the @daisy1 info pack.

Please remember that aging alone means that our bodys metabolic functions arn't as efficient as they may once have been. May I ask about your diet, please? A lot of us find that even with a healthy diet a few tweaks here and there can often make a big difference. Could you give us a typical day's menu, we may be able to point out foods that are considered healthy for those who do not have problems with blood glucose levels but that can greatly affect us.

 

[Bluetit1802]

Hi and welcome to the forum.

I wish I had a pound for every new comer to this forum that states they eat a healthy diet so cannot understand why they have high blood sugars. One thing that jumps out at me is that you eat more fruit. Fruit is one group of foods that we, as diabetics, have to be very careful with. It contains a lot of sugar (fructose). It isn't just table sugar and chocolate you need to avoid I'm afraid. All carbs convert to sugar once eaten, so we have to be very careful in how many and which type of carbs we eat.

As @Guzzler said, we may be able to spot something to help you with if you give us a list of foods you typically eat at each meal time and snacks.

 

[Sunnysarah 2]

I basically cut fruit out after I was given the first blood result-I do have some blueberries but I have researched and they are the lowest sugar fruit and I don't have many.

Typical day

Toast
Chicken or cheese salad with mayo
Meat with Sweet potato or veg

Snacks- handful of blueberries (sometimes) homemade broccoli and cauliflower soup
Crackers and cheese

Drinks- water, tea with no sugar or milk. No sugar cordial or no sugar pop

 

[Bluetit1802]

Before people become very confused when trying to respond, please would you check your diabetes status in your profile? It is saying you are Type 1, and this shows under your avatar. If you go to your profile settings and look for the drop down box, you can pick a more correct status. There is a "pre-diabetes" choice. It makes a big difference to the type of responses you will receive.
(I am assuming you are pre-diabetic, diet only)

 

[Guzzler]

The things that stand out are the bread, could you try out a lower carb option like HiLo or Bergen?
The sweet potato, better than white potato but there is celeriac which is a great alternative.
The blueberries, I find a small portion of raspberries or strawberries in double cream or full fat greek yoghurt does not spike my levels at all. By the way, do you use a glucometer at home?

 

[dawnmc]

Toast is not really an ideal breakfast, try changing it for eggs in any form. Also read your statin leaflet, I believe it now says something about diabetes being a 'side effect'.

 

[Bluetit1802]

I agree that toast is not a wise choice, including wholemeal bread. Also blueberries can be very difficult. Strawberries and raspberries are better choices, in small amounts as part of a meal with cream or full fat yogurt, and not as a stand alone snack. Nuts are a better choice. Crackers? It depends how many and which type. It should tell you on the packet how many carbs per cracker or per 100g there are. Sweet potato has the same amount of carbs as ordinary spuds.

 

[Guzzler]

Toast is not really an ideal breakfast, try changing it for eggs in any form. Also read your statin leaflet, I believe it now says something about diabetes being a 'side effect'.

Aye, statins are known to raise blood glucose levels.

 

[Sunnysarah 2]

I can happily change toast for eggs, again it's all very rough and isn't every day of course, I follow the guide I got given at the drs and check the carb/'of which sugars' as they told me to. The drs leaflet told me to swap regular potato for sweet which I have but i usually have meat and veg for tea so my carb intake isn't high, crackers-low sugar/calorie.

Blueberries have the lowest sugar so I have those occasionally but not daily.

I have cashew nuts as snacks also..sorry I forgot to mention

I don't use a gluco meter religiously, my daughter bought me one to keep an eye on it and I do it first thing and get reading of 5-6.5

 

[Alexandra100]

I have cashew nuts as snacks also..sorry I forgot to mention

A few nuts make a great snack, though even with nuts the carbs can mount up, so better to measure out a portion before hand. Sadly, cashew nuts are comparatively high in carbs, though not as high as peanuts. Walnuts, pecans, almonds, brazils are a lower alternative.

 

[Alexandra100]

I don't use a gluco meter religiously, my daughter bought me one to keep an eye on it and I do it first thing and get reading of 5-6.5

Even more important than your fasting bg first thing is the rise you see on your meter after meals. With a person who has a totally normal response to carbs, their bg tends to rise somewhat by one hour after a meal and have fallen again to their pre-meal level after 2 hours. It is therefore suggested that we test just before eating and then 2 hours after to start getting an idea which foods are a problem for us. This time scheme is very approximate, as lots of fat in a meal can delay things, as can other factors, but testing like this is a good start.

 

[Resurgam]

Check the packet of the blueberries - when grown in the US they are the highest, not the lowest carb content - and having tried then I fin that they have very little flavour. I tried some UK grown blueberries which are lower in carb, but they are still not the lowest.
You need to check the amount of carbs, not the sugars - carbohydrate is digested to form simple sugars, so if there are 10 gm of carb there are 10 gn of carb - even if there is no sugar, or 'no added sugar' which is no help at all if the product contains carbs or sugars by its nature.
For me sweet potatoes are worse than ordinary ones, I don't eat grains of any sort, and chose low carb nuts, as there can be a huge difference in the carb content.
I have been reduced to tears of helpless laughter at the advice I have been given for diabetes 'education', followed by tears at the thought of those who have been mislead by it.

 

[Sunnysarah 2]

It's so frustrating to work so so hard at something (understand the labeling for 'of which sugars' and now to be told to go for the carbohydrate before the 'of which sugars'

I was told to aim for under 20g 'of which sugars' which I have done to a t

Thank you for your advice, what number of carbs should I aim for? My drs never mentioned it once to me.

I just checked my blueberries vs rasberies and carb raspberries win and blueberries win the 'of which sugars' I'll go bang my head against the wall

 

[bulkbiker]

It's so frustrating to work so so hard at something (understand the labeling for 'of which sugars' and now to be told to go for the carbohydrate before the 'of which sugars'

I was told to aim for under 20g 'of which sugars' which I have done to a t

Thank you for your advice, what number of carbs should I aim for? My drs never mentioned it once to me.

I just checked my blueberries vs rasberies and carb raspberries win and blueberries win the 'of which sugars' I'll go bang my head against the wall

The problem you have is.. we all have (or have had) diabetes.. I'm guessing your doctors and nurses don't?
A whole lot of us have used a low carbohydrate diet to keep our bloods sugars close to or in the "normal ranges".
All carbohydrates are processed into glucose by the body which is why the "of which sugars" is irrelevant to you (and us) you need to look at the whole carbohydrate content of food.
Breads. starchy veg, pasta, rice, most fruit are all high in carbs so are best avoided.
Meat, fish, eggs, dairy, green veg, salads are all far better so if you base your meals around those you should get much better results.

 

[sally and james]

@Sunnysarah 2 Don't bang your head against the wall, it'll hurt! Instead, have a good long look at this site, https://www.dietdoctor.com/low-carb
It'll tell you all your own doctor should have told you about diet, then you can come back here and ask any questions.
Sally

 

[Alexandra100]

It's so frustrating to work so so hard at something (understand the labeling for 'of which sugars' and now to be told to go for the carbohydrate before the 'of which sugars'

I was told to aim for under 20g 'of which sugars' which I have done to a t

Thank you for your advice, what number of carbs should I aim for? My drs never mentioned it once to me.

I just checked my blueberries vs rasberies and carb raspberries win and blueberries win the 'of which sugars' I'll go bang my head against the wall

Sorry about the frustration. Chalk your superseded knowledge (about "of which sugars") up to Alzheimer's-defeating mental exercise. The good news is that where you felt you had come up against a brick wall, you have actually discovered a door into a better future! There is so much ignorance and out-dated thinking abut diabetes among health professionals (and fear of change AND often determinedly blind arrogance). Many of us have had to choose between the low carb theories that have helped so many people here and the official guidance. Well, you gave the method you were taught a good go, and it hasn't worked.

I too started with an A1c of 41, but as I had been following a fanatically pure Mediterranean-style healthy diet I knew that to lower my bg I had to try something different. In the beginning I thought that as 41 is not even quite pre-diabetic, all I would have to do was reduce my intake of fruit and chocolate a little bit. How wrong I was! Painfully over months I have been obliged to lower my carb intake until I am only eating c.20g / 30g max daily. You may well be luckier. But at worst even on 20g carbs daily, life goes on, food still tastes good. There's a lot to learn, but it's very interesting.

You will learn from your meter how many carbs you can tolerate / thrive on. No-one else can tell you. If you look at the signatures below posts, many people have mentioned their diets and their A1cs, among other details. There are many successes, and you can glean ideas from what they have done. You might find this helpful:
http://www.phlaunt.com/diabetes/14045524.php
Good luck!

 

[Bluetit1802]

I was told to aim for under 20g 'of which sugars' which I have done to a t

Goodness me! That is poor advice. It is no wonder your HbA1c is creeping up.

The more "sugar in the of which sugar amount" the faster the glucose in the food will be released to the bloodstream, but that is the only reason to take note of the "of which sugar" amount. This is because any sugar is already included in the total carb amount. You need to look at the total carb count as ALL carbs turn to glucose. How much you allow yourself in a day is up to you and how well your body copes with carbs. We all differ in this. This is where your meter will guide you.

Try this -
Test immediately before you eat.
Test again 2 hours after first bite
Keep a detailed food diary including portion sizes
Record your before and after levels alongside the food
Look at the difference between before and after
This needs to be as little as possible, and definitely under a 2mmol/l rise.
Too big a rise and there are too many carbs in that meal for your body to process.
Make notes alongside of any activities/snacks/drinks you had during that 2 hour period.

The 2 hour test is a general guide. This level will not be your peak. Your peak could be anywhere between half an hour after first bite to 3 hours after first bite, depending on the content of the meal and also your own metabolism.

 

[daisy1]

@Sunnysarah 2

Hello Sarah 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 like and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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 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. Most of these are 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
  
  
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