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Help please. I am very confused

P

Psub

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Messages
5
Hi all

After a few days of reading I am still confused as to the pre-diabetic news received from my GP. I have a HbA1c aligned level of 6.3%. This seems to indicate that my blood sugars over 3 months are higher than normal.

I have bought myself a blood sugar tester and after a week of testing the pattern reveals as follows

A fasting average first thing in a morning of 5.7 mnol/L

Two hours after breakfast it rises to 7.2 mnol/L

Before food it’s at 5.8 mnol/L

After food it’s at 7.3 mnol/L

The above seems to suggest my blood sugars are on the lower side for a prediabetic ?

Does the HbA1c test contradict the test results I am taking with my tester ?

Confused !
 
Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

It seems you have traversed from normal blood glucose levels to high normal and on to low pre Diabetes levels. At this stage you could go back to normal levels within weeks or months. A few tweaks to your diet should see your fasting and pre/post meal readings improve by leaps and bounds.
Well done on buying and using your meter, this is our best tool in managing our levels by teaching us which foods we may need to cut back on.

Have a wander around the forum and ask as many questions as you like.
 
Your hb1ac is the equivalent of 45mmol, pretty much the middle of prediabtic range.

Depending on what food you’re eating you might be missing higher numbers. Some things spike you quicker eg some fruits, others more slowly eg whole grains or food eaten with a lot of fat.

Your fasting is a smidge above normal.

Have you changed your eating patterns since diagnosis? If for example you had a carb heavy Christmas with lots of higher numbers then your hb1ac would be higher.
 
Psub said:
Hi all

After a few days of reading I am still confused as to the pre-diabetic news received from my GP. I have a HbA1c aligned level of 6.3%. This seems to indicate that my blood sugars over 3 months are higher than normal.

I have bought myself a blood sugar tester and after a week of testing the pattern reveals as follows

A fasting average first thing in a morning of 5.7 mnol/L

Two hours after breakfast it rises to 7.2 mnol/L

Before food it’s at 5.8 mnol/L

After food it’s at 7.3 mnol/L

The above seems to suggest my blood sugars are on the lower side for a prediabetic ?

Does the HbA1c test contradict the test results I am taking with my tester ?

Confused !
Click to expand...
Hi!

Your levels look like you can be brought back from the brink, of the brink. ;) Think just a bit of tweaking will work wonders for you, so you might just cut back some, instead of scratching food items off your list entirely. But it's up to you of course. Here's my little nutrition thingy, hope it helps!
Jo

There’s a few things you should know.

1. Practically all carbs turn to glucose once ingested, so not just straight sugars, but starches too. Food doesn’t have to taste sweet to make your blood sugars skyrocket.

2. A meter helps you know what foods agree with you, and which don’t. Test before and 2 hours after the first bite. If you go up more than 2.0 mmol/l, the meal was carbier than you could handle. (It’s easy to remember, as you’re a T2: all 2’s, all over the place!)

3. In case you didn’t know already, this isn’t your fault. It’s genetics, medication, decades of bad dietary advice, and basically all manner of things, but nothing you can actually blame yourself for.

4. Diabetes T2 is a progressive condition, unless you (also) change your diet. So you have options. Diet-only, diet with medication, or medication only. But that last option will most likely mean more medication over the years. (And there is more than just metformin, so if it doesn’t agree with you, there’s lots of others to try). So even if going really low carb isn’t for you, you might consider moderately low carb an option, with meds to assist.

5. Are you overweight? 90% of T2’s are. Yeah, that means 10% are slim and always were. If you did gain weight, it was the precursor of this metabolic condition. We make loads of insulin, but become insensitive to it. So carbs we eat turn to glucose, and normally, insulin helps us burn that glucose for fuel. When it doesn’t, that glucose is stored in fat cells instead. When those fat stores are full, the glucose remains in our bloodstream, overflowing, into our eyes, tears, urine, saliva… And then we’re T2’s. So weight gain is a symptom, not a cause. This also means that “regular” dietary advice doesn’t work for us. The problem lies in our inability to process carbs. And most diets focus on lowering fats and upping carb intake. Which is the direct opposite of what a T2, or prediabetic, for that matter, needs.

6. There are 3 macro-nutrients. Fats, protein and carbohydrates. Those macro’s mean we get the micro-nutrients we need: that would be vitamins and minerals. So… If you ditch the carbs, you should up another macro-nutrient to compensate, to make sure you don’t get malnourished or vitamin deficient. Carbs make our blood sugars rise. Protein too, but nowhere near as bad as carbs do, so they’re alright in moderation. Fats however… Fats are as good as a glucose-flatline. Better yet, they’ll mitigate the effects of any carbs we do ingest, slowing down their uptake and thus the sugar-spike. Contrary to what we’ve been told for decades; fats are our friends.

7. Worried about cholesterol? On a low carb diet, your cholesterol may rise a little as you start to lose weight. That’s a good thing though. (Believe it or not). What was already there, stored in your body, is starting to head for the exit, and for that it’ll go into your bloodstream first. So when you have lost weight and it stabilises, so will your cholesterol. And it’ll probably be lower than what it was before you started out.

8. You’ll lose weight on a low carb diet. Weight loss will help with your insulin-resistance, and not only that… Going low carb might help with other issues as well, like non-alcoholic fatty liver disease and depression.

9. Always ask for your test results. You don’t know where you’re going, if you don’t know where you’ve been.

10. Last, but certainly not least: If you are on medication that has hypoglycemia listed as a side-effect, like Gliclazide for instance, do NOT attempt a LCHF diet without a meter nor your doctors’ knowledge/assistance. You can drop blood glucose levels too far, too fast, if your dosage isn’t adjusted accordingly. This could mean a lower dose in stages or even stopping medication completely. Never do this without discussing it with your doctor first!


So what raises blood sugars? Aside from the obvious (sugar), starches raise blood glucose too. So bread, and anything made with grain/oats flour, rice, potatoes, pasta, corn, cereals (including all the “healthy choices”, like Weetabix and muesli), most beans and most fruits. So you’ll want to limit your intake, or scratch them altogether.

Which food items remain on the shopping list? Well, meat, fish, poultry, above ground veggies/leafy greens, eggs, cheese, heavy cream, full fat Greek yoghurt, full fat milk, extra dark chocolate (85% Lindt’s is great!), avocado, (whole) tomatoes, berries, olives, nuts, that sort of thing… Meal ideas? Have a couple:

Scrambled eggs with bacon, cheese, mushrooms, tomato, maybe some high meat content sausages?
Eggs with ham, bacon and cheese
Omelet with spinach and/or smoked salmon
Omelet with cream, cinnamon, with some berries and coconut shavings
Full fat Greek yoghurt with nuts and berries
Leafy green salad with a can of tuna (oil, not brine!), mayonnaise, capers, olives and avocado
Leafy green salad with (warmed goat's) cheese and bacon, maybe a nice vinaigrette?
Meat, fish or poultry with veggies. I usually go for cauliflower rice or broccoli rice, with cheese and bacon to bulk it up. Never the same meal twice in a row because of various herbs/spices.

Snacks? Pork scratchings, cheese, olives, extra dark chocolate, nuts. :)

Of course, there’s loads more on the web, for people more adventurous than I. (Which is pretty much everyone). Just google whatever you want to make and add “keto” to it, and you’ll get a low carb version. There’s a lot of recipes on the diabetes.co.uk website, as well as on www.dietdoctor.com where you’ll also find visual (carb content) guides and videos. And I can wholeheartedly endorse Dr. Jason Fung’s book The Diabetes Code. It’ll help you understand what’s going on in your body and how to tackle it, whilst not being a dry read. Not only that, but you’ll know what to ask your doctor, and you’ll understand the answers, which is, I believe, quite convenient.
 
Guzzler said:
Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

It seems you have traversed from normal blood glucose levels to high normal and on to low pre Diabetes levels. At this stage you could go back to normal levels within weeks or months. A few tweaks to your diet should see your fasting and pre/post meal readings improve by leaps and bounds.
Well done on buying and using your meter, this is our best tool in managing our levels by teaching us which foods we may need to cut back on.

Have a wander around the forum and ask as many questions as you like.
Click to expand...
Thanks so much for the reply
 
Thank you all for the replies, they are appreciated. Could I expand a little further as you may be able to help.

Since getting the unexpected news two weeks ago that I am pre-diabetic, I have straight away cut out the very limited processed food that I eat and switched away from white rice, bread, pasta to wholewheat alternatives. For a number of months now I have noticed that I feel quite unwell at times before meals. This seems to have been a little worse in the past two weeks and I have had a couple of occasions when I really have felt anxious, tense and stressed all of which seems to ease within twenty minutes of eating.

I was diagnosed in November last year with M.E which throws up many strange symptoms. My mission at the moment is to work out what triggers what and do my best to tackle each symptom. Given the readings I report do you feel that they are low enough to trigger the pre-meal episodes that I get ?

Thanks all
 
JoKalsbeek said:
Hi!

Your levels look like you can be brought back from the brink, of the brink. ;) Think just a bit of tweaking will work wonders for you, so you might just cut back some, instead of scratching food items off your list entirely. But it's up to you of course. Here's my little nutrition thingy, hope it helps!
Jo

There’s a few things you should know.

1. Practically all carbs turn to glucose once ingested, so not just straight sugars, but starches too. Food doesn’t have to taste sweet to make your blood sugars skyrocket.

2. A meter helps you know what foods agree with you, and which don’t. Test before and 2 hours after the first bite. If you go up more than 2.0 mmol/l, the meal was carbier than you could handle. (It’s easy to remember, as you’re a T2: all 2’s, all over the place!)

3. In case you didn’t know already, this isn’t your fault. It’s genetics, medication, decades of bad dietary advice, and basically all manner of things, but nothing you can actually blame yourself for.

4. Diabetes T2 is a progressive condition, unless you (also) change your diet. So you have options. Diet-only, diet with medication, or medication only. But that last option will most likely mean more medication over the years. (And there is more than just metformin, so if it doesn’t agree with you, there’s lots of others to try). So even if going really low carb isn’t for you, you might consider moderately low carb an option, with meds to assist.

5. Are you overweight? 90% of T2’s are. Yeah, that means 10% are slim and always were. If you did gain weight, it was the precursor of this metabolic condition. We make loads of insulin, but become insensitive to it. So carbs we eat turn to glucose, and normally, insulin helps us burn that glucose for fuel. When it doesn’t, that glucose is stored in fat cells instead. When those fat stores are full, the glucose remains in our bloodstream, overflowing, into our eyes, tears, urine, saliva… And then we’re T2’s. So weight gain is a symptom, not a cause. This also means that “regular” dietary advice doesn’t work for us. The problem lies in our inability to process carbs. And most diets focus on lowering fats and upping carb intake. Which is the direct opposite of what a T2, or prediabetic, for that matter, needs.

6. There are 3 macro-nutrients. Fats, protein and carbohydrates. Those macro’s mean we get the micro-nutrients we need: that would be vitamins and minerals. So… If you ditch the carbs, you should up another macro-nutrient to compensate, to make sure you don’t get malnourished or vitamin deficient. Carbs make our blood sugars rise. Protein too, but nowhere near as bad as carbs do, so they’re alright in moderation. Fats however… Fats are as good as a glucose-flatline. Better yet, they’ll mitigate the effects of any carbs we do ingest, slowing down their uptake and thus the sugar-spike. Contrary to what we’ve been told for decades; fats are our friends.

7. Worried about cholesterol? On a low carb diet, your cholesterol may rise a little as you start to lose weight. That’s a good thing though. (Believe it or not). What was already there, stored in your body, is starting to head for the exit, and for that it’ll go into your bloodstream first. So when you have lost weight and it stabilises, so will your cholesterol. And it’ll probably be lower than what it was before you started out.

8. You’ll lose weight on a low carb diet. Weight loss will help with your insulin-resistance, and not only that… Going low carb might help with other issues as well, like non-alcoholic fatty liver disease and depression.

9. Always ask for your test results. You don’t know where you’re going, if you don’t know where you’ve been.

10. Last, but certainly not least: If you are on medication that has hypoglycemia listed as a side-effect, like Gliclazide for instance, do NOT attempt a LCHF diet without a meter nor your doctors’ knowledge/assistance. You can drop blood glucose levels too far, too fast, if your dosage isn’t adjusted accordingly. This could mean a lower dose in stages or even stopping medication completely. Never do this without discussing it with your doctor first!


So what raises blood sugars? Aside from the obvious (sugar), starches raise blood glucose too. So bread, and anything made with grain/oats flour, rice, potatoes, pasta, corn, cereals (including all the “healthy choices”, like Weetabix and muesli), most beans and most fruits. So you’ll want to limit your intake, or scratch them altogether.

Which food items remain on the shopping list? Well, meat, fish, poultry, above ground veggies/leafy greens, eggs, cheese, heavy cream, full fat Greek yoghurt, full fat milk, extra dark chocolate (85% Lindt’s is great!), avocado, (whole) tomatoes, berries, olives, nuts, that sort of thing… Meal ideas? Have a couple:

Scrambled eggs with bacon, cheese, mushrooms, tomato, maybe some high meat content sausages?
Eggs with ham, bacon and cheese
Omelet with spinach and/or smoked salmon
Omelet with cream, cinnamon, with some berries and coconut shavings
Full fat Greek yoghurt with nuts and berries
Leafy green salad with a can of tuna (oil, not brine!), mayonnaise, capers, olives and avocado
Leafy green salad with (warmed goat's) cheese and bacon, maybe a nice vinaigrette?
Meat, fish or poultry with veggies. I usually go for cauliflower rice or broccoli rice, with cheese and bacon to bulk it up. Never the same meal twice in a row because of various herbs/spices.

Snacks? Pork scratchings, cheese, olives, extra dark chocolate, nuts. :)

Of course, there’s loads more on the web, for people more adventurous than I. (Which is pretty much everyone). Just google whatever you want to make and add “keto” to it, and you’ll get a low carb version. There’s a lot of recipes on the diabetes.co.uk website, as well as on where you’ll also find visual (carb content) guides and videos. And I can wholeheartedly endorse Dr. Jason Fung’s book The Diabetes Code. It’ll help you understand what’s going on in your body and how to tackle it, whilst not being a dry read. Not only that, but you’ll know what to ask your doctor, and you’ll understand the answers, which is, I believe, quite convenient.
Click to expand...

Wow, what a great response, thanks. Lots to consider there.

One thing that I do eat quite a lot of is porridge with skimmed milk and a banana, sometimes twice a day I always choose plain rolled oats and never the sweetened pot types. Is this not a good choice when prediabetic
 
Could I also add that I have never smoked, I don’t drink alcohol and I am 5ft 9 with a weight of 70kg. Probably not the typical risk type but then again I don’t seem to be too lucky with my health of late :banghead:
 
Your numbers wouldn’t indicate you are going hypo (low). However it can feel like it if it’s a big drop, a false hypo. It’s like withdrawal from the high glucose levels your body has got used to. Feels unpleasant it not dangerous and passes fairly quickly. But again your changes don’t seem likely to have made huge differences so I’m not sure.

The wholewheat options won’t reduce carbs by much. It may slow down the time to hit the blood though. So maybe the high point after these is more than 2hrs. Oats can be quite slow for some too. All rice bread pasta and cereals of any colour are very likely to raise levels by a fair bit. (Some people get a bit luckier but they are the minority)

As to height weight etc there a genetic predisposition to diabetes. For sure being overweight, sedentary, drinking and smoking won’t make you healthy but there’s plenty like that who don’t get diabetes too. And the weight gain is a symptom of diabetes, as is tiredness and lack,of energy. So while the media keep telling us being fat and lazy make us diabetic in fat being diabetic makes you “fat and lazy” (please note the quotes people)
 
I agree, your readings are not what I would call low i.e not low enough to cause even mild hypo symptoms but if they are lower than your body has been used to of late it may suggest false hypo.

Having multiple conditions can throw a spanner into the works when trying to figure out which condition may be causing a particular symptom. This is where a detailed food diary (and perhaps an activity diary) can be of immense help.

Just as an FYI bananas and grapes have the highest amount of carbs so fruit with fewer carbs is best to go with i.e berries such as strawberries, blackberries and raspberries. The fructose in fruit is a funny ol' carb, it can only be metabolised in the liver and stored there as fat so I would recommend that you keep an eye on fruit overall.
 
Psub said:
Wow, what a great response, thanks. Lots to consider there.

One thing that I do eat quite a lot of is porridge with skimmed milk and a banana, sometimes twice a day I always choose plain rolled oats and never the sweetened pot types. Is this not a good choice when prediabetic
Click to expand...
Everything you mention (and also, all the "brown" versions of rice etc) are very carb-heavy... And thus, not a good choice. I just whipped myself up some scrambled eggs with bacon and cheese, just waiting for my husband to join me at the breakfast table, That is a meal that won't spike you at all. Less carbs, more fats. So no skimmed milk, but full fat. No banana, but berries. Skip the rice (whatever colour), and try cauliflower rice instead; just as versatile! (Yeah, that surprised me too.).

Ah, time for breakfast, he's up!:)
You'll be okay. It's a learning process. ;)
 
@Psub
Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.

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

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
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