Opinions please

[Debs57]

Hello everyone, I had my yearly blood tests for thyroid last week and I went online to check it was all ok at saw this


Result Borderline
What you need to do .....Need to repeat

GLYCOSYLATED HAEMOGLOBIN
Haemoglobin A1c level 6.2 % [4.0 - 5.9]
Above high reference limit
Haemoglobin A1c level - IFCC standardised 44 mmol/mol [20.0 - 41.0]
Above high reference limit
HbA1c of 42-47mmol/mol indicates non-diabetic
hyperglycaemia (NDH) with a high risk of
developing T2DM.
If not known to have diabetes, lifestyle changes
are advised and recheck yearly for progression to
T2DM with fasting glucose or HbA1c. If NDH result
is within the last year, consider referral to the
NHS Diabetes Prevention Programme.

I rang the surgery and the receptionist said to be repeated in 6mth .... is it normal to leave it so long before being repeated & how concerned should I be, I didn’t know they were even testing for it.

 

[Resurgam]

Perhaps they are doing checks of the two together - I went to have my annual thyroid check and got diagnosed full blown type two over two years ago now.
From my experience, though, they don't seem very bothered about checking up when someone is in the prediagnosis range.

 

[Prem51]

Welcome to the forum @Debs57. A HbA1c of 44 mmol/L would indicate you are pre-diabetic.
Below 42 is non-diabetic, 42-47 is pre-diabetic, and 48 and above is diabetic. It's good that you will be retested in 6 months.
Many of us weren't even told we were in the pre-diabetic range, so it's just as well you looked at your results online.

You have time to lower your blood glucose level before your next test. It's not too far into the pre-diabetic range so you should be able to reduce it into the non-diabetic range, by changing what you eat - cutting out sweet sugary stuff and reducing starchy carbohydrates like bread, potatoes, pasta and rice. These turn to sugar quickly in our bodies so aren't good for Type 2 diabetics and pre-diabetics.

 

[HSSS]

As others have said it’s not unusual to combine checks at a annual blood test. And you are lucky in that unlike many of us you have a chance to turn things around before a diagnosis is made, probably with less extreme measures than if you leave it and do nothing then have to tackle it later.

Have you heard about low carb eating? It helps many of us keep our numbers down and for some even eliminate medications.


I’m going to tag @daisy1 for our general welcome.


I also suggest you take a look at https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for more info including low carb made simple and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.

 

[Debs57]

Thanks everyone , I feel a lot less anxious now. I shall look at the low carb eating as I do have a sweet tooth, combine that with being in the “obese” range and waist of 42” plus high blood pressure and I suppose I shouldn’t really have been surprised:/

 

[KK123]

It really annoys me to see the first response is to advise 'lifestyle' changes. To write off this first warning marker as 'well it's your own fault if only you weren't so fat and lazy' is criminal. They did this to me when I was diagnosed as pre diabetic (I did not fit the so called 'profile' in any way, shape or form apart from age, was slim, active, blah, blah) but still got 'well, be more active then' or as good as. 3 years later, oh look, it's type 1. They really should TEST people properly at this early stage, how many people struggle on for the next few years getting more ill and possibly damaged? I still believe that had I been overweight they would not even have bothered doing a C peptide test or Gad test on diagnosis. That would have meant more months of potential repercussions.

 

[Listlad]

It really annoys me to see the first response is to advise 'lifestyle' changes. To write off this first warning marker as 'well it's your own fault if only you weren't so fat and lazy' is criminal. They did this to me when I was diagnosed as pre diabetic (I did not fit the so called 'profile' in any way, shape or form apart from age, was slim, active, blah, blah) but still got 'well, be more active then' or as good as. 3 years later, oh look, it's type 1. They really should TEST people properly at this early stage, how many people struggle on for the next few years getting more ill and possibly damaged? I still believe that had I been overweight they would not even have bothered doing a C peptide test or Gad test on diagnosis. That would have meant more months of potential repercussions.

Totally agree.

Even a few members on this very forum seem to be dismissive of the Prediabetic range of results and on the contrary for everybodies benefit it is surely the time to take things more seriously and with more support from the health support providers.

I did have the “ you need to exercise more” advice when I was going to the gym already three times a week”.

 

[britishpub]

It really annoys me to see the first response is to advise 'lifestyle' changes.

I don't see why.

Lifestyle changes are the best way to deal with T2D.

Changing your lifestyle is not an admission of anything, other than there is a better way.

 

[KK123]

I don't see why.

Lifestyle changes are the best way to deal with T2D.

Changing your lifestyle is not an admission of anything, other than there is a better way.

Because they are saying that straight off instead of finding out what is really going on. If you went to the Doctors with symptoms of liver cancer, would you be happy for them to say 'well here are your pills or change your lifestyle' or give any advice BEFORE testing to see that you actually have it? My point is that many people are just sent away with a guesstimate as to what type they have. It's dangerous.

 

[HSSS]

I don’t know whether to agree or not @KK123

I completely agree we should be tested for type 1 or 2, especially if there is any indication of being atypical or not seeing a swift improvement when management is applied. And having meters issued to all diabetics at least in the short term would identify rapidly rising or successfully falling numbers further identifying potential T1’s or LADA etc.

Saying change can help in itself isn’t judgement or blame. More an indictment of the awful carb heavy diet advice we’re all told is healthy and have often tried to follow without success or improvement. What’s wrong is not giving specific and useful advice, just bandying cliches around or prejudging of what we currently do without knowledge of what that is.

And for the vast majority we are T2 and lifestyle change is exactly the right option in many cases. Change of eating - for life. And whilst undiagnosed diabetes won’t help ability to exercise we should all move around a reasonable amount (within any limitations we might have) for general health, and let’s be honest many don’t do what they could do. It may not have caused our diabetes but it would help it.

 

[Mbaker]

The good news @Debs57 is that your HbA1c is at the lower end of pre-diabetic, so getting into the "normal" range could take you a matter of weeks.

Being overweight and having high blood pressure with the elevated blood glucose usually means you have what is termed as metabolic syndrome, which is 3 or more markers requiring attention.

By addressing the root cause of metabolic syndrome you can resolve or mitigate all 3 issues. Insulin resistance can be one of the key high blood pressure causes and also is a key culprit of laying down fat. If you choose to reduce insulin, you can look forward to better numbers all round - this can be achieved by reducing carbs and sugar based items. If you search the site you can pick up "eating to your meter (glucose meter)". I should say carbohydrate intolerance does mean that you will have to find work out your limits. If you would like more specifics you can ask.

 

[KK123]

I don’t know whether to agree or not @KK123

I completely agree we should be tested for type 1 or 2, especially if there is any indication of being atypical or not seeing a swift improvement when management is applied. And having meters issued to all diabetics at least in the short term would identify rapidly rising or successfully falling numbers further identifying potential T1’s or LADA etc.

Saying change can help in itself isn’t judgement or blame. More an indictment of the awful carb heavy diet advice we’re all told is healthy and have often tried to follow without success or improvement. What’s wrong is not giving specific and useful advice, just bandying cliches around or prejudging of what we currently do without knowledge of what that is.

And for the vast majority we are T2 and lifestyle change is exactly the right option in many cases. Change of eating - for life. And whilst undiagnosed diabetes won’t help ability to exercise we should all move around a reasonable amount (within any limitations we might have) for general health, and let’s be honest many don’t do what they could do. It may not have caused our diabetes but it would help it.

Hi HSSS, don't get me wrong, I absolutely agree 100% that after you have been diagnosed as diabetic, diet is the key (notwithstanding insulin for those who need it of course). I am an advocate of exercise too and all the other things that anyone can do to be healthy, diabetic or not and agree that lifestyle is the key. My only concern is that when your levels are first found to be raised they simply say 'pre diabetic'. How would they know whether that person was in fact a type 1 in a honeymoon period or lada? I wonder if anyone can answer this? I asked my Consultant once and he just said 'it's usually obvious because of their lifestyle and weight'.

 

[Guzzler]

Hi HSSS, don't get me wrong, I absolutely agree 100% that after you have been diagnosed as diabetic, diet is the key (notwithstanding insulin for those who need it of course). I am an advocate of exercise too and all the other things that anyone can do to be healthy, diabetic or not and agree that lifestyle is the key. My only concern is that when your levels are first found to be raised they simply say 'pre diabetic'. How would they know whether that person was in fact a type 1 in a honeymoon period or lada? I wonder if anyone can answer this? I asked my Consultant once and he just said 'it's usually obvious because of their lifestyle and weight'.

Which is exactly why I laughed in the face of the locum GP who first mentioned Diabetes to me. I dismissed the initial A1c as a lab error and even after two more A1c's were done I was not wholly convinced because I did not fit the bill of 'Poor lifestyle choices causing T2'. Perhaps when the boffins pin down the causes of each and all types of Diabetes the judgement call that often comes before a patient sits down in the consult room will become a thing of the past. Until that day then at least they should get the blummin diagnostic tools out of the airing cupboard!

 

[Debs57]

The good news @Debs57 is that your HbA1c is at the lower end of pre-diabetic, so getting into the "normal" range could take you a matter of weeks.

Being overweight and having high blood pressure with the elevated blood glucose usually means you have what is termed as metabolic syndrome, which is 3 or more markers requiring attention.

By addressing the root cause of metabolic syndrome you can resolve or mitigate all 3 issues. Insulin resistance can be one of the key high blood pressure causes and also is a key culprit of laying down fat. If you choose to reduce insulin, you can look forward to better numbers all round - this can be achieved by reducing carbs and sugar based items. If you search the site you can pick up "eating to your meter (glucose meter)". I should say carbohydrate intolerance does mean that you will have to find work out your limits. If you would like more specifics you can ask.

It does seem all rather more complicated than just calorie counting

 

[Resurgam]

Lifestyle changes and reducing calories - - like that has ever worked.
Poor ol' William Banting was advised to row a heavy boat up and down the local river - gave him a greatly increased appetite and no weightloss at all - and that was back in the 1800s. He happened on the low carb diet back then - and was given the same reception as Dr Atkins 100 years later - and another 50 years on - still the same old same old and the smirk when it doesn't work.

 

[Mbaker]

An interesting set of points above. I think some of the problem is inconsistency. When I was diagnosed I was told to come back in a week for a re-test, then tested again in 3 months. Maybe there is a different directive for pre-diabetic numbers - seems like unless you self check, there may not be an official warning of a longer term rising blood glucose.

I think in the example I gave for myself, an experienced GP / Diabetic Nurse could tease out Type 1, 2 (or maybe 1.5), if there is a "honeymoon" process then this will be more

It does seem all rather more complicated than just calorie counting

Yes and No. If you choose to adopt the low carb high (healthy) fat or Keto protocols, you count carbs, once you have done this a few times it is so easy. Personally I have not even counted carbs, just eaten foods with minimal carbs and sugar. Today I ate twice: Salmon steak, garlic and butter prawns, a fried egg (soft yolk to ooze onto the salmon) and some nuts. Just finished dinner of Beef skirt casserole style, broccoli and cauliflower and directly after sending this I have chocolate coconut pancakes.

 

[Debs57]

That seems like a whole heap of food (no offence intended) maybe it will be better than my paltry 1200 cals living of tea and coffee trying not to eat. Left to my own devices I would snack rather than eat meals and the snacks would be toast or tea cakes ... terrible sweet tooth

 

[Mbaker]

That seems like a whole heap of food (no offence intended) maybe it will be better than my paltry 1200 cals living of tea and coffee trying not to eat. Left to my own devices I would snack rather than eat meals and the snacks would be toast or tea cakes ... terrible sweet tooth

It is substantial, so I walk around 7 miles a day, and weight train in total between 30 minutes and 45 each day. I am not saying it would be easy initially, but I naturally went from 3 meals at the start to 2 and most of the week one meal a day. When you body starts to prefer fat over carbs, it is the weirdest (but natural) feeling of not wanting / needing food. I only eat twice a day some days to make sure I get in a range nutrients.

 

[Debs57]

That’s a lot of exercise you’re doing as well. I really need to get my head around this being a life style change and not just a quick fix diet for me

 

[bulkbiker]

That’s a lot of exercise you’re doing as well. I really need to get my head around this being a life style change and not just a quick fix diet for me

Very true its a new way of eating.. personally I haven't increased my exercise at all but have had multiple heath benefits but if exercise is something you enjoy knock yourself out (well build up to it slowly!). But it is far from essential. Dietary changes will have a far greater impact.