Do I really have prediabetes?

[PedroCavalleiroBR]

Good evening everyone.
I am 42 years old and I live in Brazil. In the last month I had routine tests that showed pre-diabetes, but some people questioned this diagnosis because it was on a borderline between normal and diabetes. Maybe I'm still not accepting this new condition and I'm trying to find a way out. But in fact my doctor prescribed me metformin. I am thin and athetic without any abdominal fat, and my father and part of the ancestry on this side of the family have a history of type 2 diabetes. Investigating this situation, I ended up having 3 exams at intervals close to 1 week each approximately. The first, which brought suspicion of the condition, was a fasting glucose of 87 and glycated hemoglobin of 5.8. The second, fasting glucose of 100 and glycated hemoglobin of 5.7. The third was a TTGO that showed a glycemia after 2 hours, of 155, with fasting glucose of 96, and glycated hemoglobin of 5.6.Something curious is that in an exam in 2018, it already showed a fasting glucose of 100. I was always careful with my food and went for walks every day. Now after the diagnosis I do weight training and low carb diet in addition to metformin. I would like to know your opinion about this scenery. It would really be of great help.

 

[Ronancastled]

The first, which brought suspicion of the condition, was a fasting glucose of 87 and glycated hemoglobin of 5.8..

Fasting perfect, A1c raised above normal & just into the bottom rung of pre-diabetes US, btw it's 6.0 in the UK.

The second, fasting glucose of 100 and glycated hemoglobin of 5.7.

Fasting bang on the cut-off & A1c just inside the US diagnostic for pre-diabetes

The third was a TTGO that showed a glycemia after 2 hours, of 155, with fasting glucose of 96, and glycated hemoglobin of 5.6.

First red flag, that 155 @ 2 hours on your OGTT, again it puts you in the bottom rung of pre-diabetes, cut-off being <140 @ 2 hours.
My advice is get a meter & measure at 1 hour & 2 hour post meals, learn which foods spike you & start avoiding them.
Eat lower carb then watch your A1c tumble.

Now after the diagnosis I do weight training and low carb diet in addition to metformin. I would like to know your opinion about this scenery. It would really be of great help.

Smart move, you're ahead of the game.
Great move coming here & congrats on your English, I work with a Brazilian guy, both engineers & his English is better than mine, all my love

 

[EllieM]

Hi @PedroCavalleiroBR and welcome to the forums.

I have to be careful what I say here because forum rules specifically don't allow us to diagnose but I can say a little bit about hba1c levels and diagnosis.

There seems to be a reasonably worldwide consensus that official diabetes starts at hba1c 6.5% (using your units, or 48mmol/mol using the competing measurement system that is used in the UK). But even that is a bit of an arbitrary choice in that most people don't get diabetic complications if their levels are less than this.

Prediabetes is more dependant in where you are located, with some countries using a measurement of 6% or above others 5.9% and above and others 5.7% and above (which is I believe where your diagnosis may be coming from). Diabetes isn't, in my opinion a well defined on-off condition, where suddenly you have it at one level and magically don't have it at a level a tiny tiny bit less. (Plus remember that the lab tests aren't 100% accurate.)

My understanding of prediabetes is that it's meant to be a warning that you are edging closer to full blown diabetes, and it's much easier to reverse the condition then than to wait for higher levels of blood glucose.

A lot of the folk on here cut their blood sugar levels without medication by reducing the carbohydrate in their diet. The reducrion needed is very dependent on the individual. (eg My husband has/had two T2 parents so is at pretty high risk of the condition, but whenever he reduces his carb levels for a while he drops a few kgs and loses cms off his waistline seemingly without even trying. He's thrown out all his 36" jeans now and has to use a belt on any 34" ones.)

If you are interested in that approach here is a link to my favourite intro to T2 diabetes and low carb
JoKalsbeek's blog | Diabetes Forum • The Global Diabetes Community

I suggest you have a read round the forums and see what you think.

By the way, most of the folk here are measuring their blood sugars in mmol/L, you'll want to multiply by 18 to get the units you are using.
And here is a converter for the two systems of measuring hba1c
HbA1c Units Converter - DCCT to IFCC (diabetes.co.uk)

Good luck, and once again, welcome.

 

[markpj31]

I was always careful with my food and went for walks every day. Now after the diagnosis I do weight training and low carb diet in addition to metformin. I would like to know your opinion about this scenery. It would really be of great help.

Sounds like how it was with me.

Was a keen exercise fanatic - my diet wasn't perfect but I just ate breakfast, dinner, etc but worked out daily, was around 85kg. Exercise bike, walking and lifting every after day. It wasn't until I started noticing that I was losing weight without any real reason and losing power when lifting that I then went on to find I had T2 diabetes.

 

[PedroCavalleiroBR]

Sounds like how it was with me.

Was a keen exercise fanatic - my diet wasn't perfect but I just ate breakfast, dinner, etc but worked out daily, was around 85kg. Exercise bike, walking and lifting every after day. It wasn't until I started noticing that I was losing weight without any real reason and losing power when lifting that I then went on to find I had T2 diabetes.

But I'm not losing strength, on the contrary, I started at the GYM very motivated by this condition, I've been going every day, I don't notice any known side effects of pre-diabetes, maybe because it's still bordering between normal and altered.

 

[PedroCavalleiroBR]

Fasting perfect, A1c raised above normal & just into the bottom rung of pre-diabetes US, btw it's 6.0 in the UK.



Fasting bang on the cut-off & A1c just inside the US diagnostic for pre-diabetes



First red flag, that 155 @ 2 hours on your OGTT, again it puts you in the bottom rung of pre-diabetes, cut-off being <140 @ 2 hours.
My advice is get a meter & measure at 1 hour & 2 hour post meals, learn which foods spike you & start avoiding them.
Eat lower carb then watch your A1c tumble.



Smart move, you're ahead of the game.
Great move coming here & congrats on your English, I work with a Brazilian guy, both engineers & his English is better than mine, all my love

My english is so bad, google translator always helps me with this