Confused as to my status - any thoughts?

[NameNotFound]

Hello, I've spent a lot of time going through this forum and have found a lot of useful information on it. I've also been very impressed about how friendly and helpful everyone seems to be.

My question is really around whether I'm diabetic, prediabetic or not. I've not been to the GP yet. When I woke up I got the following blood glucose levels from Freestyle Libre CGM:

- Saturday: 7.7 mmol/L - Diabetes - change my eating from incredibly high carbs to low carb after finding this site
- Sunday: 6.0 mmol/L - Ah, prediabetic - continue low carb
- This morning: 5.2 mmol/L - Normal - so I posted this!

Any thoughts?

About me

I'm a 53 year old male, 78kg, BMI 25.5. I used to exercise a lot between 2005 and 2015 but now exercise much less. I walk the dogs a lot (averaged around 20,000 steps a day between July and October but 15,000 a day now that there is less daylight).

Until Saturday morning, I had a very high carb diet. I love chocolate, cakes, pastries, bread, etc. I mostly drink cherry Pepsi Max as I'm addicted to it (headaches if I stop or drink less of it).

With the exception of the dry mouth bit below, I'm generally healthy but do have a sore back as some of my disks have deteriorated (which I've had MRI etc for) but this is pretty manageable most of the time.

Why I got a free CGM

I'm quite worried about always being thirsty / having a dry mouth. This keeps me awake a lot (and has done so for a couple of years) as I keep having to have a sip of water during the night. I also drink a lot (mostly cherry Pepsi Max as I'm addicted to it) and need to pee a lot. I also need to pee in a rush (e.g. no need now but in a few minutes time there will be a great urge to).

I saw the advert for a free Freestyle Libre CGM after listening to a podcast where someone talked about blood sugar and thought I'd give it a go. I got it at Friday lunch time and it said 5.8 mmol/L. Great. So I took the dogs out for a walk, ate a load of chocolate (2x giant chocolate button bags - over 200g) and saw my blood glucose go up to 7.6mmol/L. A bit later I had a big packet of mango and it went up from 5.6 to 12.8mmol/L and I got quite worried. Within two hours of eating, it had gone down to 6.2mmol/L though.

Saturday and Sunday

When I woke up on Saturday with 7.7 mmol/L (with no food for ten hours before) I was quite worried and spent a lot of time reading the posts on the forum. After quite a while I decided that:

1. I needed to be very serious about sorting myself out.

2. The best way of doing that would be to substantially reduce my carbs and exercise more (walking, weights and CV). I'd also ween myself of cherry Pepsi Max.

3. I was going to start immediately and be the one who says "no, I can't eat that" rather than let things slip.

So I went to Lidl, bought a load of proper food and ate it (eggs, chicken, mixed vegs, nuts, etc). I'd planned around 50g of carbs and 1,600 cals a day. Both days turned out to be around 43g and 1,500 cals (measured with scales and myfitnesspal). I also walked the dogs lots (but with no chocolate).

I was quite pleased when Sunday morning's waking blood glucose was 6.0 (prediabetes range) but completely confused when this morning's was 5.2 mmol/L (normal). I did have a go with a keto stick and it said that I had traces of keytones.

Being completely confused, I signed up here and wrote this rather long post.

Any thoughts please?

My plan is to assume that I have diabetes or am prediabetic (because of always being thirsty) and continue eating low carbs, continue walking a lot, start weights and CV exercise. I don't like GPs and so I've done a deal with my wife that means that I will go in three months' time if things don't look good then. I'm likely to buy some more CGM sensors when the free one runs out and wear them from time-to-time rather than for the whole of the three months.

I'd welcome any thoughts but I'm fully aware that no diagnosis can be given!

Thank you

 

[In Response]

What are your readings like the rest of the time and how do they respond to food?
Libre may not be accurate enough to conclude anything from one reading per day. The value of the sensors is being able to see your trends throughout the 2 week period.

 

[Daibell]

From what you say, those readings indicate an early stage of diabetes if any. The Libre 2 will provide more guidance during the 2 weeks. Keep going with low-carb diet and exercise. The BMI is too high so with a bit of luck the figure will improve with that better lifestyle and lower insulin resistance

 

[bulkbiker]

I don't like GPs and so I've done a deal with my wife that means that I will go in three months' time if things don't look good then.
I'd welcome any thoughts but I'm fully aware that no diagnosis can be given!

Thank you

It might have been better to have got an HbA1c before making such dramatic changes but the changes you are making certianly won't do you any harm so go for it!.

I personally didn't up my exercise one jot in my journey to remission although the dog walks became a lot less of a strain.
In my view it's what and also when you eat that makes all the difference.

 

[NameNotFound]

What are your readings like the rest of the time and how do they respond to food?
Libre may not be accurate enough to conclude anything from one reading per day. The value of the sensors is being able to see your trends throughout the 2 week period.

Thanks. They are:

Friday (half day from noon onwards): Av=7.2 mmol/L (5.1 to 12.8), 66 measurements
Saturday: Av=6.7 mmol/L (5.1 to 8.8), 124 measurements
Sunday: Av=5.9 mmol/L (4.8 to 7.8), 109 measurements

In terms of response to food with little experience, I'm not really sure. On the Friday I had some mango and it rocketed up (5.6 to 12.8 after two hours). But my meals on Saturday and Sunday was low carb and there was a relatively small change (e.g. 6.8 to 8.4 after two hours).

 

[NameNotFound]

From what you say, those readings indicate an early stage of diabetes if any. The Libre 2 will provide more guidance during the 2 weeks. Keep going with low-carb diet and exercise. The BMI is too high so with a bit of luck the figure will improve with that better lifestyle and lower insulin resistance

Yes, I agree that my BMI is too high. Hopefully, I'll get into the normal range in the next couple of weeks.

 

[bulkbiker]

A bit later I had a big packet of mango and it went up from 5.6 to 12.8mmol/L and I got quite worried. Within two hours of eating, it had gone down to 6.2mmol/L though.

On the Friday I had some mango and it rocketed up (5.6 to 12.8 after two hours).

These two statements appear to be at odds.. was the 12.8 after 2 hours or a different time period?

 

[NameNotFound]

It might have been better to have got an HbA1c before making such dramatic changes but the changes you are making certianly won't do you any harm so go for it!.

I personally didn't up my exercise one jot in my journey to remission although the dog walks became a lot less of a strain.
In my view it's what and also when you eat that makes all the difference.

Thanks bulkbiker. It would have been nice to get an HbA1c test before. I've just done a bit of googling and I can see that Boots sell one and so I will order one of those in a second.

I actually used to like exercise and so this is a good excuse to bring it back to my life.

 

[NameNotFound]

These two statements appear to be at odds.. was the 12.8 after 2 hours or a different time period?

My bad. It was 5.6 before eating, after one hour it was 12.8 and after two hours it was 6.2.

 

[ianf0ster]

My bad. It was 5.6 before eating, after one hour it was 12.8 and after two hours it was 6.2.

That doesn't appear to be diabetic. It sounds like the reaction of a normal non-diabetic to eating a load of sugary ****.
Mangoes (especially dried mangoes) are one of the few things I really miss with my Low Carb way of eating, but I know that all that glucose and fructose would be harming me.

 

[NameNotFound]

That doesn't appear to be diabetic. It sounds like the reaction of a normal non-diabetic to eating a load of sugary ****.
Mangoes (especially dried mangoes) are one of the few things I really miss with my Low Carb way of eating, but I know that all that glucose and fructose would be harming me.

Thanks Ian. I've now spent a bit of time trying to find out what "normal" is and I've found an article that suggests that blood glucose levels go up by 8.0 ± 1.1 mmol/L (when type 2 people eat some mango). It also goes on to say that after two hours the increase was 1.8 ± 0.5 mmol/L. So I now feel more relaxed about that big jump, and the increase being +0.6 after two hours. Saying that though, I think I will be avoiding mango for a while. Thanks again (oh, I like dried mango with coconut too!).

 

[In Response]

Another thing to consider is that Libre (and all CGMs) are less accurate when in double figures. So a 12.6 may actually be 10.6.

I found it useful to look at Libre graphs from real people without diabetes to see what is "normal" - you can find quite a few with Google. For me, this was more realistic than reading research papers on academic results.

 

[Dr Snoddy]

I agree with Ian. Your response to a large amount of delicious mango would seem to be fairly normal. However, as you have pretty much already decided, your very high carbohydrate diet could be leading to a range of health problems e.g. Non-alcoholic fatty liver disease. Your BMI is only a little too high and doesn't take skeletal muscle mass into consideration. Maybe look at waist to height ratio instead?
The caffeine and sugar in the Pepsi Max will also really be ramping up your blood glucose levels. Headaches are a common response to caffeine withdrawal. Choice of cold turkey (with painkillers!) or gradual, controlled reduction???

 

[NameNotFound]

Another thing to consider is that Libre (and all CGMs) are less accurate when in double figures. So a 12.6 may actually be 10.6.

I found it useful to look at Libre graphs from real people without diabetes to see what is "normal" - you can find quite a few with Google. For me, this was more realistic than reading research papers on academic results.

Thanks Ian. That's a good idea. I looked at a couple of pages on the web that I found and can see what you mean. These were:

1. https://lilynicholsrdn.com/cgm-experiment-non-diabetic-continuous-glucose-monitor/

2. https://www.nutrisense.io/blog/cgm-blood-glucose-experiment-5-insights-from-a-non-diabetic

Just for the record, they came up on a google search, I know nothing about them otherwise. I'd welcome any pointers to ones you found helpful.

Other than the difficulty of convertible the numbers to tie in with mmol/l (i.e. found a table in the end) it does demonstrate that my "baseline" is quite high at the moment. The comments about having high carb foot on there make me feel much more reassued with the mango!

 

[NameNotFound]

I agree with Ian. Your response to a large amount of delicious mango would seem to be fairly normal. However, as you have pretty much already decided, your very high carbohydrate diet could be leading to a range of health problems e.g. Non-alcoholic fatty liver disease. Your BMI is only a little too high and doesn't take skeletal muscle mass into consideration. Maybe look at waist to height ratio instead?
The caffeine and sugar in the Pepsi Max will also really be ramping up your blood glucose levels. Headaches are a common response to caffeine withdrawal. Choice of cold turkey (with painkillers!) or gradual, controlled reduction???

Thanks Dr Snoddy. Fortunately the Pepsi Max has no sugar but getting off the caffeine isn't going to be fun. My plan at the moment is to concentrate more on the food side (i.e. low carb) now and (i) drink more water / squash in the meantime, and (ii) go cold turkey (with paracetamol!) in the new year.

In terms of waist to height, I've had a look at that at the waist-to-height ratio and it comes in at 0.5 (88 vs 175). That's just on the "green-to-yellow" boundary so a bit of work to do there.

 

[MrsA2]

Pepsi Max has no sugar

It may not have any sugar but it is full of sweeteners which are chemical manufactured substances . Google Pepsi max (or soda) addiction and you will come across thousands (of mainly American) people desperately trying to rid themselves of addiction to sweeteners, and sugar.
It is totally devoid of any nutrional value at all, and isn't even hydrating. PepsiCo is making a fortune out of this product of coloured sweetened water.
I do hope you manage to get yourself off it
Oh, and as regards the peeing, some of that maybe the Pepsi, but at your age a prostate check wouldn't go amiss.

 

[NameNotFound]

It may not have any sugar but it is full of sweeteners which are chemical manufactured substances . Google Pepsi max (or soda) addiction and you will come across thousands (of mainly American) people desperately trying to rid themselves of addiction to sweeteners, and sugar.
It is totally devoid of any nutrional value at all, and isn't even hydrating. PepsiCo is making a fortune out of this product of coloured sweetened water.
I do hope you manage to get yourself off it
Oh, and as regards the peeing, some of that maybe the Pepsi, but at your age a prostate check wouldn't go amiss.

Thanks MrsA2. It definitely costs too much, and it definitely makes me feel thirsty. But it is so nice and I don't fancy headaches just as I'm trying to adjust my eating.

In terms of the prostate, thanks for giving me something extra to worry about. Looking at the NHS website, I can see that I can ask my GP for a PSA test so I will probably do that when I next see them. But I will wait until I know more about my blood sugars (the HbA1C test has been posted to me) and have got off the Pepsi Max. Thanks again.

 

[Dark Horse]

There are various criteria for diagnosing diabetes, including:-

Methods and criteria for diagnosing diabetes​

1. 1. Diabetes symptoms (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) plus:
      • a random venous plasma glucose concentration ≥ 11.1 mmol/l or
      • a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or
      • two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting random values are not diagnostic the two hour value should be used. https://www.diabetes.org.uk/profess...nitoring/new_diagnostic_criteria_for_diabetes

A level of 12.8 mmol/l would therefore fall into the diabetic range although accuracy of the monitor needs to be considered.

 

[NameNotFound]

Thanks Dark Horse. I think I have some diabetes symptons and my glucose on waking up was 7.7 mmol/L on Saturday. So that suggests diabetes based on the bit you quoted. Then after changing what I eat so that it is low carb, it was 6.0 the next day (so not diabetes based on the bit you quoted) and then 5.2 for each of the next two days. The 12.8 mmol/L was a one off after eating mango during the day so I don't that is one of the conditions.

I've just received the HbA1c test pack and squeezed a surprisingly large amount of blood out of my fingers. Off to the post office to post it so will hopefully no more later this week.

 

[NameNotFound]

Just a quick update.

Boots sent the HbA1c kit and I returned it the same day. I still haven't had my results so I messaged Boots and the lab hadn't received it so they are sending me a new kit. I found the Post Office receipt for the Tracked 24 Hour delivery and looked online and it said that it had been collected but not delivered. No idea what has happened to it but Boots were very good.

The first week I basically followed a low carb diet and I saw my blood glucose levels get lower and lower, with the volatility of my blood glucose going lower too. One "accident" was that I had some salted pistachios one evening and the increased numbers meant that the next morning the numbers were in the pre-diabetes range.

After the first week, I experimented with what I ate. I found out that a Chinese takeaway wasn't very good. Neither were cookies, chocolate or coissants. Not a suprise really. I've now given up that experiement. I've also noticed that I feel a lot worse getting to sleep / waking up during the night if I do have carbs in the evening.

I've also experimented with the Cherry Pepsi Max and the more of it I drink, and the less squash I drink, the more thirsty I feel. Who would have though that drinking water (or squash) is good for you?

I will buy a couple more of the Freestyle Libre sensors but use them in the last half of Janaury and the last half of February as I've now got more of a hang of what works and doesn't. Then at the end of February will visit my GP (unless all the numbers are looking good and I'm continuing with the low carb diet).