Pre-Diabetes?? Confused

[NickiSanta]

Hello all,

I was sent a letter from my GP in December to inform me I have abnormally high glucose levels following a yearly check - they said this was pre-diabetes. They said I could refer myself to a local well being group and/or the NHS programme. The information leaflet they said they had enclosed wasn't in the envelope.

I referred myself to both programmes and did my own research, bought a glucose monitor for daily observation and switched to a low carb eating plan.

However, I have had the symptoms of diabetes 2 for about a year (including thirst, frequent peeing, blurred vision, fatigue, generally feeling meh) and when I asked for my hba1c blood results I was told 147.5 mmol or 6.5%. . Isn't that just on the cusp of type 2 diabetes?! If so why would my GP say this is pre-diabetes? I've been met with varying numbers representing diabetes 2 versus pre-diabetes and I'm confused. Has anyone else experienced this? Advice would be appreciated as none is forthcoming from my GP. I've got a telephone appointment with the diabetes nurse but that's not for weeks

Thanks

Nicola

 

[VashtiB]

Hello and welcome,

It is confusing as different countries have different numbers for what is diabetic and what is pre diabetes. In my view it probably doesn't matter. The important thing is what you do now and you are doing all the right things. Unfortunately most of the medical profession see diabetes as a progressive illness and don't think there is anything you can do about it. If you have gone low carb you are likely to be able to surprise your GP after the next blood test.

I would also suggest that you ask for a copy of the results so you know what your levels are. This will allow you to take control and make the necessary changes.

Good luck and welcome.

 

[Member496333]

Hi. For the most part, GPs operate within a strict set of guidelines. The UK diagnostic criteria for diabetes is 48 mmol/mol. I assume yours is 47.5 rather than 147.5. Pre-diabetes is 42 mmol/mol, so technically you are not yet diabetic, but honestly it's splitting hairs. You are actually quite fortunate in that sometimes doctors don't recognise pre-diabetes at all. It's not unheard of for people in your position to not even be informed.

But none of that really matters now. Pre-diabetes and diabetes (type 2) are ultimately the same thing. The two arbitrary numbers are just waypoints on the spectrum of diabetic pathology. The great news is that in using these forums you are definitely in the right place to fix yourself, and you appear to be quite low on that spectrum, so hopefully it shouldn't be too hard for you to make swift improvements.

 

[ianf0ster]

I have been criticised both in this forum and the other UK diabetes forum about my views on the distinction between Type 2 Diabetes and 'Pre-diabetes' or 'At risk of diabetes.
Since the risk of serious complications is on a fairly continuous scale from 'Pre-diabetic' Blood Glucose levels upwards, then I thing it's silly to distinguish between them so far as treatment by lifestyle is concerned (that is the best treatment in my opinion).

In the USA the starting HbA1C number for diagnosis of 'pre-diabetes' is lower than that in the UK, so there are good reasons for taking it seriously even at so called normal levels just below 42 mmol as well.

 

[Member496333]

I have been criticised both in this forum and the other UK diabetes forum about my views on the distinction between Type 2 Diabetes and 'Pre-diabetes' or 'At risk of diabetes.
Since the risk of serious complications is on a fairly continuous scale from 'Pre-diabetic' Blood Glucose levels upwards, then I thing it's silly to distinguish between them so far as treatment by lifestyle is concerned (that is the best treatment in my opinion).

In the USA the starting HbA1C number for diagnosis of 'pre-diabetes' is lower than that in the UK, so there are good reasons for taking it seriously even at so called normal levels just below 42 mmol as well.

Annual insulin testing instead of fawning over low cholesterol is the answer to stopping T2DM dead in its tracks, but that will never happen in my lifetime because it will shine a critical light on the established dietary paradigm that has favoured the food and pharma giants for at least fifty years. The status quo right now means that the majority will be obese upon official diagnosis, at which point we just blame them for eating too much.

 

[NickiSanta]

Thank you all for your replies!

I do understand that worrying about whether I'm type 2 or pre-diabetic could be seen as splitting hairs. For me, it is important they get this right. I am under a bariatric team and have a gastric band - bypass surgery (which is what I want), is only offered to someone of my BMI if there are further complications with high blood pressure - or diabetes. I am of the opinion the bariatric team will see pre-diabetes as not as serious as type 2 diabetes and I will be denied a bypass on a technicality. I understand I should lose weight on a low carb eating plan, but it doesn't stop the worry that I am eating too much and will continue to gain or plateau if I'm not given the additional help I had to have years ago. My journey with bariatrics is long and fraught, so I've simplified it for the sake of this forum, but it is important to me I am diagnosed correctly and get surgery.

During my short (but intense) research on diabetes and all related I've also reached the conclusions that Jim has above - mostly influenced by Fat Head the documentary movie which echoes his points about cholesterol and the big pharma giants. I'm annoyed I've spent my life up until a month ago, ignorant of any other real nutritional advice other than 'low fat' and 'calories in calories out'. I now understand why I could never lose weight following that advice - a question which has hounded me for years.

Cheers everyone. I hope to be a useful contributor in the future.

 

[ultradad]

Wish you well on your journey nickisanta . I have struggled with my weight for over 25 years and been as high as 19.5 stone. Since being diagnosed and coming onto this great forum i have lost 5 stone and i am actualy trying to put some weight on now . I would recommend trying a low carb high fat diet and see where it takes you. Just test before you eat and 2 hrs later on everything you eat and drink and you will see what works and what spikes your sugers.
I was shocked what 2 shredded wheat and milk (50 grams carbs) did to me, went from 7.0 to 14.5 and i was like *** not good. Cutting a long story short once i cut out what spiked me i started loosing the weight 1-2 pound a week, i only did walking at the time and only now i am working with resistance bands
Hope you find what works for you and you can keep doing long term

 

[NickiSanta]

Thank you @ultradad . Funny you should mention shredded wheat as the doc I watched last night said it has a GI of about 74, higher than the GI of sugar (64) and one slice of wholemeal bread (70). No wonder it spiked your BG! I have been following a low carb high fat diet, as you mentioned. I do worry about the amount though, and don't weigh or measure cheese, cream etc. I'm worried that by not eating what I need, I will get hungry and eat inappropriately, this is why I don't weigh fats.

As for testing BG before and after meals, I'm finding I did get through lancets and strips at an alarming rate. I was shocked to read that the NHS rarely give out glucose monitors, strips or lancets. As a pre diabetic I would be lowest priority so I've got to pay for this myself, unless I've misunderstood. This would be around £50 a month which is a hit for me as I'm considered long term disabled (not linked to diabetes) and in receipt of benefits. I must admit to just checking fasting levels every few days Perhaps I need to just suck it up and do it

 

[MrsA2]

@NickiSanta a gastric by pass wasn't the answer for my friend as she continued to eat small portions, but very frequently. She lost 6 stone initially has put over half her weight back on again.
Re testing you don't need to change lancets everytime, that advice is for the medical professionals who use it on a different person each time. I've used about 6 in 2 years. And after a few months you won't need so many strips as you will know what to avoid by then. I'm down to one a day, I probably don't even need that but I like to make sure I'm staying in zone.
Please do go low carb. It has become a successful way of eating (not a short term diet) for so many of us, mostly with out hunger.
Tonight I've had a roast beef, a small Yorkshire, 4 veg and a dessert of cheesecake followed by cheese, and wine! It's not a bad life. Join us.

 

[ultradad]

I agree with MrsA2 as i know someone who went private and spent over £5k on a gastric by pass and she put all the weight back on as she didnt adress the biggest problem which was her life style and eating habits, still enough room to get a few chunks of chocolate in etc
When i started testing myself it was expensive for the strips but once you work your way through what you eat and drink and cut out what isnt working for you can drop down to just testing 3 times a day or just in the morning like i do. Now it only costs 20ish pound every 3 months

 

[NickiSanta]

Thank you both. The bypass is a more reliable replacement for the gastric band, which I've had for 15 years. I am aware it's not the answer for everyone but it worked for me for 14 years until the NHS decided to empty it in may 2019 and refused to refill it because of covid restrictions. In that time my weight has almost doubled from 60kg to 110kg. A bypass is permanent and cannot be fiddled with by the NHS which is why I want it and why my diabetes diagnosis had to be right. I didn't have BG problems before it was emptied (instead of just adjusted slightly) so I am (understandably I hope) crushed and devastated by an avoidable 50kg weight gain and BG problems. I had hoped to avoid explaining this to keep on topic, but that's why I was asking about whether I had the correct diabetes diagnosis in my OP.

Thank you for the info about reusing lancets!! I will keep a diary of bloods from now on. My pre dawn FBG was a respectable 5.4.

 

[Alexandra100]

As a pre diabetic I would be lowest priority so I've got to pay for this myself,

@NickiSanta Yes I'm afraid so. Have you got a meter with the cheapest possible strips? I and a lot of people here use the Navii from Home Health
@Rachox[/USER] has posted some extremely useful tips for cost cutting:

"HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews if you use this link and select the meter plus 5 packs of strips and then add the code dcuk (all lower case) at check-out, you’ll get the meter free. So total cost for meter + 5 x 50 strips will be £31.76.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

Links to the strips and the meter for future orders:

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.

 

[pre-predb]

@NickiSanta Yes I'm afraid so. Have you got a meter with the cheapest possible strips? I and a lot of people here use the Navii from Home Health
@Rachox[/USER] has posted some extremely useful tips for cost cutting:

"HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews if you use this link and select the meter plus 5 packs of strips and then add the code dcuk (all lower case) at check-out, you’ll get the meter free. So total cost for meter + 5 x 50 strips will be £31.76.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

Links to the strips and the meter for future orders:

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.

Thanks for this link. Is it best to get mmol or mg/dL?

 

[Resurgam]

The NHS seems unable to believe that when I eat carbs I put on weight, despite that happening over and over again whenever I was nagged into going on a diet of their choosing.
Now I have been eating low carb for five years and more I have been kept busy renewing my wardrobe as I used to wear XXL but have lost over 12 inches from my waist. In addition my thyroid seems to have made a partial recovery, after being 'dead' and unresponsive for many years. I can only recommend it as a way to control blood glucose levels and see weightloss happen without any effort.

 

[Alexandra100]

Thanks for this link. Is it best to get mmol or mg/dL?

mmoL in the UK and, I believe, Europe, mg/dL in the US.

 

[pre-predb]

mmoL in the UK and, I believe, Europe, mg/dL in the US.

Thanks! I've just scrolled down on the product description and seen that anyway! First glucose meter ordered.

 

[NickiSanta]

I bought my meter only a day or so after diagnosis so didn't have the benefit of a great deal of advice. It's a Sinocare Safe AQ.

Now I wish I'd bought a combined glucose and ketone meter.

Thanks for the links! I will be changing at some point.

 

[bulkbiker]

Now I wish I'd bought a combined glucose and ketone meter.

Meters are pretty cheap it's the strips that are the main cost .

For ketones I have a On-Call GK dual but only use the ketone strips

https://www.valuemed.co.uk/collecti...n-you-buy-50-on-call-blood-ketone-strips-here

The blood glucose strips are expensive so I use a Tee2 for that

https://shop.spirit-health.co.uk/collections/tee2

Hope that helps.

 

[Widgets]

I bought my meter only a day or so after diagnosis so didn't have the benefit of a great deal of advice. It's a Sinocare Safe AQ.

I did the same - looked on Amazon, found what seemed to be the most sensible deal/price and bought it. They work just fine and the strips aren't too extortionate.

 

[NickiSanta]

I noticed you're near me @bulkbiker - I'm in Littlehampton.

Thanks for the recommendations! I'm not too far out price wise with the testing strips then.