Advice for a newbie.

Hiya. If you're 46 you're 2 points away from diabetic so you need to be careful, and I would advise against cakes, sweets, biscuits and puddings until you get a meter and check out what sends your blood sugar up. Moreover you may find bread, pasta, rice and roots crops including spuds also send your BS too high for comfort. Have a read of the guide to managing diabetes @daisy1 gave you in your other post and then tell us what you think.

Hi. Yes, you are marginal, so just keep the carbs down and choose things which aren't full of sugar or large carb portions. Have cake, but not covered with icing or loaded with sugar etc. Get hold of a meter, test 2 hours after typical meals and see what affects you most

Yes, you are what they call pre-diabetic. In other words, you are a borderline diabetic, not quite over the line. If you take yourself in hand and change your diet a little you can avoid full blown diabetes. If you continue to eat "normally" you will most likely cross the line fairly soon. If I were you I would be avoiding cakes, biscuits, sweets, sugary drinks apart from an occasional treat, and try to lower your carb consumption.

sammimac39 said:

Thanks it was just a worry to be told with no explanation

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That's similar to what happened with me. My blood tests showed I was prediabetic and the doctor didn't really say much about it, so I took my cue from her and didn't pay much attention either. Within less than a year I was diabetic and she started talking about it a bit more... but it wasn't until I found this forum that I discovered how to send it into remission and get back to blood sugar levels below even the prediabetic range. I wish doctors would provide more info when someone is prediabetic so they have more chance of not progressing to diabetes.

If you start to make some changes now you will hopefully never be diagnosed with diabetes. At my last Hb test, when I rang up for the results the told me "yes they are fine" and she was going to leave it at that to which I then asked to pick up a copy of the results only to find out my Hb was at non diabetic levels so make sure you always ask for copys of any tests done and if you are unsure of what the results mean ask them to explain them to you. It is your right to know and their job to ensure you know. If you have any questions dont be afraid to ask, we are a helpful bunch.

sammimac39 said:

So from what I have read I should be following a predominantly low gi diet? With exercise thanks for advice.

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I tried low GI to start with but it didn't do the trick and I found I had to cut out bread, pasta, rice and root crops altogether. I understand what the GI table is about but now I use a book called Carbs & Calories (Amazon). You can also get an app for it I believe
Exercise is good but don't go mad.

sammimac39 said:

To be honest I us ally do as I was told my fasting glucose was ok at 8.2 and would be filed w away until I asked a doctor to do further testing my gps are quite poor tbh

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I suggest you change GPs if possible. If not, then we can let you know which tests and treatments to consider and ask for. But it really is best to have a competent GP you can trust to look after you well.

If you do nothing else, please ask for an HbA1c blood test every 6 months unless the result is below 42, in which case you only need the test annually (as long as it stays under 42). If you don't have these tests, you could develop diabetes and not know it.

Did the doctor check your blood pressure?

According to testing criteria laid down by the World Health Organisation for diabetes, two fasting blood sugars over 7.1 would be a diagnoses of diabetes if other symptoms are present.

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).

It confuses me why a HBA1c test would then over rule a diagnosis of diabetes. The HBA1c test is a measure of the average blood sugar over the previous three month period. This forum advocates eating low carb to bring down blood sugars and most people see major improvements in their blood sugars as a result of changing their diet to low carb. The HBA1c does not take into account diet. For example if someone wakes every morning with a blood sugar of 7.9 eats breakfast skips lunch and has meat and salad on a regular basis for their evening meal then it's likely their average blood sugars over a three month period would not be high enough to indicate diabetes. That persons normal diet may already be low in carbohydrates (not fond of carbohydrates) maybe they are dieting? If that's the case then surely that person could still be diabetic. Another example would be someone wakes every morning with blood sugars within the normal range but then eats a large bowl of cereal. Their blood sugars at one hour postprandial are 13.2 and at two hours it's down to 9.7 (clearly diabetic ranges) but lunch consists of lean chicken and salad which doesn't affect their blood sugars in the way breakfast did, if repeated consistently that diet would likely show a normal HBA1c result. The HBA1c test should surely take into account a persons normal diet during the three month period to be accurate?

It's much the same with random blood sugars over 11.1. Two random blood sugars over 11.1 with symptoms of (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) is a diagnosis of diabetes but can then be ruled out by a HBA1c test. I'm not sure the WHO intended the diagnostic criteria to be used in that way? I'm not convinced it's safe to label someone pre-diabetic or non diabetic based solely on the results of a single testing method, or to rule out a diagnosis based on HBA1c test without explaining those high fasting/ high postprandial readings. No one will dispute that blood sugars greater than 7.8 are damaging and seldom occur in non diabetics so why is it safe for pre/non diabetics to run at these higher levels? And more importantly what's the point of the WHO recommendations for testing if they're not being followed?

@rosserk my understanding of the diagnostic criteria is that a non or pre diabetic HbA1c would not override diabetic FBGs/GTTs. These days doctors tend to use just the HbA1c as a screening test, and to bring in the others if needed.

CatLadyNZ said:

@rosserk y understanding of the diagnostic criteria is that a non or pre diabetic HbA1c would not override diabetic FBGs/GTTs. These days doctors tend to use just the HbA1c as a screening test, and to bring in the others if needed.

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Not according to the original post? Samminmac39 has had three fasting blood sugars over 7.1 which is a diagnosis for diabetes according to the WHO but because her HBA1c was 46 (non diabetic) has not received a diagnosis?? Which was kind of my point? I would go back and ask for an explaination...

Fasting test results
The results of a fasting test with respect to glucose levels in the body are as follows:

• Normal: 3.9 to 5.5 mmols/l (70 to 100 mg/dl)
• Prediabetes or Impaired Glucose Tolerance: 5.6 to 7.0 mmol/l (101 to 126 mg/dl)
• Diagnosis of diabetes: more than 7.0 mmol/l (126 mg/dl)

The American Diabetes Association reduced the level of diagnosis in this test from 140 to 126 mg/dl in 1997.

You need to go back and speak with your doctor 7.9 is not a normal fasting blood sugar

That's the question for your Doctor and the reason for my lengthy post (apologies) I am confused about why the World Health Organisation (WHO) would sanction three different tests for diagnosis and then discard a result? It doesn't state anywhere that once you've tested positive in one test you must undergo a different test to confirm. It clearly states there are three types of tests that can be used to diagnose diabetes. Sorry I hope I'm not confusing you? Truth is I'm a bit confused myself why a doctor would rule out diabetes on the result of three fasting blood sugars above 7.1 theoretically discounting one of the WHOs recommendation for diagnosis in favour of one of the other recommended tests (in your case the HBA1c test)