Am I on the wrong track completely?

I have just had 18 months of intense investigations, mostly under gastroenterologist, after symptoms of unexplained weight loss, chronic diarrhoea, tiredness. My GP is convinced I may have cancer and I have had several scans, endoscopy, colonoscopy, every conceivable blood and stool tests but (thankfully) all clear.

However! I have been atypical of someone with pre diabetes despite raised HbA1c, slim, fit, low stress, healthy lifestyle and the only change I made after attending the Pre-diabetes course was to add in some moderate intensity exercise (running) to my already active life. When I tried a Freestyle Libre monitor in spring 2023 I was getting highs of up to14.4 mmol/L but clearly with good enough Insulin response to return this to near normal later.

I have recently had more blood tests for cortisol levels (plus others) and all ok. I didn’t know they were going to test plasma glucose as well which was also ok but possibly only because I had run, in a fasted state to the appointment .

As far as my HbA1c and plasma glucose shows I don’t have diabetes but I not so sure that this isn’t what is brewing and that my regular exercise is just keeping any deterioration slowed down? I have two immediate family members with different autoimmune diseases.

I am currently trying out another 2 weeks of Freestyle Libre CGM and for example today I ate a regular lunch with readings of 12.6 at 1hr15 after and still 9.2 at 2 hrs after. Because I time restrict my eating and never snack I wonder if it will have a reducing effect on my overall HbA1c as I am in a fasted state for 15 hrs a day despite any highs I might have during my eating window?

I am also finding now that after a heavy carb meal I can feel really unwell, dizzy, headache and nausea like I’m dehydrated. I now also drink a lot and am out to the toilet several times a night. The only activity that makes me feel well these days is fasting and exercise. If I was to reduce my carbs to lower my HbA1c I would lose more weight which I can ill afford.

I’m thinking of doing a DIY OGTT to see how I respond to a measurable amount of carbs under strict conditions and using a finger prick tester to monitor my response.

I’m not sure what to do next. I’m amassing some data to speak to the GP (again) but concerned she’ll think I’m just a hypochondriac although all I want is to just feel well again.

It’s really hard to decide if my response to carbs is within normal range or if I should be concerned. (My husband did a finger prick to check his sugar levels 1hr after eating the same portion of the same meal as me. His was 5.5 when mine was 12.2!)

Any helpful suggestions please?

………………………..

I am a 70 year old retired nurse from the UK. I come from a family of health professionals and have a keen interest in all things health related. I am anxious to remain fit and healthy into my old age. I am keen to be proactive and make good health choices.

Had mild Gestational Diabetes in1996

HbA1c
2022 Mar - 45 mmol/mol
2022 Jun - 43
2023 Mar - 44
2024 Jan - 44
2024 Jun - 43
2025 Mar - 41
2025 Nov - 43

2023 (all year)
Attended Xyla in person Pre-diabetes course. I followed the advice but no improvement in HbA1c!

2024 Mar
2 weeks Freestyle Libre monitoring (self directed)
Highs of up to 14.4 mmol/L after eating with often a rapid return to normal. Fasting levels around 5.5 to 6.5 mmol/L

EXERCISE
Always been a regular brisk walker. Current average around 8000 steps daily.
2023 Oct - Started Running. I now run5k 3 x week including local Parkrun on occasions.

WEIGHT
2022 Jun 66.5kg
2022 Dec 63kg
2023 Jun 62kg
2023 Dec 59kg
2024 Apr 56.5kg
2024 Aug 54kg
2025 Feb 54.5kg
2025 Jul 51.5kg
2025 Dec 51kg

DIET
I have never been overweight and have not intentionally dieted to lose weight but have lost around 15 kg over the last 2 years. I am now underweight for height and I can’t afford to lose more!

I have been practising time restricted eating for about 6 years and have an eating window of between around 12:30 and 21:30. This helps my cholesterol levels and the symptoms of chronic diarrhoea I suffer from.

I am an early adopter of low GI food choices and have eaten brown rice, wholewheat pasta, granary bread and new potatoes etc.. for years. However I love to bake but I often use ‘healthy’ recipes eg. from DiabetesUK website.

I eat a good number and variety of fruit, vegetables and nuts every day according to current advice. I don’t snack between meals. I’m not a fussy eater and eat most things.

I love healthy food and cook all meals from scratch with only occasional meals out or takeaways. I am not vegetarian or vegan.

I have inherited high cholesterol and have been on Statins for 15 years. I don’t particularly try to cut my cholesterol intake (which isn’t high) as the source is less to do with my diet but because I make it in my liver.

Hi @Melgar, thank you for your reply.

You are right that there are carbs in all sorts of foods but for non-diabetics they shouldn’t be too much of a problem if chosen wisely but they certainly are for me. I can see in my response to the carbs in the foods I eat using the CGM that many otherwise ‘healthy’ foods are causing high spikes in blood sugars.

I am clearly not insulin resistant nor type one diabetic as the CGM shows that I am producing insulin but not always very quickly and not always enough. It’s not normal to have to severely restrict carbohydrates to control blood sugars nor is it necessarily healthy. I am not just lean but thin now with all my ribs showing. Last time I had a CT scan of my abdomen, it was hard for them to visualise my organs because I was told that I have no visceral fat to move them apart! I can’t afford to lose much more weight as I am now underweight.

C-peptide test is not generally used in the UK in the initial investigations for Diabetes but tests for autoimmune antibodies are sometimes, so I might ask my GP if that would be appropriate.

The 4 T’s used in the UK to aid diagnosis of Diabetes are Thinness, Tired, Thirst and frequent Toilet visits. All of which apply to me and I thought it might explain my unexpected weight loss. I was thinking that my exercise regime could explain an extended ‘Honeymoon’ period of possible early LADA? (see footnote) I’m just searching for an answer to my weight loss and persistent pre-diabetes which could result in an improvement in my general well-being if identified and treated appropriately.

NeetaMD



As you keep yourself fit I thought you might also be interested in this research paper “ Type one diabetes honeymoon is almost 4 times longer in people who exercise”
I can’t share the link because I have only just started posting but it is from the University of Exeter in the UK. I’m sure you could Google it if interested.

Wow @Melgar, a competitive runner! Well done! I can’t claim to be more than an amateur jogger but I try to be consistent whatever the weather.

I will consider any other tests as you have discussed privately only if I get a negative response from my GP. I am due my annual blood test in March and by then I’ll have collected a little more data including maybe a DIY OGTT which might be interesting.

Thanks to the link to the paper which I’ll be interested to read tomorrow. It’s 23:16 here!

Hi @Antje77 thank you for your response and questions.

I do need to consume enough calories for my needs and I have looked quite closely at that yet I have had no significant changes to my diet during the period of weight loss. In fact (on advice from the gastroenterologist) I am ensuring that I eat full fat yoghurt and cheeses, add olive oil based dressings to my salads and regularly add double cream to my coffee, soups, casseroles etc in a bid to add extra calories. I have plenty of protein in my diet with red meat twice a week as I am prone to anaemia as well as poultry, fish as well and some meat free meals including pulses.

What is strange is that my husband and I are both retired, both active, similar height and build and we eat all the same food and same serving size, he’s not lost any weight at all despite men’s calorific needs being typically greater than a woman’s. I am puzzled?

Hi @EllieM, thanks for your comments and links to the study of non-diabetic using CGM’S

I will hopefully be able to discuss my concerns with my GP after my annual blood tests in March and maybe get some further tests done.

The study you sent a link to is interesting but I can clearly see that my blood sugars regularly fall outside of the range found in the non-diabetic participants of my age group in the research. So far after a week of using the CGM I am outside of target range for 19% of the time. Oh well, I guess time will tell if there is anything to worry about.
Thanks again