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Another worried prediabetic..

Guitarman63

Member
Messages
11
Location
UK
Type of diabetes
Prediabetes
Treatment type
Diet only
Hello, I have been reading all these helpful threads for a few weeks now so I thought I would share my story and perhaps ask a few questions. I'm 63, male, active, BMI in the healthy range (just!) at 25. Until fairly recently I have always been fit with no health problems whatsoever. But recently I was diagnosed with prediabetes, and not just a little bit high either, both H1c tests (three weeks apart) showed 47.

I started by following the NHS advice of slow release carbs like porridge but when I got a glucose monitor I was horrified to see how much my BG was spiked so since then I have been following a very low carb diet so no grain, bread, rice, pasta or potatoes or other below ground veg. Low carb soya milk and yogurt, no pastry or cakes. I haven't found this as hard as I thought but I do miss the baked potatoes and oven chips! This low carb regime was definitely an improvement but it seems to have plateaued as if I haven't found the real problem. During the last week all my morning fasting readings have started with a seven, whereas they were sixes at the start. As a recent example of this is, I recentely had a bedtime reading of 6.1. At 3.15am it was 7 and by 8.30 it was up to 7.5 which according to most medical websites, if repeated, makes me already diabetic!

The problem is that while my BG is generally between 5 and 8 as you might expect for a prediabetic, the fasting morning readings are often as high as 7.8, much higher than they were the night before. I am usually at around 6 or 7 two hours after my evening meal. I have tried several variations, increasing and decreasing the carbs in my evening meal, with and without alcohol, taking my statin (more about that later!) in the morning instead of at night, but the morning readings just keep getting higher. When I first started the low carb my BG readings were really good but they seem to be getting progressively worse although I haven't increased my carb intake.

For me there has been another health scare to complicate matters having been so fit and healthy all my life.

Back in June 2019 I had a heart attack one night. I didn't realize it was a heart attack, I thought it was indigestion! Or perhaps a pulled muscle in my back or both. So I took paracetamol and it went off. Anyway, my wife persuaded me to see the GP the following morning who hooked me up but could find nothing so I was rather surprised to be whisked off to A&E in a 'precautionary' ambulance! More ECG's followed, all clear but the very sensitive test for a heart stress enzyme showed I had suffered a heart attack. 2 stents later and I felt exactly as I always had before, fit and raring to go! I mention the heart attack because of the drugs - Ramapril for lowering blood pressure (I didn't have high blood pressure but they like it to be very low) a beta blocker to lower my pulse (it was normal before but they like it even slower) and Atorvastatin which blessedly I have had no side-effects at all from. I was on a big 80mg dose for a year and I asked to get this reduced to 40mg because I wonder if this is what is causing my high morning fasting readings. I would like to change to another statin which has no link with HBS but they say Atorvastatin is the best at stopping any more plaque breaking off causing another heart attack or stroke. The reduced dose has made no difference, nor has taking it in the morning instead of at night.

I know the dawn spike thing is a fairly common question but most pre-diabetics don't seem as bad as me! I feel like I am teetering on the edge of a diabetes diagnosis despite completely changing my diet for these last few months. The odd thing is despite both serious health issues I feel absolutely fine, the same as I always did. I can go off cycling across the moors and keep up with my fit and healthy wife.

Apologies for such a long ramble but I would be interested to know if anyone has any suggestions. I don't want my next H1c test in nine months time to have me firmly in the diabetc range!
 
You have been through the mill. Yes you are right hi morning readings are DP, please just ignore for now.

Some statins can raise your blood glucose so you need to be aware of that.

Test before you eat and again 2 hours after the first bite. Eliminate those foods that raise you over 2.

Use the free app mysugr. Record your food and readings, after a few days it will give you an estimated hba1c. Won't be as accurate as a lab but after you have used it a few weeks it is good enough.
 
Hi @Guitarman63, It isn't as bad as you think!
You say that your HbA1C was fairly recent, if so then you are being unrealistic in expecting your Fasting BG to drop.
Mine hasn't even though my HbA1C has dropped from 53 to 44 and I have been on a Low Carb High(er traditional ) Fat way of eating for just over 15months.

It is the fasting BG numbers which are the last to reduce and many LCHFers report that although their post meal BG reduces immediately and their HbA1C reduces in a few weeks, that even if their HbA1C is all the way below 40, so in the normal range, their DP causes their Fasting BG to be the highest BG reading for the day.

I no longer test every day, but back when I did, if my FBG was higher than 7.5 I found that it dropped to under 7.0 by 2hrs after my first low/zero carb meal.

I get the feeling that you are taking several medications as precautions even though you don't have the underlying conditions they are meant to treat.
I was similar to you in that I had a 3x Coronary Artery Bypass (though no heart attack) just under 4yrs ago. I always had/have below normal blood pressure but they still prescribed Ramipril for me (though at the lowest dose). I was also prescribed Atorvastatin (known for raising Blood Glucose and for crossing the blood/brain barrier), but fortunately at a low dose, which I first got the GP to reduce and then eliminate altogether after I did research into the lack of actual evidence of its benefits.
I would rather risk a heart attack but with the expectation (on average) of living longer, than avoid a heart attack but at a higher risk of earlier death or worse still things like Parkinsons or Dementia.

The only medication I'm currently taking out of heart health cocktail I started on is the low dose Aspirin. But read the thread on Cholesterol by @bulkbiker and make up your own mind!
 
Thanks both for your replies. It makes me feel better to know things may improve over a longer period. I probably was asking a lot when my diet has always been 'good' if carb heavy. I don't mind waiting as long as things are going in the right direction.

Test before you eat and again 2 hours after the first bite. Eliminate those foods that raise you over 2.

I have been doing that since my a1c test at the beginning of August. Nothing spikes my BS by more than 2 unless I deliberately eat carbs as a test. Only sleep does that. Wish I could give up sleeping! I think I might be eating too late (7.30 - 8pm) so therefore going to bed with already higher than necessary BG. I never actually had the meter to check BG on my old diet so I don't know what they would be like. I might try a week just to see!

Re the statins, my bad cholesterol is very low and good cholesterol is normal but the main purpose of the Atorvastatin in my case is the 'supporting' the plaque in my arteries to avoid another piece breaking off. I would certainly risk not taking it but for that. I had one single blockage on the right but the level of disease was described as 'slight' in the rest of my heart, perhaps everyone has that at 63? I only wish I had been offered/asked for a a1c test years ago. All my other bood results liver, pancreas, kidneys etc have always come back normal.

Thanks again for all your helpful comments and if anyone else has had similar I'd be glad to hear them.
 
HI. Yes, those tablets will be raising your BS. I would suggest you possibly don't need the Ramipril if your BP is in the normal range. A low BP can be dangerous so keep it in range. Do your own measurements at home with a BP monitor, doing it properly, as surgery tests can be unreliable. Only take statins if your lipids ratios are not good. I wouldn't take them 'just in case'. Make sure you know what your lipids measures are without the statins. Low cholesterol can be as bad as high cholesterol. It may be that taking Metformin that most T2s do can help a bit and it's a very safe drug
 
Personally, I wouldn't take statins unless they were prescribed by a cardiologist after a cardiac event. You would have to discuss this with the appropriate hpc.

As far as BP goes, if you have got a BP monitor, prepare for it. Sit quite still for 5 minutes, relax, then press the button. Wait an hour if you have just had a long walk or done exercise. Takethe best out of 3 readings. This advice comes from my nurse. She used to be a theatre nurse. The surgeon used to ask her to hop on the bed and lower her BP until the alarm sounds. What a talent!

If I suspect I am going to have my blood pressure taken at an appointment, then for at least 4 days beforehand, I take 2 readings in the morning and 2 in the afternoon. I have white coat syndrome, when the nurse or GP takes my BP and is contemplating an ambulance to take me to A&E I just give them my readings and murmer white coat syndrom. It saves everyone a lot of time,
 
The Ramapril was prescribed by the consultant but everyone gets the 'protocol' after my sort of heart attack. You are prescribed Ticagrolor for the first year, Ramapril, a beta blocker, a low dose aspirin and a statin. I do now have a blood pressure monitor. My average BP over 40 days was 109/72 pulse 60. I'm going to keep on with the Ramapril for now but I will start agitating to come off it next year. The idea of the Ramapril and the beta blocker is to give a damaged heart an easier time with lower blood pressure and a slower beat. Luckily in my case there was no detectable muscle damage to my heart unlike many after such an event. I understand the need for public health because they know on average, outcomes are better with that drug regime but I hate being lumped in with that 'one size fits all' mentality.

I'm still not happy to be taking Atorvastatin even at the lower dose. I think it should only be given in conjunction with full cholesterol tests and a proper personal cardiac risk assessment rather than just 'protocol'. I asked the Clinical Pharmacist and she said I could change to the lower dose but it was the best statin for me to lower risk of another cardiac event because of its 'scaffolding effect' on plaque in arteries. Nobody seems to care that according to some recent studies, Atorvastatin can cause T2 diabetes. They all say the cardiac risk outweighs the T2 risk but I don't believe that everybody's cardiac risk can be the same. I don't want to be given T2 by treatment for something else, and the T2 risk is quite high. I'm just finding out everything I can so I can judge the risks for myself with the help of any medical people that will listen!
 
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