Blood glucose monitors

[nabilla]

Hi, I was very recently told I have prediabetes with only an HBA1C of 42. BMI is now 20.8. waist 79cm. I was also told I had low B12 and a positive Qfit for which I have an urgent colorectal referral. About 3 weeks ago I had two close faints. I've got an ECG next week for that. I wear a fitbit, and between May and now, my resting heart rate has steadily increased from 70 to 80 average. I'm giving all this info incase someone reads it and puts the pieces together, but I'm aware the pieces may not be part of the same puzzle.
I immediately went on a low carb diet and switched my 0 Percent greek yoghurt for full fat. I'm now ill and have been in bed all week with fever coming and going/body aches/extreme fatigue. I also have a dry cough bringing up some.phlegm.
I'm not doing Keto--I've done it before any prediabetes and I can do it (I'm pretty obsessive) but I really don't enjoy it.
This week I've been weighing all my food. I've been aiming for a 750kcal deficit, which has been hard as I'm mainly in bed, so most days that's been missed but I'm still only eating about 900 kcals. Daily carbs between 53-98g. All whole food. All my blood glucose readings have been great. Highest was 6.6 and lowest 5. I'm between 5 and 5.5 on waking.
I want to start trying some of my favourite carbs, namely white rice and porridge (jumbo oats), to see how this affects my glucose. My question is, is this a worthwhile test? Will my capacity to cope with these starchy carbs be affected by my overall lower carb diet, or not? What reading should make me put away the oat jar? Sorry if this is all too much detail. I'm constantly hungry. If I need to continue like this to avoid diabetes, I will, but if I can safely introduce some oats, I would like to.

 

[nabilla]

Above is my highest carb day. Glucose readings seemed unaffected

 

[ianf0ster]

We are not allowed to even try to diagnose in this forum, We generally only talk from our own experience.

Thus, I'm surprised that with a BMI of only 20.8 you are aiming for a 750KCal per day deficit. How thin do you want to be?
In my experience, when reducing carbohydrates, there is no need to cut calories to reduce Blood Glucose, or even to reduce weight. In fact, it can be counterproductive by making you tired, cold, hungry and making fat adaptation more difficult, when you should be aiming for fat adaptation to make your body able to switch to using stored body fat for energy seamlessly.

I am/was a slim Type 2 diabetic, now in remission for over 4yrs. I have been slim all my life and am now 73, but as my diabetes developed some extra fat around my belly became noticeable. This is often called TOFI (Thin Outside, Fat Inside) and means that there is extra fat in and around organs such as my liver.

From my research into my situation, I had the choice between an 800 KCal per day diet and going Low Carb, I chose Low Carb since I did not want to lose too much weight or to be very hungry. This forum helped me to adjust my carb intake to what my body could handle by 'eating to my meter' i.e. measuring the glycaemic effect of each meal and adjusting so that my Blood Glucose rise from just before a meal to 2hrs after first bite was no more than .0 mmol and the 2hrs after meal reading was below 8.0 mmol. That was enough to get me into T2D remission even though I never counted calories, or went hungry. In fact, I'm sure I was eating more KCal per day than before since I was eating more Protein and Fat. (I had been over 10yrs on a low fat, high carb way of eating - which I hated).

As a pre-diabetic it's likely that it would only need a small decrease in carbs to get you back into the normal Blood Glucose range. But since we all process carbs differently, the only way to know which amount of which carbs are right for your body is to use a Blood Glucose meter or a CGM. Glycaemic Index and Glycaemic Load are only rough guides based upon how someone else's body processes those foods, and foods digest differently in combinations i.e. adding fat or alcohol tends to slow down the digestion of carbs into glucose.

 

[Rachox]

Hi @nabilla , this does all sound complicated and needs a Dr with an overall view of your health and test results to evaluate what might be going on, are you getting followed up with your GP? And more immediately have you seen anyone about your illness that’s rendering you bedbound?
I second what @ianf0ster says about your calorie deficit, why are you eating such a low calorie diet when your BMI is in the lower half of healthy?

 

[KennyA]

Hi and welcome.

First point - we don't diagnose, or try to diagnose, on this forum.

You've got a mix of things, and it can be a bit hard to sort out what's doing what. For example, I can be pretty sure that any illness will put my bg levels up by around 20% - it seems my liver thinks extra glucose is needed. I tend to think if that's a natural response, as it seems to be, why should I worry about it?

You say you're doing low carb, but you're counting calories. Is there a reason for this? My guess would be that the calorie deficit is maybe why you're hungry. I've never bothered with counting calories.

The best way of finding out what rice or oats would do to your BG levels is to test before you eat them, then at +2 hours. You'd probably need to exclude other carb sources in the same meal. This is to see how well your system copes with the resulting glucose load, not to see "how high you go". By +2 hours your insulin response system should be returning you back to your starting point (or reasonably close) . If you're more than 2 points above your baseline, or above 8, your system isn't currently capable of dealing with that glucose load.

For me either rice or oats, as very high-ticket carb items, are still not an option.

Best of luck. Your 42 reading is only just out of normal range and given the accepted inaccuracy of the test , may not even be as high as that.

 

[VashtiB]

Hello and welcome @nabilla

That sounds like you have a lot to deal with. Virtual hugs. As everyone else has said we don't diagnose here. I also agree that you should make an appointment with your GP and discuss it with him/her.

With so much going on I would suggest writing it all down before you go so that the doctor has all the information.

Take care of yourself.

 

[nabilla]

Thanks everyone, for some reason I got the idea that I needed to cut carbs and also count my calories. If I want to not count calories, I thought I had to go proper low carb (keto?). I've done that before and it didn't work for me. I think I had the idea that I'm maybe 'skinny fat' and that's why I was counting calories. I think I'll start introducing more calories, but I'm feeling a bit lost about how to manage this. At the same time, I can see that the way I'm eating just now is keeping me well within the range that Kenny A suggests. I'll maybe try and be a bit more experimental. I do get quite anxious about health as my partner has had terrible health issues and been in and out of hospital/ICU for many years. I'm the breadwinner and we have a child. I'm terrified of being unable to work.
Yes--the doctor is aware of all the issues. I've got urgent referrals for bowel and heart issues. I've a suspicion that the main issue is a bowel one which has caused absorption problems, resulting in low B12, which can give false-high HBA1c readings. I've not been bed-bound--just in bed a lot/resting and very short walks on a few days. It just means I'm not doing my usual daily exercise which made the calorie deficit harder to achieve.
Thanks for all the very patient and useful responses. I do understand that I'm lucky to have good readings and a pretty low HBA1c to be starting with

 

[nabilla]

Hi, I ate 30g of jumbo oats with 150ml semi-skimmed lactofree milk for breakfast. Fasting glucose was 5.4 and two hours after eating the porridge, it was 5.7. I'm thrilled, and will start experimenting with other foods. Thanks for all the advice. I expect at some point I'll find the food/s portion sizes that affect me. I'll also weigh my portions as my breakfast bowls tend to get bigger and bigger if I don't use portion control. Nobody talks about free sugars. I've cut that completely and will reintroduce via dark chocolate using the BGM. I'm wondering if my weekend sugar has been responsible for the prediabetes. I certainly eat less refined sugar than many folk, but maybe I'm sensitive to it. I've always felt that gaining even a few pounds leaves me feeling **** physically (I no longer care about having small clothes sizes).

 

[ATB123]

Hi, I was very recently told I have prediabetes with only an HBA1C of 42. BMI is now 20.8. waist 79cm. I was also told I had low B12 and a positive Qfit for which I have an urgent colorectal referral. About 3 weeks ago I had two close faints. I've got an ECG next week for that. I wear a fitbit, and between May and now, my resting heart rate has steadily increased from 70 to 80 average. I'm giving all this info incase someone reads it and puts the pieces together, but I'm aware the pieces may not be part of the same puzzle.
I immediately went on a low carb diet and switched my 0 Percent greek yoghurt for full fat. I'm now ill and have been in bed all week with fever coming and going/body aches/extreme fatigue. I also have a dry cough bringing up some.phlegm.
I'm not doing Keto--I've done it before any prediabetes and I can do it (I'm pretty obsessive) but I really don't enjoy it.
This week I've been weighing all my food. I've been aiming for a 750kcal deficit, which has been hard as I'm mainly in bed, so most days that's been missed but I'm still only eating about 900 kcals. Daily carbs between 53-98g. All whole food. All my blood glucose readings have been great. Highest was 6.6 and lowest 5. I'm between 5 and 5.5 on waking.
I want to start trying some of my favourite carbs, namely white rice and porridge (jumbo oats), to see how this affects my glucose. My question is, is this a worthwhile test? Will my capacity to cope with these starchy carbs be affected by my overall lower carb diet, or not? What reading should make me put away the oat jar? Sorry if this is all too much detail. I'm constantly hungry. If I need to continue like this to avoid diabetes, I will, but if I can safely introduce some oats, I would like to.

As you're unwell, would it not be better for you to concentrate on getting your gastro investigations and low B12 levels sorted, and see your GP about feeling unwell as could all be connected. Then when you're well, concentrate on managing your diet? Your blood glucose levels are fine but you can't do everything at once especially if you're feeling poorly.

 

[nabilla]

As you're unwell, would it not be better for you to concentrate on getting your gastro investigations and low B12 levels sorted, and see your GP about feeling unwell as could all be connected. Then when you're well, concentrate on managing your diet? Your blood glucose levels are fine but you can't do everything at once especially if you're feeling poorly.

Yes, in response to the earlier posts, I'm going to eat more calories but still be fairly low carb (not full low carb like keto). I'm going to make an appointment to see the doctor again as my resting heart rate is increasing on a daily basis. I have an ECG on Wed too. I also wonder if it's all connected--maybe a B12 absorption issue or bleeding causing low B12 setting off the other things, including hyperglycaemia.

 

[littlebrownbird]

Hi, I was very recently told I have prediabetes with only an HBA1C of 42. BMI is now 20.8. waist 79cm. I was also told I had low B12 and a positive Qfit for which I have an urgent colorectal referral. About 3 weeks ago I had two close faints. I've got an ECG next week for that. I wear a fitbit, and between May and now, my resting heart rate has steadily increased from 70 to 80 average. I'm giving all this info incase someone reads it and puts the pieces together, but I'm aware the pieces may not be part of the same puzzle.
I immediately went on a low carb diet and switched my 0 Percent greek yoghurt for full fat. I'm now ill and have been in bed all week with fever coming and going/body aches/extreme fatigue. I also have a dry cough bringing up some.phlegm.
I'm not doing Keto--I've done it before any prediabetes and I can do it (I'm pretty obsessive) but I really don't enjoy it.
This week I've been weighing all my food. I've been aiming for a 750kcal deficit, which has been hard as I'm mainly in bed, so most days that's been missed but I'm still only eating about 900 kcals. Daily carbs between 53-98g. All whole food. All my blood glucose readings have been great. Highest was 6.6 and lowest 5. I'm between 5 and 5.5 on waking.
I want to start trying some of my favourite carbs, namely white rice and porridge (jumbo oats), to see how this affects my glucose. My question is, is this a worthwhile test? Will my capacity to cope with these starchy carbs be affected by my overall lower carb diet, or not? What reading should make me put away the oat jar? Sorry if this is all too much detail. I'm constantly hungry. If I need to continue like this to avoid diabetes, I will, but if I can safely introduce some oats, I would like to.

That's an impressive BMI and waist measurement!

Regarding white rice/oats, try it. If your bg spikes to an unacceptable level at the 2-hour mark (post-eating), then leave it out of your diet until your HbA1c is back in the normal range. If you decide to eat small amounts of white rice or oats, just ensure you pair it with sufficient protein to dampen the bg spike. TBH, I'd err on the side of caution and substitute something like quinoa (more complex carb, fibre and protein, mineral rich etc.).

I've dabbled with 0% yoghurt and it's just not as satiating as full-fat. If you're constantly hungry (I know that feeling) increase your protein and fibre. Also, I tend to stick with moderate low carb (10-15% carbs per 100g) as it gives me better bg balance and staves off the hunger pangs (as do a handful of almonds or a tablespoon or two of yoghurt or finger-sized piece of cheddar/hard cheese).

 

[nabilla]

Thanks littlebrownbird. I tested before eating the oats (fasted as it was first thing in morning) and two hours later. I was 5.4 on waking and 5.7 two hours after the jumbo oats with lactofree milk. I'm going to keep.testingbwith different foods and find out what's been spiking it. It may be a bit like when I did the FODMAP diet and found I could eat most things without gastro issues, but only in the right quantities. For example, a bit of milk in my tea is fine but if I have a latte I get gut symptoms and if I have a latter then an ice-cream then a hot chocolate...i bloat so much I look very pregnant.
Need to find out what's triggered the prediabetes. I do understand it's carbs, but I can see a small serving of oats is fine for me whereas for another prediabetic, it would be a sugar spike.

 

[nabilla]

Hi, sorry to keep posting in such detail. I did a pre-prandial test this evening. The only reason I did it was because I'd had such good results from the jumbo oats porridge this morning that I thought I'd try some white rice (basmati) with my curry. I fully expected a reading of 5ish but it was 13.2. I've also had a raging headache for the past few hours. I had a very low-carb lunch of leafs, 1/3 avocado, a few tomatoes, a smoked mackerel and then some full fat yoghurt with a medium pear. Could it be a late reaction to the oats I had about 11 hours ago, or couldn't be something like the pear--can pears cause high readings??? Also aware it may be an anomaly and will test again in a few hours