Low carb approach adopted... [snip]
Anyone else on Uk NHS prevention course?
I am in America, but my understanding of the NHS policy is that it doesn't usually involve an explicit low-carb approach, but rather, a more conventional "balanced diet" or "eatwell plate." It might help if you could give us details of what you eat in a typical day. (If you don't mind.) Thanks!
Breakfast
2 hard boiled eggs
Natural Greek yogurt three tablespoons
Snack
Salted peanuts 1 Packet
Main meal
Beef or chicken with green vegetables lots!
Snack
Soup and or cheese
This is similar to what I do (details differ, but carb load similar) and is similar to others who have had success with the low-carb approach.
Have you been following that approach for all of the three months since your diagnosis?
By the way, the change in your HbA1C is statistically insignificant (because of the margin of error). It could have actually gone done more than the test indicated, or it might even have gone up slightly. If I were you, I would consider it "a draw" -- the lack of significant change in blood glucose, despite dietary change, is the issue.
Going to increase resistance exercises to see if this has an effect over next three months
Good idea, because there is some evidence that having more muscle and less fat can help. But, based on what I have read, unlikely to make a determining difference.
Sorry to ask again: Have you been on that low-carb gig since your diagnosis three months ago? The reason I ask is that most of us who have tried it find it can take some months to work. Plus, some of us have a faster result than others. And, of course, some of us don't achieve sufficient control through diet alone.
Yes have been on low carb since diagnosis however must admit there have been some occasional lapses when on a couple of holiday breaks! Think I need to think more in advance and look at restaurant menus more carefully with my low carb glasses on!
If the lapses are occasional they are unlikely to have more than a tiny effect on HbA1c. I think you are probably doing all of the following things but just in case:
At this point you "only" have pre-diabetes so you probably have a little bit of time to sort this out. Well done for dealing with it now!
- Decide what kind of "low-carber" you want to be: 150 grams per day? 100, 50, 30, 20? If you start at the high end of the range and the HbA1c doesn't budge, tighten up for the following months and see what happens. (The sample daily food list that you provided indicates that you are probably trying to be at the low end of the low-carb range.)
- Double-check everything you eat and drink. Carbs lurk in unexpected places. Read the label on the packet, or Google "nutrition" for a particular food.
- The labels need to be interpreted. Often, the grams of carbs listed are "per portion" or "per 100 grams" or whatever. Make sure you translate that properly to the portion sizes you are eating.
- We have been conditioned to think that certain foods are "healthy" but they can be a minefield for anyone trying to go low-carb. Among the common "misleaders" are: fruit, certain kinds of vegetables, certain dairy products, and anything containing grains/cereals. The list is very long.
- Yes, restaurants are minefields, although if the menu is large enough you can usually find something relatively safe such as meat or baked fish. Ask them to substitute garnishings such as potatos with spinach or whatever your favorite low-carb vegetables are.
- Obtain a blood-glucose meter and "eat to your meter." Find out which foods "spike" you. Some people on this forum may advise that getting a meter is among the first things you should do, and they have a good point. (This is a personal decision. I don't use a meter.)
- There is scientific evidence that moderate exercise helps lower HbA1c (slightly). The studies I have seen show that effect could be, perhaps, half of a percentage point (in the old HbA1c measuring system). That is nothing like as powerful as diet, but still helpful "at the margin." Personally, I have a brisk 3-mile walk every day, without fail. The resistance exercises you mentioned may help too. In my opinion, the most important thing is regular (i.e. daily) exercise rather than the total quantity of it.
Many thanks for that detailed response and advice extremely kind of you to take the time to give such a considered and detailed piece of advice
Maybe someone could clarify this for me
First Hba1c three months ago was 46 but this was after a 10 hour fast as doctor instructed
Second one three months ago taken on NHS xpert prevention course was 45 but had not fasted
Significance and the difference?
Thanks
HbA1c measures the average blood glucose level over the previous 8 to 12 weeks. It is not affected by anything that happens on the day of the test, or in recent few days.
There is a "margin of error" too. The difference between 46 and 45 is not statistically significant.
Edited to add full explanation, highly recommended: http://www.diabetes.co.uk/what-is-hba1c.html.
Edited again to add: The reason your doctor requested the fast is probably because s/he was also running a "fasting glucose test." This is a separate test, nothing to do with the A1C.
Just wanted to say hello and welcome to the forum
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