Prediabetes How do you reduce fasting blood levels?

[andyR57]

Hi



Hoping someone will have some advise for me.



Was told about 2 years ago was pre-diabetic and to be honest after some initial action regarding diet and exercise I then slipped back into my old ways and really did nothing about it.



In January I started taking my blood readings again and they were not good but still in the pre-diabetic range. Since then I have lost weight [from 15st to 13st] and exercise everyday except Sundays. The assurance from the Doctors was that this would be enough but sadly my readings are getting steadily worse. The Doctors are quite lax about things because I am not diabetic and so I feel as if I am on my own and trying to work out what I should be doing!



Some low carb meals send my sugar reading above 8 even after 2 hours whilst some higher carb meals seem to have my sugar level below 6.5 after 2 hours. So to say I am confused is an understatement. I have started taking Cinnamon with my breakfast to see what effect that generates and I am looking at the Keto diet but have stage 3 Kidney disease so don’t think it is suitable.



My main problem [advise sought] is my fasting bloods which are typically around 6.4- 6.8 even after a 16 hour fast. I have read about the dawn phenomena and so took reading throughout the night . At bedtime it was 5.7, at 2.30 am 6.2 and at 6.30 am 6.7 and at 9.30 am 6.1. One hour after Breakfast and 20 minutes aerobic exercise it was 6.8. I have figured out exercise does reduce my levels fairly fast.



So what do I do. I don’t normally eat after 6pm until 10am next day – is the problem and should I perhaps have supper but then that will break my fast and hinder my weight loss? I thought cheese might be a good thing to have?



The other issue I have is that I feel a bit betrayed to be honest because exercise and weight loss have not produced a cure and I feel I am now into diabetic management and pretty much on my own in trying to stop pre-diabetes becoming T2D. One of my concerns is if diet and exercise reduce sugar levels is it just a temporary measure and will sugar levels continue to rise over the longer term - so in effect are my efforts just delaying the inevitable?



Sorry for the rant, it’s just frustration I guess. Any help or suggestions greatly appreciated.

 

[hankjam]

I think it is generally accepted that even after a complete switch to low carb high fat the FBG test is the last that will "fall" into line. The dawn / start the day is a complex process and your body is probably not up to speed with the new regime, so it will produce glucose in the normal way.
You mentioned you've lost weight, would you say you still have some extra reserves that can be tapped?
You mentioned having low and some high carb meals, how focused are you on low carb, it helps.
Exercise and diet/ wt lose will not produce a cure, it may, if applied, avoid T2 but if it happens it will only ever "control" the process. I used "" as I don't want to go into another round of definitions, see numerous threads on forum.

 

[andyR57]

Hi.



Thanks for your input. Yes, although I have lost weight I still have about another 12-14 lbs to go to get to my 12 stone target.



I am not on the Keto diet - just observing that a low 45g carb breakfast of oats see's my readings over 8 at 2 hours, whereas a dinner with potatoes. meat , veg and Yorkshire puddings [80g carbs] is below 6.5 after 2 hours. I initially made the mistake of taking my readings at 1 hour and if OK didn't bother with the 2 hour reading but then found out sometimes the readings were worse at 2 hours than 1 hour.



I am considering the keto diet but need to watch proteins because of my stage 3 CKD.



I am really wanting a cure rather than management but guess it is not going to happen. I have exercised all my life so that is not an issue, I eat well and diet modification is not a major issue and weight loss has not proved too difficult or problematic for me. Perhaps it is still early days but the readings seem to be getting worse not better and I just feel at a loss of what to do - the more I take readings the less sense it seems to make and I am so confused and frustrated right now.



Another things is that there is so much information out there and it is often contradictory. For instance one websites says to reduce the dawn phenomena have a carb snack at bedtime whilst another site says don’t eat carbs for at least 4 hours before bed – it’s just so bewildering.



Thanks anyway.

 

[Pasha]

" low 45g carb breakfast of oats "

For me thats not at all low carb . Do you measure your macro nutrient intake for the day ? Could easily be that you are taking in too much carbs , protein, or both. We all have VERY DIFFERENT tolerances, maybe the problem lies here ?

 

[Bluetit1802]

I agree. 45g of carbs at breakfast time is not a good choice. That is more than many of us eat in a day.
Also, 80g at one sitting is putting a huge strain on the pancreas.

Insulin resistance plays a big part in this, in fact, the biggest part. Our insulin resistance is at its worst in the mornings but does improve a bit as the day progresses. You will never reduce your fasting levels in a morning if you continue to eat high carbs, which oats and potatoes are, not to mention Yorkshire puddings. (and presumably gravy). Higher than acceptable morning fasting readings are due entirely to insulin resistance combined with a fatty liver. Get rid of those blighters and your fasting numbers will come down. (Eating carbs at bedtime is the worst idea ever for T2s, in fact, any snacking is a bad idea)

The best way to get rid of resistance and much of the fatty liver is to cut right down on carbs, especially oats, potatoes (gravy?) and yorkies. Also, if you eat fruit or other forms of fructose, this won't be helping the fatty liver. The more carbs we eat the more insulin our pancreas has to secrete. The more circulating insulin we have, the worse our resistance to it becomes. The worse the resistance becomes, the more insulin we need. Vicious circle.

Perhaps try virtually zero carbs at breakfast - eggs cooked any way you like, maybe omelettes, bacon and eggs with mushrooms fried in butter, cheese and cold meats, or a full fat plain yogurt with a couple of strawberries chopped up or half a dozen raspberries. There is no need for carbs.

As for your roast dinner, be careful which veggies you have, use butter instead of gravy, keep the yorkies for a Christmas Day treat, and keep the spuds down to 2 small pieces or none at all. 80g worth of carbs is too much at one meal.

I would simply concentrate on reducing the amount of insulin you need, and that can only be done by reducing the carbs. Fasting helps many people - have you tried skipping breakfasts completely apart from a coffee with cream? It works for most.

 

[bulkbiker]

I am considering the keto diet but need to watch proteins because of my stage 3 CKD.

For many keto is a high fat, moderate protein, ultra low carb diet.
Have you yet found Dr Jason Fung.. a Canadian nephrologist you may find some of his videos both helpful and informative.

 

[andyR57]

I agree. 45g of carbs at breakfast time is not a good choice. That is more than many of us eat in a day.
Also, 80g at one sitting is putting a huge strain on the pancreas.

Insulin resistance plays a big part in this, in fact, the biggest part. Our insulin resistance is at its worst in the mornings but does improve a bit as the day progresses. You will never reduce your fasting levels in a morning if you continue to eat high carbs, which oats and potatoes are, not to mention Yorkshire puddings. (and presumably gravy). Higher than acceptable morning fasting readings are due entirely to insulin resistance combined with a fatty liver. Get rid of those blighters and your fasting numbers will come down. (Eating carbs at bedtime is the worst idea ever for T2s, in fact, any snacking is a bad idea)

The best way to get rid of resistance and much of the fatty liver is to cut right down on carbs, especially oats, potatoes (gravy?) and yorkies. Also, if you eat fruit or other forms of fructose, this won't be helping the fatty liver. The more carbs we eat the more insulin our pancreas has to secrete. The more circulating insulin we have, the worse our resistance to it becomes. The worse the resistance becomes, the more insulin we need. Vicious circle.

Perhaps try virtually zero carbs at breakfast - eggs cooked any way you like, maybe omelettes, bacon and eggs with mushrooms fried in butter, cheese and cold meats, or a full fat plain yogurt with a couple of strawberries chopped up or half a dozen raspberries. There is no need for carbs.

As for your roast dinner, be careful which veggies you have, use butter instead of gravy, keep the yorkies for a Christmas Day treat, and keep the spuds down to 2 small pieces or none at all. 80g worth of carbs is too much at one meal.

I would simply concentrate on reducing the amount of insulin you need, and that can only be done by reducing the carbs. Fasting helps many people - have you tried skipping breakfasts completely apart from a coffee with cream? It works for most.

Yes with gravy - you making me feel guilty now! My Doctor told me to restrict carbs to 150g/day so have been allowing 45g breakfast/ 35g lunch and the rest for dinner. Sunday dinner is the exception rather than the rule and I don't snack between meals. I explored low carb diets but the Doctor said moderate carbs was fine. My Hba1c was 39 at the time. I do feel that I am becoming more insulin resistant and intend reducing the carbs to about 100 a day to see if it helps. I don't eat after 6pm until 10am, still losing weight and exercising and my levels are still prediabetic but steadily getting worse so I agree with you all that I do perhaps need to reduce carbs since there is nothing much else I can do.

 

[Bluetit1802]

Yes with gravy - you making me feel guilty now! My Doctor told me to restrict carbs to 150g/day so have been allowing 45g breakfast/ 35g lunch and the rest for dinner. Sunday dinner is the exception rather than the rule and I don't snack between meals. I explored low carb diets but the Doctor said moderate carbs was fine. My Hba1c was 39 at the time. I do feel that I am becoming more insulin resistant and intend reducing the carbs to about 100 a day to see if it helps. I don't eat after 6pm until 10am, still losing weight and exercising and my levels are still prediabetic but steadily getting worse so I agree with you all that I do perhaps need to reduce carbs since there is nothing much else I can do.

150g a day is the top of the low carb range. I started my journey on about 100g a day and was losing weight very quickly, but my blood sugar levels were not acceptable to me. I gradually reduced them, eventually ending up on 30g a day and was a happy bunny.

As you are steadily getting worse, your current eating plan is clearly not working for you. Your regime seems very good - not eating after 6 and fasting till 10am, and your exercise. Unfortunately, whilst exercise is good generally, diet is the key for blood sugar control.

 

[TriciaWs]

Your doctor may not be up to speed on recent research - 150g is too high for most of us, and I found eating more than 30g of carbs in one meal would raise my blood sugars.
I started as soon as I was diagnosed, on 100g a day. My daytime blood sugar readings dropped fast but I wasn't completely within the normal range in the morning for a while longer - I dropped down to 85g to get fully into remission.
I also tested for certain foods, so I knew I could eat 1.5 small slices of a low carb bread but not 2, and that strawberries would raise my blood sugar more than raspberries even for the same amount of carbs.

Cheese sounds like a good idea - I was having 20g portion before bed to reduce the chocolate cravings.