Prediabetes I would love some people with experience to answer this question. As my question will be quite tricky unless you've experienced similar situation.

[diabeticfighter23]

HI all,

I am 32 years old male who has been prediabetic past 5 years (5.8%) Last year before Christmas, I did a blood test resulting in 107 fasting and 6.4% A1c level.
I was shocked but I had bmi of 29 so I knew it's time to lose weight.

I started to get strict with my diet and lost 11 kgs in 3 months. In March this year, I got the result of fasting sugar of 91 and a 6.0% A1c level.
I was quite disappointed how high my A1c level was, hoping I was no longer in diabetic risk.

Doctor asked me to test again in 6 months, which I did, and this time I lost 4 kgs more so in total lost 15 kgs since December. I also did more exercise after meal.
Still, my fasting glucose was 95, and A1c level 6.0%. Now I am starting to think whether I am already diabetic and perhaps that is why my a1c is still high.

do you guys think I should take oral glucose tolerance test to know whether i am diabetic type 2 or not? Or does my blood test results are enough?

I am now in a normal weight BMI so I thought this should be enough to reverse it... or is it too late?
If anyone has similar readings or happenings and did oral test and got diagnosed as diabetes please share your story.
I am currently considering oral glucose tolerance test but I am not sure if it will be any different.

My biggest frustration is I am no longer obese and I don't eat extremely unhelathy since I am able to maintain my current weight and I do exercise more. So why am I not fully reversed after 9 months...? That's why I start to think whether I am already diabetic maybe.

 

[KennyA]

Hi and welcome. I think you're giving values in percentages amd mg/dl. I'm firstly going to attach a graphic that translates the percentage values to the more commonly used (in the UK) mmol/mol (for A1c) and mg/dl to mmol/litre.

5.8% is 40mmol/mol - that's in normal range.
6.4% is 46mmol/mol - pre-diabetic
6.0% is 42mmol/mol - borderline normal/pre-diabetic. Because of the 5% allowable inaccuracy of the test these tests are possibly pretty close together.

107 mg/dl = 5.9 mmol/l
91 mg/dl = 5.0 mmol/l
95 mg/dl = 5.2 mmol/l

Your fasting readings seem perfectly normal to me. You've not had a diabetic level result in any of these tests. The weight loss may well help overall, but is there anything - symptoms, for example - that make you think you're diabetic?

 

[diabeticfighter23]

Hi,

thank you for your response.

the big concern for me is that - from 92kg to 83kg then to 75kg is a big weight loss and I was hoping my A1c level would go down below 5.6%.
I always had protein before meals and walked at least 10 mins after meal. STill, my A1c is 6.0% which is still at risk.

so my reasoning is = 6.4% is very close to 6.5%. Given the margin or error was it possible I was already diabetic back in december?
After weight loss my A1c did not change = only reason I could think of is my sleeping problems. I had bad habits past 6 months of sleeping between 3-4am and I think I sleep around 4-5 hrs a day. Can this be the reason why it's still high?
third possibility, given that I was in prediabetic state (5.8% or 40mmol) for 5 years is it that it takes longer time for me to be in normal a1c level state?
I don't have physical symptoms and I am maintaining at 75kg since march more or less +-1 kg.

I guess I lack the understanding of what type 2 means. Since I haven't been technically over 6.5% and my fasting glucose has been in the past 9 months
not yet over diabetic level, maybe my glucose tolerance is very high and I need to reduce it.
Do you know then, how to effectively lower glucose tolerance and possibly able to fully reverse my condition?
I am still young and the thought of giving up foods that I love to eat bc of my health condition really makes me feel depressed.

 

[KennyA]

40mmol/l is normal, not prediabetic, not "at risk". Another graphic attached, showing the blood glucose ranges of non-diabetic people.

Secondly there is absolutely nothing magical about the 48 mmol/mol reading. It was agreed by the medics in around 2008 at the level at which they would all agree to "automatically diagnose" diabetes. The level was chosen because retinopathy is rare (not unknown) at levels below that figure. I had a nearly full set of diabetic symptoms awhile my BGs were around 43/44 mmol/mol, and despite the symptoms over ten years, was told I wasn't diabetic.

The issue for us is insulin resistance. If we have that, it stops the insulin clearing glucose out of the blood and into the cells as fuel. Instead glucose gets converted to bodyfat, or hangs around in the blood. High levels of blood glucose can do physical daamge to nerves and capillaries. It is likely, again in my opinion, that there may be several causes of insulin resistance.

Weight loss, if you have it to lose, is probably a good thing in itself. I'm assuming you lost weight through calorie restriction rather than carbohydrate restriction. Is that correct? My weightloss happened long after my BG was back to normal and was achieved by carbohydrate reduction, as I didn't limit or even count calorie intake. So (in my view) my carb reduction achieved two things which are linked but not necessarily dependent on each other.

However if you mauintained a relatively high carb intake while losing weight I can see why your BG might not be particularly affected.

My thinking is it's probably a good thing not to be diagnosed as diabetic. It affects things like life insurance, for example. And because there isn't a cure, you would never not be diabetic, not matter how well you controlled your glucose. I guess what I'm saying overall is that don't obsess about whether you are or aren't diabetic (the figures you report say you aren't), or whether you levels might or might not have been higher at some point in the past. The issue is maintaining normal BG levels now and in the future. You can do that fairly easily by only a relatively minor adjustment to your carb intake.