Impaired Fasting Glucose: when to worry, if at all?

[hose1975]

Some background: I suspect that I'm heading towards prediabetes at a rate of knots as my last three monthly self administered FBG tests all came back at 7.0 mmol/l or slightly higher. However, my postprandial results are still bang on normal at the two-hour mark. I have a BMI of 22, run three times per week and walk at least half an hour per day on the days when I'm not running (inclement weather notwithstanding). My carb intake is not very low, but neither is it spectacularly high (around 150g / day). My blood pressure is normal, as are my cholesterol readings. I've had gestational diabetes twice and was not able to control by diet either time, so had to inject insulin (starting at 17 weeks the second time). I am currently 38, have one autoimmune disease and my dad was diagnosed with type 2 diabetes in his late fifties.

I will be seeing my GP soon about this, but would like to engage in some hypotheticals.

Now for the questions:

1) Reading suggests that treatment for IFG consists mostly of lifestyle changes, to reduce weight, control blood pressure, etc. Since none of these apply to me, what could I do?
2) Would injecting a small dose of basal insulin be a viable option to discuss? I've also read that metformin is the medication of choice for IFG as well as IGT but would that mess up my naturally produced insulin during the rest of the day (i.e. cause hypos)?
3) Have any of you had IFG to the extent that you should have been diagnosed with diabetes (i.e. fasting reading over 7 mmol/l on two or more separate occasions) but maintained rock-solid glucose control postprandially without intervention? If so, did it progress to any type of full-blown diabetes (either type 2 or LADA, I'm guessing)?
4) Is this really anything to worry about at all? (Probably should have been the first question!)

Looking forward to your answers!

Jo

 

[jack412]

you can tell me, with your prior experience
with 75g of glucose, your 2 hr 'bang on normal' less than 11, hopefully under 8 for nice,
it sounds more like a liver dump of a morning 7 and high pre-diabetic
see you Dr for proper tests, GTT and fasting, it needs checking out,
with a low GTT you may not need insulin at a guess, metformin and less carbs

 

[Bluetit1802]

Hello Jo and welcome,

I'm sorry you find yourself in this position. There are plenty of pre-diabetics on this forum who will help you.

Yes, pre-diabetes treatment is lifestyle changes, but not just weight loss. It means a change of diet.
As far as I am aware, diabetic drugs are not licensed for pre-diabetics, including Metformin.
If you are pre-diabetic, you may have years left before you go over the edge to full blown diabetes, if ever, but this is down to you and a suitable diet.
In addition to 2 fasting readings of over 7mmol/l you need an HbA1c test before a proper diagnosis can be made. Fasting BG tests are notoriously unreliable as there are so many variables, such as liver glucose dumps, timing, disturbed night, and many other factors.

I hope all goes well for you. Ask as many questions as you like and good luck.

 

[Totto]

Some background: I suspect that I'm heading towards prediabetes at a rate of knots as my last three monthly self administered FBG tests all came back at 7.0 mmol/l or slightly higher. However, my postprandial results are still bang on normal at the two-hour mark. I have a BMI of 22, run three times per week and walk at least half an hour per day on the days when I'm not running (inclement weather notwithstanding). My carb intake is not very low, but neither is it spectacularly high (around 150g / day). My blood pressure is normal, as are my cholesterol readings. I've had gestational diabetes twice and was not able to control by diet either time, so had to inject insulin (starting at 17 weeks the second time). I am currently 38, have one autoimmune disease and my dad was diagnosed with type 2 diabetes in his late fifties.

I will be seeing my GP soon about this, but would like to engage in some hypotheticals.

Now for the questions:

1) Reading suggests that treatment for IFG consists mostly of lifestyle changes, to reduce weight, control blood pressure, etc. Since none of these apply to me, what could I do?
2) Would injecting a small dose of basal insulin be a viable option to discuss? I've also read that metformin is the medication of choice for IFG as well as IGT but would that mess up my naturally produced insulin during the rest of the day (i.e. cause hypos)?
3) Have any of you had IFG to the extent that you should have been diagnosed with diabetes (i.e. fasting reading over 7 mmol/l on two or more separate occasions) but maintained rock-solid glucose control postprandially without intervention? If so, did it progress to any type of full-blown diabetes (either type 2 or LADA, I'm guessing)?
4) Is this really anything to worry about at all? (Probably should have been the first question!)

Looking forward to your answers!

Jo

Hi Jo and welcome,

I think you should ask for an OGTT. That way you will know how bad or not things are and take it from there. OGTT is much more reliable than the fasting readings.

 

[jack412]

@ bluetit, the more conformation the better, but technically it seems just one type is sufficient
http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/
Any one of the following tests can be used for diagnosis:*
•an A1C test, also called the hemoglobin A1c, HbA1c, or glycohemoglobin test
•a fasting plasma glucose (FPG) test
•an oral glucose tolerance test (OGTT)

*Not all tests are recommended for diagnosing all types of diabetes. See the individual test descriptions for details.

 

[Loobles]

I'm told OGTT's are falling out of favour, except during pregnancy.

 

[Totto]

I'm told OGTT's are falling out of favour, except during pregnancy.

Yeah as HbA1c is much simpler. However, without OGTT I wouldn't have been diagnosed.

She can always ask.

 

[Loobles]

Yeah as HbA1c is much simpler. However, without OGTT I wouldn't have been diagnosed.

She can always ask.

Exactly.

I asked. Refused. Didn't push it because I didn't actually want to be diabetic. Denial is everything LOL

 

[Lamont D]

I'm told OGTT's are falling out of favour, except during pregnancy.

Not for me! Next one January!

 

[Bluetit1802]

Not for me! Next one January!

You always are the odd one out! I've never been offered one, and had never heard of it until this forum. I was diagnosed with a FBG test followed by an HbA1c. No need for further tests, it was clear I was diabetic!

 

[Lamont D]

You always are the odd one out! I've never been offered one, and had never heard of it until this forum. I was diagnosed with a FBG test followed by an HbA1c. No need for further tests, it was clear I was diabetic!

Don't think I'm odd!

Special, maybe?