Is this a wake-up call?

[Steinios]

Hi,

My doctor recently diagnosed me as "pre-diabetic" - which really surprised me, as my baseline weight is in the centre of the "approved" body-mass index, so I'm nowhere near obese, and I hardly drink alcohol, but it turns out there are some high risk markers I was unaware of:
I'm 50, there's a family history (my dad is 80 and has type 2), I'm an ex smoker (I now use vapes).

The symptoms I presented were a rapid weight loss of approx 10kg which did not fluctuate over 2 weeks (I've quite a high metabolism anyway), and random moments of fatigue.
I mentioned to him although I eat fairly sensibly I have a taste for sweet snacks, but he didn't seem to think it was an issue.

A non-fasting random urine sample showed normal. A blood test was carried out and this showed higher than normal carbohydrate and a borderline blood-sugar reading of 6. Another blood sample a week later confirmed the blood-sugar reading was still 6.

He explained that my borderline reading put me in the "pre-diabetes" category and although not the "type 2" group is considered a risk, but at this point diabetes could be prevented with the correct lifestyle. I am due to attend a 13 week "web" course arranged by the NHS, which starts in July.

I'm looking forward to finding out more, but I want to start making changes now, so in the meantime I've been researching some ways to stay healthier (mainly though this and the NHS website ). I've realised there are a few other symptoms I had which I had previously dismissed as "getting old" which tally with "type 2" such as: I used to be able to read the tiny numbers printed onto drills, a pint of beer makes me feel unwell afterwards, and having to pee at night sometimes, and the tingling fingers and lips.

As we are still in partial lockdown it is not easy to connect with a doctor to ask non-urgent questions without having to wait a few days for a call-back. I am calling for any specialists on this forum to answer the following concerns I have? I've tried to research these, but the answers have not been fully conclusive:

1) Am I correct in saying in the UK the risk marker for pre-diabetes is a blood test result of >5.4?
2) I read that America has a higher threshold to indicate pre-diabetes? Is this true??
3) Is "pre-diabetes" completely reversible, given sensible lifestyle changes?
4) When it comes to diabetes factors why are vapes better than cigarettes?
5) The terms hypoglycaemia and hyperglycaemia are very similar, yet mean totally the opposite. Is it time we used different conventions?
5) There's plenty of information about the revised sugar content of lucazade causing an uproar with hypoglycaemic patients who used it as a moderator. But what about hyperglycaemia? Assuming my "6" means I have hyperglycaemia and drinking lucozade would be adding to the (converted) sugar?
6) Before my diagnosis I would drink 2 x 500ml of flavoured lucozade in a typical day and a "Purdeys" natural grape drink. In your professional opinion, do you think these have somehow caused an intolerance to sugar and contributed to "pre-diabetes"?
7) If the above is true then my lifelong taste for sweets and snacks HAS to be associated with it diabetes?
Doctors and health advisers at "well man" clinics have always told me there is no link?

I would appreciate any advice you could provide

Thank you

Carl

 

[JoKalsbeek]

Hi Carl,

It's so nice when people come in here with "I'm not a fat drunk, why am I diabetic?", meaning that the rest of us must be fat, irresponsible blobs who are drunk out of our minds 24/7. Not the best way to introduce yourself, if you pardon me. But can't really blame you as that's basically what the media and even our docs seem to think of us as: gluttons who just got what they deserved. Ah well. Educating one person at a time'll have to do!

Your questions:

1&2) I don't know the numbers right off the top of my head, but yeah, the US and the UK use different markers. Just decided by national health authorities. It's not something that's decided on a global scale.
3) Prediabetes is reversable in sofar that you can change your diet, get your blood sugars back into the normal range, and then... Stick with the diet. Otherwise your blood sugars will go right back up again. Remission is nothing other than "well controlled" and a-symptomatic.
4) Dunno. Either one's lethal. Besides, where diabetes damages veins, so does nicotine... Why try and help destroy your body when it's already doing a fine job ruining itself as it stands?
5) Hypoglycemia and hyperglycemia are greek in origin, meaning under/low sugar and high/too much sugar. I don't think they're going to change terminology any time soon, as basically they are medical terms and they're often rooted in greek and latin. If you want though you can say sugars are high or low. Same thing.
5) The lucozade thing was an issue because a lot of people on insulin used it to treat potentially lethal hypoglycemia (low blood sugars due to miscalculation or overreaction of insulin). If someone grabs one when they could well be on the brink of a coma or even death, and if it's sugar free, well... Can get ugly. And deadly.
6) We're not professionals, I'm certainly not a doctor. But in my experienced opinion, the things you are and drank which were rich in carbs got you to this point, in combination with genetic predisposition.
7) Not at all. Without a genetic component, or in some cases, medicinal (statins, steroids), there's no need to become diabetic at all, regardless of a sweet tooth.

Hope that helps,
Jo

 

[bulkbiker]

Hi Carl and welcome
To answer your questions

1. No - diagnosis here in the UK is done by HbA1c levels for most people. A single blood glucose reading is hardly ever (never ) used.
2. Each country has different ways to diagnose and so Yes I think they use single blood glucose readings anything from 100 to 125 mg/dl (5.5 to 7.0 mmol/l) may be looked at as pre-diabetic although they also should use an HbA1c as well.
3. Most of us have found that T2 and pre diabetes is reversable yes.
4. No idea (they may or may not be)
5. Lucozade as you say is used to treat hypos so drinking it with high blood sugar is kinda crazy
6. Not professional but I drink water tea and coffee only but those drinks probably didn't help over time
7. Again could be depends how your body reacts to sweets and snacks.. they again certainly won't make you healthier.

Your sudden and unexpected weight loss is a slight warning sign to me that all may not be well. It might be worth trying to get your c-peptide levels tested to see if you are low in endogenous insulin production. This may mean you are a late/slow onset T1 rather than T2 which will be your HCP's assuming looking at your age.

 

[HSSS]

Not every type 2 is overweight, though the condition itself can cause weight gain, or a drinker. Family history is relevant both for habits ingrained and genetics. Vapes or fags it is still smoking. Don’t kid yourself. Perhaps the risks are slightly different but vapes are not risk free.
Rapid weight loss is not typical for type 2, more type 1 or LADA if it is diabetes related. A sweet tooth is not a good thing if you are diabetic regardless of whether your dr has that opinion or not.

What blood test was done that measures carbohydrates? I’m not aware of one. Blood glucose definitely related though as carbs raise bgl.

pre diabetes can be managed and returned to normal readings by reducing carbs in your diet and where possible increasing activity/muscle. The 13 week course may or may not be useful. If it bangs on about calories low fat and portion size I personally wouldn’t bother. If it discusses carbs then I’d listen. They are run by different organisations in different areas.

1) Am I correct in saying in the UK the risk marker for pre-diabetes is a blood test result of >5.4?
U.K. diagnose using hb1ac. A 3 month average test not a moment in time. A blood glucose level also makes a difference if it is fasting or not but it’s just an indicator not diagnostic.
2) I read that America has a higher threshold to indicate pre-diabetes? Is this true??
I thought it was the opposite
3) Is "pre-diabetes" completely reversible, given sensible lifestyle changes?
Yes in many cases
4) When it comes to diabetes factors why are vapes better than cigarettes?
Never heard they were. It’s poison no matter what.
5) The terms hypoglycaemia and hyperglycaemia are very similar, yet mean totally the opposite. Is it time we used different conventions?
HypO is lOw. Medical terms, not likely to change.
5) There's plenty of information about the revised sugar content of lucazade causing an uproar with hypoglycaemic patients who used it as a moderator. But what about hyperglycaemia? Assuming my "6" means I have hyperglycaemia and drinking lucozade would be adding to the (converted) sugar?
Yes. Drinking sugar will do that.
6) Before my diagnosis I would drink 2 x 500ml of flavoured lucozade in a typical day and a "Purdeys" natural grape drink. In your professional opinion, do you think these have somehow caused an intolerance to sugar and contributed to "pre-diabetes"?
they won’t have helped and definitely won’t help in the future
7) If the above is true then my lifelong taste for sweets and snacks HAS to be associated with it diabetes?
Again won’t have helped but unlikely to be the full story. Genetics needs to have loaded the gun that lifestyle and diet fired.
Doctors and health advisers at "well man" clinics have always told me there is no link? Rubbish. It won’t make everyone diabetic but if you are predisposed genetically it’ll hasten it along.

 

[Mrs T 123]

Hi Carl,

It's so nice when people come in here with "I'm not a fat drunk, why am I diabetic?", meaning that the rest of us must be fat, irresponsible blobs who are drunk out of our minds 24/7. Not the best way to introduce yourself, if you pardon me. But can't really blame you as that's basically what the media and even our docs seem to think of us as: gluttons who just got what they deserved. Ah well. Educating one person at a time'll have to do!

Your questions:

1&2) I don't know the numbers right off the top of my head, but yeah, the US and the UK use different markers. Just decided by national health authorities. It's not something that's decided on a global scale.
3) Prediabetes is reversable in sofar that you can change your diet, get your blood sugars back into the normal range, and then... Stick with the diet. Otherwise your blood sugars will go right back up again. Remission is nothing other than "well controlled" and a-symptomatic.
4) Dunno. Either one's lethal. Besides, where diabetes damages veins, so does nicotine... Why try and help destroy your body when it's already doing a fine job ruining itself as it stands?
5) Hypoglycemia and hyperglycemia are greek in origin, meaning under/low sugar and high/too much sugar. I don't think they're going to change terminology any time soon, as basically they are medical terms and they're often rooted in greek and latin. If you want though you can say sugars are high or low. Same thing.
5) The lucozade thing was an issue because a lot of people on insulin used it to treat potentially lethal hypoglycemia (low blood sugars due to miscalculation or overreaction of insulin). If someone grabs one when they could well be on the brink of a coma or even death, and if it's sugar free, well... Can get ugly. And deadly.
6) We're not professionals, I'm certainly not a doctor. But in my experienced opinion, the things you are and drank which were rich in carbs got you to this point, in combination with genetic predisposition.
7) Not at all. Without a genetic component, or in some cases, medicinal (statins, steroids), there's no need to become diabetic at all, regardless of a sweet tooth.

Hope that helps,
Jo

Hi Carl,

It's so nice when people come in here with "I'm not a fat drunk, why am I diabetic?", meaning that the rest of us must be fat, irresponsible blobs who are drunk out of our minds 24/7. Not the best way to introduce yourself, if you pardon me. But can't really blame you as that's basically what the media and even our docs seem to think of us as: gluttons who just got what they deserved. Ah well. Educating one person at a time'll have to do!

Your questions:

1&2) I don't know the numbers right off the top of my head, but yeah, the US and the UK use different markers. Just decided by national health authorities. It's not something that's decided on a global scale.
3) Prediabetes is reversable in sofar that you can change your diet, get your blood sugars back into the normal range, and then... Stick with the diet. Otherwise your blood sugars will go right back up again. Remission is nothing other than "well controlled" and a-symptomatic.
4) Dunno. Either one's lethal. Besides, where diabetes damages veins, so does nicotine... Why try and help destroy your body when it's already doing a fine job ruining itself as it stands?
5) Hypoglycemia and hyperglycemia are greek in origin, meaning under/low sugar and high/too much sugar. I don't think they're going to change terminology any time soon, as basically they are medical terms and they're often rooted in greek and latin. If you want though you can say sugars are high or low. Same thing.
5) The lucozade thing was an issue because a lot of people on insulin used it to treat potentially lethal hypoglycemia (low blood sugars due to miscalculation or overreaction of insulin). If someone grabs one when they could well be on the brink of a coma or even death, and if it's sugar free, well... Can get ugly. And deadly.
6) We're not professionals, I'm certainly not a doctor. But in my experienced opinion, the things you are and drank which were rich in carbs got you to this point, in combination with genetic predisposition.
7) Not at all. Without a genetic component, or in some cases, medicinal (statins, steroids), there's no need to become diabetic at all, regardless of a sweet tooth.

Hope that helps,
Jo

Oh your 1st paragraph made me laugh out loud - so funny x - if we don't laugh we will cry eh?

 

[JoKalsbeek]

Oh your 1st paragraph made me laugh out loud - so funny x - if we don't laugh we will cry eh?

I aim to please. And yeah, better than yanking my hair out in frustration, haha!

 

[Tophat1900]

Your sudden weightloss stands right out as a red flag, a c-peptide measurement and GAD tests would be what I'd want done. You could possibly be be looking at another diagnosis other than t2, even though you have been classified as pre-diabetic. That rapid loss of weight is a sign you are not producing enough insulin aka LADA or T1...

 

[Steinios]

Oh your 1st paragraph made me laugh out loud - so funny x - if we don't laugh we will cry eh?

Thank you for your valued comments.

I think the doctor may have ruled out T1, as there were a number of possible causes for the symptoms I presented and they took at least 3 blood samples.

I'm frustrated that all the facts weren't properly explained to me by the GP. This could be due to lockdown restrictions and some of it was over the telephone . I want to start changing now, but it's difficult with the limited diagnostic information I have. They did ask that I monitor my weight and report back in 6 months, but didn't seem overly concerned. It may be a placebo effect but I certainly haven't been feeling right.

What I DON'T want to do is make my condition worse, with my inherited super-high metabolism I need to eat regularly and have I've had malnutrition issues in the past.

I never thought being 50 would suck so much!

Thanks

 

[HSSS]

Thank you for your valued comments.

I think the doctor may have ruled out T1, as there were a number of possible causes for the symptoms I presented and they took at least 3 blood samples.

I'm frustrated that all the facts weren't properly explained to me by the GP. This could be due to lockdown restrictions and some of it was over the telephone . I want to start changing now, but it's difficult with the limited diagnostic information I have. They did ask that I monitor my weight and report back in 6 months, but didn't seem overly concerned. It may be a placebo effect but I certainly haven't been feeling right.

What I DON'T want to do is make my condition worse, with my inherited super-high metabolism I need to eat regularly and have I've had malnutrition issues in the past.

I never thought being 50 would suck so much!

Thanks

If you are unclear what has been tested for and rules out it seems you need to speak with the dr again And seek clarity about what your diagnosis actually is. If it is type 2 or prediabetes the way to manage it is low carb eating. It will not make your condition worse nor give you malnutrition. In fact for many people it is better nutrition because t cuts the processed junk out of the equation. And it’s a long way from starvation as you replace the reduced carbs with increased fat and protein. There might be a period of adaptation but it’s a matter of a few weeks potentially for a lifetime of benefit. See my signature for some links to get you started.

 

[JoKalsbeek]

Thank you for your valued comments.

I think the doctor may have ruled out T1, as there were a number of possible causes for the symptoms I presented and they took at least 3 blood samples.

I'm frustrated that all the facts weren't properly explained to me by the GP. This could be due to lockdown restrictions and some of it was over the telephone . I want to start changing now, but it's difficult with the limited diagnostic information I have. They did ask that I monitor my weight and report back in 6 months, but didn't seem overly concerned. It may be a placebo effect but I certainly haven't been feeling right.

What I DON'T want to do is make my condition worse, with my inherited super-high metabolism I need to eat regularly and have I've had malnutrition issues in the past.

I never thought being 50 would suck so much!

Thanks

My personal record in test tubes is 11. I think that might've been my age at the time too. See whether you can get some answers on what you were tested for, and go from there. If C-peptide and GAD were not among them, you'll want to get those done. Sooner rather than later. Six months when you could be misdiagnosed based on the info you shared, is too long a wait.

In the meantime, hit the low carb diet, but if you can't stand to lose weight, go for 3 meals and 3 snacks per day, and don't skimp on the fats and protein. No need to get hungry nor malnourished.

 

[Steinios]

Hi, and thanks for your learned opinions,

I contacted the doctor and she explained that they had definitely ruled out T1 and T2 and a bunch of other bad stuff like liver function and blood cell count etc.

Apart from the slightly raised cholesterol and the two blood-glucose samples over a period of a week (non -fasting).
The first was 6.0 and the second was 3.7. But again didn't seem to be a concern for her.

Meantime I've been changing my diet to healthier foods, with just 1 sweet item a day.
Weight increased a tiny amount and is fluttering (as it always has with my high metabolism),
definitely not dropping, but still 5Kg below normal baseline.

I'm starting to feel less tired, although still not 100%.
Even though the GP didn't think it was an issue I'm curious to identify the cause of the swing in blood-sugar readings
so have ordered a blood-sugar testing kit, and because I'm a scientist.

BTW would these things work with saliva, as I hate needles?

It's a start, if anything.