Newbie with some concerns

[SQ71]

After my annual blood tests this year, I had an HBA1C of 51 (Has been 33 for the past 5 or more years). I was told I had prediabetes, and needed to lose some weight, reduce my carb and sugar intake, and to come back in 3 months. I was also started on a statin medication at the same time for high cholesterol that has not been successfully reduced through diet.

I have lost 6kg in the past 8 weeks. About 3 weeks ago, I decided to buy a blood glucose monitor so that I could get an indication of the impact that certain meals were having on my blood sugar levels. What I have found in the past 3 weeks, is my avg fasting level is around 8.6. My average level across the board is 9.2.

I had a very scary experience on Friday. I slipped up with my food intake at lunchtime (I'm human and can't be 100% good all of the time), and I had quite a large carb/sugar intake. Within 30 minutes of eating that meal, I felt ghastly. I was peeing like crazy, drinking like crazy, super thirsty no matter how much I drank, and I could barely keep my eyes open. My 2 hour after meal level was 13.8. I tested again an hour later (as I felt really unwell) and it was 12.8. Five hours post-meal, it was still at 12.5, I felt really unwell and I was starting to worry a bit. I had a high protein dinner (Only chicken and eggs) and it came down to 9, 2 hours after that meal. I still felt awful, so had an early night, but woke up in a pool of sweat around 2 in the morning, drank a ton of water and went to the bathroom, and feel back asleep. When I got up on Saturday morning, I felt like I had a hangover. I hadn't had any alcohol. My head was yuck all day. I continued to drink loads and pee loads. It took me until about Monday to finally feel better.

I have never experienced anything like that before in my life and it was really quite frightening. I called my GP on Monday but could not get an appointment until next Monday (10th Aug). In the meantime, I've joined this forum, and was wondering if anybody knew what I should do if I have a slip up like that again and have a spike like that? How can I quickly reduce my blood sugar level in that situation? Bearing in mind, I'm not on any diabetes meds. Does this sound more like I actually have type 2 diabetes rather than prediabetes?

 

[Tophat1900]

Welcome.

That doesn't sound good I'm afraid. When was the hba1c done?
Perhaps it's time for another, it really sounds like you need to get some updated results. Staying that high for as long as you did isn't good.

Check out the red link in my signature, it's a great piece for dietary advice written by one of our members here. This will help I think in addressing changes you could well benefit from.

 

[Goonergal]

Hi @SQ71 and welcome

Sounds like you need that GP appointment! In the meantime as you’re not taking any diabetes related medication the simplest way to reduce blood sugar levels would be to reduce your consumption of carbohydrates.

 

[MarkMunday]

... Does this sound more like I actually have type 2 diabetes rather than prediabetes?

Sounds more like LADA (adult onset Type 1 Diabetes) to me. When blood glucose goes that high, only insulin will bring it down. I would ask the doctor for antibody tests to see if it is in fact LADA, because it requires different treatment.

 

[SQ71]

Welcome.

That doesn't sound good I'm afraid. When was the hba1c done?
Perhaps it's time for another, it really sounds like you need to get some updated results. Staying that high for as long as you did isn't good.

Check out the red link in my signature, it's a great piece for dietary advice written by one of our members here. This will help I think in addressing changes you could well benefit from.

HBA1C was done on 3rd June, so not due to have a repeat one until 3rd September. Yeah, that was my exact concern that it stayed so high for so long. I will check out the link. Cheers

 

[SQ71]

Sounds more like LADA (adult onset Type 1 Diabetes) to me. When blood glucose goes that high, only insulin will bring it down. I would ask the doctor for antibody tests to see if it is in fact LADA, because it requires different treatment.

I have never heard of LADA so will ask my Dr about that.

 

[Marie 2]

A T2 is insulin resistant, so when things start to go wrong you still have insulin that usually brings down your levels but it takes time and maybe not to a complete "normal" level.You stayed kind of high for a while and have been staying steadily high and I would be very suspicious that it could be Type 1/LADA. Latent autoimmune diabetes in adults.

Ask for an antibody test, which tests for the antibodies you produce when you are a type one. There is more than one, but the most common one people have is a GAD test. If it's positive you are a definite type 1. But a negative could still be a type 1, some type ones don't have antibodies but stop producing insulin, they don't know the why of that.

The next important test is a C-peptide test. If that is low or low normal, it's a sign of type 1. If it's high or high normal it's a sign of type 2.

A type 2 is insulin resistant, you still make insulin, usually more than normal even, it just doesn't work well. A type one stops making insulin altogether. When you develop type 1 as an adult it's usually LADA/type 1. That takes a certain amount of time, it could be months or years before you eventually stop insulin production completely. It is commonly misdiagnosed as type 2 because of the insulin you still make for a while.

You want to be careful of feeling really sick, a type one lacks enough insulin and can be susceptible to DKA. You can get ketone strips to test at home. But if you feel really bad, I would go to the hospital. You can get sick fast. Type 2's rarely get DKA, but it can happen. Type 2's can get something similiar too, HHS. You can get sick fast from that too, but it is rarer.

I'm not saying you are, but there are a few oddities enough I would ask about being tested.

DKA
https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones

Type 1/LADA
https://www.healthline.com/diabetesmine/what-is-lada-adult-onset-type-1-diabetes#5

 

[SQ71]

A T2 is insulin resistant, so when things start to go wrong you still have insulin that usually brings down your levels but it takes time and maybe not to a complete "normal" level.You stayed kind of high for a while and have been staying steadily high and I would be very suspicious that it could be Type 1/LADA. Latent autoimmune diabetes in adults.

Ask for an antibody test, which tests for the antibodies you produce when you are a type one. There is more than one, but the most common one people have is a GAD test. If it's positive you are a definite type 1. But a negative could still be a type 1, some type ones don't have antibodies but stop producing insulin, they don't know the why of that.

The next important test is a C-peptide test. If that is low or low normal, it's a sign of type 1. If it's high or high normal it's a sign of type 2.

A type 2 is insulin resistant, you still make insulin, usually more than normal even, it just doesn't work well. A type one stops making insulin altogether. When you develop type 1 as an adult it's usually LADA/type 1. That takes a certain amount of time, it could be months or years before you eventually stop insulin production completely. It is commonly misdiagnosed as type 2 because of the insulin you still make for a while.

You want to be careful of feeling really sick, a type one lacks enough insulin and can be susceptible to DKA. You can get ketone strips to test at home. But if you feel really bad, I would go to the hospital. You can get sick fast. Type 2's rarely get DKA, but it can happen. Type 2's can get something similiar too, HHS. You can get sick fast from that too, but it is rarer.

I'm not saying you are, but there are a few oddities enough I would ask about being tested.

That's a lot to take on board. Thanks for your reply and the links to DKA and LADA. I will be sure to ask about getting antibody testing done when I see the doc on Monday.

 

[Brunneria]

When blood glucose goes that high, only insulin will bring it down.

I strongly disagree. I am neither T1, nor LADA, nor (officially) T2, yet I have recorded blood glucose levels higher than the original poster mentions, and they have returned to base within 5 hours with no intervention by myself other than not eating any more carbs. No meds. No insulin.

 

[Brunneria]

@SQ71

Hi and welcome

Am very glad you are heading back to the docs. It certainly needs clarification, and further testing, and LADA could be a possibility. However, so could type 2 diabetes. Until you get the test results back, you won't know for sure.

You mentioned how unpleasant and frightening your symptoms were, and asked for how to allieviate them if they reoccur.
- well you have already worked out that the most straightforward way to do that is to avoid the carby stuff in the first place. Depending on your diagnosis, you may find that you can reintroduce carbs alongside medication, in future, but until then avoidance is a good choice.
But I do get that we are all human, and that occasionally temptation strikes.
When that happens, drinking plenty of water, and going for a walk, or climbing a few flights of stairs can help. Not talking about running up the side of a mountain, but just enough to get your muscles moving and warm. If my blood glucose goes high then exercise is the last thing I want to do, but if I force myself to actually do it, I feel better afterwards.

Hope you get proper answers soon, because once you have a diagnosis, then you can focus on a regime that is best suited to your individual situation.

 

[EllieM]

I have lost 6kg in the past 8 weeks. About 3 weeks ago, I decided to buy a blood glucose monitor so that I could get an indication of the impact that certain meals were having on my blood sugar levels. What I have found in the past 3 weeks, is my avg fasting level is around 8.6. My average level across the board is 9.2.

Is this weight loss before or after you started to watch what you eat?

My average level across the board is 9.2.

Corresponds to an hba1c of 57.... (Though it does depend a lot on when you are testing.)

The thing is, those figures aren't actually that high yet, some folk come on here with a T2 diagnosis and hba1c's of 100. But, if you reduce carbs and they don't come down you have to consider the (probably small) possibility that you might have T1 instead of T2, in which case high sugar levels combined with high ketones can be dangerous, and require a call to 111 and a trip to casualty.

https://www.nhs.uk/conditions/diabetic-ketoacidosis/

Good luck. Reducing carbs should help whether you have T1 or T2.

 

[DCUKMod]

@SQ71 - It makes a great deal of sense to have a discussion with your Doc about your recent experience, and see what he says.

From my own experience, I was diagnosed in 2013 with an HbA1c of 73.

I started watching my diet straight away and bought myself some testing kit. When I started testing, I saw some very shocking numbers. I was never, ever a big consumer of sweet things, but a bag of Salsa and Mesquite Kettle Chips were to die for.

Anyway, as I say, when I started testing my numbers were high, and sometimes, in the very early days higher than yours.

By taking note of my meter readings, I started to learn what I could, and couldn't tolerate in my day to day diet.

You say yourself you had a bit of an excursion and consumed "quite a large sugar/carb intake". That would just be like fanning a fire. It would just rev up.

Keep an eye on things, and certainly do try to give the big carb/sugar hits a swerve, for the time being at least.

Over time, you are likely to notice your numbers generally trimming back.

Yes, do go back to your Doc. Yes, do learn about other styles of diabetes, and the big risks, and finally, I would suggest you buy some test strips for measuring ketones. For the time being, urine strips would be fine.

Depending on the levels of carbs you are eating, and your blood sugar numbers, you may see some ketones.

If you have a blood sugar reading on, say 13+, and ketones, it's time to seek help.

 

[DCUKMod]

Apologies, @SQ71 , I meant to add my HbA1c history, since diagnosis. I have never taken any medication for my diabetes:

HbA1c:
October 13: 73 or 8.8% (How did that happen?)
February 14: 37 or 5.5%
May 14: 34 or 5.3%
August 14: 32 or 5.1%
November 14: 33 or 5.1%
May 15: 31 or 5.0%
October 15: 33 or 5.1%
September 16: 31 or 5.0%
November 17: 33 or 5.1%
March 18: A "bonus", unexpected test due to other bloods - 30 or 4.9%. I joined the 4s club! I hadn't expected a reduction, having got used to toggling 33<>31<>33<>31 for the last 3 years, literally.
March 19: 27 or 4.6% Another surprising reduction.
February 20: 29 or 4.8%. I'll take that

Work in progress, but GP has taken me off the Diabetes Register.

As you can see, my HbA1c reverted t non-diabetic levels within 4 months and has never gone back.

I'm fortunate, and not everyone is able to replicate this, whether by virtue of other health conditions, their attitude to risk , their ability to reduce cabs enough, or a million and one other reasons.

I'm not posting that to show off, but to demonstrate that in T2, much can be possible, without medication of any sort in the mix - never mind injected insulin.

 

[SQ71]

@SQ71
When that happens, drinking plenty of water, and going for a walk, or climbing a few flights of stairs can help. Not talking about running up the side of a mountain, but just enough to get your muscles moving and warm. If my blood glucose goes high then exercise is the last thing I want to do, but if I force myself to actually do it, I feel better afterwards.

Thanks for the hints. Obviously not letting it get that high in the first place is the better option. I didn't think to exercise.

 

[SQ71]

Is this weight loss before or after you started to watch what you eat?

Good luck. Reducing carbs should help whether you have T1 or T2.

Thanks for your reply. The weight loss has been since the diagnosis of Pre-diabetes, and as a result of reduced calorie, carb, and sugar intake. I realise that reducing sugar and carbs is the way to go, but it seems the more I reduce them, the less my body can handle it when I do up the intake or add something back into my diet that I had previously cut out. Just for example, I stopped eating potato for a few weeks but then one dinner time, I felt like having it, but the impact was that my blood sugar shot up, so that's another food off the menu. I've never been good at sticking to rigid eating plans that feel too restrictive, and I know I'll slip up again.

 

[SQ71]

Apologies, @SQ71 , I meant to add my HbA1c history, since diagnosis. I have never taken any medication for my diabetes

As you can see, my HbA1c reverted t non-diabetic levels within 4 months and has never gone back.

Congrats on getting your HBA1C back within a normal range through diet and exercise alone. Very inspiring.

 

[MrsA2]

Thanks for your reply. The weight loss has been since the diagnosis of Pre-diabetes, and as a result of reduced calorie, carb, and sugar intake. I realise that reducing sugar and carbs is the way to go, but it seems the more I reduce them, the less my body can handle it when I do up the intake or add something back into my diet that I had previously cut out. Just for example, I stopped eating potato for a few weeks but then one dinner time, I felt like having it, but the impact was that my blood sugar shot up, so that's another food off the menu. I've never been good at sticking to rigid eating plans that feel too restrictive, and I know I'll slip up again.

Those are good results , and I can sympathise with the food reduction problems
. I think it must like an alcoholic who used to need 12 drinks to get drunk, but after abstinence for a while, only needs one.
If I am really tempted by something we try a "2 bite rule". Hubby has it and I have just 2 bites of his. One bite is supposed to satisfy the taste and 2 the craving, and it seems to work.
As time goes on there's less and I'm tempted to try and quite often 1 bite is enough for me to know I no longer like something. I even found his ice cream to be too sweet and sticky after 1 lick yesterday.

 

[Marie 2]

@MrsA2. I love that, the 2 bite rule! I sort of do that although I am fine eating what I want. But my husband will get something to eat and it looks good, but I always like to prebolus or I might not actually be hungry, but it looks good so I will just have 1 or 2 bites of his. That almost always solves the food craving! Husbands can be useful lol!

 

[DCUKMod]

Congrats on getting your HBA1C back within a normal range through diet and exercise alone. Very inspiring.

Loads of folks have done as I did, and from much higher numbers.

To be clear, my view is, we were lucky having systems that could repair themselves sufficiently to support the better numbers, once we found modified eating regimes.

Nothing is a race. Nothing is a competition. In my head, I'm going for the best me I can be, within the bounds of my wider life, family, stresses, and other conditions (for me that's "just" a wonky thyroid and an inability to deal with gluten). When others do better than me, I feel happy for them, but don't beat myself up.

It's important, along the way, to find a "ticking over" way of living that doesn't strain you, challenge too much and where we can maintain a decent weight (whatever that is for each of us). Once that ticking over place is found, things get a lot easier.

Take it steady. Don't beat yourself up. For most of us, our fiercest, and least forgiving critics are ourselves, so we need to tame those unreasonable expectations and plough our own furrow.

 

[SQ71]

Update: Saw the dr today. Told fasting levels were fine and not to worry about the blood sugar spike and feeling unwell, as apparently this is just something that happens to people after clean eating for a while (herself included), when they overload the carbs/ sugar. Advice: Just don't have the blips and blood sugar spikes in the first place, but if I do, to drink loads, and exercise to get it down.

She refused any repeat tests or further exploration and advised me that the earliest she will repeat HBA1C and lipids is early Jan 2021, which will be 7 months from when I had my last tests.

She was also not concerned that I have been recording some really low BP readings. They are not dangerously low, but are super-low for me. On initial diagnosis of hypertension 12 months ago, my BP was 200/120, stabilised at 140/80 with a combo of 2 meds, but recently I have been getting readings as low as 100/75. Outcome: No adjustments made to chlorthalidone and cilazipril.

Just adding that today I saw my regular GP and not the stand-in that I saw 9 weeks ago, who had said repeat tests would be done after 3 months, so conflicting info between Drs

I guess I just need to get on with eating clean, losing weight, and hopefully by Jan the numbers will be down.