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Newly diagnosed prediabetic - diet and exercise questions

S

Skinny43

Well-Known Member
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Last week the nurse called and broke the news with hba1c of 44. I was kind of expecting this day because I had gestational diabetes 3 years ago. However It still struck me.

Determined to do something about it before it’s too late. The nurse suggested there wasn’t much I could do because I am so skinny (bmi 19-20) I can’t lose much weight. Losing weight is usually the best thing to reverse prediabetes. My situation is probably mostly caused by genetic.

What I’m left with is diet control. I do eat a fair amount of carbohydrates normally. I’ve cut down carbs and can notice a big difference in the 2 hour glucose reading. What’s my odd of delaying type 2 by diet control only (without big weight loss)?

However I do love exercise and am a big fan of running (ran a couple of half marathons). I read different opinions on the time of exercise and effect of it on blood sugar. Some say exercise on empty stomach will increase blood sugar and you should exercise 1 hour after meal. Some say it’s better to exercise before breakfast. I’m all confused as to when to do my running. I have done both before and after meal and it doesn’t seem to make a difference on the glucose reading. Does anybody have any experience? In certainly don’t want to do it the wrong time and make the whole thing worse!

So in summary - diet makes a big difference 6-9.5 after meal but not exercise. Is this normal? Best time of exercise? Have I been doing it wrong by mainly running on empty stomach?

Thanks in advance.
 
I find that if I run on an extra stomach that my blood sugar will sometimes go up a little and sometimes down a little. E.g. starting 5.5 it might go to 6.0 or to 5.0.

If I run after eating carbs, my blood sugar usually drops a fair amount. E.g. starting at 7.2 it might drop to 4.4 while running.

For me exercise the most effective way to reduce blood sugar if it goes above normal.
 
You've got things a tiny bit backwards. Weight gain is a possible symptom of diabetes/prediabetes. (You're one of the 10% for whom it isn't). So when the bloodsugars get under control through diet, the weight is lost. Most of us have T2 due to genetics, and if not that, then because of medication like chronic steroid use or statins, that's about all the options there are. It's not caused nor solved with weight loss, though weight loss does fix insulin sensitivity/resistance to some extent. So let's put that to bed first: even if you have little to no weight to lose, you can still beat this prediabetes thing! You're not 100% doomed or anything. Secondly, the odds are you will lose some weight on a low carb diet, and if it becomes too much, up the fats and protein, and eat regularly, something like 3 proper meals and 3 snacks. Don't go for Intermittent Fasting/OMAD if you've got not a gram on you to to spare, as you don't want to be underweight either.

Can't help you with the exercise because I don't do it myself. I will go for long walks with heavy camera gear and I find that if I don't eat then, my liver keeps dumping glucose until I do, which 'll sometimes push me up towards sevens and eights by lunchtime. (Post prandial I'm usually a five, or thereabouts). It's different for everybody though, so you keep testing and experimenting, and your meter'll tell you.

You can do this. And there's a massive amount you yourself can do to stay ahead of this thing. Prove that nurse wrong!
Hugs,
Jo

PS: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ for a low carb quick start guide, and https://www.dietdoctor.com/low-carb/gain-weight in case you lose too much weight.
 
Having no weight to lose makes diabetes harder to fix, but by no means impossible. It arguably requires more time and effort than if you were obese, and undoubtedly needs a greater longterm commitment to keep it from coming back, but contrary to popular opinion, putting on weight is a protective mechanism from hyperglycaemia & hyperinsulinemia (high blood sugar & insulin resistance). If you're unable to gain much weight then this safety buffer of fat storage is greatly diminished. There are plenty of slim type 2 on here with whom this will resonate. Myself included.

With regards to exercise, the best way to minimise any major glucose excursions is to keep it light. Anything heavy - fed or otherwise - is very likely to increase blood sugar. However, elevated blood glucose in these situations isn't always necessarily a bad thing. It means your body is burning off stored energy. Anything you do now will help improve insulin sensitivity later. Reasonably brisk but not strenuous walking, and lifting light weights, is a very effective strategy. Anyone who is able-bodied and can afford a set of dumbbells can reap the rewards. Having said all that, some people report that they experience less of a rise if they eat before exercise. Personally I've never found that to be the case, but your experience may be different.

Good luck with everything, and welcome to the forums. Stick around!
 
I wasnt overweight when prediabetic but had a higher normal bmi than you. I did lose weight and got to a bmi of 19. I then maintained by eating lots of nuts, avo's etc. I now maintain. Going to a lower bmi made no difference to how I handle carbs, time has. Ten years down the line I can eat more carbs with normal blood sugars. Running also made my bg go up, in the end I didn't take it around exercise as my hba1c went down and I considered overall exercise was good for me.

It is frustrating though.
 
When I was diagnosed type2 I was told there wasn’t anything I could do apart from take medication. I have never been overweight and ate what was considered a ‘healthy’ diet. I now have good control of blood sugars and don’t loose weight with low carb. I eat plenty of nuts and cheese. Good luck.
 
Thank you so much for sharing your knowledge and experiences. It’s really encouraging to hear from your stories that it’s possible to control diabetes even for non-overweight people.

Sapien- I shall experiment with exercise and monitor my sugar level more closely. I’ve not actually done a check right before exercise and during or right afterwards. I’ve only checked after exercise and felt disappointed it wasn’t way lower, but maybe the before reading would have been even higher if I had checked! It’s going to take some practice to get this thing tamed! I am going to the diabetes prevention course in a couple of weeks and will see what the professionals say too.

Jo- After more than a week’s trying on low carbs , I find myself actually less hungry when I eat less carbs! That’s contrary to what I initially felt. I have always been addicted to carbs especially white rice and constantly hungry but now I don’t miss it much at all and I’m less hungry. Weird but I take it as a positive. I have lost 1kg since starting low carbs. I have read the links and will keep an eye on my weight and use your tips to gain weight if needed. Thank you!

Jim - I’ll try a light exercise next time possibly a slow jog and measure before and after to see how the sugar level goes. Perhaps my run was too strenuous so the sugar level went up. It’s also interesting about weight lifting. It’s frustrating that everybody find different things that work and don’t work. So the key is to keep trying to find what works and stick to it isn’t it! I can feel some patience is needed.

Jo and Concordjan - it’s so encouraging to learn from your examples and it’s possible. Yes indeed I shall try and prove the nurse wrong!

I started using mySugr app and my estimated a1c was 40 (diagnosed with 44) after a week of trial and error. How accurate can the estimate be?

Thank you again.
Ruiyan
 
It's not strange at all! Carbs are quick fuel, and a body is per definition lazy: if carbs are available, it'll use those to burn, because they're easy to process. Drawnback being, that they burn relatively fast, and then the body gives out signals that it's hungry again. Sometimes within an hour or two after having eaten. (Hence people talking about carb-addiction. It really is one.). If your bloodsugars even out a little, and your sugars don't spike, there's no resulting relatively large low... And no hunger trigger. Doesn't work for everyone, but... For the bulk, it does. it takes a little while to break the carb habit, but after a few days.... Not a problem. And after a bit longer you'll find your pallette changes too, so food ends up being more flavourful. Perks all around.

Edited to add: The MySugr app can be pretty close with its estimate, depending on how many measurements you enter. It's not going to be 100%, but a fair indicator.
 
Thank you Jo. I’m learning so much here
. I used to have what I called “hunger attacks”. Even went to the doctors a few years ago they couldn’t find anything obviously wrong. Sugar level then was right on the top end of the normal range. One doctor did suggest I felt hunger and dizzy and hypo-like symptoms when my sugar level dropped quickly. That must have been due to the high spikes! Now I don’t feel terribly like dying when it’s 5 mins late for meal time. I definitely feel healthier! Yes first few days was difficult but I think it’s becoming easier and more natural now. Thank you for the educational reply
.
Ruiyan
 
I am prediabetic, never been overweight, BMI is 19 to 20.
It is frustrating that so much advice concentrates on losing weight. I started off with Hb1Ac of 45. Luckily I had a Diabetic Nurse (who was diabetic herself) who told me to reduce carbohydrate and told me about this forum. She was also happy to discuss the results of my own testing.

When I initially reduced carbs I lost weight and I never felt hungry. I started a food diary to keep track of carbohydrate and tested before and after meals. I then started counting Calories. I know that for most people on this site that is not helpful, but it showed me I wasn't eating enough (my weight loss was also showing that but was harder to connect to individual food items. I was only eating about 1500Kcal and after a while of doing the food diary I found I need about 2500 Kcal to maintain weight.
I experimented and carried on testing and adjusted my diet. I found out what foods I could eat for my circumstances.
I was able to regain a bit of weight and then I have maintained a constant weight (+/- 1 pound) for about two and a half years.
I haven't kept a food diary for about 18months (or more) but still do blood tests(not as often as at the beginning). I weigh myself once a week. If I lose a pound I eat a bit more, If I gain a pound I don't have to eat the extra.

I had to find a way to eat more calories than I really wanted. Avocados, nuts and cheese are a great help to me in this situation.
For example, Lots of people have Greek Yoghurt and Berries for breakfast. I have this with a large amount of chopped nuts (the low carb ones, Brazil, Almond, Pecan, Hazel). As well as enjoying it, it contains a lot of calories which gives me a good start in maintaining weight.

My last 3 annual HbA1c test have been 40 - so more than 2 years at normal levels.
I can't advise on running as I never do it but I do walk quite a lot.
Best of luck with managing your condition
 
Your nurse is wrong - even a fully diabetic (type two, I should have said) can reverse back into normal by eating low carb.
The essential foods are protein and fat - you can't life without them, but sugar and starches are optional.
If you eat only enough veges and a small amount of fruit in order to provide the micronutrients and to give variety, you should never progress from the normal range - with any luck, that is.
Weightloss is just a red herring - lower blood glucose and you are going to be fine. I am.
 
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Hi, your situation sounds very familiar and I can relate to a lot of what you said. Many thanks for sharing your success and congratulations on achieving normal result. That gave me confidence I’ll find a way to fight insulin resistance without losing weight and I’ll find food that I enjoy and healthy. I love avacado and nuts so shall give them a go!
Actually I lost about 1kg since trying low carb but I don’t mind (yet). Losing a little is ok especially actually I waist lower belly is quite full for my bmi. Also I’m Chinese, I’ve seen some reports recommending people of Chinese or Asian origin should aim for lower waist size than western people, because our genes. Sometimes I wonder whether I’m the “skinny fat” people.
I guess the bottom line is whether I feel healthy. If I’ve lost some around the belly but feel fine and has energy I guess that’s fine. Obviously don’t want to lose too much.
Thanks again for sharing your story!
Ruiyan
 
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Without wishing to complicate matters, I was diagnosed as 'pre diabetic' 5 years ago and was also slim, usually eating one or two meals a day due to shift work and a non smoker, lots of exercise, in fact very virtuous!!!! I say that for context only. The only thing the Nurse could say about 'lifestyle' was 'Well, don't eat anything processed, too much salt' (I had mentioned that very occasionally I might have a microwaved meal at work). 3 years later (with no tests inbetween) I was diagnosed as having type 1. I still wonder whether this pre diabetes diagnosis was actually the beginnings of type 1 and a honeymoon period. Who knows when they don't bother doing any actual tests other than the hba1c.
 

Thank you for the advice. I actually like the low carb diet now - with more fat and protein I feel full for a lot longer without having the high glucose spike.
Perhaps I should trust my body and feeling more than the number for my weight?
I hope I can stay within the normal range just like you are
.
 

Sorry to hear that they didn’t do any tests for you for 3 years. They should have followed up at least with a yearly hba1c!
I didn’t know prediabetes can progress to type 1. People tend to think it’s type 2 that you develop once in adulthood.
How do they differentiate type 1 from type 2 if you don’t mind me asking? Did they do any special test to check your insulin levels?
Thank you and hope you manage your type 1 well.
Ruiyan
 

I don't mind you asking at all. Well, the consensus seems to be that pre diabetes can't progress to type 1, I think that I might have been type 1 WHEN I was diagnosed as 'pre diabetic' and then went in to some sort of honeymoon period akin to LADA, (a slow developing form of type 1 if you like). When I went to the Drs with extreme symptoms (3 years later), I ended up in hospital with very high ketones and an extremely high glucose level. Even then one Consultant reckoned type 1 because I was slim and didn't fit the so called 'profile' for type 2 other than age and because of my presentation, and one said type 2 because of age (54 then). They put me on insulin immediately and my levels went down instantly. It was quite amusing in the hospital actually because I was on an insulin drip which kept dropping me to the 2's, the Nurse would go into a panic, get me some toast, then they would go up into the teens, hence more insulin and back into the 2s!!

Over the next 3 months they did a few extra tests, C Peptide (to see how much insulin I was producing naturally) and antibody tests. My C Peptide came back as 'low end of normal' and I was positive for GAD antibodies. I do recall someone saying that once you start exogenous insulin your body won't need to produce so much of its own so this could impact the C Peptide test but I have asked about that comment since and not really had a definitive reply.

Adding up all of that, the diagnosis was type 1. I thank God that I was slim because had I been overweight I am convinced they would have gone for type 2 with NO extra tests and who knows how ill I would have become trying to do it by diet or metformin etc. x
 
KK - oh what an eventful story! And I thought I am old enough (43) to rule out type 1 altogether.
I’ll remember to ask the question when I speak to the diabetes nurse next time in March with the repeat HbA1c test. Doesn’t mean I suspect I have type 1, just in case.
Thank you for providing a new way of looking at things.
Ruiyan
 
Cute dog, Jo! When you say you can eat more carbs now, do you mean to say that being on a low carb diet has increased your tolerance for carbs? I have this fear that by eating low carb I am further reducing my ability to handle them.
 
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