Newly diagnosed prediabetic, feeling bewildered

I have had a similar experience with same sort of blood sugar level. I was about a stone overweight so thought it a good idea to move away from sugary cakes and biscuits. I also took the advice to eat more whole grains - and I also just eat smaller portions of them. Although I wasn’t actively attempting to lose weight, I lost that extra stone in 3-4 months without any effort - including that I’m a lazy exerciser since having a frozen shoulder 2 years ago. My blood sugar is not massively lower so I’m not sure if this enough, overall. However, I feel a lot better. I had been experiencing dizziness and fatigue - which I now think might have related to blood glucose spikes and drops because I didn’t really believe that eating the odd sweet thing could have such an effect! But I get a lot less problems like that now.

I bought a meter to test blood glucose reactions to certain foods and times of day - although the nurse said they discourage it. But the more experienced community members on here seem to swear by it, so I thought it useful to at least try that and see how it might be useful. At the moment it’s helping me gauge what affects morning blood glucose levels, as mine are slightly higher than is ideal. Sleep/lack of and other stressors can affect levels too. But I’m monitoring what I ate the night before as well as that.

I have been attending the NHS national pilot course to help prediabetics and they give the same advice as for type 2 diabetics. It doesn’t differ hugely from what the nurse says, but we have had input from a variety of trainers, who all have their own ideas as well. I found that broad exposure quite useful, if a little confusing at first. It helped to realise that everyone with blood sugar issues is an individual and may react differently to different foods, or have different challenges 3 out of 20 of us on my course had shoulder problems for example - not unusual for diabetics apparently, as I understand there can be a chromium deficiency. But it meant that we couldn’t all just solve our slightly high blood sugar issues through normal exercise routines.

As you are prediabetic I would recommend that you look at what you were eating - list a typical week of purchases if you have access to the evidence - er - data - I meant data - and then reduce the heavy carbohydrates, the starches and sugars, to less than half. That is just a guess at a level to go down to, but it is probably a good way to make a start. You should then see a reduction at your next Hba1c test. A meter might be useful for a little while - but a simple change in diet might be all that is needed.
I suggest that things such as potatoes, pastry, pasta are reduced right down and replaced with salads and stir fries - there's far more nutrition and volume in them - and avoid anything low fat.
To provide energy I eat things which have natural fats - chicken thighs rather than fillets, (roasted on a rack so the skin is crisp) and the full fat Greek style yoghurts.
Asda do a very low carb protein bread - it looks like a brown brick and is rather expensive but it means I can eat kippers again, as they are too strong a taste for me without bread.
The advice from the nurse to replace sugar with starch seems to show a lack of understanding of the problem.

You shouldn't need to cut out carbs completely, but the NHS advice to just swap sugar for other carbs is not supported by recent evidence.
I started on 100g of carbs a day, swapped my skimmed milk for a mix of full fat and coconut milk, changed my high carb breakfasts and swapped milk chocolate to 85% dark (and a lot less of it).
The low carb programme suggests starting at 130g or less and reducing further if you blood sugar isn't improving.
As you don't need to lose weight make sure you eat enough fat - butter, double cream, chicken skin, cheeses, eggs, etc.
Eat berries instead of other fruits, or rhubarb - I make a crumble with ground almonds and butter and use truvia sweetener in the rhubarb or use a mix of raspberries and rhubarb. But only one portion of fruit a day and extra green veg instead.
I replaced rice with cauliflower rice, which tastes fine.

The course is once weekly for 4 weeks; then there are monthly follow up sessions for maintenance.

I feel I have benefitted from the NHS advice to some degree. I think it really depends on where the person has started from though. In my case I didn’t have a sky high blood glucose reading and had not reached the level of fully fledged type 2 diabetes. Many people seem to say that with prediabetes you don’t have so much work to do.

When I had my blood retested as part of a routine check before an operation (6 months later) it had moved down from 43 to 42 - it’s progress. I’d like it to drop a bit further to be out of prediabetes. Only time will tell if the approach I’m following will achieve that. I’ve mixed the NHS ideas with my own conclusions that a certain (low) level of carb suits me.

Also significant is that I developed quite a sweet tooth after needing to cut fats out of my diet when I had severe gallbladder disease. I think I became tolerant to sugar - as happens with an addictive pattern. So eating carbs became a habit. It worked best for me to wean myself off them. So, gradually reducing, swapping, etc was a positive strategy.

There’s no doubt in my mind that the odd teacake with butter (once a month or less) is a better choice for me than a weekly (or twice weekly) helping of buttercream filled and covered cake from a coffee outlet.

Although weight loss is not needed by all prediabetics or diabetics, the NHS course info included education in the processes of how insulin operates in the body - it became clear to me that less body mass (through weight loss) could positively influence blood sugar level.

The NHS model used to include a link between saturated fat and insulin resistance. However, recent studies have disputed that and the NHS literature was changed quite recently (we were asked to cross that bit out of the printed course booklet one week!) But the NHS still considers saturated fat a risk for cardiovascular ill health.

Thing is, if anyone takes a lot of carb out of their diet, they will tend to feel hungry. Fat fills you up. It’s the same issue in reverse of what many dietary ‘healthy eating’ approaches have focussed on for decades (it used to be all about keeping fat intake low and favouring carbs - or, more accurately, favouring fruit and veg. Anyone with diabetes issues may have to be more careful with fruit, in particular - and with root veg.

In my opinion potatoes are the worst. But part of the problem is - like with pastry/bread/flour products - they’re around everywhere if you happen to eat out at all! So it’s not easy to keep it low carb in that context - requires some effort to hunt down the right types of foods.

The alternative to eating more fats when going low carb is being hungry and lacking energy.

It doesn’t have to be excessive amounts just enough and olives, olive oil and nuts can be added to the list. For some just ditching the low fat versions and eating the full fat is enough. Eg milk, yogurt and meats, using butter rather than chemical spread, sorry margarine.

Most people find that after any initial weight loss settles triglycerides and ldl are lower and Hdl is higher than before the changes.

More and more evidence is being shown that fat is not the demon the last generation has been told it is (with little evidence it seems too). The nhs are slowly taking this on board.

Hooty said:

Thank you @HSSS , I won’t go overboard on the fats, but in a way it’s good to know there is something I can indulge in. I do prefer butter to marg-type spreads anyway, and have always gone for full-fat yoghurts as the low fat ones tend to have added sugar or sweeteners which I’m not keen on, so will carry on with those. I have been nibbling on nuts as an alternative to the biscuits/chocolate that I’d have been eating before. I think I read that seed oils weren’t good, is that right?

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That’s right, avoid the seed oils. For cold uses olive or avocado oil are my preferences. For hot use I go for coconut oil or butter. Some like lard

Hooty said:

Hello all,
I recently had a blood test which showed by HbA1c level to be 43 (this was a repeat test after the previous one a month or so earlier gave a reading of 42). I saw the nurse at my GP surgery who said this was in the prediabetic range, and advised me to cut out sugary food, and go for wholegrain options of bread, rice, pasta. She said to have scones or teacakes instead of cakes/biscuits as they are lower in sugar, and not to have fruit in-between meals. She also advised me to have 30mins brisk exercise per day. All this sounded fairly manageable, so I came away not feeling too worried.

However I have since been doing lots of reading, including on this website, and the advice almost overwhelmingly seems to be to drastically reduce or cut out carbs altogether, which is a completely different kettle of fish!

My BMI is 19, so I don’t want to lose weight, but I do want to get my blood glucose down. Should I be cutting out all/most carbs? I am due to have a repeat blood test in 6 months but don’t want to spend 6 months doing the wrong thing!

I see a lot of people test their blood at home, should I be doing this?

Also the nurse asked if I wanted to go on a national diabetes prevention course, but because the advice she gave me seemed fairly easy to follow I declined, but I’m now wondering if I should go on this. Does anyone know what it entails?

Thank you in advance for any help and guidance! I am trying to be positive and am grateful that I have been diagnosed at an early point, but still quite anxious and confused about it all.

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The diabetes prevention course is really helpful. Recommend you go for it. Ofc to some extent, it does depend on how good the tutor is, but the information is really useful. Good luck with your journey to better health.

Hooty said:

Hello all,
I recently had a blood test which showed by HbA1c level to be 43 (this was a repeat test after the previous one a month or so earlier gave a reading of 42). I saw the nurse at my GP surgery who said this was in the prediabetic range, and advised me to cut out sugary food, and go for wholegrain options of bread, rice, pasta. She said to have scones or teacakes instead of cakes/biscuits as they are lower in sugar, and not to have fruit in-between meals. She also advised me to have 30mins brisk exercise per day. All this sounded fairly manageable, so I came away not feeling too worried.

However I have since been doing lots of reading, including on this website, and the advice almost overwhelmingly seems to be to drastically reduce or cut out carbs altogether, which is a completely different kettle of fish!

My BMI is 19, so I don’t want to lose weight, but I do want to get my blood glucose down. Should I be cutting out all/most carbs? I am due to have a repeat blood test in 6 months but don’t want to spend 6 months doing the wrong thing!

I see a lot of people test their blood at home, should I be doing this?

Also the nurse asked if I wanted to go on a national diabetes prevention course, but because the advice she gave me seemed fairly easy to follow I declined, but I’m now wondering if I should go on this. Does anyone know what it entails?

Thank you in advance for any help and guidance! I am trying to be positive and am grateful that I have been diagnosed at an early point, but still quite anxious and confused about it all.

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I have no weight to spare either, and have found it necessary (as well as enjoyable) to make sure to compensate for lower processed carbs by eating a lot more good fat. Otherwise, I cannot keep the weight on.

Getting over the bogus ‘fat-is-bad-eat-bread’ orthodoxy has got us into this mess in the first place is key. Just eat real food. Cutting down/out suger, flour and nasty vegetable seed oils will automatically cut out 95% of processed **** from your diet because those things are what processed **** is made of. That leaves you with lovely real food, which is delicious as well as good for you.

I feel a million miles better now, with blood results to match, and hope that you will too.

I suggest people to go low carb. When we generally do combination these two it's mostly disastrous. Ideal situation would be when we know what amount of carbs our body would consume and not store it as fat and not eat additional fat so that it also does not just get stored.
You can try eating low carb enough to not feel low in energy and u would want to deplete body glucose level as well.

Hooty said:

Sorry about the above message, trying to get the hang of this forum!

Thank you for the replies.

Glad to hear that your blood test results have improved @andromache , thar’s encouraging. Would you mind sharing your before and after figures please? And how much carbs did you cut out? Thank you so much.

@Veryanxious I’m not quite sure which combination you’re referring to as disastrous?

I have now been referred for the diabetes prevention course, so I’m waiting to hear when I will be offered a place to start this.

I’m thinking I should get a meter as I just have no idea how drastically I need to change my diet... keep wondering if I am cutting out more than I need to, or not enough, and my blood test in October feels a really long time away without knowing if I am on track.

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I am ashamed to say that I don't know what my score was when they were sending me to scamper about in the hospital garden to get my BG down enough for them to be able to give me steroids. Or what the result of the subsequent OGT that the GP made me have and that came back with a result of (if memory serves) 'not great - but technically just OK.' I didn't take much interest, I'm afraid, because I was never formally dx with pre-diabetes, although I was obviously headed that way. It was unexplained hypertension and a lousy family history of CVD and T2D that made me take my nutrition in hand. I began to take the importance of insulin sensitivity and metabolic health a lot more seriously, particularly in the context of keeping as well as possible (I have multiple sclerosis)

After 6 months or so of L(ish)CHF the GP did some blood tests at my request and blood lipids and HbA1C were good rather than just OK, so I'm doing something right, but I never did see what my baseline was. On the carbs front, I find I must have 100/125g carbs daily - otherwise I cannot keep the weight on no matter how much fat and protein I eat (and I eat lots.) I feel better with fewer carbs than that, quite honestly, and have not yet resolved my BP issues, so would rather persevere with fewer carbs in the hope of improvement, but needs must. It's all about health, and being underweight is damned unhealthy, as well as being a bad look. One thing's for sure - I am firmly convinced that LCHF is very good for general health and minimizing chronic inflammation, which can only be a good thing for the MS too. Sorry for this over-long outpouring in reply to your simple question- I really ought to have put all this in the 'Introductions' section, but didn't know it was there when I started.

Hooty said:

Hello all,
I recently had a blood test which showed by HbA1c level to be 43 (this was a repeat test after the previous one a month or so earlier gave a reading of 42). I saw the nurse at my GP surgery who said this was in the prediabetic range, and advised me to cut out sugary food, and go for wholegrain options of bread, rice, pasta. She said to have scones or teacakes instead of cakes/biscuits as they are lower in sugar, and not to have fruit in-between meals. She also advised me to have 30mins brisk exercise per day. All this sounded fairly manageable, so I came away not feeling too worried.

However I have since been doing lots of reading, including on this website, and the advice almost overwhelmingly seems to be to drastically reduce or cut out carbs altogether, which is a completely different kettle of fish!

My BMI is 19, so I don’t want to lose weight, but I do want to get my blood glucose down. Should I be cutting out all/most carbs? I am due to have a repeat blood test in 6 months but don’t want to spend 6 months doing the wrong thing!

I see a lot of people test their blood at home, should I be doing this?

Also the nurse asked if I wanted to go on a national diabetes prevention course, but because the advice she gave me seemed fairly easy to follow I declined, but I’m now wondering if I should go on this. Does anyone know what it entails?

Thank you in advance for any help and guidance! I am trying to be positive and am grateful that I have been diagnosed at an early point, but still quite anxious and confused about it all.

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@Hooty
The same happened to me. Similar advice from the surgery.

The only thing that worked was / is a lower carb, higher fat diet. Until then my blood sugar levels would not drop below 40/41 along with increasing and persistent diabetic symptoms. The advice given in the surgery (like your own) was obviously wrong but I didn’t know that until recently.

The success I have had has not been by cutting carbs out completely, it has though been a case of radically reducing them and increasing fat content in my food such as cheese, cream, streaky bacon, full fat milk etc.