Newly diagnosed

[Caz141]

Newly diagnosed, posting for the first time. I was diagnosed in October with a reading of a HbAc1 of 10.8. A month later i went down to 9 and 3 months later I’m currently on 6.3. I was severely anaemic when this was picked up and my blood works were quiet all over the place. I had questions around can the anaemia be causing the diabetes. Some profession said yes and others said no. It’s kinda felt like which came first, the chicken or the egg. It would seem as my anaemia has got out of that zone and I’m no longer anaemic so has my blood sugars improved or my diet i don’t know. I’m not on meds and chose to try the diet route first. I have cut my carbs to 80g a day but now I’m left with the question of is this me controlling my insulin needs because of my diet or am i not diabetic? I’m living like i am diabetic because too be honest it scares me to live any other way, knowing that i could be stuffing up my body if i let go of the reins. I test 3 times a day on a BG monitor and my averages are ranging since January between 5.3 to 6.4mmol/l per week. I’ve read the NICE guidelines and they say below 5.8 pre meal and 7.8 2hrs aft meal (but at what level of carbs is this based on?) which as long as i stay away from all the usual spikes of a diabetics mine field then I’m well within. Would i be right in saying that if i were to up my carbs to what is considered a healthy persons diet of about 150-180g pr day (i think) that this would give me the answer if i was diabetic or the anaemia was screwing up my figures. Looking for some wise answers, out there on how i can go about testing this safely? How much does having high reading mess up the body for a short time just to figure this out?
5 months on and it is still stressing me out and I’m no longer relaxed around food and quite often Hungary but getting a little easier on where I’ve come from so far. My weight keeps dropping because I’m not consuming enough calories. Help appreciated, thanks

 

[CatsFive]

Sounds to this very naive person like you are diabetic - type 2 - but your change in diet has sorted it out. The units are presumably % rather than the more usual (in the UK) mmol/mol. 10.5% = 91, 6.3 = 45. The good news is that 45 is in the pre-diabetes range.

Losing weight helps with type 2 diabetes. You don't want to become underweight, but if you were obese or overweight the reduction is good for your general health as well as the diabetes. If you are getting too thin add more calories from healthy fats - ones not mucked around with. Full fat milk, yoghurt & cheese, butter, oil in cooking & salad dressings, less lean meat and so on. And as well as reducing starchy foods you need to increase fruit & veg. There are various ways of looking at your weight. BMI is well-known and works for most people. However if you have very little muscle it will give too low a reading, and if you have a lot of muscle it will look too high. It also doesn't reflect where your fat is.

One that does is your waist to height ratio:
"To measure their waist, they should find the bottom of their ribs and the top of their hips, wrap a tape measure around the waist midway between these points and breathe out naturally before taking the measurement.

As an example, a 163cm (5ft 4in) female with a waist circumference of 74cm (29in) would have a healthy ratio, but 81cm would push her into the unhealthy range. A man who is 178cm (5ft 10in) would be at increased health risks if he had a 91cm (36in) waist."

Ensure waist size is less than half your height, health watchdog says

Guidance for England and Wales comes amid increasing concern over rate of obesity and cost to NHS

www.theguardian.com

Is the 3x daily glucose test stressing you? If it is then don't to it! The post-meal spike depends not just on how much carbohydrates & sugars, but on their GI - how quickly they hit the bloodstream. However if I read your post correctly, your HbA1c has come down to a pre-diabetes range so any spikes you are getting are no longer affecting you much.

Are you diabetic? In my view, yes. However you have it under control.

 

[JoKalsbeek]

Newly diagnosed, posting for the first time. I was diagnosed in October with a reading of a HbAc1 of 10.8. A month later i went down to 9 and 3 months later I’m currently on 6.3. I was severely anaemic when this was picked up and my blood works were quiet all over the place. I had questions around can the anaemia be causing the diabetes. Some profession said yes and others said no. It’s kinda felt like which came first, the chicken or the egg. It would seem as my anaemia has got out of that zone and I’m no longer anaemic so has my blood sugars improved or my diet i don’t know. I’m not on meds and chose to try the diet route first. I have cut my carbs to 80g a day but now I’m left with the question of is this me controlling my insulin needs because of my diet or am i not diabetic? I’m living like i am diabetic because too be honest it scares me to live any other way, knowing that i could be stuffing up my body if i let go of the reins. I test 3 times a day on a BG monitor and my averages are ranging since January between 5.3 to 6.4mmol/l per week. I’ve read the NICE guidelines and they say below 5.8 pre meal and 7.8 2hrs aft meal (but at what level of carbs is this based on?) which as long as i stay away from all the usual spikes of a diabetics mine field then I’m well within. Would i be right in saying that if i were to up my carbs to what is considered a healthy persons diet of about 150-180g pr day (i think) that this would give me the answer if i was diabetic or the anaemia was screwing up my figures. Looking for some wise answers, out there on how i can go about testing this safely? How much does having high reading mess up the body for a short time just to figure this out?
5 months on and it is still stressing me out and I’m no longer relaxed around food and quite often Hungary but getting a little easier on where I’ve come from so far. My weight keeps dropping because I’m not consuming enough calories. Help appreciated, thanks

You're asking good questions. Anemia can make a HbA1c come out higher than it truly should be. So there is a chance you weren't actually diabetic to begin with, but that's all it is, really... A chance. There's no way to know, now, what was going on then. You could try going back to a normal way of eating for a while, and check with your meter what happens. (Test before and two hours after the first bite) If you see diabetic numbers, then yeah... In any case, your numbers are improving and in what I THINK may be the prediabetic range, as your numbers are differently measured than what I'm used to, and your iron deficiency seems tackled, so you're doing something right.

As for the level of carbs those numbers are based on, I can't say. No-one can, really, as what someones response is varies as much as snowflakes do. Depends on the amount of insulin output, insulin resistance/sensitivity, physical acticity, stress, sleep... It's something you end up having to find out for yourself, what's right for you. I keep carbs to as few as I can possibly manage, with other conditions in the mix. That seems to work for me just fine. Though you seem to be doing rather well, https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might help too.

Good luck eh,
Jo

 

[TriciaWs]

No need to count calories if you are counting carbs. And no need to feel hungry as you can up proteins and eat healthy fats.
I have cheese, double cream, full fat plain yogurt, olive oil dressings, etc.

 

[Caz141]

No need to count calories if you are counting carbs. And no need to feel hungry as you can up proteins and eat healthy fats.
I have cheese, double cream, full fat plain yogurt, olive oil dressings, etc.

Thanks for taking the time to read my post. I will try upping my proteins. Is there a limit on protein and healthy fats. I use an app currently to help with the dietary side and keep me on track

 

[ajbod]

The limit is if you start to gain weight you're eating too much. If you're still losing not enough. It's a balancing game.
Don't worry about it as it will take a little time to hit the sweet spot, but once you do you'll find things a lot easier.

 

[Caz141]

The limit is if you start to gain weight you're eating too much. If you're still losing not enough. It's a balancing game.
Don't worry about it as it will take a little time to hit the sweet spot, but once you do you'll find things a lot easier.

Thanks ajbod, you’re right on the balancing game and trying not to overdue on the other nutritions at the same time. Still losing at mo. Not found the sweet spot yet..

 

[Caz141]

Thank you oriental for taking the time to answer my questions, the info you gave me was helpful. As to the figures of mmol and mg/dl still trying to get my head round these ones on the conversion charts that I’ve found.

 

[CatsFive]

Thank you oriental for taking the time to answer my questions, the info you gave me was helpful. As to the figures of mmol and mg/dl still trying to get my head round these ones on the conversion charts that I’ve found.

Thanks! You might see I'm CatsFive now.

 

[KennyA]

Thank you oriental for taking the time to answer my questions, the info you gave me was helpful. As to the figures of mmol and mg/dl still trying to get my head round these ones on the conversion charts that I’ve found.

Hi - welcome. You've found out already that there are several ways to measure the same thing - blood glucose - and it's important to be sure that we're all talking about the same thing. I'm attaching a picture that makes it a bit easier to read across percentages, mmol/l, mmol/mol etc.

If your HbA1c was 10.8% that equates to around 95mmol/mol - which is very clearly diabetic, and would often mean you being put on medication straight away. I'm just checking it wasn't a blood glucose reading of 10.8 mmol/l which is still out of normal range but not by so much.

The thing about the pre-meal and post-meal reading is just that when anyone takes in carbohydrate, it will be metabolised and hit the bloodstream. The issue for many of us who are T2 diabetic is that our systems are insulin resuistant, and therefore don't shift the glucose into cells for use as fuel very effectively. This is shown by the meter reading going higher after eating carbs (everyone's does), but not coming down as quickly as a non-diabetic person's would. It's high glucose levels for a long period of time that seems to do the damage.

For someone without insulin resistance, it doesn't matter how many carbs are eaten - the body will provide enough insulin to do the job. There is the argument that a carb-rich diet over a period of years (as still recommended by the NHS) will tax your pancreas and lead to insulin resistance developing.

I've been doing fine on about 20g carbs/day for over three years. Blood glucose has been low normal since four months in and I've lost all the weight I put on before I was diagnosed (more than 60lbs). If you do have a carb/insulin /blood glucose issue, you need to find out what works for you - it can't be assumed that someone else's eating pattern will suit.

Best of luck. This forum - the people on it - are a great source of expertise and advice.

 

[Caz141]

Hi Kenny, thank you for the information. The 10.8 was my first reading and this was a HbA1c test. My current HbA1c test 3 months on is 6.3 -46mmol/mol from what is on my doctors records. This I’ve brought down with my carb intake of 15g or below per meal. My mid morning and lunch time are always on the blood glucose meter between 5.4 and 6mmol/l which if i read it right
as 31- 40mmol/mol. Am i on the same page. There is a lot to take in on this journey. My evening reading goes up to 7.8mmol/l (48mmol/mol) which i think is still in a ok zone according to the NICE website if a lot on the end of the scale. I worry why does my evening meal go up or why do my readings rarely come down through the day? I’m taking from the information you’ve given me that this is diabetic model behaviour. That after 2 hrs from a meal would they normally return to the 5 mark? The only difference being from my lunch time meal to my evening meal is salad and not so energetic? I’m really trying to stay away from the meds and educate myself to eat better. This forum and the people on it have been a lot more of an help than the NHS Oviva course that I’m currently on has been.
Thank you again and it sounds like you have really got your diabetes worked out.

 

[catinahat]

7.8mmol/l (48mmol/mol)

Hello @Caz141
I think you are getting a little confused with the tests and the units used
The 7.8mmol/l is a result from a glucose meter(finger prick) and gives you an idea of your blood sugar level at the time you did the test
The 48mmol/mol would be a result from a HbA1c test, a blood sample is taken and sent to a lab, it measures how much glucose has stuck to your blood cells over their life time. Blood cells will live for around 12 weeks so the HbA1c is a sort of average of your blood sugar over the last 3 months.
An individual test result (finger prick) will not change your HbA1c level, if your current HbA1c is 46mmol/mol then one single finger prick test of 7.8 will not change it to 48
The graphic you have been given just shows that if your average finger prick results over several weeks were to be say 7mmol/l for example then that would equate to a HbA1c of somewhere around 42mmol/mol or 6%

 

[Caz141]

Hello @Caz141
I think you are getting a little confused with the tests and the units used
The 7.8mmol/l is a result from a glucose meter(finger prick) and gives you an idea of your blood sugar level at the time you did the test
The 48mmol/mol would be a result from a HbA1c test, a blood sample is taken and sent to a lab, it measures how much glucose has stuck to your blood cells over their life time. Blood cells will live for around 12 weeks so the HbA1c is a sort of average of your blood sugar over the last 3 months.
An individual test result (finger prick) will not change your HbA1c level, if your current HbA1c is 46mmol/mol then one single finger prick test of 7.8 will not change it to 48
The graphic you have been given just shows that if your average finger prick results over several weeks were to be say 7mmol/l for example then that would equate to a HbA1c of somewhere around 42mmol/mol or 6%

Thank you for clearing that up. I’m easily confused lol.

 

[Daibell]

No need to count calories if you are counting carbs. And no need to feel hungry as you can up proteins and eat healthy fats.
I have cheese, double cream, full fat plain yogurt, olive oil dressings, etc.

I agree. It's all about keeping the carbs down to a level where you aren't gaining weight and/or BS level and having enough fats and proteins. Yes, think Carbs and forget Calories as they are irrelevant.

 

[KennyA]

Hi Kenny, thank you for the information. The 10.8 was my first reading and this was a HbA1c test. My current HbA1c test 3 months on is 6.3 -46mmol/mol from what is on my doctors records. This I’ve brought down with my carb intake of 15g or below per meal. My mid morning and lunch time are always on the blood glucose meter between 5.4 and 6mmol/l which if i read it right
as 31- 40mmol/mol. Am i on the same page. There is a lot to take in on this journey. My evening reading goes up to 7.8mmol/l (48mmol/mol) which i think is still in a ok zone according to the NICE website if a lot on the end of the scale. I worry why does my evening meal go up or why do my readings rarely come down through the day? I’m taking from the information you’ve given me that this is diabetic model behaviour. That after 2 hrs from a meal would they normally return to the 5 mark? The only difference being from my lunch time meal to my evening meal is salad and not so energetic? I’m really trying to stay away from the meds and educate myself to eat better. This forum and the people on it have been a lot more of an help than the NHS Oviva course that I’m currently on has been.
Thank you again and it sounds like you have really got your diabetes worked out.

What @catinahat said. You can't read across from a single fingerprick to an HbA1c value. Fingerprick is a snapshot, and tells you what's happening right now, A1c tells you a rough average over the last three months, but nothing about right now. Both are useful.

It's normal for everyone's BGs go up after eating. It's normal for everyone's BGs to fluctuate throughout the day for various reasons. The issue for those of us with insulin resistance/T2 is that our systems cannot process the glucose in the bloodstream, and instead of it being used for fuel it either hangs around for a long time, or gets stored as body fat, or the body tries to remove it eg via urine and sweat.

Net result is that for a given intake you'd expect someone with T2 to have higher bgs for longer compared with a similar non-diabetic individual. The problem is that prolonged exposure to high blood sugar does physical damage particularly to the nerves and small blood vessels, so that damage to eyes and kidneys is possible, as well as loss of sensation in feet (particularly), as well as things like blood not clotting properly.

 

[Caz141]

I agree. It's all about keeping the carbs down to a level where you aren't gaining weight and/or BS level and having enough fats and proteins. Yes, think Carbs and forget Calories as they are irrelevant.

I get why the carbs are relevant,
forgive me if I’m lost again but why are calories not relevant?there kinda not relevant at the moment to me as I’m under weight but when i do gain weight and suss this new way of eating. When i do suss the balance out and stop losing weight. Will the calories not be relevant then?

 

[ajbod]

As long as you reach a point you're happy with, and neither losing or gaining weight. Then it doesn't matter how many calories your eating, it's obviously the right amount. So one less thing to worry about.

 

[KennyA]

I get why the carbs are relevant,
forgive me if I’m lost again but why are calories not relevant?there kinda not relevant at the moment to me as I’m under weight but when i do gain weight and suss this new way of eating. When i do suss the balance out and stop losing weight. Will the calories not be relevant then?

We have all been told that it's calories in, calories out (CICO) that matters. Not always.

Calories are units of energy. Thing is, once I started using body fat for fuel (in other words, when I moved into ketosis) because my carb intake is low the actual overall calorie intake doesn't matter, and I have no idea what my total calorie intake has been for the last 3+ years. Probably quite high.

I am using (mainly) ketones for fuel. There are no excess carbs to be metabolised to un-needed glucose to be stored as fat.

It's fairly easy for me to come in and out of ketosis. When I want to stop losing weight I'll need to up my carb intake a little to stop ketosis, and stabilise at that - which I estimate for me will be a daily carb intake of around 60-75g. Shouldn't affect my BG but should stop weight loss.

 

[Omar51]

Sounds to this very naive person like you are diabetic - type 2 - but your change in diet has sorted it out. The units are presumably % rather than the more usual (in the UK) mmol/mol. 10.5% = 91, 6.3 = 45. The good news is that 45 is in the pre-diabetes range.

Losing weight helps with type 2 diabetes. You don't want to become underweight, but if you were obese or overweight the reduction is good for your general health as well as the diabetes. If you are getting too thin add more calories from healthy fats - ones not mucked around with. Full fat milk, yoghurt & cheese, butter, oil in cooking & salad dressings, less lean meat and so on. And as well as reducing starchy foods you need to increase fruit & veg. There are various ways of looking at your weight. BMI is well-known and works for most people. However if you have very little muscle it will give too low a reading, and if you have a lot of muscle it will look too high. It also doesn't reflect where your fat is.

One that does is your waist to height ratio:
"To measure their waist, they should find the bottom of their ribs and the top of their hips, wrap a tape measure around the waist midway between these points and breathe out naturally before taking the measurement.

As an example, a 163cm (5ft 4in) female with a waist circumference of 74cm (29in) would have a healthy ratio, but 81cm would push her into the unhealthy range. A man who is 178cm (5ft 10in) would be at increased health risks if he had a 91cm (36in) waist."

Ensure waist size is less than half your height, health watchdog says

Guidance for England and Wales comes amid increasing concern over rate of obesity and cost to NHS

www.theguardian.com

Is the 3x daily glucose test stressing you? If it is then don't to it! The post-meal spike depends not just on how much carbohydrates & sugars, but on their GI - how quickly they hit the bloodstream. However if I read your post correctly, your HbA1c has come down to a pre-diabetes range so any spikes you are getting are no longer affecting you much.

Are you diabetic? In my view, yes. However you have it under control.

Good analysis
I am Pre for 13 years and in the same range,but my numbers are in non diabetic range.

 

[Caz141]

I’m not sure if i should open a new thread to ask a different question but if i am please to educate me. Also thanks all for the great help you have been so far..

Since learning that i am diabetic 5 months ago i have stuck to a breakfast of porridge and half a banana with almond milk (35g carb) my last HbAc1 was 46mmol/mol with this diet. I’ve heard a few say that they cant do porridge and I’ve not tested this one a lot. I tested this morn. I started with a fasting of 5.2mmol/l (which i think translates to uk measure of 96mg/dl) and 2 hrs later I’m at 8.2mmol/l (149mg/dl) this sounded high. I’ve normally been doing my second reading of the day before lunch which is usually at 5.6mmol/l, 4hrs after breakfast.

I remember reading a thread from a link that Jo posted, no more than a 2 point rise.
One side of my logic is saying I’ve got almost down to pre diabetic on a HbA1c with this diet and the other voice is saying is this effecting the rest of my day figures?

Do i have like a limit on what my insulin produces in the morning and the rest of the day runs from this bucket as such?

Am i putting excess problems on my pancreas/kidneys to produce or come down? With a reading of 8.2.

I’ve watched a video on diatribe (which i am not sure about because it’s American and can be different information) and it said that the rise is between 4-11mmol/l 2hrs after?
UK NICE website saying under 7.8

Which figures do i need to be aiming for.?

Sorry if the figure values that i measure in are all over the place. Still trying to configure to UK values.it feels like that metric and imperial balance going on in my head.

What are the figures i need to be aiming for 2hrs after a meal so my time in range is better or is this norm/ok as diabetes goes?

Is 3/4hrs too long out of range?
Thank you…