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Newly diagnosed

Matcha

Member
Messages
14
Type of diabetes
Prediabetes
Treatment type
Diet only
Hello everyone.

I was diagnosed pre-diabetic 4 months ago after a random blood test during a GP visit for something minor.

So here I am, 68yr old female, mature athlete, lean as a whippet, BMI 21.2, cycle 300km a week, strength training with a personal trainer twice a week. My hbA1c is 42.
I also was told my Cholesterol was high and both HDL and Triglycerides were in a bad place too. So I set on the mission of reversing this. There is heart disease in my family and diabetes. All 3 of my siblings have heart disease and are pre diabetic, my father passed away with complications of diabetes years after a quadruple bypass. So I don't have great genes but I have tried to make up for this with fitness and diet.

Since this diagnosis I have spent the last 3 months trying to turn things around. I was convinced the high Cholesterol was caused by fuelling on the bike, 30g of glucose in my bottle and an energy bar in my pocket just in case I needed it, after all these were 5 hour rides. During a coffee stop I would have a flat white coffee and my husband and I would share a brownie or flapjack thinking we were using up the glucose on the next section of the ride. Apart from that we don’t have sweet stuff in the house.

Every meal for years has always been cooked from scratch, no HP or UPF’s.
I don’t drink alcohol, I don’t eat bread or grains or starchy vegetables, I don’t eat baked goods, biscuits, cakes except for the coffee stop as described above. My daily treat is an apple consumed with almond nut butter to slow the absorption of the sugar in the apple or nuts…the wrong type, pistachio or cashews which I’ve replaced with macadamia and pecans.

Changes I have made, I have put health before fitness and stopped all fuelling on the bike which was really difficult at first and is detrimental for endurance athletes because we need the carbs to keep going.
I eat a protein breakfast instead of my normal oatmeal and then go out for a ride and be back in time for lunch which would be something like canned fish and salad leaves, tomatoes, artichoke, olives, olive oil etc, no starches. Dinner would be chicken breast without skin and green non starchy vegetables, no gravy, sauces etc. Fruit wise, I only have a few berries sometimes with Authentic Greek yoghurt. I’ve stopped coffee because it can raise cholesterol in some people and replaced it with green tea that I import from Japan.

After doing this for 3 months I went for a retest. I was not at all concerned about the bg because after having a good diet, the only thing I could tweak was the on bike fuelling and stopping the coffee shop treat surely my hbA1c will be about 37…NO it did not change at all, it’s still 42. I’ve no idea how to change this, I feel I have no room to manoeuvre unless I go completely keto. I can’t do more exercise, I really don’t want to be leaner or I‘ll feel my tailbone when I sit.
My lipids came back to completely normal which is astonishing, so no statins but I almost don’t feel the joy because I realise I have to keep this up forever and I‘m shocked that after everything I put in place, my hbA1c didn’t go back into the normal range.

Interestingly, wearing a blood glucose monitor, I noticed I could spike myself riding hard and fast and with no food at all and then I would get a crash when I stopped. I don’t know what that means. The Dr. just said it’s the liver pushing out glucose because your in fight or flight mode. When I eat I’m generally in the green band, I got spiked once after eating a ripe banana, lesson learned. I also get dips at night below the green band but wonder if it’s because of the exercise or perhaps lying on the meter.

It’s really quite daunting and I’m still partially in denial that this can’t be forever but I don't know what to try to get that 42 to become 41 or less!
 
Hello and welcome to the forum @Matcha. I could have written your story, except I was a competitive long distance runner and I do not have type 2 diabetes in my family, just my brother with Type 1. I have been unable to reduce my blood sugars.

You may well be aware that pre diabetes and diabetes t2 are, in the main, driven by insulin resistance and your pancreas’ an inability to produce enough insulin. Having said that, around 15% of prediabetic s and diabetics do not have insulin resistance, so that leaves the possibility that your pancreas cannot produce enough insulin to keep your blood sugars in the normal range. Genetics can play a role, or some insult on your beta cells that prevents them from secreting enough insulin.

Exercise is good, it increases insulin sensitivity. Exercise can also raise your blood sugars, depending on the type of exercise. The more demanding the exercise the more glucose the liver will release to supply your demanding muscles. Your body releases Adrenalin which signals your liver to release glucose, so if you reduce the intensity of your exercise your liver maybe less inclined to pump out glucose. Another idea would be to mix aerobic and anaerobic exercises. Just thoughts.

If your body was working at optimum this Increase in blood sugar would be swiftly used up. You may have reduced insulin sensitivity or your pancreas has a decreased ability to produce enough insulin. I know these are questions I have asked myself, being a very fit, lean 63 year old who, and for some reason, who is unable to reduce my blood sugars. None of the above is diagnostic as we are not allowed to diagnose on the forum, however my own research have highlighted these possibilities and they make sense to me.
 
Frustrating, isn't it? You do everything right, down to details like importing your tea, and still... I'm sorry.

Right at the start of your post, my mind went straight to "carb loading"... Would you believe there are competitive athletes out there who don't burn carbs, but protein and fats? Following a keto or even carnivore diet? So you can with a certain likelihood actually keep that up, but it takes a while for your body to adjust. In that period you'll experience fatigue and feel like you're basically moving your entire body through sludge all day, every day, but... It does pass as your body starts to switch over in a couple of weeks. It burns what is easy, and carbs are easy... But if you can't process those, it'll have to put in a bit more effort to switch to protein and/or (healthy/unprocessed) fats. I know, you don't want to drop more weight, but if you up the other macro's and increase your caloric intake, that should compensate. Don't ask me for numbers, I wouldn't know where to start, but your body'll let you know. Small adjustments: add avocado, eggs or meat/poultry/fish into your salad, leave the skin and fats on the chicken (better thighs than breasts), maybe add in some mayo. What is a protein breakfast? Eggs? Because those are fine too. Add in a bit of bacon, if you're going to bike it off anyway, might as well. If a protein breakfast means a shake or something, check what the amount of carbs are, and what liquid you put in there, because it can add up fast and being liquid, hit the system fast, resulting in a spike. I tend to steer clear from apples, but your meter'll tell you whether that's a treat you can keep included. (Might make it harder to get fat-adapted though). You say you can't add in more exercize, but T2 is more about food than it is about moving about. You can't out-run a bad diet, as they say. The bitter thing is that the biking put your blood sugars up... Not down. So yes, you made changes, but any changes you made were possibly cancelled out by biking in a fasted state.

And Melgar was right, as was your doc: you're asking a lot of your body, which triggers a glucose dump. If you were a long distance walker, you might not see a blip. Slow and steady wins that particular race. Bike at a decent speed for 30 minutes and you're spiking. You mention biking after skipping breakfast, and spiking hard: you got a double whammey there. Dawn Phenomenon is your liver dumping glucose to help you start the day. You got active but didn't eat, so it "helps" you some more with another dump. The dip afterwards is normal, as is the spike. Maybe eat some eggs and high-meat content sausages before stepping on the bike, that might help some. No guarantees though.

Basically, you're making changes and it takes a while to find out which ones work for you. Like the banana-incident. That was a clear signal to avoid those. Don't throw in the towel just yet. You're only just getting started.
Good luck!
Jo
 
Thank you Melgar for your reply.
I’m sorry to hear you were not able to reduce your bg. I fear I may not be able to either, my GP said as much “try again, give it another 3 months and we’ll retest, but you have to understand this may be out of your control”

My sister went on a Desmond programme. She is carrying much more weight than I, has alcohol at the weekend, doesn’t exercise much, eats bread occasionally but has still managed to get back to 41. I’ve implemented a more rigorous regime but the number stays the same.

I’ve noticed in 2021 my hbA1c was 39 so it’s taken 3 years to move up 3 points. During this time I’ve been racing or training and therefore sugar doping as I refer to it now, by fuelling the rides for optimal performance. I think that has played its part hence ceasing to do that. I’ve also changed my rides to be longer but less intensive. I do one intense session a week for 30 to 40 minutes to keep up my V02max.

I also think stress plays a big part, I have a family member with mental health issues which also takes it toll on me. I’ve bought an Oura biometric ring to try to learn about my sleep quality and stress levels and how when they are raised I need to take action to calm myself down.

I guess there Is not much else I can do apart from keep calm and carry on.
 
Hi, it's most frustrating isn't it. I was diagnosed pre diabetic as a slim runner. I've remained non diabetic now for about 15 years. My last hba1c was 33.

I think 4 main things have helped,
1. Keeping my bmi at 19.4, it really seems to have helped getting my hba1c down
2. Not eating or drinking (except water or tea without milk) after 7, although when we eat out, or on our holidays I break this rule
3. having a 12 hour fast between eating from night to morning, I eat before exercise as I find my blood sugar doesn't go up as much
4. At the beginning testing my blood glucose before and 2 hours after my first mouthful of everything I ate. This I was absolutely key.

I hope this helps.
 
You've actually done really well over a very short time, so don't be discouraged - be proud! Bodies take time to adapt: they like to do what they've always done (a bit like most minds as well!). We often say here that this is a marathon not a sprint. You've had some great advice in previous posts here, so I won't say any more than you've already been told, just that you should hang on in there and keep doing what you are doing.
 
Jo thank you for your comments and helpful tips.

To clarify, I eat a protein breakfast of scrambled eggs and spinach or tomatoes or cottage cheese and pecans and macadamia nuts etc then I cycle for 3hrs before I have lunch which is protein and salad or green leafy vegetables. No fuel in my bottles or energy bars and I really missed that today, the breakfast kept me going but no rocket fuel to sprint. My old breakfast was oatmeal only 15g with a tsp each of oat bran, psyllium husk, hemp seed, chia seed, raw ginger, raw turmeric, matcha, and turmeric powder. Turmeric and ginger to try to limit inflammation. I’d also add a few raspberries and blackberries to this which was probably too sugary but it made me ride well.

I have a performance cycling coach and my weekly training is 3hr ride Friday, 4hr ride Saturday, 5hr Ride Sunday, all at endurance pace with a power meter and heart rate monitor. Rest Monday, interval session which could be 5x full gas up a 5 minute hill and then strength training with a personal trainer. Wednesday rest. Thursday strength training With a personal trainer. I’ll add here, losing weight when I‘m already lean can mean losing muscle not fat.
Racing is up hill is what I do, safer at my age. All carb loading tested and rehearsed for optimal performance. Recovery nutrition practiced to find what works best.

Seven years ago I had six months of Chemo which was a combination of drugs for a gynae cancer, so I don’t know how that affected my organs, normally does some damage but I don’t know how this may have affected my liver or pancreas.

At the same time before I started Chemo I did a DNA test to see how foods affect me. It came back that coffee depletes vitamin D in myself and I’m poor at regulating lipids and very poor at regulating blood glucose. It specified not to eat grains and starches and eat cruciferous vegetables. That is the time I changed my diet and learned a raw carrot is less starchy than a cook carrot etc.

Two years ago, I did the whole Zoe microbiome test and that backed up the DNA test and said my blood lipid control was poor and my blood glucose control was worse! It also gave me a list of foods that were good for me and ones that were really bad. All grains and sugars and starches are off limits but doctors have previously told me that fuelling on the bike was different because I was using those sugars and starches and just to stop 45 minutes before the end of the ride.
Peas are a superfood for me scoring 95 and the traffic light system but perhaps not now? As you can see I have a lot of insight about how my body operates but the rule book seems to be thrown out the window now as I wasn’t pre diabetic when those tests were done.

I think it’s going to a matter of testing with a bgm what works and just like you’ve all done, I guess I will eventually work this out.
 
Thanks Jo for these tips, I already do 2 and 3.
what concerns me about 1 is getting my body weight that low means my hip bones jut out and that’s a scary thought when riding a bike on winter roads, if you touch black ice, you hit the deck. I would normally gain a couple of pounds to pad those during winter months but maybe not this year.
Point 4, this is very useful and I will put this into practice Thank you.
 
Thank you, you’re so right, I can see this is going to be a marathon ‍
 
Your diet is better than mine @Matcha. I did 9 months of very low carb intake (35 grams of carbs per day) plus I was rebuilding a coastal cottage at the time so plenty of lifting and grunt. I felt pretty fit for a 62 year old woman. I was expecting my blood sugars to be in the lows 5’s , but no, they simply dropped from a Ac1 of 6.7 to 6.3 mmol/ls . I dropped so much weight I looked like I had crossed the Sahara on nothing more than an apple. I have a bmi of 19, it must have gone much lower than that on that very low carb diet. I concluded from it was not my food intake but my pancreas‘s inability to produce enough insulin. In other words my beta cell mass was permanently depleted . And I know beta cells replenish but mine haven’t. I am also plagued with low blood sugar events. I had the tests for cancer/tumours of the pancreas but all negative (Done because of the hypos) . I did get a C-Peptide test done as part of that investigation which showed low normal C-Peptides ( C-Peptide production from the pancreas correlates with insulin secretion) so I am not over producing insulin. My Drs are on the fence about my diabetes type. I wonder if I’m producing autoimmune antibodies to insulin. I may ask my Dr about that.

I have coeliac disease so no gluten in my diet. I tend to eat simple foods and I always cook from scratch. I have very little red meat, so chicken , fish or just veggies. I have a poor tolerance for fats. My triglycerides are low at 0.54 mmol/ls my Total cholesterol is 6.50 mmol/ls, HDL 1.71 and LDL 4.79 but when I do the ratios I’m at optimum. I’m guessing my LDL’s are the larger particle Type. My resting heart rate averages around 65 bpm , it has been a lot lower. My BP hovers around 112/60.

I don’t smoke or drink alcohol, I do between 25,000 - 30,000 steps a day. I do weights and other exercises where I’m forcing my muscles to failure. On this last point I note that my blood sugars can go as high as 15 mmol/ls lifting weights.
I wear a CGM to monitor my food/exercise to blood sugar. A very useful gadget.

It flies in the face of everything you read about type 2 diabetes. It leaves you in a place with there is no where to go. It’s frustrating because you get folks who lose some weight and their blood sugars drop into the normal range (great news for them) Same also with this who go keto and their blood sugars normalize, great news , but when none of that works , as you say where do we go from here.
 
Wow, I hear you!
You have put an amazing amount of effort into improving your situation so kudos for that.
I was wondering if this turns into full diabetes what type would it be as it doesn’t fit a t2 profile but then I’m not yet familiar with different types. It seems there are a lot of histories that are very different from each other, the main feature poor blood glucose control.
I have a lot to learn but reading everyone’s story and what they have found helpful makes good positive reading.

It seems I’ve joined another Club that I never actually signed up for!
 
Nothing particularly incisive to add here - as far as I can see, @Matcha - your already on the right path; you need to be motivated and to know your own body - all the rest is gravy (as long as it's meaty gravy, no starches please...)

The only thing I would try to nudge on is this - I think that when people talk about Diabetes, they mentally focus on sugar. That's natural, so reducing sugars and starches is a given. That becomes difficult for endurance athletes, as you are well aware, but diabetes is really about a hormonal imbalance - and it's statistically as a result of demonising fat (must add - this only applies to type 2) - so all of us have been told for so long to swap out fat for .. oh, you know the rest.. but as a consequence of thinking about reducing sugars... it's difficult to do that and hold to the mantra of less fat.. you have to get your fuel from something.. and we have an incredibly complex system for managing fat, and a very simple system for sugars that can easily get overloaded.. anyway, I'm desperately trying not to suggest anything, but for me, a big part of this was discovering, or re-discovering how to include fats in my diet. I was Jack Sprat, and hated even putting fat in my mouth.. it's taken a lot to re-learn, but I'm finding it a really positive journey..

Anyway, good luck..
 
Thank you for that Chris.
I am eating a lot of Polyunsaturated and Monounsaturated fats…fish oils, extra virgin OO and nuts. I’ve only recently found out that my favourite pistachio and cashews are not the nuts I should have been eating so switched to Macadamia and Pecans, that is what the Dr recommend to bring down my high Cholesterol (as I refused statins)
In the first 3 months of working on this before a retest, I upped those fats and removed the sugars and starches. The cholesterol came back to normal so we are no longer talking about statins.
When you have poor control of both glucose and lipids it’s confusing to know what to do but as my cholesterol is now stable, I guess I have to play with the glucose ratio and find what works for me. Seems hugely complex at the moment.
 
The nasty thing about diabetes is that either your insensitive to your own insulin, or you make too little of it. (And both is a possibility, too, come to think of it!) Either way, the carbs you load can't burn off effectively, so they just float around your body, doing damage as they go, rather than giving you the stamina you need for your rides. It might feel like it does, but in the end, it's more harmful than helpful, I guess. So while burning something off sounds good, it's not always especially do-able when you have a metabolic condition. And the bulk of us are most insulin-resistant in the morning, so maybe that needs looking at too, the timing of your rides.

Upping the protein should keep your muscles happy and in place, and if you want to stick with the tumeric, it goes wel with cheesy cauliflower rice, and I usually toss my psyllium husk powder into my full fat greek yog, with berries and some pecans, coconut and whatnot. The protein breakfast sounds excellent, so, yeah... Listen to your meter, look for meals with the things you want to keep eating to keep your health and muscle mass up and inflammation down, possibly with the help of Dietdoctor.com... It takes a while. Give yourself time. You're just barely on the threshhold of prediabetic, so.... You have a moment to get this right.

No idea what the chemo did to your pancreas, but you could request a test (C-peptides) to see whether you still make enough insulin, or your production is impaired. Might be something to look into. Because when there are more factors at play, it can complicate things or demand a different approach.

Hugs,
Jo
 
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