Pre-diabetes & 'mild' T2 diabetes?

[Daibell]

Hi

I'm an engineer by training and profession and used to looking at things logically and perhaps coldly (!). I have yet to understand why the term 'pre-diabetes' is used and yet the term 'mild diabetic' is frowned upon by the medical profession. Like most things in nature there is a complete spectrum of conditions e.g. T2 diabetes from 'none' i.e. below the 6.5'ish HbA1c figure through to those way above that and officially diabetic. Those who are not much above 6.5 most of the time although they will never improve, unless their diet is full of carbs, they don't have to worry too much about what they eat and do. Those much above 6.5 despite diet and tablets etc do have to take great account of what they do. To me this means the term 'mild' or 'severe' etc do have a use in defining where someone is in the T2 spectrum. I do find these rigid positions taken by the medical profession and, I believe DUK, rather illogical; anyone else have a view on this?

 

[sugarless sue]

The reason the term 'mild' diabetes is frowned upon in medical circles is that Type 2 used to be thought of as a mild form of diabetes as compared to Type 1. However they eventually came to realise that Type 2's get just as many complications, if uncontrolled, as Type 1's can get, if uncontrolled.

The term 'pre-diabetes' just means you are heading for full diabetes if you do not do something about your lifestyle etc and reverse or contain the process. Many with pre-diabetes have lost weight and stopped full diabetes happening but the warning that they are predisposed is enough for some to tackle the issue before it becomes irreversible.

 

[hallii]

Just like sugerless sue said, but I thought I would add my thoughts as an engineer (retired, by gum things move along very quickly when your out of touch! ( electro /mechanical).

Remember that T2 is progressive, so any catagorization is subjective.

Pre Diabetic simply means that you will probably eventually become a full member of the club!

Even the point at which you would be considered a full club member varies, it is around 7% HbA1c but that's only an average, high and repeated "spikes" could have undesirable effects upon your wellbeing but the HbA1c might give the OK reading of 6.5 to 7%.

There is not even an agreed way to treat T2, US and UK advice is at variance, and even that depends upon who is giving the advice.

It's a bit like trying to catch a f&*t in a collander!

Especially when you are used to working with hard and fast rules of physics and well defined international standards.

I just do my thing, manage MY T2 as best I can and try and keep my Doc. up to speed on the latest treatments and research, I am not sure he always appreciates it......

Geoff

 

[Hobs]

For many years last century I was told during my annual check up that I was Pre Diabetic but offered absolutely no advice whatsoever. In those days I was not told about T2 & T1 types but was swiftly briefed with the terms Insulin Dependant and Non Insulin Dependant Diabetes (NIDD) and ended up none the wiser.
Then as the year changed from 1998 to 1999 I changed my GP and all of a sudden I was checked over again and declared a NIDD. I was sent on a 1/2 day course that was over so quickly it was a waste of time sending me. I was 'given' a Roche test meter for which I was charged and a script for 200 test strips ( there were no constraints in those days) with instruction to try and keep my readings at 10 or lower 2hrs after meals. When this did not work with readings hovering around 11 to 12, I was told nobody was going to fuss about 2mmol and to keep on with what I was doing. Within the same 12months I was called by the hospital to attend a diabetes clinic and given metformin x 2, which got me down to around 10.5 and that was how I managed my diabetes until another GP took over.
That was when I received better education and had my target lowered to 8.5mmoll. I was also given more metformin to help and a proper eating plan to help even further + proper instruction about testing and testing timing.
Then other health issued over took me and more time passed.
I am now well controlled by a mixture of meds and hope to remain so, but my point is that all those years ago the medical profession did not take T2 seriously enough, where today they have a duty of care and therefore mostly give T2 patients the better care that was lacking before.
Where the terms mild and severe were banded about, these days its you are or you are not ..plain and simple. If you are diabetic remedial action is needed and if you are not but heading that way then serious adjustments need to be made to your way of living to keep actual diabetes at bay for as long as possible.

I hope this makes to sense to those reading and not just myself.

 

[DazG]

I was told I was pre-diabetic for quite some time, and given no info on how to prevent me from becoming a full blown diabetic, hence I am now a T2.

I wish I would have been given more information back then, because I would have acted on it immediatly and prevented full blown diabetes for as long as I possibly could.

 

[dorjac]

I agree with Hobs and Dazg too. Treat us more vigourously at the prediabetic profile stage and save some money too. If I had been told more firmly and seen slightly more often that I was in the danger zone ie too fat....but I swim three times a week......still too fat. I suspect the NHS does not want to be weightwatchers! I did read something that says NHS might pay for weightwatchers!!! I once lost 3 stone with them in a year and got my gold pin. Took 10 years to put 2 stone of it back. I had vanished over the horizon when they altered the goal posts to BMI. I have just had a phone call from someone who had 2 diabetic parents. Mum T1 gave up at 73 and dad T2 nearly got to 80. Dad had most of the trimmings that go with neglected T2.... denial and, so what if I eat whatever I like. Life's too short...it was.

 

[cugila]

As with most things, if you are told you are 'Pre Diabetic' that should be a wake up call to change your lifestyle to make sure that you don't develop into full Diabetes.

It's a pity as others have mentioned many don't get told anything other than 'avoid sugars'........if only it was that simple ! As many of us know it is a complicated balancing act to avoid weight gain, Bg levels rising way too high after meals etc.......with the proper advice all of that can be controlled and progression towards Diabetes avoided or delayed for many years.

As for Diabetes being progressive.........no it isn't. You need to have tight control of all areas otherwise it can be. Assuming that it is and will be progressive is a negative thought and should be avoided at all costs. Using tight Bg control can not only improve things but in many cases actually reverse the symptoms, reduce any medications. It is hard work but not impossible.

I myself was on a 'shed load' of medications, then moved onto Byetta.........since then, Meds reduced to just 2 Metformin daily, Byetta reduced to 5ug dose twice daily, eyesight improved to my pre-Diabetic levels so no longer need glasses to drive. Weight lost 5 1/2 stone. Energy and fitness levels vastly improved. Nothing progressive there !!

So, forget all the 'doom and gloom' about it will get worse........it doesn't have to. It's what YOU make it. Me, I am making it take a back seat, it's always there........but I'm the Driver.

 

[Patch]

Daibell - until the HCP's approach diabeties as if they were solving an engineering problem, they will not be able to offer completely effective treatment to everybody.

Engineers SOLVE PROBLEMS. HCP's TREAT SYMPTOMS.

It all seems so simple to me (I'm an (ex) engineer too). We get the worlds best Diabetes specialists, and the worlds best Engineers, lock 'em all in a room for a year, and not let 'em out until they have done a proper Root Cause Analysis, and have established a process for treating the CAUSE of high BG's.

Like I said - seems simple to me. If only the engineers could have the knowledge of the HCP's...

 

[sugarless sue]

Machinery, built to specifications should, in theory, all work the same.

The Human body, however, although possessing the same basic biological workings, works differently in everyone because of all the differing factors.......if only it was that simple to solve.

 

[RoseRodent]

Personally I think it's because diabetes is used as a fear word, and if you use that word "mild" people are going to wait until they become "very diabetic" before taking it seriously.

Then again I find few places will use the term "brittle diabetic" any more. Some say it's because they don't want anyone to think their sugars are uncontrollable so they don't need make an effort, but some diabetics are just waaaaaaaay out there the same as brittle asthmatics can have a limited life expectancy and many asthmatics will occasionally need the odd puff from an inhaler. A friend of mine would probably have every complication on the diabetic menu if he'd not moved to Germany where he was offered better treatment and monitoring and education which took into account that he is a brittle diabetic, his sugars will shoot all over the place when he's done nothing differently.

He can eat the same foods, inject the same insulin and do the same exercise routine and one day he's scarfing down the glucose tabs and the next he's reading "hi" on the same regimen. He now has a continuous monitoring system which will wake him in the night if he needs to take action on his readings, an expensive meter which takes huge amounts of information and a pump. Daft things like taking a shower that is a little too hot can shoot his BG down to the danger zone. This is by comparison with his UK doctor who just lectured him about how everyone can control their diabetes, if you put in the same as the next person you will get out the same as the next person, forgetting bodies are not machines.

 

[Ricky]

I was found to be pre diabetic about 5 or 6 years ago. I was not over weight, as mine is inherited and because of this have never had much in the way of sugar but was unaware of Carbs in general. I did loads of research and settled down to a low Carb/low GI diet and am at the gym more than I was doing high impact classes like body combat and spin and from fasting blood sugars of 6.8 I am now down to anywhere between 4.6- 5.2. Although it looks like I have reversed the trend I am aware that if I went back to my previous diet I would probably be on the upward slope . Also last time I got a cold my blood sugars went to 8 and took 10 days to come back down.
However I have avoided medication up to now and hopefully also complications. I am lucky in that I have slipped through the prescription net at the moment and still get 50 strips a month on a repeat prescription to test with. Although this is not so vital now it certainly was when I first started my diet as I had to check what my body reacted to and what it was OK with as everybody is individual when it comes to this. I daren't ask for another Hb1Ac (my last for a couple of years ago) as I don't want the strips stopped!!!