Pre diabetes

[Jj1234]

hi I am in the uk and have recently been told that my hba1c is 43 mol/mol. I have gained a lot of weight over the last year but have been doing regular exercise and have cut all gluten and dairy and sugar out my diet. I eat mainly vegetables and small amounts of protein. And only drink water. My diet is very clean and don’t eat more than 1000 calories a day (at best) and am very active.
I was told by my GP surgery that they won’t put me on metformin unless I am diabetic - I am pre
My question is if I went to a private doctor are they more likely to put me on metformin? I have done a lot of research and it shows that metformin lowers the risk of turning in to full diabetes. Also I have heard it will regulate my weight gain of which I have tried religiously for a year to lower without success. Can anyone shed some light?

 

[Daibell]

Hi and welcome. Although Metformin is a good safe drug it never has that much effect on blood sugar. It mainly reduces the liver's output of glucose a bit but doesn't influence whether you will progress or not. Reducing gluten or dairy will not affect blood sugar or diabetes progression but won't do any harm but as part of a low-carb diet you will need to have enough protein and fat as well as veg and fruit to keep you feeling full. Exercise always helps but diet is key and you should find going low-carb will help a lot.

 

[Bluetit1802]

Hello and welcome,

You are lucky. You have been diagnosed early with pre-diabetes. Another year and you could well have been a full blown diabetic. You have every chance of reversing this. Losing weight is a good idea, but the best way is to restrict all carbohydrate and this always converts to sugar once in the system. Cutting out gluten and dairy won't make the slightest difference to your blood sugar levels. My advice to you is to forget Metformin and buy yourself a blood glucose meter. You can use this to test out different foods to see how your body reacts to them. The best method is to test before you eat and again 2 hours after your first bite, plus first thing as soon as you get up after fasting all night.

Tagging @daisy1 for her information pack for newcomers. Have a good read of it, follow the links, and take note of the role of carbs. Also read round the forums and ask as many questions as you like. Good luck!

 

[Chronicle_Cat]

I found the chart on this page very helpful in explaining why high carb foods are best avoided for people with Type 2 diabetes. This site is very useful, the visual guides there are also very helpful as they show which vegetables (and other foods) are high in carbs. (Personally I'm no longer eating potatoes, sweet potatoes, rice, pasta or bread and seeing good results on my meter, my followup is at the beginning of October.)
https://www.dietdoctor.com/how-different-foods-affect-blood-sugar-levels

BTW reducing carbs usually helps with weight loss (don't overdo the amount of nuts though). I find it is much easier than past low fat diets.

 

[Resurgam]

If you are unlucky enough to react badly to the Metformin then eating low carb should help a lot.
I had a miserable five weeks taking the tablets, but I don't seem to need them as I get normal levels with low carbing.

 

[Mbaker]

As you have pre-diabetes this means that mechanistically high glycaemic carbohydrates (potatoes, pasta, rice and many shop bough processed items) and sugars will mostly cause your blood sugars to elevate for too long a time, so this is a permanent management situation. The good news is that there are 1000's of different combinations of foods that will catch your eye and stomach.....truly. I personally now eat more variety than I used to. Here's some of what I eat as real examples (curry, salads, beef dishes, pancakes (coconut or almond flour):

 

[daisy1]

@Jj1234

Hello Jj and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[rhubarb73]

Hello - is there a reason you have cut out dairy? Are you intolerant to dairy, or is it for weight loss? If you are Ok with dairy then you might want to reintroduce it if you go for a Low Carb High Fat diet approach. If you are intolerant you'll need to think about other healthy fats to replace some of the carbs you take out (eg nuts, avocado, olive oil).
I've lost 16kg in 4 months and I eat a LOT of cheese. In fact being able to eat cheese, guilt free is one of the best things about this diagnosis.

 

[Sirmione]

Many types of dairy product are okay but some types aren't particularly milk and commerical yoghurts. With yoghurt it is simply added sugars but milk is interesting because for genetic reasons it is okay for some adult diabetics but not others. This is because the natural sugar in milk Lactose has to be broken into simpler sugars to enter the blood stream as glucose but a lot of adults particularly those not of northern European ancestry don't possess the ability to break it down.

 

[bigladneast]

Pre-diebeties is and isn't a permenant condition, hwta it simply means is at the weight your at or your diet is really bad your body is struggling to cope.

Advice would be to lose weight and eat a sensible healthy diet, you can still have any food once you have lost the weight as long as you maintain the weight a good example is that if your planning to eat out or have take away have a low calourie lunch

 

[Guzzler]

Pre-diebeties is and isn't a permenant condition, hwta it simply means is at the weight your at or your diet is really bad your body is struggling to cope.

Advice would be to lose weight and eat a sensible healthy diet, you can still have any food once you have lost the weight as long as you maintain the weight a good example is that if your planning to eat out or have take away have a low calourie lunch

I'm afraid you are wrong about that. Pre Diabetes means that you have a measure of insulin resistance and that your body does not metabolise carbohydrates properly or efficiently.
The whole weight loss thing centres on losing weight you can see (around your middle) and losing the fat you can't see in and around the liver and pancreas. Your idea that losing weight will 'fix' your Diabetes permanently enabling you to return to your former lifestyle without ever having to watch what you eat risks complacency. Diabetes is not transitory, reaching non Diabetic numbers does not mean that you are no longer Pre Diabetic.

 

[bigladneast]

Sorry that was the advice I was given from Diebeties UK on the phone yesterday, it is the weight carried around you mid rift that stops you from processing carbs and sugars full. Lose the weight and keep it off sensistivty to innsulin will improve.

Sure if you gain the weight or eat enourmous amount of sugars you will move back in to the pre-diebetic range but to say people can never eat certain foods is crazy.

Lets remember pre-diebetic isn't actually a condition reconised medical it is a marker which can be moved by human behaviour

 

[Guzzler]

Sorry that was the advice I was given from Diebeties UK on the phone yesterday, it is the weight carried around you mid rift that stops you from processing carbs and sugars full. Lose the weight and keep it off sensistivty to innsulin will improve.

Sure if you gain the weight or eat enourmous amount of sugars you will move back in to the pre-diebetic range but to say people can never eat certain foods is crazy.

Lets remember pre-diebetic isn't actually a condition reconised medical it is a marker which can be moved by human behaviour

I agree that lifestyle can improve/worsen outcomes.

For most people with Pre Diabetes and Type 2 Diabetes weight gain is a symptom of insulin resistance, some people do not suffer this symptom at all but almost all of us carry excess ectopic fat and it is this ectopic fat (and the ridding of it) that improves outcomes for those with IR. Improving insulin sensitivity can take a while depending on how early one is diagnosed. To stop ectopic fat building up again one must follow the diet that is used to reduce it, no use going back to the diet that filled your liver with fat in the first place.

 

[bigladneast]

No and I am not suggesting that my diet was poor and I was advised I am pre-diebetic I intend to lose the weight that is causing it as advised by my doctor.

Then eat a better diet but that doesnt mean you not allowed any foods it just means less rubbish and eat to the amount of calouries to maintain you health weight. If you are rid of pre-diebties you will not be classed as pre-diebetic

A big part of my poor diet was skipping meals and eating lots o excess sugar i.e cakes, buscuits, choc full fat pop, I intended to cut all of these out but will occassionally allow myself a bar of choc

 

[Guzzler]

I feel that I must say it again, being overweight or obese does not cause Diabetes though it can put you at risk (but it comes down to what made you gain weight in the first place that matters). And again, there are people who never gain any excess weight but still develope Pre Diabetes and Type 2 Diabetes. And there are people who through diligence manage to improve their blood glucose levels/HbA1c but see little of their excess weight lost. Weight gain is a symptom not a direct cause.

 

[Resurgam]

Have you counted up the carbs you are eating each day?
Low carb was the only way I have ever been able to lose weight and calories are pretty much irrelevant.
Once my BG levels came down I lost weight without effort.

 

[Chronicle_Cat]

Pre-diebeties is and isn't a permenant condition, hwta it simply means is at the weight your at or your diet is really bad your body is struggling to cope.

The metabolic factors that cause your body to become prediabetic (or diabetic) do not resolve when your blood glucose levels (and weight if that is an issue - about 10-20% of Type 2s are not overweight) get better. Your body will always struggle to cope with certain foods, so they need to be reduced and/or avoided. If you go back to eating like you did before the prediabetes (or diabetes), you will once again find your blood glucose levels and the weight returning (if you are overweight like most - not all - Type 2s.)