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pre-diabetes

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susan8white

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Hi about 2 years ago I was diagnosed with impaired glucose after having GTT. I have just had my annual GTT and the results were 5.9 fasting then 10.6 two hours later after the lucozade. I am back at the Doc's tomorrow as he has requested to see me. I assume as I am overweight and suffer from hypertension he is going to tell me to lose weight. I have tried all this and I do not crisps, chocolate, biscuits or cakes very often. Nor do I fry foods or eat loads of takeaways. I am unsure of what the doc wants but I have been checking my glucose levels every now and then on rising in the morning. This morning it was 6.1 before I do anything. My eldest son who is a nurse said I need to have the HB1 thing if thats what it is called. Any advice would be very much appreciated. Thanking you in advance. Sue W
 
Hi Sue, and welcome!

You'll find this forum a very helpful and supportive place - it's been a lifeline to me. Have a read round and you'll find lots of useful info. You're not alone - many of us are trying to lose weight.

Someone will be along soon to give you the link to the Information for the Newly Diagnosed, which is on the Greetings thread.

Viv :)
 
Hi Sue and welcome to the forum :) Just in case you do get the diagnosis of diabetes, or if you have got pre-diabetes and want to try to stop progression into full diabetes which may well be possible, here is the information that Viv just mentioned which will give you some tips. Apart from this info you will find a lot of other information that should help you. On losing weight especially. Cutting down the carbs will help you a lot. I must say that your fasting levels look good.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS.
Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.
Click to expand...
 
Hi, Thank you for the info. It is very helpful. I do have a tester and test randomly if I feel out of sorts. one day last week my fasting one was 7.2 and another time after a meal it was 9.4. I will of course tell the GP this tomorrow and ask for some strips for my monitor. Like you say he can only say no :) In the mean time cutting down on carbs, this is going to be a battle as my meals are bread and potatoes though I don't eat rice and pasta is only occasionally. How much is to much? is 3 rounds of toast for breakfast to much? Sorry I just want to find out what I can before I go tomorrow as I know my diet is going to be the topic. I only eat twice a day is this ok or should I be looking how to change the way I eat as well as what I eat. Thank you Sue
 
The only way to find out what you can eat is to test before you eat and two hours after. If after 2 hours your bg comes down to about where it was before your meal, you've handled that amount of carbs okay. 3 rounds of toast would esnd my levels way up :shock: Tell your doctor you need to test to see how different foods affect your levels.

Some doctors/nurses recommend a diet with far more carbs than I would be able to tolerate - I eat between 20g and 70g daily, and get most of them from veg and some fruit. Other people seem to manage on more carbs with few problems. You should be aiming for the NICE guideline levels for Type 2s (if you are Type 2) which are: -

4 - 7 mmol/l fasting/before meals
less than 8.5 mmol/l 2 hours after eating.

If you take those figures with you - remembering to say that you know these are the NICE guidelines - you should be able to make your case.

I hope I don't sound too negative there - I have an excellent GP who treats me like an intellilgent adult, but there are other people on here who have endless trouble with their Health Care Professionals (HCPs). It can be very difficult to get enough strips for testing.

There's another post somewhere entitled 'Questions to ask your GP'. or something similar, which I'm sure someone else will be able to give you the link for! I'm a techno-wimp! :oops:

As for number of meals in a day - I think that really depends on what suits you and what you can cope with. Other people will have more input about that. I eat very little carb, as I said, and lots of eggs, meat, cheese. fish, low-carb veggies and some fruit.

Let us know how you get on tomorrow.

Viv :)
 
Hi again Susan :) This is the information that Viv referred to in her post which I'm sure you will find useful. It's a list of suggested questions that you could ask at your next consultation. Here is the link:

viewtopic.php?f=20&t=17091
 
Thank you so much, I am so glad I found you. The 3 rounds of toast is probably to much for then as I had that with 3 boiled eggs then 2 hours later my test was 9.4. What does NICE stand for please. I am going to write all this down so I do not forget things tomorrow. Thank you so much again I am so grateful. regards Sue W
 
NICE stands for National Institute for Clinical Excellence. They are the body that makes up guidelines for the NHS and doctors and other HCP's to follow in regards to health related subjects in England and Wales.
 
I've just realised - no-one has said anything about the HbA1c test.

This is a blood test that shows what your sort-of 'average' blood sugar levels have been over the past 3 months. As I understand it, some of the glucose in the blood sticks to the haemoglobin-bearing red cells in your blood, and they can measure this so they know what's been going on. The red cells live about 3 months.

Not a very scientific explanation, but I hope it gives you some idea. When I was diagnosed my HbA1c was 6.5 - a bit high. Last time it was 5.4 - okay. I achieved that drop in 6 months on a low carb diet.

Your breakfast sounds good - I haven't had a boiled egg for years! - unfortunately, too much toast! I have a 2-egg omelette every morning, with bacon or cheese or mushrooms, and no toast at all. I find it lasts me very well until lunch time.

Viv :)
 
My eldest son told me to ask for that test you mentioned. He is a nurse in London. Will see what is said tomorrow then and look to cut my carbs. Thank yoy so much
 
That Hb1c thing :D

See here

http://medweb.bham.ac.uk/easdec/prevention/what_is_the_hba1c.htm

All info from above link:
Diagnosing diabetes

Diabetes may be defined as having an HbA1c>6.5%

* >6.5% = diabetes
* <6.0% = not diabetic
* in between....6.0-6.5...may be this is 'pre-diabetes' or 'at risk of diabetes'.

Red cells live for 8 -12 weeks before they are replaced. By measuring the HbA1C it can tell you how high your blood glucose has been on average over the last 8-12 weeks. A normal non-diabetic HbA1C is 3.5-5.5%. In diabetes about 6.5% is good.
Click to expand...
Convert HbA1c to Average Blood Sugar Level.
http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html
 
Hi, just been to the GP and it was a waste of time as he asked why I had a GTT in the first place so obviously not read my notes. He said it was still in normal levels as it has to be 11.1 for diabetes. I told him I had tested this morning on waking and it was 7.1 and he told me that doing these test were not a true result as sugar levels go up and down with stress among other things. I am now totally lost as I thought people with diabetes have these monitors to check their own glucose levels. He said to wait a yr and have another GTT unless I get ill in the meantime. Never even got to ask for test strips cos he said not to test let alone the HBA1C. HELP
 
What a very frustrating experience for you! He might at least have listened to you properly and discussed things with you :evil:

In some ways your GP is right, although 7.1 is high for a 'normal' fasting test - NICE guidelines for non-diabetics are between 3.5 - 5.5 mmol/l, according to the figures I have. Having said that, we seem to have caught my Type 2 very early, so I'm almost always on target, but my early morning fasting level is almost always the highest of the day!

Yes, I believe the GTT figure is over 11.1, 2 hours after.

Can you get back to see the person who sent you for the GTT in the first place? You might get a more sympathetic hearing from him/her. You're obviously concerned about this, and don't need a brush-off :roll:

The monitors are not as accurate as lab tests, but they are excellent for showing trends and for self-monitoring. It's possible to get test strips off prescription, but they are expensive - up to £25 for a tub of 50. I test more than our 'diabetic specialist' would like, so I buy some off ebay. There's also another site called 'Abbott Health' (I think - never used it) that is supposed to be good value.

In your place I think I would work on the principle that you may not be diabetic yet, but your readings may be high enough that you soon might be if you don't take control. Keep testing. Even if you don't do it 8 times every day, you could do the full daily routine once or twice a week, or even one week testing, one week not. Also test 2 hours after a meal with foods you're not sure about.

Buy yourself a carb counter book - available from all the usual on-line sources, or high street shops - and check the amount of carbs you're eating at the moment. I think you'll be very surprised at how many you're consuming :shock: Once you've done that, cut down on your carbs and see what happens. Many Type 2s control very well with diet and exercise alone. The only thing you're really missing out on is the strips.

It's not too late to take control. If you are eventually diagnosed as diabetic, you'll be in control of YOUR diabetes anyway - we're all different! If you treat yourself now as if you are diabetic, maybe you never will be! :D

Try not to worry too much about this - stress does affect the bg levels, as your doctor says. Take an interest in diabetes, learn as much as you can - who knows, you may end up knowing more than the doctor! :lol: :lol: :lol:

Keep in touch - thre's always support on here.

Viv :)
 
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