Prediabetes/the range/the future

Danny90 said:

All what I want to believe is that the range in UK is the right range ( prediabetes hba1c is 6% to 6.4% ) of course I'm gonna be careful with everything I eat/do ...but really that is better for me because I feel I'm guilty about this result.

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I don't think there can be a 'right range' any more than you can divide shades of grey. I don't know how the ranges were arrived at, presumably from statistics.

Whatever, feeling guilty about the results is not going to help you. You might be pre-diabetic, you are somewhat overweight but your recent change of food etc. is bringing your weight down and almost certainly bringing your HbA1C down to a point where you are not in any prediabetic range. However if you then go back to your previous diet, your HbA1c will probably creep up again.

Danny90 said:

Well I will say this clearly, I'm afraid to have diabetes at this age ,because I want to have a family, I want to marry, I want to have kids, I don't know if any girl gonna accept this when she knows that I'm a diabetic, I'm sorry I'm writing here stupid things that I can't tell to anyone in my life ,no one from my family knows I'm a prediabetic... do you know if someone could reverse it for long time? I mean more than 10 years...

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Do all those things. Don't let a possible diagnosis hold you back. Keep doing what you are doing that is getting weight off, look after yourself, keep getting your HbA1c tests, and live your life.

BTW someone who won't accept a pre-diabetic diagnosis isn't worth having.

Pre diabetes IS NOT diabetes, BUT if you don't do something about it IT WILL BE.
Your body cannot handle carbohydrates properly. If you had a nut allergy would you still feel the same.
Any stigma attached to diabetes is pure and simple ignorance. By doing Keto to sort your weight out, which is not the cause, but a symptom of insulin resistance. And then eating reduced amounts of carbs, as far as diabetes goes, you have no problem, as long as you eat the amount of carbs YOUR body can handle.
Many years down the line, you may find you need to reduce carbs further, but then again that may never happen.
Cheer up, you've been given a fantastic chance to ensure your health for decades to come.

Here in the UK it's my understanding that a diagnosis of 'full blown' type 2 diabetes won't be made on the strength of a single HbA1c result, especially in a borderline case. Could someone confirm this and comment on whether this also applies to the diagnosis of prediabetes here in the UK? It may be a similar case in Germany.

The reason I mention this is because the HbA1c test is not 100% accurate. I'll paste in this from another thread:

KennyA said:

Total allowable error of 5% - eg 2.5 mmol/mol either way at an indicated A1c result of 50 mmol/mol.

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Yes, I was borderline 1st test 48, then redid tests month later, this was 49. .
Now on Metformin daily, but hope to turn this arounfd in months ahead.
Have reduced sugars, egcakes, biscs, and now looking at carbs.... that was a shock when i realised how much foods are affected..
Just have to work through the options and see how your body responds.
I'm now seeing weight loss, with noticable difference... its amazing seeing the damage sugars do to you but can be reduced, and hopefully into remission...

Keep trying, don't give up theres to much to live for . Things will settle given time and effort. .
Good luck..

It’s surprisingly difficult to find the diagnostic criteria for Germany. It may even vary from region to region. I did find this though

Diagnostic criteria for Diabetes Mellitus
▪ Random plasma glucose value of ≥ 200 mg/dl ( ≥ 11.1 mmol/l) or
▪ Fasting plasma glucose value of ≥ 126 mg/dl ( ≥ 7.0 mmol/l) or
▪ 2-horalglucosetolerancetest(oGTT)valueinvenousplasma ≥ 200 mg/dl ( ≥ 11.1 mmol/l)
▪ HbA1c≥6.5%(≥48mmol/molHb)
https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-0584-6223.pdf and the same values in https://www.degruyter.com/document/doi/10.1515/labmed-2018-0016/html?lang=en and
https://www.primomedico.com/en/trea...to https://drs,risk of diabetes is calculated.

All of which match the uk levels. They don’t give an hba1c for prediabetes. This one doesn’t use that label but says healthy is under 5.8% and diabetes over 6.5%. Other sources discuss impaired fasting glucose and impaired glucose tolerance as alternates to the prediabetes diagnosis. So regardless of whatever label is put on 5.8% you are no closer to someone in the uk or the USA with the same reading. Nor is the status of your dad evidence of your status. At best it’s suggestive that you should be alert to the possibility.

All of which is a long winded way to say rather than stress about the poor manner of this dr focus on taking the actions outlined above and that you know has worked before. Reduced carbs and wisely chosen for those you do have, more activity if possible and those actions will likely result in weight loss. All of which will likely mean you can live healthier without a diabetes diagnosis or drugs for it.

IncogKeto said:

Here in the UK it's my understanding that a diagnosis of 'full blown' type 2 diabetes won't be made on the strength of a single HbA1c result, especially in a borderline case. Could someone confirm this and comment on whether this also applies to the diagnosis of prediabetes here in the UK? It may be a similar case in Germany.

The reason I mention this is because the HbA1c test is not 100% accurate. I'll paste in this from another thread:

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Your are correct according to NICE re type 2. A second test of some sort, or significant symptoms would be the norm. Few tests are 100% (especially without clear symptom) not least because you could have a lab error or someone else’s results!

Info on German diabetes is hard to find on quick looks, let alone intracacies like that.

There isn’t/wasnt an official diagnosis of prediabetes. More that it’s a now common and well used phrase to warn of a potential impending DM diagnosis. So no I doubt there’s a need for a 2nd test. It’s a call to action more than a condition in its own right in the uk.

HSSS said:

Your are correct according to NICE re type 2. A second test of some sort, or significant symptoms would be the norm. Few tests are 100% (especially without clear symptom) not least because you could have a lab error or someone else’s results!
<snip>

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Yes, after the initial HbA1c result my doctor arranged for another sample to be taken and sent away. And instead of putting me straight onto metformin (or whatever), she made an appointment with a nutritionist and in retrospect I'd say the nutritionist was good.

Anyway, courtesy of low-carb and a lot more exercise, 56 has turned into 44. One of the GPs was very impressed when I was in as a patient for medical students to see during the week they looked at asthma.

Danny90 said:

I'm gonna be thankful if you have any advice...
no one from my family knows I'm a prediabetic

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This would be my advice to you:
Speak to your family, friends and anyone who asks about how you are doing. I have had to deal with things in my life that I could not share with others and I know that it messes with your mind and makes things a lot harder. Tell them as much or as little as you feel is sensible. If any of the following is true then say it -
"I had an upsetting conversation with my doctor a few weeks ago. He said that because I have a family member with type 2 diabetes then I'm probably at higher risk of developing it myself and that I need to be more careful than most people in my choice of food. He said that judging by my test results, if I carry on the way I've been going then I'll be heading towards diabetes. That really scared me and it's given me the kick up the **** I sorely needed. So I'm now going to make my own health and wellbeing a top priority - I'll be exercising, losing weight and being far more mindful of the food that I'm eating."