Prediabetes with family history

[RCA]

Hey All,

I have recently joined this forum.
I was diagnosed with Hypertension back in 2010 with kidney disease. Due to constant moving and my laid back attitude, it never went past that diagnosis.
When I was a bit young, I was quite athletic and use to do karate so really didn't get many problems

Back in 2016, I came back to UK and was forced to take medicines for Hypertension.
Now I have been overweight all my life despite my lifestyle. Got a family history with diabetes and insulin tolerance. Asian so diet is mostly carbs with a lot of protein and on top I like to cook

Since the COVID hit us, due to staying mostly at home, I am getting high blood glucose regularly.

I have done a bit of ATKINS back in 2016 and lost nearly 10 kg but went back to same unhealthy eating regime.

Since COVID, i have been doing Keto diet without much success, I haven't been that regular.
The problem is that my BG is rising very quickly. Sometimes it's 18 mmol after a heavy carb meal and sometimes it goes down to 5.8 mmol on a low carb diet.
Recently the GP asked me to do a blood test and I'm getting protein in my urine which is bad as well but the Hba1c was 45 which is pre diabetes range.
I'm 5.6' in height and 88 kilos currently. Life style is still sedentary so not much exercise.

So I'm not sure what should I do? How to tackle this? Anything you guys suggest to help? How should I do keto?
The advice i have been given is to limit the carb to less than 50g per day. Shall I aim for that? Would the protein and fat increase affect my kidneys etc.?

Thanks in advance

 

[JoKalsbeek]

Keto's a really good way to get your prediabetes under control, but whether the upped protein is harmful? That wholly depends on how bad your kidneys currently are. https://www.dietdoctor.com/low-carb/kidney-health#kidney-disease might help. Check your test results and go from there eh.

Good luck!
Jo

 

[NicoleC1971]

Hi there,
I think you know that cutting out some of the starchy foods works both for your diabetes (the pre diabetes indicates to have high insulin levels) , kidney disease and hypertension. The focus should be on tackling the root cause which is insulin resistance - everytime you eat more rice etc. than your body can burn off easily, your insulin level spikes as your body tries to store that carb as fat. You develop resistance to your own insulin until your pancreas can't keep up with the demands put upon it and some of that sugar spills into your blood hence diabetes. As an Asian person your body has less capacity to store fat before this happens.
You could think of it as being carb intolerant perhaps? Maybe think of the carb part of the meal as a small side portion rather than the main event which still leaves plenty of delicious meat, chicken, fish, eggs etc. to be had. This could be a step change to going keto.
Another option is fasting i.e. eating only between certain times so that you are not constantly snacking and raising your blood glucose levels. For many skipping breakfast is easy.
Note that as you are on hypertension meds you would need to be careful if you take a huge reduction in carbs because your blood pressure could then go too low leading to dizziness so always take a little extra mineral salt and take any lowering of blood pressure as a good sign as it probably means you have reduced your insulin resistance too! Blood sugars will follow downwards as will weight.
Lastly as this point bear in mind you want to pick something you can actually live with in the long term as I am sure you will get results quickly in the short term.
Good book to read on the whole topic is Benjamin Bikman'sWhy We Get Sick (informative and practical too).

 

[RCA]

Interesting read Jo. I'm in 3b stage of CKD. Based on the articles I would need to consult with GP or Nephrologist. GP doesn't have much info for me as he clearly has no idea about the diet apart from lifestyle change which is generic advice.
Thanks

 

[RCA]

Hi there,
I think you know that cutting out some of the starchy foods works both for your diabetes (the pre diabetes indicates to have high insulin levels) , kidney disease and hypertension. The focus should be on tackling the root cause which is insulin resistance - everytime you eat more rice etc. than your body can burn off easily, your insulin level spikes as your body tries to store that carb as fat. You develop resistance to your own insulin until your pancreas can't keep up with the demands put upon it and some of that sugar spills into your blood hence diabetes. As an Asian person your body has less capacity to store fat before this happens.
You could think of it as being carb intolerant perhaps? Maybe think of the carb part of the meal as a small side portion rather than the main event which still leaves plenty of delicious meat, chicken, fish, eggs etc. to be had. This could be a step change to going keto.
Another option is fasting i.e. eating only between certain times so that you are not constantly snacking and raising your blood glucose levels. For many skipping breakfast is easy.
Note that as you are on hypertension meds you would need to be careful if you take a huge reduction in carbs because your blood pressure could then go too low leading to dizziness so always take a little extra mineral salt and take any lowering of blood pressure as a good sign as it probably means you have reduced your insulin resistance too! Blood sugars will follow downwards as will weight.
Lastly as this point bear in mind you want to pick something you can actually live with in the long term as I am sure you will get results quickly in the short term.
Good book to read on the whole topic is Benjamin Bikman'sWhy We Get Sick (informative and practical too).

I have now got Dr Jason Fung's The Diabetes code. I will read this and see. I need to have a talk with Nephrologist and ask him/her some critical questions. I am seriously been let down by these people.
It happened to me 4 times when I arrange an appointment they gave me timings but then change it to a different one 1/2 weeks before and because of this the appointment which should have taken place last year was delayed until this year April.
Once COVID hits and now this is delayed until next year mid. What a joke?
When I complained about this behaviour last year, I have been told that there are many patients and the clinic is busy.
Anyway, that's me done. I will ring them on Monday/Tuesday and see how this goes.

Many thanks because of you guys I at least have a direction

 

[NicoleC1971]

I have now got Dr Jason Fung's The Diabetes code. I will read this and see. I need to have a talk with Nephrologist and ask him/her some critical questions. I am seriously been let down by these people.
It happened to me 4 times when I arrange an appointment they gave me timings but then change it to a different one 1/2 weeks before and because of this the appointment which should have taken place last year was delayed until this year April.
Once COVID hits and now this is delayed until next year mid. What a joke?
When I complained about this behaviour last year, I have been told that there are many patients and the clinic is busy.
Anyway, that's me done. I will ring them on Monday/Tuesday and see how this goes.

Many thanks because of you guys I at least have a direction

Jason Fung's book is really good and as you probably know he is a nephrologist who has dealt with many diabetics in his time.
Good luck and if you've got a list of questions that will make the most of your consultation and show that you can't be fobbed off.

 

[RCA]

Hi,
I couldn't get to the nephrologist yet. Having called them a few times this week without going anywhere.
I now bought a Libre sensor to constantly monitor blood glucose.
It shows that when I am on keto diet, my blood glucose in fasting is a bit higher after 12 hours fasting so it's around 6-7mmol but certainly not less than 5.5 mmol. It also shows after a keto meal the blood glucose is quite stable and doesn't go beyond more than 2 mmol after and sometimes it goes lower than fasting levels. A bit strange.
Interestingly I had 2 naans with eggs the other day in the morning and my BG rise to 14.8 mmol within 2 hours.
The sensor suggested my Hba1c might be within 41-42 mmol.
I know I shouldn't eat carbs but can I not even have carbs even 1 time in a week?
My current macronutrients are 55g protein, 33g carbs, 134g fat. I deliberately put protein to less than 60g not to worse CKD.
I have started with intermittent fasting and doing mostly 16-18 hours fast. According to Dr Fung book, I should do 24 hours fast at least 2 days but it seems hard. Can I drink tea with coconut oil not to spike insulin response after 18 hrs and then had my meal at 23-24 hrs?
What else shall I do?

Thanks
RCA