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Prediabetic diagnosis and questions

M

mshaf

Member
Hello,

I've been diagnosed with prediabetes after a routine blood test last month. This was during Ramadan so I'd been fasting.

At the end of Ramadan and start of this month I started a 18/6 Intermittent fasting and keto/low carbs diet.
I'm also doing some exercise (treadmill and cross trainer) and weights at home.

Weight at the doctors: 89 kilos
Weight now: 85.1kilos.

I've never lost 4 kilos in my life - so this is a big deal for me. My aim is to be 78 kilos.

My goal is to try and reverse prediabetes if possible.

I was wondering if I could get some help with some readings. What do they mean and what should I be aiming for?

My home readings are as follows:

Morning (fasting): 4.9-5.2
Evening (after meal): 5.0-5.5

Yesterday, we had a takeaway and I was careful but had half a veg burger with my meal.
Evening (after meal): 6.4

How do I assess if my condition is improving?
Am I masking my prediabetes by making the diet changes?
If I eat a "normal" meal with carbs, it seems that my readings are higher - should lowering this reading be my goal?

Thank you.
 
great job on losing weight
curious on after meal readings is that 2 hours after meal checked?

excuse my ignorance regarding ramadan, fasting dawn to dusk i'm aware of, couple of my friends also celebrate ramadan and used to have an evening meal slightly larger than normal. My old boss also is a muslim and have fond memories Eid being invited around to his place for a giant feast at the end of it, i used to try be supportive of his fasting drinking only water whilst at the workplace I'm unsure of rules for drinking (water), keeping hydrated can help with glucose control i know if unwell / pregnant rules can be different.

You'll likely get Hba1ca checked again in the future which equates to roughly 12 weeks average glucose control if that figure is down its an improvement.

Have a wee browse through the forum, sucess stories area.

Making dietry changes alongside exercising is a good way to go. good luck
 
You're not masking anything, you're treating. Look at it that way. The intermittent fasting and lowering carbs brings your blood glucose down, which is excellent and prevents damage from prolonged high blood sugars. So basically, you're staving off a type 2 diagnosis for as long as you can, and who knows how long that will be? Maybe until you're 70, or well beyond. The fasting month will have had an affect on your HbA1c results, but from what I gather, Iftar meals tend to be carb-heavy, so might not be so much out of true: as it is an indicator for the past 3 months, it's still of value. Your current readings look okay to me, and if you keep going like this, I think your next HbA1c will be fairly good also. I do have to ask, when you say "(after meal)", how long after the first bite are we talking? We tend to test before the meal and 2 hours after the first bite. Has it been two hours, or longer? As the bun in that (even half a) burger, and possibly the burger itself, depending what it was made of, could've driven numbers up higher at the 2 hour mark than a 6.4. But if it was 2 hours after, then at 6,4 sound pretty good... Except for the fact that half a burger isn't very filling. You might want to look into nutrition dense foods, if you haven't already.

If avoiding medication and type 2 diabetes is something you want, then yes, lowering carbs in your meal, and thereby your blood glucose as well, would be a good place to start. Remember: Not masking. Treating.

Good luck!
Jo
 
Hello,

Thank you so much for the helpful advice and encouragements.

@JoKalsbeek
Ramadan - yes iftars can be carb heavy but we as a family tend to eat healthy even in Ramadan. Saying that though, if you're not looking for carbs then they can easily add up for example, I love my fruit and I would open my fast with lots of fruit (water melon, strawberry, apple etc), I have cut down on fruit considerably now.

I am not too sure how long after the first bite I tested. I believe it was 2.5hrs.
I'll take a reading today before eating and 2hrs after the first bite (I've learnt something already ) .
 
You're off to an excellent start, that's for sure!
 
Hi @mshaf and welcome to the forum.

For somebody trying to either lose weight or control/postpone T2 diabetes through Low Carb way of eating, It's quite important to know the cab content of the main things you like to eat. Both Watermelon and Strawberries are Low Carb fruit as are Raspberries and Blackberries. Apples have about 50% more carbs per 100gms than those.

To help get my T2D into remission, I used the dietdoctor website to get lists of low carb foods such as Vegetables, fruit and nuts:
For example, just Google Dietdoctor low carb fruit .
Some veg and nuts are quite a bit higher in carbs than most people may think they are.

Good Luck
 
Thanks @ianf0ster

Thanks for the dietdoctor website suggestion. Coincidentally, I have been on that website recently, looking at food carb content as you can never be too sure what is in the food you are eating.
 
Hi. Most non-diabetic people have an HbA1c somewhere between 36 and 41 mmol/mol inclusive. Most of those are clustered around 38 - have a look at the graph attached.

The HbA1c isn't actually an average of anything but does show how your blood glucose has been over the last three months ot so, with a big skew towards the most recent month. An individual fingerprick test can't be used to predict anything - all it does is give you a snapshot of what's going on right now - could have changed a lot in 30 minutes and might change further in the next 30.

What you're actually aiming for is to be within 2 mmol/l of the original reading when you;re testing before nd after food.That confirms that your system can deal with that level of carb. If this isn't clear, please say!
 

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Thank you for the advice.

@KennyA

So today I did the test as follows:
Fasting: 5.2
Right Before food: 4.7
After food (2hr): 5.1

So that is a 0.4 difference, which from your information suggests a good result.

My question is:
My food only had a content of 20g carbs (Salmon, avacado, lettuce, orange and strawberries).
Should I check with a larger content of carbs?
 
Seems that meal was absolutely perfect for you Me personally I wouldn’t add more carbs to a meal that had worked so well for me. Do you have a reason to want more carbs?
 
That's a decent result, and you should take from it that you can currently manage that meal. The only thing with any substantial carb is the orange.

The other thing is that the fingerprick test is subject to an allowable inaccuracy of 15%. In practice this means that a true BG value of 6.0 could generate fingerprick test results of anywhere from 5.1 to 6.9, and still be "sufficiently accurate". A difference of 0.4 is really negligible.

My example this morning - up very early and a very late breakfast with quite a few more carbs than I'd usually have (I don't usually have any breakfast at all). 5.1 before, 6.3 at +2hrs. I don't usually see results over 6 these days, but I expected it given what I ate. Although it technically ticks the "within 2" box, it's not something that will be a regular occurrence for me.

As for checking larger quantities of carbs - it depends on choices you make. What you are looking to do long-term, in getting back to normal blood glucose values, is reduce the amount of excess glucose in your system. It helps not to be taking in either glucose or carbs in excess of what you can handle. And if you want to reduce levels, going for a little lower both relieves the pressure on your system, helps to increase your insulin sensitivity, and should start helping your liver reset what it thinks of as "normal" blood glucose levels.

So you're really (to my mind) looking to establish what foods and meals will not raise your BG beyond acceptable levels. Then you make a choice about whether you can accommodate some of the carby stuff, and if so how much.
 
mshaf said:
I've been diagnosed with prediabetes after a routine blood test last month. This was during Ramadan so I'd been fasting.
Click to expand...
I heard a muslim say that it was usual to break your fast in the evening during Ramadan with dates. She said that by the end of Ramadan people were sick of dates! Is that your experience? If so, I'm wondering if the high bgs caused by consuming dates might have influenced your A1c. If you have been looking at Diet Dr you will realise how high carb dates are.
 
Hi @Alexandra100

It's a good point and one that did come to mind. Yes it is customary to open fast with dates and that is what I was doing. Although I like dates, I've never been one to have too many. I would usually have one or two and no more. I am also aware of the high sugar content although have also heard that they have a low glycemic index (GI) and hence do not significantly spike blood sugar. Everyone is different though.
 
mshaf said:
have also heard that they have a low glycemic index (GI) and hence do not significantly spike blood sugar
Click to expand...
A lot of doctors teaching about diabetes consider the glycemic index a mistake. At all events I suggest you experiment by eating one or two dates and testing afterwards. It should make a difference whether you eat the dates alone or with protein and fat. It has been suggested that you can reduce the effect of carbs by consuming the carbohydrate part of your meal last, but I suspect you ate the dates first? I see that 100g carbs gives 67-69g carbs. Of course you were not eating 100g carbs. Googling one date I find that it will give you about 4.7g net carbs, so 2 will give nearly 10g - which is the whole of my daily carb allowance!

At first it is a good idea occasionally to test maybe 1 hour after eating, then 2, then 3 and maybe 4. The idea is to catch the first rise in bg, the height of the rise, and then see how soon it goes down. Of course if you can see your way to using a cgm (continuous glucose monitor) for a couple of weeks you can avoid a lot of finger pricking. CGMs are usually considered less accurate than finger pricks, but they are great for showing trends. By the way, the more fat and protein (and fibre) in a meal, the slower your digestion will probably be. Dates might kick in long before other foods.

Have you come across Richard K Bernstein's great books "The Diabetes Solution" or "the Diabetes Diet"? He generously made long extracts available online:

Read Online - Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site

Read selected sections of Dr. Bernstein’s books online: Dr. Bernstein’s Diabetes Solution, A Complete Guide to Achieving Normal Blood Sugars – Dr. Richard Bernstein’s groundbreaking approach to diabetes care enables you to take control of the disease by normalizing your blood sugars. The...
www.diabetes-book.com
His autobiography is fascinating and he gives exhaustive lists of what to eat and not eat.
 
@Alexandra100

Thanks for the info - that's very interesting and informative.

It was only yesterday someone recommended Roy Taylor's book on reversing type 2 diabetes and I started reading it.

I'll add Richard K Bernstein on the list now too - thanks for the recommendation.
 
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