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Prediabetic? New to this

Discussion in 'Prediabetes' started by geob, Feb 10, 2019.

  1. geob

    geob · Newbie

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    Hi all,

    I am 37 male with a lot of weight (137kg / down from 158 9 months ago).

    I started reading about insulin resistance and metabolic syndrome after I borrowed a friend's meter and checked by BG after a heavy pizza meal, only to see a reading of 220mg/dl. That got the alarm bells ringing, so in the last 9 months I adopted a low carb diet, lost about 20kg. My blood readings last month were

    Fasting: 100mg/dl
    HbA1C: 5.1%
    Fasting insulin: 25 uil/ml
    Triglyceride: 76
    Total Chol: 176
    LDL: 142
    HDL: 40

    My fasting level had come up in the last year, from 90mg/dl to 100mg/dl and so far I have not really managed to get this down; I can also see that 'Dawn effect' - what is the BG rise for 'normal' people?

    I have been using a Freestyle Libre sensor in the last couple of weeks as it allows me to track daily changes; But I am puzzled sometimes by the following - Post meal spike, drop after 1-1.5hrs, then spike again then going down again. Is that because of slow digestion? The limit in the app is set to 110 mg/dl (the green boundary).

    Appreciate any advice/ideas

    Many thanks!

    Attached Files:

  2. Pipp

    Pipp Type 2 · Moderator
    Staff Member

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    Hello, @geob, and welcome.
    First of all, congratulations on your weight loss, and for taking action to control your blood glucose.
    I don't use the Freestyle Libre, or any other CGM system, but hope some of our more knowledgeable members who do will look in and answer that query.
    As for the post meal spike in blood glucose levels, I believe there is no set time for the true spike after eating. Depending on what I have had to eat mine varies between half an hour, and up to 3 hours. Again, I am hoping others will be along with their better explanations.
    As you are new, I am tagging in @daisy1 , who posts useful info for new members. She should do that soon.
  3. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Your fasting insulin of 25 is high, which indicates you have a lot of insulin resistance and may explain why some of your levels are on the high side.. In the uk our measurement units are different for cholesterol, triglycerides etc, so I can't help there
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  4. daisy1

    daisy1 Type 2 · Legend
    Staff Member Retired Moderator

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    Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it both useful and interesting.


    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.
  5. SlimLizzy

    SlimLizzy Prediabetes · Well-Known Member

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    hello geob,
    you have come to the right place, here you will find lots of helpful advice.
  6. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Hi, and welcome!

    Oh boy, I'm not familliar with your numbers... I think your fasting insulin levels are a little on the high side. I'm guessing it should probably be around 8. (Which may also explain your struggle with weight; high insulin levels = high insulin resistance. And that does indicate something's off. Can't diagnose here so I won't, but you do want to keep an eye on things.) And the last time I tried to calculate the measurements I botched it, so I'm not going to touch that, if you don't mind. But there's a few things I have on offer which might interest you. Just yesterday I was talking to someone about Glycemic Index, while it rarely ever comes up usually, so hello coincidence! It basically deals with slow and fast carbs. Slow ones have a longer molecule chain, so they're digested slower. Short ones hit your bloodstream quicker. On top of that, fats can slow down the uptake of the carbs too (practically all carbs turn to sugar once ingested), so that could well explain the variation in your spike's timing. Not everything gets digested at the same speed, but it will raise your bloodsugars sooner or later. So whether it's fast or slow doesn't really matter for a T2, (for people who use fast acting insulin it does) but a carb is a carb and we don't process those well. Which you already know.

    Anyway, back on track: You're already losing weight, so good on you! The low carb thing is working for you. And the Dawn Phenomenon, well... I'm kinda useless because I only deal in mmol/l's, but for me, after a rather sleepless night or an early morning where I fast till noon, I may even creep up to 7.0, while I'm usually between 4.5 and 5.5... Which probably tells you as much as your numbers do me. But just so you know, when you're low carbing, the fasting bloodglucose is always the last thing to go down. Better to just keep an eye on what's happening around meals, as that you have more say in than what your liver's up to without your permission.
  7. geob

    geob · Newbie

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    Thank you all for your replies - I seem to have confused many with my bloodwork...You'd think Greece being in the EU since 1981 would have switched to SI units...

    So my data converts to:
    Fasting: 5.55 mmol/L
    HbA1C: 5.6 mmol/L or 32.2 mmol/mol
    Fasting insulin: 174 pmol/L (which understand is the 'end' of the 'normal upper limit' for labs)
    Triglyceride: 0.8588 mmol/L
    Total Chol: 1.988 mmol/L
    LDL: 1.6 mmol/L
    HDL: 0.452 mmol/L

    I understand from reading around that the real problem is the very high fasting insulin; I am guessing the way to reduce this is lose further weight, combined with the low carb diet? A question I do have though, is what is the 'optimal' spike level after eating? I have seen the guidelines saying below 7.7 after 2 hours or even better 6.6. My question though is:

    If at fasting or before a meal I am at 5.5, then is a spike after 1 or 2 hours of say 1mmol considered 'good' and that is a level I should be aiming for, or is it something lower (ie. even less carbs). Eg. a breakfast of eggs benedict will get me up by maybe 0.6 but say a Greek Salad (tomatoes/cucumber/feta/olive oil) + chicken will get me up by 1 or 1.1mmol.

    Many thanks!
  8. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    I think you may have converted your cholesterol and lipids incorrectly. You can't use the same conversion methods for cholesterol that we do for blood glucose - it doesn't work. The amounts you have quoted don't make sense - and are way too low apart from the triglycerides. There are cholesterol conversion tables on the internet somewhere if you have a Google.

    Yes, your insulin levels are high. I am guessing you are severely insulin resistant, so cutting carbs and some added exercise along with some intermittent fasting will help with that.
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