Having recently been diagnosed pre diabetic and posted on here I have some more questions and thoughts more so to check my understanding.
Firstly pre diabetes is reversible but this is now a lifetime commitment?
Secondly. There is a chance of developing type 2 diabetes in the future even if I reverse pre diabetes?
Thirdly. Is some form of blood glucose monitoring at home a good idea?
Fourth. How do you find out which dietary approach works for you? Some people cut out carbs some people still eat carbs?
Final one for now food labelling how do you interpret carbohydrates and how much you can eat.
I'm enjoying this forum but some parts to me are confusing so any advice is much appreciated.
1. "Pre-diabetes" is just abnormally raised blood glucose that isn't raised as high as 48 mmol/mol. In my view diabetes starts when your blood glucose goes out of normal levels. Both "pre-diabetes" and t2 diabetes are "reversible" if by that you mean that you can still reduce your blood glucose levels to normal. It's a life time commitment in the sense that if your BG can become abnormal once, it can do so again.
2. Yes and no. No is if you reduce your BGs to normal and keep them there, then you will not (by definition) be diabetic. Yes is if you reduce BGs to normal levels and then let go of control, your BG will (probably) rise and you might well hit diagnostic levels.
3. Absolutely essential in my view. You are not testing to see "how high you go". You're testing to see how well your insulin system is working. It is the only way we have of establishing day to day how your body is coping in response to the foods you eat. An HbA1c every six months will tell you how well you're doing overall (and maybe that you're not doing well, at all), but there is no substitute for structured testing around food. It will give you the info you need to avoid the foods that raise your BG most (see below). I don't think there's a lot of value in testing randomly now and then, because there's no way to make sense of the info.
4. Bit of reading around, and a bit of trial and error, based on structured testing of your BG. I started off by excluding almost every carb I could. Then you see what a small amount of that carb does to your BG - ie how well your insulin system handles that carb. Obviously this only works if you're testing before and after food. You find out a few odd things: for example, my system deals totally differently with a carb in grain products (bread etc) compared to a carb in green veg or pulses and legumes; alcohol markedly lowers my blood glucose; and they put sugars in everything processed. It's worth keeping a diary with both the test results and all your food intake.
5. Read the labels, and look for carbohydrates. Ignore the "of which sugars" - you're interested in the total carbohydrate. All carb is digested to glucose. Ignore the stuff you read on the internet about subtracting fibre. That's for foods produced in the USA. In the UK undigestible fibre is already subtracted. Then think about how much of the food you're going to eat. Food A might be only 6g per 100g, but if you're going to eat 400g of it - that's 24g carb. Food B might be 30g carb per 100g, but you're eating only 20g of it - that's 6g carb.
The "how much you can eat" depends on you. How many grams of carb are you intending to eat today? I found that I could avoid doing the sums by not eating anything carby. Essentially I was going for around 20g/day, which is the amount of carb in one apple (not that I eat apples anymore). So it follows that anything with any substantial amount of carb was out for me. I can cope with that and have for six years, so it's not a short-term option - I expect to be doing this forever. As well as normal BGs inside four months, I subsequently lost around 90lbs and feel great. 70 next year btw.
Best of luck
