thin fit prediabetic - is there hope?

I have impaired glucose tolerance, slim build (BMI 20.4) with no dietary sins. I ate whole grains, fruit, veg, pulses. I didn't have a sugar habit, rarely touched alcohol, no family history. Unlike you, I'm not fit (housebound due to ME/CFS) and that's probably why I have developed this problem and why it's so difficult for me to address because I can't exercise. I've cut the carbs and I'm eating to the meter. I am working on increasing my physical activity but exercise for someone with ME is not the same as exercise for the general population, so it's not enough to make an impact on my blood sugar levels. I don't have a lot of weight to spare and I'm not specifically trying to lose weight either. Would a few pounds make any impact considering that some people lose stones? Again, it's not as if there's all that excess weight demanding more insulin than what's available. It's a tough call.


Sent from the Diabetes Forum App

Hi

I am officially Type 2. Diet and exercise controlled.

Like you I am slim, I teach yoga and I had a good diet on diagnosis. So making huge sweeping lifestyle changes did not figure in my equation as much as it would if I had had weight to lose, or had been living a sedentary life up to that point.

So in a sense, this is quite tough.

However, through educating myself on this forum and doing a lot of reading, I have made changes that have influenced my Blood Sugar control, hopefully helping to keep my diabetes in the 'well controlled' bracket, and delaying any medication at present.

Changes have been mostly dietary - changing the amount of carbohydrate I consume - which when I really looked into it, was fairly high for someone with diabetes. Since diagnosis, I have lost a stone without trying to. - so weight has dropped to 8st 5. So, BMI has improved which is no bad thing. ( I am 5'1 ).

Cholesterol too has dropped through dietary changes and this is important for heart health when you are pre or fully diabetic.

Pre diagnosis, I was feeling exhausted. Now, my energy levels are back to normal and I feel very well.

My fasting glucose hovers around the 6.5 mark.

I understand what you mean about resigning yourself to the fact that you have inherited this, and as you are fit and healthy and eat well and exercise well, you may be inclined to imagine there's nothing for it but to wait until Type 2 is finally diagnosed. But with improved glucose control you could well stave off the diagnosis of type 2 for some years whilst improving your chances of preventing diabetic complications which arise when blood sugars are allowed to stay high over a long period.

You may be surprised with what you can achieve by just tweaking your diet for better control.

So I would say, yes - following selectively the advice I have gleaned from this forum has made a long term impact on my diabetes. It is on going, and sometimes feels like a pain, but my HbA1C tests have all been lower than the one at diagnosis, so something positive has occurred!!

I am 49 now and had Impaired Fasting Glycaemia first mentioned to me 10 years ago. I was given no advice from the doctor that this may result in diabetes down the line, and I became diabetic before I realised I needed to take action.

My advice would be, take action!!

best wishes

CathyN

Hi,

I am also thin and fit with a good diet (male aged 54, non-smoker, very moderate drinker, with no family history of diabetes). About a year ago my cardiologist told me that my fasting glucose had risen to 5.6 mmol/l and that I should take more exercise and cut down on carbohydrates. (I already ate muesli, fresh fruit, salads, fish, chicken, wholemeal bread and fresh vegetables, rather than processed food and sugary drinks.) I did as he said and my blood sugar fell slightly, but not enough. I redoubled my efforts, started taking at least one serious period of exercise every day and at least 15 minutes of good aerobic workout after every meal, and cutting out anything that might have too high a glycemic load. After all that hard work, I now find that my fasting glucose has risen to 6.3 mmol/l.

With my dietary changes and exercise I am losing weight, down to a BMI of 19.8 this morning. I am full after every meal and never hungry. I already add extra large helpings of olive oil to my salads and fresh fruit and nuts to my muesli to try and increase my calorific intake without adding to my glycemic load.

I really want to avoid getting diabetes; I have a thing called cardiac syndrome x (chest pain and abnormal ECG, but clear arteries). I also have very high homocysteine (a risk factor for everything you can think of except diabetes) and high LDL cholesterol (partly lowered with statins). I have just discovered that have lost 3cm in height, have arthritis and very bad osteopenia, and I am waiting for the results of a follow up test after having some protein in my urine.

Diabetes would make all of these problems worse. I am not resigned to getting it and would like to know what I can do to avoid it, but all the advice on diet, exercise and weight loss seems totally irrelevant to my circumstances.

You ask 'is there hope?' I would like to think so, but I don't know. My next steps are to get myself checked for type 1.5 diabetes and fatty liver disease, find out my HbA1c and buy a monitor to see how my blood sugar varies before and after meals, with or without exercise. I can only hope to find some clues from this information as to what else I can do.

Any advice from forum members would be greatly appreciated.


Alan

Are you due for an NHS health check? My surgery does the Hba1c test as well as a fasting blood glucose test as part of the NHS health check. Check if your surgery offers this too. I don't recommend going to a pharmacy or shopping centre that offers the NHS health check because they will only do a pinprick test. Failing that, just go ahead and ask your GP for one. It might help if you do your own readings and kept a record which you can take to your GP.

Without the option of weight loss etc you really need to focus on getting your diet right. I'm afraid that's all that can be done if you have no more weight to lose and you are already exercising. Some people take the low carb route, but I have found it to be counter productive in my case. (Although it may help you. Everyone is different.) You still need to find out which carbs you can tolerate and which amount to get your numbers under recommended limits and close to normal as possible.


Sent from the Diabetes Forum App

I have heard that statins increase the risk of diabetes, muscle degeneration and joint pain. There seems to be a lot of empirical evidence out there

Thanks for the comments and encouragement. I am abroad at the moment, with my wife who is Taiwanese. I will have the tests done in the Taiwanese health system, in a big hospital - even if it means that I have to test my assertiveness and my Chinese skills to the limit.

I know the research about statins, and it is very worrying that they not only have these side effects, but also have no proven ability to save lives at all in people like me who have not already had a heart attack or stroke. On the other hand, experts at the Brompton Hospital in London say that they are good for my Syndrome X as well as cholesterol management. I will discuss switching from Avortastatin to Pravastatin, which led to fewer incidences of diabetes in a very big Canadian study.

Otherwise, it is over to the blood sugar monitor to check the effects of different types/quantities of food.

As an aside, I understand that some 80% of people are either overweight or obese when first diagnosed with diabetes. 100% of the advice on all the web sites that I can find seems to be aimed at this 80%. It would be nice if the remaining 20% of us could get at least 5% of the advice on offer.

Good luck to everyone posting here.

Alan

I am on a restrictive diet which I put myself on and have had good results and am now back to within the normal range at 6 hr fast 5.1 and 5.2 at 2 hr after food so am very pleased.

I am also slim with a BMI of 23 although I have stopped going to the gym because when I received the diagnosis of prediabetes and high cholesterol I thought what's the point.
I am still active and walk now mainly for exercise, I need to do weights though for prevention of osteoporosis.

I have lost weight about 7 pounds since I have been on this diet which I really don't want to loose, I'm sure the GP will comment on this when I next see him. I think I may have to up my protein intake, but I'll take the advice of the dietician when I see her in August.

Good numbers, Jeanie. How are you controlling your diet? Have you lost weight as a result of your diet, even if unintentional? I can't afford to lose much weight but being physically inactive (housebound with severe ME/CFS) I don't want to consume a high fat diet because I can't burn off the calories like even the typical sedentary person who can at least get out and about. At the same time, I also have to manage my ME/CFS and that means eating for health and nutrition, so I don't want to end up eating too much of one thing and not enough of another which is quite hard as I eat relatively few calories.


Sent from the Diabetes Forum App

Hi Jane,
Unfortunately my BG test last week was still pre diabetes, blood taken from my arm, so I am very confused as the 2 prick test from the pharmacy showed a normal reading.
The good news was my cholesterol as reduced to 4.5 from 6.5 G.P said this was a very good result from the restrictive diet I am on. I was determined to try something with my diet as he had put me on Statins which had the side effect of memory loss for me which was horrendous.
Because additionally I have high blood pressure having high cholesterol and diabetes is bad news for me.
My diet
I have cut out completely all fat and sugar deserts,pastries,white flour,white rice,potatoes,parsnips, white bread,liver no sugar drinks, No processed meats or pates, no hard cheese,bacon.
Don't have cream or custard, use low fat yogurt on fruit as a dessert.
I don't add salt to anything, make my own curry powder, use chillies, garlic and herbs for flavour.
I eat roasted chicken breast no skin and steamed vegetables, roasted vegetables peppers, carrots, on a mess which means you don't use oil.

I roast bake grill or poach fish, make my own soups which I eat for breakfast mainly but do have the occasional egg,
cottage cheese with chives, soya and linseed bread but no more than two slices in a day.

I have red meat maybe one every two weeks, pork, beef,lamb, need to speak to dietician about these.

Stir fry (veg oil)vegetables, beansprouts, mushrooms,peppers, brown rice
I eat walnuts and almonds, a few per day read these had good cholesterol in them.
Very very occasionally as a treat I will have a slice of toast with butter on but normally if I make a sandwich I have no fat on it.

I eat fruit and wonder if I eat too much and this is why I have a high reading. I think I read somewhere that you should only have two pieces a day and I eat more than that for sure.

Up until my diagnosis I went to the gym 2 or 3 times a week for over 3 years and walked regularly but for all that was said about it would reduce my high blood pressure it never did. I was so fed up with the results that I have stopped going because what is the point it does seem that whatever exercise I do it doesn't make any difference.

I have an appointment to see a dietician in August there are so many questions I have for her as I do not want to loose anymore weight, need to maintain the weight at this level.

Sorry to hear that, Jeanie. All is not lost. You've made some positive changes and it's reduced your cholesterol, so that's good. I had a good diet, eating all the right things, no real vices and assumed I'd be fine. My NHS health check tests for cholesterol, BP and so on were all good, and my fasting BG was 5.1, so they said, fine you've got nothing worry about, but as soon as I raise the matter of high postprandial readings after modest portions of 'healthy' meals they don't want to know! As long as I stay under 6.1 fasting they will not send me for an OGTT. if I go into double figures 2 hours after a meal, I'm told it's normal. So, I just have to treat myself in the face of apathy and disbelief.

Last year I had every investigation possible for MS, Lupus etc, for unexplained neuropathies and I've recently been re-referred to the neurologist, but because I had a 'normal' fasting test and I was oblivious to postprandial hyperglycaemia at that point, the root cause (I believe) has been missed. How much cheaper an OGTT would have been compared to all those scans and blood tests for obscure autoimmune conditions!

Blood glucose readings from the pharmacy are just a snap shot, like any fingerstick test, and they can and do fluctuate. I suppose even after an 'official' diagnosis of prediabetes it is possible to go in and out of the range. My fasting BGs last week varied 1.0 from highest to lowest, so if your fasting varies from say 5.3 to 6.3 it's possible that you will be on one side of the diagnostic cut off point or not, several times within one week. Keep on with the diet and so on, I'm sure it's going to help and I still think there is hope that you can get those BGs into 'normal' ranges.


Sent from the Diabetes Forum App

There seems to be rather a lot of slim, fit people, who have had an excellent diet for years, that seem to be either diabetic or pre-diabetic, What is going on?

Why is no-one interested in high post-prandial levels?

I seem to be stuck in the middle of things at the moment too. I have a very acceptable fasting BG of 3.3 mmol, its never been more than 4.5mmol. But my HbA1C is stubbornly over 6, and is refusing to come down at all, no matter what I do. So, although my post prandial is not hugely high, because i'm LC, its staying elevated for hours and hours. Basically it takes about 4 hours to come down. Weight is about 8st 2lb and I'm 5ft 4ins, so thats OK, no real need to lose any, although it is dropping very very slowly - could safely go down to 7st 7lb, under that is a bit too thin.

So, is there hope? Yes, I hope so, it seems sensible to stick to a diet / regime that prevents the numbers getting too high, but maybe diabeties is inevitable, but if you can avoid the risks of getting complications then surely that must be sensible.

'There seems to be rather a lot of slim, fit people, who have had an excellent diet for years, that seem to be either diabetic or pre-diabetic, What is going on?'

...........which begs the question: is the label 'diabetic' being hung on too many people? We are talking about (in many cases) milimols (yes 'milli' - thousandths) per mol in mearsurement and it really does seem that on one day you can be on the wrong side of a line, on another the right side.

I know these numbers have been empirically derived but a line in the sand can be moved (and has been, I believe, by the Americans).

For me, the label 'diabetic' could bring my professional working life to an end - we are quibling over + or - 1mmol. There's too much riding for a lot of people over a line in the sand.

Ahhh, yes, maybe its only milli mol. But when you get a postprandial spike into double figures when consuming only about 20 g of carbs , that isn't quite right is it ? Two slices of bread will put it up to 12 and it will take about 3-4 hours to come back down. The only reason I don't get an official diagnosis is because I am not prepared to eat the stuff that makes me feel ill, and raises my bgs, I feel sick at around 8 mmol, so I assume that my body is in fact not used to being that high. So why suddenly do I feel like this and why suddenly am I getting this response?

My most resent blood result is 39 it's down from 44 it's the one taken by the GP and covers a 3 month period and I understand this is very good, my cholesterol is also down again to 4.3 now. I am off medication for BP as this is back to normal a side effect of loosing the weight I guess.
Even with these results my GP said I should go onto statins I said I wouldn't not after the side effects of memory loss which I had some months ago after taking them for 5 months.

Anyhow to cut a long story short I have taken a second opinion and found that some of the information in my records are incorrect.

I had a couple of tests done some time ago for a heart murmur the result was I didn't have one this and also a test which showed I had CKD but some time later a further test showed I didn't have this and all later tests have shown I haven't either but the results have not been altered on my records.

I've had good results on this diet but the problem I have is getting the balance right because I am still loosing weight ( over 1 stone now)BMI 21 the nutritionist said to up my good fats and snack on nuts it doesn't seem to make any difference. I'm going to have another look at the foods on the GI list non starchy. If you up fruit and some veg the blood sugar goes up.

What do other members think is this the best way to go.

Hello everyone - this is Pam from the states, hoping to revive the discussion on this thread!

I'm a 67-yr.-old thin, pre-diabetic/insulin-resistant/glucose-intolerant female (call it what you will) who has become very frustrated that virtually all the literature on diabetes management focuses on weight loss.

When diagnosed 14 months ago, I went on a reduced-carb diet (30-40 carbs per meal), eliminating white starches and rich desserts. Though not overweight at the time, I had a discretionary, unneeded 10 lbs. - which came off slowly and steadily. But then I continued to lose, and for some months now it is a real effort just to maintain a healthy weight.

I'd love to hear from other individuals in the same "boat" - to compare diets, and learn if the reduced-carb path has improved your blood sugar readings and A1C tests. I'm scheduled for an A1C in March.

Thanks and hope to hear from you!

Hi Pam from the US of A,

I am also prediabetic and through the LCHF diet have managed to improve just about everything, HbA1c, fasting blood glucose, lipid profile, blood pressure and body mass index. I also have a long history with heart problems but I have survived. Over 25 years.

For your information I eat just 20 grams of carbs a day. My only regret is that I discovered this way of eating late in life, but better later than never.
I never had a problem with losing too much weight, just the opposite but thats now easily controlled.

If you wish to ask any specific questions ,go ahead, I will do my best to share my experiences [+ and - ]

There is still a lot to learn about diabetes, why don't ALL fat people get it? Why are some thin people diabetic? Because it doesn't all hinge on diet and exercise, auto immune diseases, genetics, viruses etc all come into the equation for some people.

Ali

Ali H said:

There is still a lot to learn about diabetes, why don't ALL fat people get it? Why are some thin people diabetic? Because it doesn't all hinge on diet and exercise, auto immune diseases, genetics, viruses etc all come into the equation for some people.

Ali

Click to expand...

I am a skinny prediabetic and have been hovering on the brink for about three years now BG levels at tests being just under 7 so my GP won't say I have T2 until I go over 7. I always had a good diet not high in starchy carbs or sugar and no family history of diabetes in my close relatives So even if we don't know of any close family that have T2 I believe it can still be genetic just like having raised cholesterol can be heriditary in some people as I was told by my GP it probably is with me. She said I am not typical for any of this. I adjusted my diet to cutting out all sugar stuff and lower on the carbs like root vegetables.. I never did eat rice or pasta.. and I only have a couple of slices of Burgen Linseed and Soya bread two or three a times a week I do eat fish but the only meat is chicken as I don't like red meat and am not keen on full fat dairy except I do make EasiYo full fat unsweetened greek yogurt and I eat eggs. I lost a stone in weight that I didn't need to but I did reach a plateau almost a year ago and stopped loosing more weight but have not regained the weight I lost

Surfgal said:

Hello everyone - this is Pam from the states, hoping to revive the discussion on this thread!

I'm a 67-yr.-old thin, pre-diabetic/insulin-resistant/glucose-intolerant female (call it what you will) who has become very frustrated that virtually all the literature on diabetes management focuses on weight loss.

When diagnosed 14 months ago, I went on a reduced-carb diet (30-40 carbs per meal), eliminating white starches and rich desserts. Though not overweight at the time, I had a discretionary, unneeded 10 lbs. - which came off slowly and steadily. But then I continued to lose, and for some months now it is a real effort just to maintain a healthy weight.

I'd love to hear from other individuals in the same "boat" - to compare diets, and learn if the reduced-carb path has improved your blood sugar readings and A1C tests. I'm scheduled for an A1C in March.

Thanks and hope to hear from you!

Click to expand...

Hi,

I was diagnosed in January 2014. I have been following a low carb/increased fats diet (currently 50g carbs a day but I reached this low level gradually, bit by bit). I had weight to lose, and I lost it. I lost over 31% of my body weight very easily. When I reached my goal weight I found it a hard slog to stop losing without increasing my carbs. This I did not want to do, so up went my fats. I still kept losing, albeit a bit slower, so I upped my fats again, then again. I am now more or less stable but can't seem to gain what I didn't want to lose. So, if you want to stop losing you have to increase either your carbs, your fats, or your protein. There is no other way of doing it. It is not wise to increase carbs too much, nor protein if you already eat a normal amount, so you are left with fats.

My BS are well controlled, my HbA1c's have dropped at each test, my cholesterol is better than it was when I was on statins 12 months ago (I stopped taking them), and my other blood results are excellent.