Underweight with prediabetes

SianR1

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Hi, this is my first post. I’m 21, have a BMI of 18 and 6 months ago my blood test results came back as prediabetic. HbA1c was 6.1

Rather surprised as I don’t seem to have any other risk factors for diabetes being young and slim. No one in my family is diabetic either.

Also, I already followed a lower than average carb diet and rarely eat refined sugar (not for weight loss but in hopes of clearing acne prone skin)

I don’t eat as low carb as keto though, roughly 90g of carbs a day on a 2000 calorie diet.

I was wondering if anyone else had a similar experience, and what your greatest tips were for lowering HbA1c

I was thinking of getting a free diabetes test from Lloyd’s pharmacy, as it’s quite hard to get GP appointments at my local surgery unless urgent
 

EllieM

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Does prediabetes have to indicate that you're going to be T2? (I'm thinking that you might be at an early stage of T1 (though if the test was 6 months ago I think you would have progressed by now) or even MODY....) Or, of course, that HbA1C test might just be inaccurate. Aside from a faulty HbA1C test here are some other factors that might cause an artificially elevated hbA1C.

Here are some times the HbA1c will not be helpful:
A1c falsely elevated (HIGH)

Your test may tell you that you have diabetes, but you don’t.

  • Untreated anemia from iron deficiency or vitamin B12 and folate deficiency can result in a HbA1c value that is falsely high because your red cell turnover is low. Because you have more “older” red cells instead of making new ones (due to lack of iron, or other vitamins) your HbA1c will be higher than it should be.
  • Kidney failure or chronic kidney disease. If you have abnormal kidney function your HbA1c may be falsely high.
  • Very high triglycerides (over 1,750) may also cause a falsely elevated HbA1c.
  • Splenectomy (spleen surgically removed) will give you a falsely elevated HbA1c, due to decreased red cell turnover. This is because the spleen can’t remove the red cells from the bloodstream—which is the spleen’s normal job.
There are other possibilities as well, I believe.

Personally, in your position I'd get another hbA1C before making any drastic lifestyle changes. Most of the folk on here go low carb to reduce their hba1c, but you're already doing that. If the result is genuine, I'd be tempted to get a blood testing meter to see what's actually happening to your blood sugar as a result of what you're eating.

Good luck, and I'll tag @daisy1 for some useful intro to diabetes info.
 

SianR1

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Thank you for your helpful response! That’s really interesting, I never considered that a falsely elevated result could be a possibility too
 

DCUKMod

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Thank you for your helpful response! That’s really interesting, I never considered that a falsely elevated result could be a possibility too
Where. And why was your. HbA1c done, Sian? If it was done 6 months ago, it's now out of date anyway, so if you have concerns, best route is back to your GP and ask for another test.

Do you have any diabetes symptoms at all, like rapid weight loss, using the loo more often, extreme fatigue, recurrent thrush?
 

daisy1

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@SianR1
Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

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 147,000 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.
 

SlimLizzy

Well-Known Member
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3,212
Type of diabetes
Prediabetes
Treatment type
Diet only
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Was also underweight with prediabetes, dropped my carbs, increased activity and HbA1c went down. Exercise is likely to be your best friend here, if you are already eating lower carb.
MY Weight also declined but that is probably not related to prediabetes.
 
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Alexandra100

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Type of diabetes
Prediabetes
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Tablets (oral)
I was thinking of getting a free diabetes test from Lloyd’s pharmacy,
I just checked this out, and I think it costs £5.
http://www.lloydspharmacy.com/en/info/type-2-diabetes-testing
For that you don't get an A1c test, just a finger prick test like the ones we do with home glucose monitors. Personally I would prefer to pay a bit more and buy my own bg test kit. Not from Lloyds Pharmacy though, you can get them much cheaper online. TEE2 and Codefree are two popular ones. There is lots of info. on this site about which to buy. Just search, or ask if you don't find. I don't mean to suggest you go over the top testing all the time, but keeping an eye on things would seem to me wise.

Btw I am another skinny person with impaired glucose tolerance. I was eating a super-healthy Mediterranean style diet when I got a surprise A1c of 41