Prediabetes What next?

[Lickthelid]

Hi, 32yr old female here. I have a family history of diabetes. My brother had badly controlled type 2 that turned into type 1 as an adult. He never has controlled it and has lost a limb due to this. My sister has controlled type 2 but had a poor appetite prior.

I had Gestational diabetes which I managed to control with diet alone. I’d be testing after each meal. I’m not sure how gestational diabetes compares to type 1/2. During pregnancy I couldn’t eat strawberries on their own, I’d have to pair it with double cream or another fat to keep the readings down. Finished pregnancy with no weight gain and felt great throughout.

Went for my 6 months post partum diabetes blood test and it shows I’m pre diabetic, leaning towards type 2. Weight and cholesterol levels are normal. I asked the dr what I need to do and he said i’ll be able to see a dietician at the hospital to talk through healthy eating and it may be part of a class.

So I go and they spout all the usual healthy eating, low fat diet. I don’t need to lose weight and I already eat a healthy diet. I feel like I’m doomed and all I can do is continue as I am and wait for my blood test in 6 months to show ins type 2. I had to tell the dietician what I eat in a normal day. She suggested I switch full fat yogurt and dairy to low fat. She had no corrections on anything else I eat.
Obviously I’m not perfect but I do cook from scratch and although I have occasion treats most of the sugar I have is from fruit and veg.

I want to help myself but don’t know what I should be doing next.

 

[Antje77]

Tagging @daisy1 for you, she'll have lots of useful information for you. In the meantime, ignore the dietician, they obviously have no clue what makes blood sugars go up and what doesn't.
Good luck!

 

[Alison Campbell]

Hi welcome to the forum, I'm tagging @daisy1 for a new member post for you.

You like me maybe able to halt or reverse progression by reducing the carbs in your diet. Have you still got your meter and strips? This will be valuable for you watching for foods that spike you now.

The dietician was not very helpful, you will need to eat full fat products if you don't want to loose more weight.

Do you know your test results? If not, do get them so you can see where you are starting from.

Many members manage this with the correct way of eating, have a good read around the forum including the prediabetes section.

 

[Bluetit1802]

Hello and welcome,

There is no need to wait for your next HbA1c test to see if you are progressing. You can do this yourself by testing your meals at home with a blood glucose meter. Do you have still have one? If not, you ought to buy one as this will guide you in your food choices. Reduced carbohydrate and FRUIT coupled with the full fat products you are eating will reduce your BS levels and hopefully maintain a good weight. Fruit is not good for type 2s as it is a big culprit in causing fatty livers and liver insulin resistance, which is exactly what we do not need. If you stick to a very few berries with cream or yogurt, it should be OK. Just avoid the high carb/high fructose fruits which are mainly the tropical ones. If you can keep the rise in levels from before eating to 2 hours after first bite down to below 2mmol/l and preferably a lot less you will see a difference. (structured testing and a food diary are excellent ideas.)

I agree you need to know your test results, and have them in black and white so you can analyse them yourself. You can ask for a print out. You need the HbA1c, full cholesterol breakdown (LDL/HDL/Triglycerides) and your liver and kidney functions. If you are in England you can ask if your surgery puts these on-line and how to register for this.

 

[JoKalsbeek]

Just keep the carbs down, and ignore your dietician. Fats slow down the carb uptake, you noticed that yourself, so go with full fat. Cooking from scratch gives you control over how many carbs are in a meal. Drop/limit carby stuff like potatoes, bread, pasta, rice and corn, and in so far as I can see, you're doing fine.

 

[Lickthelid]

Thanks guys!! I just feel lost because during pregnancy I followers a low carb plan and it worked, while I also had to stay out of ketosis as I was pregnant. This was all through my own research as the nhs promoted slimming world to me.
So I went to my appointment expected to hear about lowering carbs but I was still told to follow low fat. I actually asked her if I should lower carbs and was told there is no reason to limit carbs and that I just need to eat the right kind from fruit/veg and whole meal products. To be honest I felt like she was treating me like an obese patient when I’m not obese.

So it does seem like lowering carbs is the way to go. I still have my blood testing kit from pregnancy but the strips fornit are expensive to buy. So I’m probably better off buying a different kit.

My blood test was number 47. I’m going to research that later. I had a blood test before pregnancy and she told me it was 34. I don’t feel like I have any of the ‘symptoms’ but I’m perhaps too busy to even notice them.

Thanks for all the advice. Hopefully I can get this under control.

 

[Lickthelid]

Hello and welcome,

I agree you need to know your test results, and have them in black and white so you can analyse them yourself. You can ask for a print out. You need the HbA1c, full cholesterol breakdown (LDL/HDL/Triglycerides) and your liver and kidney functions. If you are in England you can ask if your surgery puts these on-line and how to register for this.

Yes I’m in the UK. The cholesterol was all really good, especially the good cholesterol. My liver and kidney weren’t tested? do I need this? Hba1c 47

I might also add I haven’t even seen a dr at any point, only on the phone for results. The nurse did the post Gestational diabetes blood test. I requested thyroid and cholesterol as there is a strong genetic link on my mums side. But it all came back in range. I’ll get a print out, I’m sure they’ll do it.

 

[TheBigNewt]

If I were you I'd quit worrying about whether or not you will get Type 2 diabetes someday. My wife's 3 brothers all have it, her mom had it, and she does not (I've tested her blood sugar now and then). And she doesn't worry about it either. She's 57 and she knows she could get it, but so can anyone else. Right? IMO you'll impact your life in a worse way worrying about getting it than if you just live it and take things as they come. And there's no magic diet that will prevent it either, despite what others say. It's all about insulin and if you don't have it you've got the right amount of it.

 

[Alexandra100]

Yes I’m in the UK. The cholesterol was all really good, especially the good cholesterol. My liver and kidney weren’t tested? do I need this? Hba1c 47

I might also add I haven’t even seen a dr at any point, only on the phone for results. The nurse did the post Gestational diabetes blood test. I requested thyroid and cholesterol as there is a strong genetic link on my mums side. But it all came back in range. I’ll get a print out, I’m sure they’ll do it.

If you had what they call a "Complete Blood Count" that would run to many pages of results and your GP may not be willing to print all that out, or may want to charge you for it. Much simpler to register to get your results online. Your GP can arrange that if you ask. You will then be able to see all your results as and when you want, and also request repeat prescriptions and appointments. It's brilliant! A1c 47 is almost diabetic, so you don't want to mess around. If you want some authoritative backup to help you stand up against the duff medical advice you are getting, you might like to read Jenny Ruhl's "Your Diabetes Questions Answered" https://www.amazon.co.uk/Your-Diabe...d-Practical/dp/0964711672/ref=asap_bc?ie=UTF8
and / or Dr Bernstein's "Diabetes Solution"
https://www.amazon.co.uk/Dr-Bernsteins-Diabetes-Solution-Achieving/dp/0316182699
Even NHS dieticians have heard of Dr Bernstein!

 

[Lickthelid]

If I were you I'd quit worrying about whether or not you will get Type 2 diabetes someday. My wife's 3 brothers all have it, her mom had it, and she does not (I've tested her blood sugar now and then). And she doesn't worry about it either. She's 57 and she knows she could get it, but so can anyone else. Right? IMO you'll impact your life in a worse way worrying about getting it than if you just live it and take things as they come. And there's no magic diet that will prevent it either, despite what others say. It's all about insulin and if you don't have it you've got the right amount of it.

I’m not over worrying. I had it during pregnancy and now it’s in the rise since being pregnant. I can’t just ignore it and hope it stops going up. I need to get into the normal range.

 

[Lickthelid]

If you had what they call a "Complete Blood Count" that would run to many pages of results and your GP may not be willing to print all that out, or may want to charge you for it. Much simpler to register to get your results online. Your GP can arrange that if you ask. You will then be able to see all your results as and when you want, and also request repeat prescriptions and appointments. It's brilliant! A1c 47 is almost diabetic, so you don't want to mess around.

Thanks for the advice. I’ll look into all of this.

 

[Bluetit1802]

Yes I’m in the UK. The cholesterol was all really good, especially the good cholesterol. My liver and kidney weren’t tested? do I need this? Hba1c 47

I might also add I haven’t even seen a dr at any point, only on the phone for results. The nurse did the post Gestational diabetes blood test. I requested thyroid and cholesterol as there is a strong genetic link on my mums side. But it all came back in range. I’ll get a print out, I’m sure they’ll do it.

Yes, please get a print out. I get all mine (or did until I had on-line access) and have never had to pay a penny. They only run to a couple of pages of A4 including full blood counts. As for liver and kidney functions these should be tested annually. Don't worry about not seeing a doctor. I haven't seen one for diabetes at all either, and I've been diagnosed over 4 years. Most doctors devolve Type 2 diabetes care to nurses and have little to no idea how it all works. Nurses are generally more clued up. (although they still spout the poor NHS dietary advice)

Low carb is definitely the way to go, especially as your HbA1c of 47 is teetering on the edge. (48 and over is diabetic). All carbs turn to sugar once inside the system, so the more carbs we eat the higher our glucose levels will become. A meter is essential

The most popular meters for self funding T2's are the Codefree and the Tee2 because the strips are much cheaper than other meters, and you need a lot of strips. You can't buy them in pharmacies.

Try here for the Codefree meter
http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips
http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.
5 packs 264086
10 packs 975833

The Tee2 is here and the meter is free.
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/

If you are diagnosed T2 you can tick the box and VAT will be deducted.

 

[bulkbiker]

If I were you I'd quit worrying about whether or not you will get Type 2 diabetes someday. My wife's 3 brothers all have it, her mom had it, and she does not (I've tested her blood sugar now and then). And she doesn't worry about it either. She's 57 and she knows she could get it, but so can anyone else. Right? IMO you'll impact your life in a worse way worrying about getting it than if you just live it and take things as they come. And there's no magic diet that will prevent it either, despite what others say. It's all about insulin and if you don't have it you've got the right amount of it.

So you as a doctor are recommending we all stick our heads in the sand , our fingers in our ears and not take any measures to avoid blindness and amputations..great. Glad I'm not your patient..

 

[ziggy_w]

If I were you I'd quit worrying about whether or not you will get Type 2 diabetes someday. My wife's 3 brothers all have it, her mom had it, and she does not (I've tested her blood sugar now and then). And she doesn't worry about it either. She's 57 and she knows she could get it, but so can anyone else. Right? IMO you'll impact your life in a worse way worrying about getting it than if you just live it and take things as they come. And there's no magic diet that will prevent it either, despite what others say. It's all about insulin and if you don't have it you've got the right amount of it.

Hi @TheBigNewt,

I agree with the other posters on this thread.

Diet matters. By going low carb, many of us have been able to lower very high blood sugar levels to normal levels. (For me, this meant going from an HbA1c of 100 to an HbA1c of 31 (without medication for one and half years now). Also, T2 doesn't necessarily mean that we are producing less insulin than people with normal blood sugar levels. However, as T2s are generally insulin resistant, normal levels of insulin are insufficient to overcome this when on a high carb diet.

Did you have a look at the one-year results of the Virta Health study? What do you make of these results?

Here is a link to the one-year outcomes: https://blog.virtahealth.com/one-ye...ay-we-care-for-patients-with-type-2-diabetes/

 

[Alexandra100]

If I were you I'd quit worrying about whether or not you will get Type 2 diabetes someday. My wife's 3 brothers all have it, her mom had it, and she does not (I've tested her blood sugar now and then). And she doesn't worry about it either. She's 57 and she knows she could get it, but so can anyone else. Right? IMO you'll impact your life in a worse way worrying about getting it than if you just live it and take things as they come. And there's no magic diet that will prevent it either, despite what others say. It's all about insulin and if you don't have it you've got the right amount of it.

You are of course entitled to your opinion, and to express it here. But I can't help wondering WHY you bother to frequent these Forums.

 

[daisy1]

@Lickthelid

Hello Lickthelid and welcome to the Forum Here is the Basic Information we give to new members and I hope this will be helpful to you. Ask as many questions as you need to and someone will help.


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 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.
  

 

[Resurgam]

A low carb diet will - with any luck - push your metabolism back into balance, so that you see more normal responses to eating some carbs - but really, eating a delicious range of low carb foods, salads and veges rather than pasta and other starchy foods, and overly sweetened 'treats' means feeling more energetic and vibrant far into what used to be thought of as old age.

 

[Lickthelid]

@daisy1 thanks for the useful information. I started the day feeling a bit glum and demotivated about it all. But since joining this forum today and seeing some posts and getting some replies, I feel so positive and ready move forward.

 

[Lickthelid]

@Bluetit1802 am I right in thinking that type 2 don’t get testing strips on prescription?

While pregnant I was given a testing kit and got lancets and strips on prescription. But that brand of kit is too expensive to continue. So that’s for the links, I’m going to buy a kit with less expensive testing strips.

 

[Mike d]

You are of course entitled to your opinion, and to express it here. But I can't help wondering WHY you bother to frequent these Forums.

Perhaps because he's a doctor and can throw something into the mix? Just a wild guess