Pre Diabetes or not?

[Emjam56]

I had some routine bloods done for tiredness and what I thought was linked to my heavy periods

I had the results back via text first saying low folate levels and to take folic acid, then for strained kidneys so to drink more and retest in a week and then a text telling me I was prediabetic.

I was shocked as they said my levels were at 42. I am 53kg, a teacher and live healthily. We don’t drink alcohol ever, I only drink water, no caffeine and we cook our meals from scratch.

I contacted the doctor to find out more and was clearly very distressed. She said I needed to retest from my kidneys but I wasn’t aware that she also asked them to retest the HBa1c levels. They’ve now come back in normal range. Just a week later at 39.

I’m now so confused and have had no details from the original doctor. I spoke to a doctor this evening who said they can happen and doesn’t mean I am not prediabetic. And said that it doesn’t just measure it’s the average but measures blood spikes. I’m confused as to what it actually shows.

 

[Lucyr]

I was shocked as they said my levels were at 42. I am 53kg, a teacher and live healthily. We don’t drink alcohol ever, I only drink water, no caffeine and we cook our meals from scratch.

Blood tests aren’t 100% accurate every time, they’re testing a small sample of blood and there’s always room for variation in the results. Your results of 42 and 39 mean you’re close to developing prediabetes and don’t currently have diabetes.

Diabetes isn’t caused by alcohol or caffeine, or prevented by cooking from scratch, so perhaps some reading around the diabetes uk site to inform about it will help you to reduce your risk away from the prediabetes range?

 

[Leadinglights]

As things stand your HbA1C indicates you are in normal range of below 42mmol/mol, however there is nothing stoppig you from reviewing your diet and being mindful about the carbohydrates you have.
Did they find whether you are anaemic as that ca result from heavy periods and if that is the case the the HbA1C test is based on the attachment of glucose to your red blood cells which my be reduced in number if anaemic.
So if that is the case the once your anaemia is sorted out then another HbA1Cin say 6 moths would be a good plan.
Meanwhile make sure you have plenty protein and healthy fats and maybe take some folic acid as suggested and some multi vitamin pills.

 

[PerSpinasAdAstra]

Diabetes isn’t caused by alcohol.

Excessive alcohol intake might contribute to developing Type 2. The majority of alcohol ingested is converted to fat in the liver, and a fatty liver appears to be the root cause of most if not all cases of Type 2. Alcoholic fatty liver disease might possibly trigger Type 2 in a person who is genetically susceptible.

@Emjam56 - the lab testing machines that test HbA1c aren't perfect and can produce slightly varying results. It's worth nothing though that 39 mmol/mol is the threshold for prediabetes in the United States. It's a very slightly abnormally high level but is not known to be associated with health issues other than risk of progressing toward diabetes. The HbA1c test does basically measure average levels over a period of months, but big regular blood glucose 'spikes' after eating (known as impaired glucose tolerance) will effectively raise your average levels. A couple of hours at high levels raises your average for the day, if that makes sense.

If I may ask - is your life stressful at present or do you experience anxiety or anything along these lines? Do you sleep well at night? The 'stress hormone' cortisol can raise blood glucose levels and sleep deprivation can raise cortisol levels. What are your exercise patterns like? How much muscle mass do you have relative to other people - i.e. do you have a very slim build? Lack of exercise a low skeletal muscle mass are associated with Non Alcoholic Fatty Liver Disease (NAFLD) and so may also be risk factors for Type 2. Are there any cases of diabetes in your family tree?

 

[Emjam56]

Excessive alcohol intake might contribute to developing Type 2. The majority of alcohol ingested is converted to fat in the liver, and a fatty liver appears to be the root cause of most if not all cases of Type 2. Alcoholic fatty liver disease might possibly trigger Type 2 in a person who is genetically susceptible.

@Emjam56 - the lab testing machines that test HbA1c aren't perfect and can produce slightly varying results. It's worth nothing though that 39 mmol/mol is the threshold for prediabetes in the United States. It's a very slightly abnormally high level but is not known to be associated with health issues other than risk of progressing toward diabetes. The HbA1c test does basically measure average levels over a period of months, but big regular blood glucose 'spikes' after eating (known as impaired glucose tolerance) will effectively raise your average levels. A couple of hours at high levels raises your average for the day, if that makes sense.

If I may ask - is your life stressful at present or do you experience anxiety or anything along these lines? Do you sleep well at night? The 'stress hormone' cortisol can raise blood glucose levels and sleep deprivation can raise cortisol levels. What are your exercise patterns like? How much muscle mass do you have relative to other people - i.e. do you have a very slim build? Lack of exercise a low skeletal muscle mass are associated with Non Alcoholic Fatty Liver Disease (NAFLD) and so may also be risk factors for Type 2. Are there any cases of diabetes in your family tree?

Definitely high stress levels and lack of sleep. I have a 2 year old who is a terrible sleeper. Waking regularly and I also have a stressful job so wondered if this could be a factor in it.
I go to an exercise class twice weekly for an hour and we are active in terms of during the work day up and around the classroom and I walk on the weekends. I have a 6 year old too so I’m never really sat down! I have always had a slim build my whole life.

 

[Emjam56]

As things stand your HbA1C indicates you are in normal range of below 42mmol/mol, however there is nothing stoppig you from reviewing your diet and being mindful about the carbohydrates you have.
Did they find whether you are anaemic as that ca result from heavy periods and if that is the case the the HbA1C test is based on the attachment of glucose to your red blood cells which my be reduced in number if anaemic.
So if that is the case the once your anaemia is sorted out then another HbA1Cin say 6 moths would be a good plan.
Meanwhile make sure you have plenty protein and healthy fats and maybe take some folic acid as suggested and some multi vitamin pills.

They said my iron was borderline and so they recommended increasing the healthy fats and taking a supplement which I know I do need to do. My daughter is dairy free so I’d adopted a similar diet to her but have reintroduced the good stuff into my diet a bit more and I know that is something I could do more.

 

[PerSpinasAdAstra]

Definitely high stress levels and lack of sleep. I have a 2 year old who is a terrible sleeper. Waking regularly and I also have a stressful job so wondered if this could be a factor in it.
I go to an exercise class twice weekly for an hour and we are active in terms of during the work day up and around the classroom and I walk on the weekends. I have a 6 year old too so I’m never really sat down! I have always had a slim build my whole life.

You might have your answer there. You seem to be doing everything right. At 39 mmol/L you're only very slightly high - perhaps stress and chronic lack of sleep combined might well do that. If you want to be extra-cautious you could perhaps do some resistance training. You don't need to build giant muscles or even go to a gym, but building a little muscle mass can't hurt. Lifting little weights at home or even doing things like squats and push-ups might help. If nothing else it may help to keep you mobile for longer when you reach old age. Hopefully once you can get back to getting a good night's sleep things will settle down. Best of luck!

 

[SilverShaded]

I had some routine bloods done for tiredness and what I thought was linked to my heavy periods

I had the results back via text first saying low folate levels and to take folic acid, then for strained kidneys so to drink more and retest in a week and then a text telling me I was prediabetic.

I was shocked as they said my levels were at 42. I am 53kg, a teacher and live healthily. We don’t drink alcohol ever, I only drink water, no caffeine and we cook our meals from scratch.

I contacted the doctor to find out more and was clearly very distressed. She said I needed to retest from my kidneys but I wasn’t aware that she also asked them to retest the HBa1c levels. They’ve now come back in normal range. Just a week later at 39.

I’m now so confused and have had no details from the original doctor. I spoke to a doctor this evening who said they can happen and doesn’t mean I am not prediabetic. And said that it doesn’t just measure it’s the average but measures blood spikes. I’m confused as to what it actually shows.

A1C is not a very accurate test. The same blood sample could give both or either of those numbers.

They are however a little high and it would not do any harm to reduce it.

 

[Docb]

Hi @Emjam56. You say you were shocked to see an HbA1c of 42 and were distressed when you went to your GP. Despite what you might read in the popular press or see on click chasing social media posts, there was no need to be. HbAc's of 42 are perfectly normal and if you are not overweight, active (never come across a teacher who isn't) and have a reasonably balanced diet, then like as not, your natural HbA1c will be around 40. Might vary by a unit or two - all measurements have an error on them.

The "at risk of diabetes" label, that is having an HbA1c between 42 and 47, was designed to attract the attention of people who could well finish up with formal diabetes diagnosis if they did not take avoiding action. That's the upside. The downside is that it captures those people for whom their HbA1c is around 40 naturally and do not have to do anything other than get on with their life as they have been living it.

OK, there is a tiny risk that somebody has some version of diabetes where they have blood glucose control problems despite being a healthy weight, active and have a balanced diet, but they are not common and in my, non-medical, opinion not worth trying to guard against.

My thought for you is that you don't panic, don't rush off trying to deal with a problem that might not exist and see what your HbA1c is next time you have some routine blood tests. Chances are that it will be around 40 but if it isn't and is over 48, that will be the time to start thinking about some action.

 

[Leadinglights]

With the level you are the I should not worry and perhaps devote some of your energy to establishing a better sleeping pattern for your 2 year old, making sure she has a good bedtime routine and being active during the day. They do go through a phase at that age of really needing a day time nap as they become grumpy at tea time but you know if they do they will not sleep at night. Getting through that is tricky but pays off in the long run. If they are at nursery you may have to tell them not to let them have a nap.