A low risk they said…

[Skinnygirl]

Hello, I’m new to the forum my hba1c is creeping up (currently 45, was 43 6 months ago) I exercise and eat well, have a low but ‘healthy’ BMI, what can I do to dodge T2D???

 

[Martin.A]

Hello, I’m new to the forum my hba1c is creeping up (currently 45, was 43 6 months ago) I exercise and eat well, have a low but ‘healthy’ BMI, what can I do to dodge T2D???

Hi, and welcome. There's no simple answer to your question but if you're physically active and not overweight then maybe take a look your diet. Is it carb-heavy? Eating well doesn't necessarily translate into eating healthily (in T2 terms).

 

[JITR]

Hello, I’m new to the forum my hba1c is creeping up (currently 45, was 43 6 months ago) I exercise and eat well, have a low but ‘healthy’ BMI, what can I do to dodge T2D???

Martin is right, diet.

Dr David Unwin's Norwood Surgery have had great success with pre-diabetics and T2Ds. Here he is presenting how they do it to fellow GPs. I'd say it's worth an hour of your time:
The nuts & bolts of drug free T2 diabetes remission.

This is the Norwood diet sheet.

Whether you are at 45 or 48 the prescription is the same. Lose weight to get yourself back to normal, say under 40, even if your BMI is normal. The acid test is whether you can still wear the clothes you used to wear, especially round your waist.

 

[Leadinglights]

Martin is right, diet.

Dr David Unwin's Norwood Surgery have had great success with pre-diabetics and T2Ds. Here he is presenting how they do it to fellow GPs. I'd say it's worth an hour of your time:
The nuts & bolts of drug free T2 diabetes remission.

This is the Norwood diet sheet.

Whether you are at 45 or 48 the prescription is the same. Lose weight to get yourself back to normal, say under 40, even if your BMI is normal. The acid test is whether you can still wear the clothes you used to wear, especially round your waist.

That is a good summary, I have seen it used by quite a few health authorities and is concise and easy to follow.

 

[Martin.A]

The acid test is whether you can still wear the clothes you used to wear, especially round your waist.

Reminds me of one of the best pieces of advice I ever read - "Listen To Your Belt".

 

[Skinnygirl]

Thank you everyone, lots of advice! I will go into the ‘underweight’ category if I lose any weight, but I will endeavour to nit pick on the carb front: cut out my one and only alcoholic drink at the end of the week (the weekend is cancelled!) and knock my daily square of (70%) chocolate and the banana on the head!

 

[Aitchelle]

Thank you everyone, lots of advice! I will go into the ‘underweight’ category if I lose any weight, but I will endeavour to nit pick on the carb front: cut out my one and only alcoholic drink at the end of the week (the weekend is cancelled!) and knock my daily square of (70%) chocolate and the banana on the head!

I am in a similar situation, mid range BMI to start with but now close to being underweight. I am keeping the carbs low but increasing the calories by adding low carb / high cal food to my diet. It seems to be working, the weight has stabilised and is showing a slight increase this week. I have found the Carbs and Cal book very useful.

 

[rebrascora]

Thank you everyone, lots of advice! I will go into the ‘underweight’ category if I lose any weight, but I will endeavour to nit pick on the carb front: cut out my one and only alcoholic drink at the end of the week (the weekend is cancelled!) and knock my daily square of (70%) chocolate and the banana on the head!

Hi and welcome from me too.

I don't think the alcoholic drink needs to go unless it is high carb, a glass of wine or a spirit with diet mixer should not be a problem. The only reason to cut them out would be if you need to lose weight which you clearly don't. There are very minimal carbs in a square of 70% chocolate so I wouldn't lose that either, but I would give the banana the "Heave Ho"

Would you like to give us an idea of what you typically have for breakfast lunch and evening meal. I am wondering if there are some starchy carbs which are contributing to the problem...... or perhaps you have a blood disorder like anaemia which is skewing your HbA1c results and making you appear to be at risk when you are not.

 

[Leadinglights]

Thank you everyone, lots of advice! I will go into the ‘underweight’ category if I lose any weight, but I will endeavour to nit pick on the carb front: cut out my one and only alcoholic drink at the end of the week (the weekend is cancelled!) and knock my daily square of (70%) chocolate and the banana on the head!

If you enjoy your drink then a once a week will do no harm, dry wines, spirits with diet mixers are low carb, the odd dark choc will again do no harm but the banana might.
What you do has to be enjoyable and sustainable. Keeping carbs low and making sure you have enough protein and healthy fats should help keep your weight stable, cheese, eggs, avocado, nuts, full fat dairy.

 

[everydayupsanddowns]

Welcome to the forum @Skinnygirl

I suspect you aren’t old enough to be experiencing the ‘HbA1c generally increases with older age’ quite yet. And your low weight does seem to out your diabetes in the ‘atypical’ category, especially since you already seem to be following a low carbohydrate menu.

Do you have anyone with T2D in your close family? Do you have any experience of autoimmune conditions, either yourself or a close relative?

While there are people who develop T2 at lower weight, there is always the possibility that it may be a different form of diabetes such as MODY or LADA that may be emerging?

It might be worth having a chat with your GP to discuss your creeping HbA1c despite a low carb menu and low weight?

 

[Skinnygirl]

Thank you all for your advice and support. I’ve watched the you tube video and ordered the book! I have an apt with GP about this next week so we’ll see if there’s something else at play. Ps only had half a banana in my porridge this morning and it tasted sweet enough so there’s an improvement!

 

[rebrascora]

So..... breakfast is porridge, which is high carb and banana which is high carb. I know porridge is touted as being healthy and slow release but it is like rocket fuel for some of us and sends our BG into orbit. Not saying it is doing that to you, but if you are genuinely at risk of diabetes, then it could be and I wonder what other carbs you are eating which might be healthy for a none diabetic person but less so for those of us whose insulin response is failing. Things like bread, pasta, potatoes, rice, be they wholemeal/brown versions or white. Not saying you need to give up any of these foods but if you genuinely are developing diabetes then these are the food items that many of us have cut down on or avoid altogether and replace with an alternative. So mashed cauliflower instead of mashed potato, or grated cauli instead of rice, or celeriac chips instead of potato. Porridge was the last carb rich food to go from my diet but testing showed it didn't live up to it's slow release reputation.

 

[trophywench]

I haven't eaten a banana since sometime last century, 1980s I think - gave em up once I knew what they did to my blood glucose.

 

[Steve J]

My situation is similar, at least in some respects. My HbA1c was 42 last September and 45 in January (despite my having cut out cakes, biscuits, etc and having a frugal Christmas). I am an active, skinny old bloke who had always considered himself to have a reasonably healthy diet. But it wasn’t until I came across this forum last month that I realised just how carb-heavy my diet was (especially breakfast: orange, porridge, banana, toast). I have now reduced my carb intake to about 130 g / day - it took some effort initially: weighing and looking up every ingredient; but this website is a gold mine of information and support. I have lost a few pounds, but can’t afford to lose much more before I drop out of the normal BMI range. I am eating increasing amounts of protein and (good) fats, and if that doesn’t stabilise my weight I will reintroduce more carbs. I am promised another test in April, so if my HbA1c has not responded after two months of this modified diet I will have to accept that there are more significant factors at play (age, genetic predisposition, other variants of diabetes, …) and will hopefully get to see a doctor and, in any event, start to monitor my blood glucose response to specific foods.

 

[Leadinglights]

My situation is similar, at least in some respects. My HbA1c was 42 last September and 45 in January (despite my having cut out cakes, biscuits, etc and having a frugal Christmas). I am an active, skinny old bloke who had always considered himself to have a reasonably healthy diet. But it wasn’t until I came across this forum last month that I realised just how carb-heavy my diet was (especially breakfast: orange, porridge, banana, toast). I have now reduced my carb intake to about 130 g / day - it took some effort initially: weighing and looking up every ingredient; but this website is a gold mine of information and support. I have lost a few pounds, but can’t afford to lose much more before I drop out of the normal BMI range. I am eating increasing amounts of protein and (good) fats, and if that doesn’t stabilise my weight I will reintroduce more carbs. I am promised another test in April, so if my HbA1c has not responded after two months of this modified diet I will have to accept that there are more significant factors at play (age, genetic predisposition, other variants of diabetes, …) and will hopefully get to see a doctor and, in any event, start to monitor my blood glucose response to specific foods.

The more recent guidelines are that for more 'mature' people the diagnostic thresholds should be more lenient and higher than for younger people if there are no other risk factors and people should have a more personalised targets.
Where you are at sounds to be fine and making sure you eat healthily to reduce any of those risk factors is all you can do.

 

[Drummer]

Thank you all for your advice and support. I’ve watched the you tube video and ordered the book! I have an apt with GP about this next week so we’ll see if there’s something else at play. Ps only had half a banana in my porridge this morning and it tasted sweet enough so there’s an improvement!

Ah - has no one pointed out that diabetes is a number of different problems to do with dealing with carbohydrates?
For the ordinary type 2, just stopping eating so many 'healthy' carbs does the trick, and I think for many people it takes the strain off so things improve.
I did not try to lower my weight, as I knew from long experience that it was impossible to do so under instruction from those who think they know how it should be done.
I reduced my blood glucose levels to normal and that sorted out the diabetes and my weight. I don't eat high carb foods, or low fat options and I don't count calories, but I eat everything else - not all at once though.....