Advice for a pre-diabetic - do I go back to GP if mmol is 12?

[fairfowle]

Hi everyone
I've been dizzy, lethargic, confused at random points in the day, so visited my GP.
Had a blood test, was told it was my blood sugar so was referred to the pre-diabetic app "Second Nature" 1 month ago.
However nothing has changed with the dizziness and fatigue, even though I have improved my diet. I took it upon myself to buy a test kit - the finger prick ones.
My levels are a minimum of 8mmol upon waking, 12mmol 2 hours after meals. It doesn't seem to matter what I eat, my "after meal" mmol is always 12 or higher. And it comes along with the dizziness and fatigue for hours afterwards.
Everything online tells me it's too high, but is it high enough to go back to the GP? Or do I need to give it a few more months?
thank you in advance xx

 

[Ieva DUK]

Hey there,
I’m really sorry you’re feeling like this - it sounds really frustrating, especially since you’ve already made positive changes to your diet and aren’t seeing the improvements you hoped for. Your symptoms, along with the readings you’re getting, do sound like something worth bringing back to your GP sooner rather than later. You shouldn’t have to wait months, especially when you’re experiencing dizziness, fatigue, and consistently high blood sugar levels.
Based on the levels you've mentioned, I think it’s definitely worth following up to make sure nothing is being missed. Your GP may want to do further tests, to get a clearer picture of what’s going on. Do you know what your HbA1c was?
It’s great that you took the initiative to check your own levels - this gives you useful information to take to your doctor. Hopefully, they can offer you more tailored support and help get to the bottom of why you’re still feeling this way.
As for the diet, do you mind me asking what kind of changes you've made so far?
I'm wishing you all the best and let us know how you get on!

 

[Leadinglights]

Hi everyone
I've been dizzy, lethargic, confused at random points in the day, so visited my GP.
Had a blood test, was told it was my blood sugar so was referred to the pre-diabetic app "Second Nature" 1 month ago.
However nothing has changed with the dizziness and fatigue, even though I have improved my diet. I took it upon myself to buy a test kit - the finger prick ones.
My levels are a minimum of 8mmol upon waking, 12mmol 2 hours after meals. It doesn't seem to matter what I eat, my "after meal" mmol is always 12 or higher. And it comes along with the dizziness and fatigue for hours afterwards.
Everything online tells me it's too high, but is it high enough to go back to the GP? Or do I need to give it a few more months?
thank you in advance xx

Welcome to the forum
The blood test your GP should have done would have been an HbA1C which is the one used for diagnosis and a result of 42-47mmol/mol would be prediabetes and anything over that diabetes. It gives an average of your blood glucose over the previous 3 months whereas the tests you do with your finger prick monitor are a moment in time and will go up and down during the day and night depending largely on what you eat. Your finger prick readings don't seem consistent with a pre diabetes diagnosis. Your symptoms are consistent with high blood glucose levels.
It depends on how you have changed your diet as if you have been reducing your carbohydrate intake that should be helping to bring down those 2 hour post meal readings, I suggest you also test just before you eat as paired readings will be much more informative as to whether your meal is still too carb heavy. You would be wanting no more than a 2-3mmol/l increase.
You are aiming at a fasting/morning reading and before meals of 4-7mmol/l and 2 hours post meal of no more than 8-8.5mmol/l
If you would like to give some examples of the sort of meals you have for breakfast, lunch and dinner then people may spot where you may be going wrong.
Also were you told your HbA1C result as that will guide you in how much you need to do.
In answer to your question should you go back to your doctor, yes as your symptoms may not be diabetes related, ear infection, vitamin deficiency or a number of other causes.

 

[SB2015]

Welcome to the forum @fairfowle . I am pleased that you have found us.

If you are happy to do so, if you give us more information about the changes that you have already made and typical meals you choose, it can help us in response to your questions that arise.

I look forward to hearing more.

 

[trophywench]

Definitely back to the GP - BUT!! you are (comparatively) young and I'm not particularly happy that someone your age is being told they're pre diabetic and automatically treated as if they're in danger of becoming a Type 2 diabetic.

Never having had Type 2 diabetes I have no personal experience of dizziness when my blood glucose is high after a meal or otherwise. Fatigued? - oh yes. But 'dizziness' - only when my BG is LOW. (or my blood pressure is too low)

 

[Thebearcametoo]

Please go back to your gp. It may be blood sugar or it may be a whole host of other things so they need to do some checks. I hope you find a solution.

 

[fairfowle]

Welcome to the forum @fairfowle . I am pleased that you have found us.

If you are happy to do so, if you give us more information about the changes that you have already made and typical meals you choose, it can help us in response to your questions that arise.

I look forward to hearing more.

Thank you (and everyone) for your offers of advice, really appreciate it.
My HbA1c number was 43 and the doctor said come back in 12 months. But having high blood sugar for 12 months cant be safe or good for the body....

I use MyFitnessPal app and it says all of the below, which is a pretty normal day of me, has a maximum of 50g total sugar. Under 1800 calories.
Also I should say, I'm Vegan, so most of my diet is fruit, veg, legumes, nuts/seeds etc

Breakfast:
Alpro yoghurt x 2 tbsp
Sugar free granola 1 x tbsp
Chia + flax seeds 1 x tsp each
1 x banana (sometimes Blueberries instead)
Coffee with oat milk (zero sugar)

Lunch:
3 x falafel (the deli-Aldi)
100g houmous
4 x multigrain crackers
1 x pot of fresh fruit

Dinner:
Roasted veg - sweet potato, courgette, chickpeas, peppers, onions, aubergine
1 x Greek Flatbread
(Sometimes I add quorn or tofu to this if I need more protein)

Im scared to eat anymore than the above as even if I just eat the vegetables with no meat substitute, or no Flatbread, my sugar still spikes from 8mmol - 12mmol within the 2 hours.
Thanks again everyone x

 

[gail2]

please go back to GP it could be diabetes-related or it may be something else. Keep us posted
good luck
gail

 

[rebrascora]

Hi. You need to look at all carbs not just sugars.
Oat milk is the highest carb of all the plant milks so swapping to almond/soya or coconut might be a good move. Bananas are one of the highest carb fruits. Many of us just have berries like rasps, blackberries, a few blueberries, strawberries, blackcurrants etc.
Your lunch is pretty well all carbs... Pulses cause some people more problems than others. I find the likes of falafel and hummus really spike my levels. Then you have crackers which are mostly carbs and fruit which obviously contains sugars.
Sweet potatoes are pretty well the same carbs as normal potatoes and obviously flat bread is carbs plus the chickpeas (as with hummus and falafels) depends how you respond to them as an individual. Clearly you are limited in your protein sources being vegan so these pulses can be an essential source of protein.

Last night I had reasonably vegetarian food with a spinach bhaji for starter and then ratatouille for main. Admittedly my ratatouille had halloumi on top, but you could perhaps use tofu instead. The tomatoes and onions still provide some carbs but less compared to sweet potatoes and flatbread.

It does take time to figure out how to eat low carb and some home testing before and 2 hours after meals should tell you which foods your body is reacting to more than others and thereby adjust your diet/menu to your individual body's responses.

 

[fairfowle]

Hi. You need to look at all carbs not just sugars.
Oat milk is the highest carb of all the plant milks so swapping to almond/soya or coconut might be a good move. Bananas are one of the highest carb fruits. Many of us just have berries like rasps, blackberries, a few blueberries, strawberries, blackcurrants etc.
Your lunch is pretty well all carbs... Pulses cause some people more problems than others. I find the likes of falafel and hummus really spike my levels. Then you have crackers which are mostly carbs and fruit which obviously contains sugars.
Sweet potatoes are pretty well the same carbs as normal potatoes and obviously flat bread is carbs plus the chickpeas (as with hummus and falafels) depends how you respond to them as an individual. Clearly you are limited in your protein sources being vegan so these pulses can be an essential source of protein.

Last night I had reasonably vegetarian food with a spinach bhaji for starter and then ratatouille for main. Admittedly my ratatouille had halloumi on top, but you could perhaps use tofu instead. The tomatoes and onions still provide some carbs but less compared to sweet potatoes and flatbread.

It does take time to figure out how to eat low carb and some home testing before and 2 hours after meals should tell you which foods your body is reacting to more than others and thereby adjust your diet/menu to your individual body's responses.

Thank you for taking the time to read my meal plan. And that just shows how confused I am about carbs.
There are complex carbs, and normal carbs. But not sure which is better. They say to make complex carbs 1/3 of your meal - which is what i thought i was doing. Maybe not the lunch meal to be honest. But I thought breakfast and dinner was hitting the right spot.

I will focus on carbs (as well as everything else us Vegans focus on). Thanks again and always open to any suggestions ☺️

 

[SB2015]

Thank you for taking the time to read my meal plan. And that just shows how confused I am about carbs.
There are complex carbs, and normal carbs. But not sure which is better. They say to make complex carbs 1/3 of your meal - which is what i thought i was doing. Maybe not the lunch meal to be honest. But I thought breakfast and dinner was hitting the right spot.

I will focus on carbs (as well as everything else us Vegans focus on). Thanks again and always open to any suggestions ☺️

I knew absolutely nothing about carbs when I was diagnosed and I was surprised when I started to look at the carbs in apparently ‘healthy’ foods. For me bananas and grapes are an absolute no no, but I do find berries are a good replacement. It takes a bit to get your head round it all. Whether they are complex carbs or not they will become glucose once inside us. Complex carbs sometimes take a bit longer to convert to glucose. Where they want complex carbs as 1/3, the rest needs to not be carbs, ut we each need to find what works for us.

Are you using a sensor such as a Libre. These can be great to work out what foods work for you, alongside some BG testing. I was amazed at how my body reacted to anything that contains oats. Porridge is off the list for me now and some very scrum y looking flapjacks (except when temptation over rides everything)

 

[everydayupsanddowns]

Thank you for taking the time to read my meal plan. And that just shows how confused I am about carbs.
There are complex carbs, and normal carbs. But not sure which is better. They say to make complex carbs 1/3 of your meal - which is what i thought i was doing. Maybe not the lunch meal to be honest. But I thought breakfast and dinner was hitting the right spot.

I will focus on carbs (as well as everything else us Vegans focus on). Thanks again and always open to any suggestions ☺️

That may be absolutely fine @fairfowle

Unfortunately the tricky thing about diabetes and metabolisms, is that some of them stubbornly refuse to read the text books about what they are supposed to do with various food and glucose levels. So you might find that your body reacts slowly and gently to complex carbs, and slows down digestion in the presence of high fibre.

But

Your diabetes may have other ideas. And may gleefully break down those same ‘slow release’ foods with complete abandon, and at breakneck speed

Your Diabetes May Vary, as the forum saying goes.

If you would like to know for sure you could consider purchasing an affordable BG meter (it’s the cost of the strips you need to watch, the Spirit Tee2 or Contour Blue are often recommended). Then you can check immediately before eating and again 2 hrs after the first bite, to see what the differences are.

If that seems too much of a faff, you may want to just generally aim to reduce carbohydrate intake to 130g a day or less, and see what your next HbA1c comes in at?

 

[fairfowle]

That may be absolutely fine @fairfowle

Unfortunately the tricky thing about diabetes and metabolisms, is that some of them stubbornly refuse to read the text books about what they are supposed to do with various food and glucose levels. So you might find that your body reacts slowly and gently to complex carbs, and slows down digestion in the presence of high fibre.

But

Your diabetes may have other ideas. And may gleefully break down those same ‘slow release’ foods with complete abandon, and at breakneck speed

Your Diabetes May Vary, as the forum saying goes.

If you would like to know for sure you could consider purchasing an affordable BG meter (it’s the cost of the strips you need to watch, the Spirit Tee2 or Contour Blue are often recommended). Then you can check immediately before eating and again 2 hrs after the first bite, to see what the differences are.

If that seems too much of a faff, you may want to just generally aim to reduce carbohydrate intake to 130g a day or less, and see what your next HbA1c comes in at?

Thank you for replying, appreciate your advice.
I have a BG Meter, and the mmol readings are what's making me think I may already have diabetes, not just "pre-diabetes".
Here's a little diary I've been keeping:

Fri 28th (first started testing)
10pm : 12mmol (Dinner at 7pm)

Sat 29th
6.16am (b4 breakfast) : 11.4mmol
11.40am (fasting) : 8.4mmol
Ginger shot at 12pm but no food
4.30pm : 6.4mmol
Meal at 7.15pp
9.30pm : 9.9mmol

Sunday 30th
9.30am (b4 breakfast) : 10.7mmol
1pm (still fasting) : 8.7mmol
Roast dinner at 2pm
4.30pm : 6mmol
9.30pm bedtime : 10.9mmol

I'm going to continue to monitor over the next week, but it seems my levels don't drop overnight. No food/drink for 12+ hours I would expect to have a much lower level.
What are your thoughts on these readings?

Thanks again!

 

[Leadinglights]

Thank you for replying, appreciate your advice.
I have a BG Meter, and the mmol readings are what's making me think I may already have diabetes, not just "pre-diabetes".
Here's a little diary I've been keeping:

Fri 28th (first started testing)
10pm : 12mmol (Dinner at 7pm)

Sat 29th
6.16am (b4 breakfast) : 11.4mmol
11.40am (fasting) : 8.4mmol
Ginger shot at 12pm but no food
4.30pm : 6.4mmol
Meal at 7.15pp
9.30pm : 9.9mmol

Sunday 30th
9.30am (b4 breakfast) : 10.7mmol
1pm (still fasting) : 8.7mmol
Roast dinner at 2pm
4.30pm : 6mmol
9.30pm bedtime : 10.9mmol

I'm going to continue to monitor over the next week, but it seems my levels don't drop overnight. No food/drink for 12+ hours I would expect to have a much lower level.
What are your thoughts on these readings?

Thanks again!

They don't seem consistent with pre diabetes but it really does depend on what you have eaten i.e. how much carbohydrate you have had.
A more structured testing regime would help make sense of it. So on waking which is a fasting /morning reading, before breakfast then 2 hours after breakfast, the same for lunch and dinner.
Keeping a record of those together with a food diary of everything you eat and drink with an estimate of the carbohydrates.

 

[everydayupsanddowns]

I'm going to continue to monitor over the next week, but it seems my levels don't drop overnight. No food/drink for 12+ hours I would expect to have a much lower level.
What are your thoughts on these readings?

High levels in the mornings can be related to Dawn Phenomenon / Foot on the Floor. Part of the Circadian Rhythm, where the liver helpfully releases glucose either in the hours before dawn or immendiately on a person rising to ‘fire up the burners’ for the day.

To my completely un-medically-qualified eye, those levels seem slightly mixed. Some higher than ideal levels particularly in the morning, but some in-range readings too, including after meals.

One of the benefits of using pairs of checks immediately before and 2hrs after eating, is that you can observe the rise of the rise of each meal, almost separately to the actual numbers themselves (so a meal which gives say 10.2 before and 11.6 after is ‘good’ because it shows a small rise, even though ideally you’d prefer both numbers to be lower).

If you can tweak your meals to aim for a ‘meal rise’ of 2-3mmol/L or less from the ‘before reading’, and you can keep that vaguely consistent, hopefully you could see your overall levels gradually drift downwards, because the smaller meal rises will be putting less stress on your system?

 

[counsellorneil]

Nothing really to add to the suggestions about. As mentioned blood testing will be a great help. I recognise stabbing your fingers so often may not feel great. Another option is to get a free CGM sensor for a 15 day trial. That way you get an idea of what’s happening glucose wise through the day and night. https://www.freestyle.abbott/uk-en/getting-started/sampling.html - oh in case anyone wonders I have nothing to do with the company, apart from being a user of their CGM. Dexcom may also do a free trial. Also vegan .

 

[HayleyR]

Hi @fairfowle and welcome to the Forum 🙂 I would definitely recommend getting a free trial of Libre 2 from Abbott, I've been using it for some time now and it will be really useful to have data over a 2-week period before going back to the GP. It also saves you having to prick your fingers so many times 😉

 

[pjgtech]

Hi and welcome, lots of good advice already, so hope that helps.
I find the Carbs and Cals book really helpful, (written in conjunction with Diabetes UK) as it show actual photos pf portion sizes next to nutritional info, which really shows how much you should be eating, its so easy to overeat, even with the healthy stuff. As stated above you do seem to be eating a fair amount of carbs. But you've been advised of that now.
Also as above, if you do a finger prick test immediately before eating, then around two hours after the first bite (not two hours after ending the meal, as a meal can easily go on for some time). Then you will a good indication of how that particular meal and its ingredients have affected your BG levels. In a relatively quick time you can build up a good picture of what you can and can't eat.
Also remember everyones relationship with diabetes if different and the same with food, some diabetics can still eat bread, some can't, same with bananas, oats, wheat, etc, so you need to find what works for you.
Also remember that our BG levels naturally rise and fall throughout each day, they do not remain static, and many things can affect BG levels, eg: what we eat, time of day, the environment, if we are unwell, whether we are exercising or not, etc.
Hope you get a positive outcome and let us know how you get on.

 

[harbottle]

Thank you for replying, appreciate your advice.
I have a BG Meter, and the mmol readings are what's making me think I may already have diabetes, not just "pre-diabetes".
Here's a little diary I've been keeping:

Fri 28th (first started testing)
10pm : 12mmol (Dinner at 7pm)

Sat 29th
6.16am (b4 breakfast) : 11.4mmol
11.40am (fasting) : 8.4mmol
Ginger shot at 12pm but no food
4.30pm : 6.4mmol
Meal at 7.15pp
9.30pm : 9.9mmol

Sunday 30th
9.30am (b4 breakfast) : 10.7mmol
1pm (still fasting) : 8.7mmol
Roast dinner at 2pm
4.30pm : 6mmol
9.30pm bedtime : 10.9mmol

I'm going to continue to monitor over the next week, but it seems my levels don't drop overnight. No food/drink for 12+ hours I would expect to have a much lower level.
What are your thoughts on these readings?

Thanks again!

I'd get a CGM to get more of an idea, but if it's baselining around 8 I'd expect a higher hba1c than 43 - possibly in the high 40s or low 50s.

Do you go to the loo a lot at night? When levels get over 10, the body starts to eject glucose in urine and this can make you pee a lot (And get thirsty.)