Advice please

Status
Not open for further replies.
T

tren2k

New Member
Relationship to Diabetes
At risk of diabetes
Hi all,

I was recently told i was prediabetic (45 mmol on a HBA1C). My doctors arent great and havent offered any support other than sending me a text message with a link to a leaflet on prediabetes, funnily enough this was received before they even called me to tell me the reading but hey ho.

Anyways this was a good few months back and i've made a lot of changes on my own and managed to shed a stone and a half as far, I bought a finger prick testing kit at the start and i was always in the prediabetic range when i tested, when testing now my fasting reads are always in the normal range. As i've read up and learned more about readings, i've checked my post prandial a lot more on different foods to see how they trigger me. On occasion i've recorded levels as high as 11.4 mmol 2 hours after a meal, i guess im just trying to understand this as there is nothing to suggest this is normal for a prediabetic with this being in the diabetic range, 30 minutes or so after this im down to around 9 and another 30 minutes below 6. I'm just wondering what this means really, is it normal for a post prandial read to spike this high with certain meals for a prediabetic and then return to a normal fasting range?

Any help appreciated.

Thank you.
 
Well a certain post meal increase is seen by most people with or without diabetes. But if this happens regularly it's more likely to be telling you that however many grams of carb were in what you just ate - your body can no longer cope with well - hence reduce the amount of whatever on your plate - or cut whatever causes it, out of your diet on a regular basis.
 
Hi and welcome.... and many congratulations on your positive attitude towards your diagnosis and that amazing weight loss.

All carbohydrates are broken down into glucose by the digestive system and absorbed into the blood stream. As diabetics we are unable to produce enough insulin to manage that glucose and remove it as efficiently from the blood stream as a non diabetic person, so our levels spike higher and remain high for longer.
I am guessing that your premeal reading was below 7 since you say that they are mostly in range, so this post meal reading of 11.4 2 hours after the meal means that that meal raised your levels by about 4.4mmols or more which suggests that your body struggled to cope with the carbs in that meal. Can you remember what the meal was? Keeping a food diary along with your pre and post meal readings will help you to identify which particular carbs cause you more problems than others and it can be quite individual. ie some people find a slice of sour dough or seeded bread OK but potatoes are like rocket fuel whilst others need to steer clear of bread but can get away with a few new potatoes. Same with pasta and rice and don't get started on porridge, which is supposed to be slow release but sends some of us into orbit within half an hour
of it going in our mouth.... I am talking from personal experience here despite the NHS recommending it for diabetics.
The fact of the matter is that we all have a very individual mixture of gut bacteria (biome) and metabolism and as a result we will break down some carbs quicker and easier than others and eating wholemeal or brown versions doesn't always make a difference to that, so testing our individual reaction to meals helps us to figure out which foods are our nemesis and not worth the aggravation.... at least not on a regular basis and which we can get away with and in what portion size.

The general advice is that if it raises your levels by more than 3mmols at the 2 hour point then your body was struggling to cope with the glucose released by the carbs in that meal and you need to look at reducing or substituting with a lower carb alternative next time you have that meal. Gradually you build up a repertoire of meals and portion sizes which you know will not cause your BG to spike too high. For instance, a member here makes corned beef hash with butternut squash instead of potato because it is lower carb.... and actually tastier too....Mashed cauliflower also works well to replace porato mash especially if you add some cream cheese or grated cheese. Ideal as a low carb topping for cottage/shepherd's pie.

Hopefully that makes sense, but if not, do ask me to explain better.... or someone else will.
 
Stone & half is some achievement, if you have more to lose then this could help reverse your prediabetes

Reason why say this is wife was in same position 5 tears ago, told she was prediabetic but had fair bit of weight to lose, she went on to lose 5 stone in total & all bloods since have been normal. Although she didn't follow Newcastle Diet I did tell how about study & how losing visceral fat from around organs can put diabetes into remission.
 
You seem to be on the right track but make good use of your monitor to minimise the number of times you are eating a meal that pushed your level to above 8mmol/l after 2 hours which is what people with Type 2 would be aiming at to maintain normal blood glucose level.
 
Thank you all so much for the responses, it's very much appreciated, I'm finding that bread seems to be the worst thing for me which is something i've ate in most meals all my life thinking it wasn't really unhealthy in comparison to fried food etc. I regularly had 4 pieces of white toast on its own for my breakfast throughout my life. Aside of bread all meals were full of carbs, I've noticed potatoes don't effect me anywhere near as much as bead and also that consuming something with protein (eggs for example) with the same amount of bread doesn't push the reading so high (tried as i read protein slows the carb release). A sunday dinner for example with mashed and roast potatoes put me up to 5.8 but 4 pieces of best of both toast with flora butter on their own sent me to 9.5.

The meal in question was half of a Chicken Chow Mein from a Chinese Takeaway and half a portion of chips from there.

I guess the main thing i don't really understand is what it is that means pre diabetes has become diabetes, When i say my levels are now usually normal aside of post prandial, they tend to be around 4.9 when fasting and 5.2 pre meals, is it right that one meal could make it jump as high as 11.4 when the readings are usually in the 4.9-5.2 range? I've also noticed on occasion when i've consumed a meal which has raised my level significantly, after around 2.5-3 hours i suddenly crash, to the point of needing to lie down at times, I've measured my blood sugar at this point before and it had dropped as low as 3.9 on one occasion.

I'm struggling to make heads or tails of it essentially, i see some people who are type 2 diabetic controlled who are within pre diabetic ranges on readings, I'd already made lifestyle changes a few months before the HBA1C test, I'm just wondering if its at all possible that I've already hit diabetic levels before that and its potentially not diagnosed because of the test not being carried out until after some lifestyle changes were made.

I hope this makes sense, i'm finding it all very confusing, thank you all for your help and kind feedback. I'm trying lol 🙂
 
The combination of foods you are saying make up your meals, chow mein which has noodles, high carb plus chips high carb would be enough to increase blood glucose to the level you post.
The reason for a sudden crash in level after eating a high carb meal is because your pancreas over produces insulin to bring your level down quickly so you are getting low blood glucose symptoms.
Because the HbA1C is an average over the previous three months, the dietary changes you made would likely have meant that it was looking more positive at that time than it would have been three months before had you had the test then.
Identifying what food cause the high level will enable you to cut them out or reduce the portion to what your body can tolerate so 1 slice bread, no chips if you have noodles.
Don't forget that this has to become a new normal way of eating and that is how people manage to reduce blood glucose from a diabetic level to normal by maintaining a dietary regime that their body can cope with. Otherwise it can be a slippery slope to returning to the diabetic zone.
This link may help you understand what is happening and give you some ideas for suitable meals.
lowcarbfreshwell.co.uk

Freshwell Low Carb Project - Home

lowcarbfreshwell.co.uk lowcarbfreshwell.co.uk
 
Hi. What you have found is that the demarcation between 'diabetes' and 'pre-diabetes' is fairly arbitrary and the 48mmol borderline could have been placed at another number. Don't worry too much about the label but do take note of the HBa1C level and also the BS readings after meals. Both are useful in guiding you on where you are on the diabetes scale and as you have found, reducing the carbs can help a lot. Yes, there are many people who have pre-diabetes or diabetes and have no idea as they have not tested and don't have obvious symptoms. The 11.4 mmol level 2 hours after a meal does imply your body is struggling a bit but to be honest I'm on insulin, low-carbing and do my best but often have BS into the teens; not ideal but your 11.4 could be worse. Well done with the weight loss and hopefully with the lower carbs you will be fine.
 
Just to clarify, the individual readings don't in themselves make you diabetic pre-diabetic or even non-diabetic. They give you an idea oif how you are doing and how you respond to food but getting in range readings don't mean that you are non-diabetic at those times and diabetic at others. BG levels naturally fluctuate throughout the day and night even for non-diabetic people. It is the slowness and inefficiency with which the body rebalances those readings which indicates diabetes. So in your case the body was too slow to produce insulin to balance the glucose from the carb heavy meal (noodles and chips) so your BG levels spikes and then your body responded too much and a bit too late and then your levels came crashing back down by the sound of it. If your pancreas had responded more promptly with insulin as your levels were rising, it would have prevented your BG going so high and then you would not have had the sharp fall in BG afterwards. The problem with this is twofold. It makes you feel rubbish when levels are dropping rapidly and it makes you want to eat more carbs to push your BG back up again which can trigger more peaks and troughs. We call it the BG rollercoaster. Eating less carbs and more protein, fibre (veggies) and some natural fats instead of all those carbs.... and I appreciate that you say it was just a half portion of chowmein, but still together with chips that is quite a lot of carbs. I tend to get a portion of chines stir fired veg when my partner wants Chinese takeaway. I then have a very small amount of his main dish, usually chicken or pork with ginger and spring onion and the whole portion of stir fried veg and 2 rounded dessert spoons of rice to soak up some of the juice/gravy.
 
Really appreciate the feedback guys, thank you so much, i think i was focusing on the prediabetic diagnosis on the basis of it being reversible at that stage, that was the biggest motivator for me so seeing levels that high concerned me that i may actually be diabetic and just didnt test until changes were made. I guess there is no way to know for sure if thats the case so I'll just keep my focus on cutting out anything that triggers massive spikes whilst continuing with the weight loss.

Thank you all, reading through all of your replies really helped clear a few things up in my head.
 
Type 2 diabetes can be reversible in the early stages as well, so in some ways it doesn't really matter if your HbA1c would have been 48 or 49 if done 3 months earlier. If you can follow a lower carbohydrate way of eating, and lose the weight that you want to lose, and that gets your blood sugars under control enough to reduce insulin resistance, then you can hopefully get your HbA1c back under pre- diabetic level and keep it there.

And if you have an emotional or food wobble and you want someone to talk to, someone is always here and ready to be supportive. (Well except 1-4am, some nights it goes quiet here then 😉 )
 
Status
Not open for further replies.
Back
Top