'Hello!' from a confused pre-diabetic

[Milli_Co]

Hi everyone 😉

I'm new to the club and hoping to find some tips and guidance here. Some background info first...

A couple of days before I turned 40, I found out that I have borderline diabetes (nice timing!). HbA1C: 42 (increased from 36 last July). I have always been slightly underweight with BMI around 18, so losing weight is not a route to take. According to my GP, 'there is nothing you could do', and I will just have to wait for another year to check again. He also mentioned it could be adult onset type 1 (my dad was diagnosed of type 2 in his 40s when he was overweight).

Oh, I should also add that my amylase level was slightly over the normal range twice in the past 12 months (although recently dropped a little). I'm not sure if this has anything to do with my HbA1C increasing?

I don't drink, and I don't eat cakes/biscuits/sweets/snacks often. When I drink tea and coffee, I don't normally add sugar. I do like my toast/paste/noodles/white rice every day though (never massive portion), and the only exercise I do is yoga which I now know is not enough

Since finding out the news, I have started reducing my carb and eating more protein to hopefully maintain my weight. I've also started walking or jogging after every meal to increase insulin sensitivity (does this work?).

As a slim type pre-diabetic person, is there anything else that I should do/avoid? Is it necessary to buy a glucose monitor or am I over reacting? My doc told me not to read too much into my blood results, and 42 could just my 'normal', so I'm a bit confused.

Any advice is greatly appreciated. Thanks!

 

[Leadinglights]

Hi everyone 😉

I'm new to the club and hoping to find some tips and guidance here. Some background info first...

A couple of days before I turned 40, I found out that I have borderline diabetes (nice timing!). HbA1C: 42 (increased from 36 last July). I have always been slightly underweight with BMI around 18, so losing weight is not a route to take. According to my GP, 'there is nothing you could do', and I will just have to wait for another year to check again. He also mentioned it could be adult onset type 1 (my dad was diagnosed of type 2 in his 40s when he was overweight).

Oh, I should also add that my amylase level was slightly over the normal range twice in the past 12 months (although recently dropped a little). I'm not sure if this has anything to do with my HbA1C increasing?

I don't drink, and I don't eat cakes/biscuits/sweets/snacks often. When I drink tea and coffee, I don't normally add sugar. I do like my toast/paste/noodles/white rice every day though (never massive portion), and the only exercise I do is yoga which I now know is not enough

Since finding out the news, I have started reducing my carb and eating more protein to hopefully maintain my weight. I've also started walking or jogging after every meal to increase insulin sensitivity (does this work?).

As a slim type pre-diabetic person, is there anything else that I should do/avoid? Is it necessary to buy a glucose monitor or am I over reacting? My doc told me not to read too much into my blood results, and 42 could just my 'normal', so I'm a bit confused.

Any advice is greatly appreciated. Thanks!

Welcome to the forum
42 is just on the first point of the prediabetes zone and really is just a warning that over time if you allow some poor dietary choices then that level could creep up. Clearly you do not need to lose weight so making sure you have plenty of protein and healthy fats whilst just keeping an eye on carb intake, in other words make the carbs you have worth it for their nutritional value and enjoyment. Just watching portion size of any high carb foods is likely to be sufficient. Whatever you do has to be sustainable for life not a quick fix, though in your case there is not much to fix.

 

[rebrascora]

H and welcome from me too.

Have you been checked for anaemia as that can inflate your HbA1c a bit and make it look like diabetes is hovering over you when in fact you are just low on red blood cells.

 

[JITR]

Hi everyone 😉

I'm new to the club and hoping to find some tips and guidance here. Some background info first...

A couple of days before I turned 40, I found out that I have borderline diabetes (nice timing!). HbA1C: 42 (increased from 36 last July). I have always been slightly underweight with BMI around 18, so losing weight is not a route to take. According to my GP, 'there is nothing you could do', and I will just have to wait for another year to check again. He also mentioned it could be adult onset type 1 (my dad was diagnosed of type 2 in his 40s when he was overweight).

Oh, I should also add that my amylase level was slightly over the normal range twice in the past 12 months (although recently dropped a little). I'm not sure if this has anything to do with my HbA1C increasing?

I don't drink, and I don't eat cakes/biscuits/sweets/snacks often. When I drink tea and coffee, I don't normally add sugar. I do like my toast/paste/noodles/white rice every day though (never massive portion), and the only exercise I do is yoga which I now know is not enough

Since finding out the news, I have started reducing my carb and eating more protein to hopefully maintain my weight. I've also started walking or jogging after every meal to increase insulin sensitivity (does this work?).

As a slim type pre-diabetic person, is there anything else that I should do/avoid? Is it necessary to buy a glucose monitor or am I over reacting? My doc told me not to read too much into my blood results, and 42 could just my 'normal', so I'm a bit confused.

Any advice is greatly appreciated. Thanks!

H and welcome from me too.

Have you been checked for anaemia as that can inflate your HbA1c a bit and make it look like diabetes is hovering over you when in fact you are just low on red blood cells.

Hi Milli,

36 to 42 is quite a jump. The same this year will take you to 48, the diabetic threshold!

Rebeascora says it may be due to anaemia. Amylase can indicate pancreatitis, which could explain the jump. Worth investigating.

Otherwise about 98% of prediabetics and newly diagnosed diabetics have accumulated too much fat in the liver and pancreas - are your weight and waist measurements exactly what they were 15 years ago? Diet and exercise can reverse that condition. Weight loss may not be for you, but recent research suggests a 'healthy diet' and and intermittent fasting, like 5:2, could be. As fat comes the liver first, the idea is to chip away at it while maintaining your weight.

Have a look at Dr David Oliver, Introduction to Prediabetes and T2D:

and the Freshwell Time Restricted Eating page.

 

[Milli_Co]

Welcome to the forum
42 is just on the first point of the prediabetes zone and really is just a warning that over time if you allow some poor dietary choices then that level could creep up. Clearly you do not need to lose weight so making sure you have plenty of protein and healthy fats whilst just keeping an eye on carb intake, in other words make the carbs you have worth it for their nutritional value and enjoyment. Just watching portion size of any high carb foods is likely to be sufficient. Whatever you do has to be sustainable for life not a quick fix, though in your case there is not much to fix.

Thank you for your wise words Leadinglights. You are right, I should be looking to change my diet and lifestyle long-term. I'm also considering starting strength trainings to increase my muscle mass. But one thing at a time...

 

[Milli_Co]

H and welcome from me too.

Have you been checked for anaemia as that can inflate your HbA1c a bit and make it look like diabetes is hovering over you when in fact you are just low on red blood cells.

Thanks for the reply, Rebrascora. What you mentioned is interesting. I also did a full blood count with differentials. Both my red blood cells and total white blood cells were just below the normal range. I had a key hole surgery in April and a strange infection 2 weeks before the test, so I didn't think too much about it.

 

[Milli_Co]

Hi Milli,

36 to 42 is quite a jump. The same this year will take you to 48, the diabetic threshold!

Rebeascora says it may be due to anaemia. Amylase can indicate pancreatitis, which could explain the jump. Worth investigating.

Otherwise about 98% of prediabetics and newly diagnosed diabetics have accumulated too much fat in the liver and pancreas - are your weight and waist measurements exactly what they were 15 years ago? Diet and exercise can reverse that condition. Weight loss may not be for you, but recent research suggests a 'healthy diet' and and intermittent fasting, like 5:2, could be. As fat comes the liver first, the idea is to chip away at it while maintaining your weight.

Have a look at Dr David Oliver, Introduction to Prediabetes and T2D:

and the Freshwell Time Restricted Eating page.

Hi JITR,

My amylase results were 117 (last August), 120 (last December), and then 107 (this March). The normal range for my lab is 20-110, so I was told by GP and my consultant that those were just borderline and they think this is my personal normal.

'36->42 is quite a jump' Yes, that's exactly my thoughts. It happened in the same year when my amylase results went over the limit, so I thought perhaps that would warrant further investigation. Unfortunately my consultant didn't agree, and has discharged me. So, I'm sitting here guessing...

It's interesting that you mentioned liver. I did notice that my liver function fluctuated in the same way as my amylase, and I will read more online about this. Thanks also for the video. A lot more to learn. 🙂

 

[rebrascora]

Are you comfortable saying more about the keyhole surgery ie What it was?
And when you say a strange infection 2 weeks before the test, can you elaborate?

 

[Milli_Co]

Are you comfortable saying more about the keyhole surgery ie What it was?
And when you say a strange infection 2 weeks before the test, can you elaborate?My

The surgery back in April was for suspected endometriosis. I received a brief report that they did find and treat it, although I will only find out the extent and location when I see my gynaecologist in August.

I did wonder if endo was the cause of my abnormal amylase (that's before I found out my HbA1C was also abnormal), but the GP said it had to be very severe to affect my pancreas. My surgery lasted just over 1 hour, so I assume that it is not the case?

2 weeks before the blood test, I developed mild temperature, whole body muscle pain, heart burn, hyper sensitive skin, nerve pain, headache, achy joints and swollen fingers & feet... (no cough, sneeze or shortness of breath). My husband had exactly the same symptoms, which lasted for 3 weeks. Could this affect HbA1C? I don't really know. My gut feeling is that some of my symptoms are related, but the docs are not really interested in further investigation.

The whole thing just got more mysterious

 

[rebrascora]

Thanks for that. I had wondered if it was for gall stones or something like that which would make pancreatitis more of a possibility.

That is certainly an odd virus with those symptoms!! It is known that viruses can trigger Type 1 diabetes and if you were in the very early stages of that when the blood test was taken, it would just show as a small increase in HbA1c at that time.... I consider a few mmols small when considering Type 1 because changes are usually more dramatic compared to Type 2.

I wonder if investing in a BG meter and some test strips would be worthwhile so that you could keep a closer check on things, because I assume you will not get another HbA1c till next year.

You mention about your Dad developing Type 2 diabetes later in life. Did he need insulin?

 

[Milli_Co]

Thanks for that. I had wondered if it was for gall stones or something like that which would make pancreatitis more of a possibility.

That is certainly an odd virus with those symptoms!! It is known that viruses can trigger Type 1 diabetes and if you were in the very early stages of that when the blood test was taken, it would just show as a small increase in HbA1c at that time.... I consider a few mmols small when considering Type 1 because changes are usually more dramatic compared to Type 2.

I wonder if investing in a BG meter and some test strips would be worthwhile so that you could keep a closer check on things, because I assume you will not get another HbA1c till next year.

You mention about your Dad developing Type 2 diabetes later in life. Did he need insulin?

Thanks for sharing your insights Barbara! Hope you are well today.

Yes, my dad needs insulin and has been keeping his level stable so far.

I did wonder if we caught COVID, and read online that it could trigger diabetes/increase HbA1C (I suggested my husband to test it too, but he is not interested 🙄). My GP was very kind and decided to follow up with another test in 3 months' time. In the meantime, I will buy a meter to test at home just to keep an eye on my level.

May I ask if you could recommend any products/product types in terms of test reliability and convenience? I am considering those sensors that you can wear on your arm, but not sure how accurate the readings are.

 

[rebrascora]

I wonder if your Dad may be a late onset Type 1 if he needed insulin fairly soon after diagnosis. I think there are probably a lot more misdiagnosed Type 1 out there because many GPs and nurses simply don't understand that it can develop at any age and when you are older it has a slower onset so can appear to be Type 2 There are some slim Type 2s and some overweight or obese Type 1s so whilst it is easy to assume people are Type 2 if they are overweight, it isn't always the case.

As regards testing, the two BG meters which are most often recommended by members here on the forum for reliability and economy of use for those self funding are the Spirit Healthcare TEE2 or the Gluco Navii. The cost of the test strips are the key thing to consider as they are not universal, so whichever meter you buy, you are committed to the test strips for that meter and you get through a lot of testing in the early days of diagnosis so the test strips are where the company make their money. Some will give away the meters, I have some really fancy ones but the test strips are 3x the cost of the ones I use and the NHS will not fund them and I can't afford to. So those 2 meters I have mentioned above are probably the safest bets as many people here who self fund use them. You only get 10 test strips with the meter kit and ten lancets which are supposed to be single use but most of us reuse them numerous times and in fact I change my lancet once a year and never had any infections in my fingers..... I only ever use it on myself though. If you are tempted to test friends and family like your husband, then you use a new lancet for him or anyone else. Anyway, what I am saying is that you can probably get away with using the 10 lancets in the kit for at least a month or two unless you are really scrupulous about following guidance but the test strips are single use so you would be well advised to buy a couple of extra pots of 50 test strips to get you started.
As regards Libre (the arm sensor) and there are other slightly more expensive options, it is generally wise to have some understanding of finger prick testing before you use one and be able to double check the readings it gives in certain circumstances with a finger prick so I would not recommend getting one just yet. There is a Free 14 day Libre trial if you are formally diagnosed as diabetic rather than just currently being "at risk" so if/when you get that diagnosis, then it would almost certainly be worth taking up that offer then. They have their limitations and quirks but they can also give you a lot of useful info as long as you understand them and can double check when necessary.
Hope that helps.

 

[Milli_Co]

Thank you so much for the tips and advice, Barbara! You are amazing!!

My dad got on insulin straightaway by choice and that was nearly 20 years ago. I think it's a good idea to re-check and see if there should be adjustments.

I will try the finger prick test, and then purchase Libre in order to understand how my diet affects glucose level - will be on a trip to Cornwall, so definitely need to keep an eye on it when I try a Cornish pasty (or two)

I've reduced my carb in the past 2 weeks and started jogging or brisk walking. While managing to maintain my weight, I did feel tired more easily in the past few days. Is this a sign that I need to up my carb intake a little? I wouldn't mind adding another piece of toast with peanut butter in the morning

 

[rebrascora]

In my opinion it is a fallacy that lack of carbs makes you fatigued in the long run or that you need them for exercise or anything else as your body can make them from fat and protein, but there can be a period of adjustment where you feel rough or weary, sometimes referred to as keto flu even if you aren't fully keto. I would probably wait until you get your testing kit before regularly increasing carbs. High BG levels are more likely to cause fatigue and if you are Type 1 and levels are starting to rise significantly then eating more carbs would push them higher, so see what your meter says when you get it.
Going straight onto insulin as a Type 2 is very unusual and not something you are just given the option of doing unless levels are dangerously high, so I am guessing that your father's levels were very high at diagnosis which would suggest he may be Type 1.

 

[Milli_Co]

Thanks again for your wise advice.

I'm hoping that those symptoms are just my body adjusting to the low-carb diet, and won't make any further changes until my meter arrives.

And yes, I remember my dad was quite unwell and had to stay in the hospital for a couple of days when he was diagnosed, although he doesn't remember doing any specific test before being told that he was type 2. I will definitely ask him to recheck.

 

[Leadinglights]

Thanks again for your wise advice.

I'm hoping that those symptoms are just my body adjusting to the low-carb diet, and won't make any further changes until my meter arrives.

And yes, I remember my dad was quite unwell and had to stay in the hospital for a couple of days when he was diagnosed, although he doesn't remember doing any specific test before being told that he was type 2. I will definitely ask him to recheck.

There is no specific test for Type 2 and diagnosis is usually made from an HbA1C test result (well now it is) and clinical presentation.
There are now tests for Type 1 that can be done C-peptide and GAD antibodies.

 

[Milli_Co]

Thanks Leadinglights. That explains why. My dad was diagnosed 20 years ago in a different country. I'd assume that C-peptide and GAD antibodies tests were not available back then.

It has always been a struggle for me to get BMI up into normal range despite eating normal portions of almost everything. Now I'm at high risk at BMI 18, so that got me thinking... Still so much to learn.

 

[Leadinglights]

Thanks Leadinglights. That explains why. My dad was diagnosed 20 years ago in a different country. I'd assume that C-peptide and GAD antibodies tests were not available back then.

It has always been a struggle for me to get BMI up into normal range despite eating normal portions of almost everything. Now I'm at high risk at BMI 18, so that got me thinking... Still so much to learn.

Probably 20 years ago people would likely have had a urine test to detect glucose as when blood glucose is high the body excretes it in the urine. There was a oral glucose tolerance test (OGTT) that was often done where people had a glucose drink and blood samples were taken at intervals for several hours to see how their body coped with a fixed amount of glucose. I think that may still be done when people are pregnant and gestational diabetes is suspected.
I'm not quite sure when the HbA1C was introduced as the standard test in the UK.
I suspect 20 years ago ideas about suitable diet were very different, people seemed to think it was only 'sugar' that was important not all carbs.

 

[everydayupsanddowns]

Welcome to the forum @Milli_Co

Sounds like you are off to a solid start.

Good to know you are keeping an open mind about the possibility of T1 (which can come on more slowly in adults).

Keep up with those modest menu changes, and keep an eye on how thing progress over the coming weeks and months.

Sometimes it can take a while (years in some cases) for the situation to become clear.

 

[Milli_Co]

Probably 20 years ago people would likely have had a urine test to detect glucose as when blood glucose is high the body excretes it in the urine. There was a oral glucose tolerance test (OGTT) that was often done where people had a glucose drink and blood samples were taken at intervals for several hours to see how their body coped with a fixed amount of glucose. I think that may still be done when people are pregnant and gestational diabetes is suspected.
I'm not quite sure when the HbA1C was introduced as the standard test in the UK.
I suspect 20 years ago ideas about suitable diet were very different, people seemed to think it was only 'sugar' that was important not all carbs.

Yes, I remember doing OGTT during my pregnancies, and passed on both occasions. However, during a recent dental check for my kid, the dentist mentioned that there were signs on her teeth that might indicate I actually developed gestational diabetes after OGTT?! Nice to know! So that's one more risk factor for me and I need to take actions now.

'Life can only be understood backwards, but it must be lived forwards.' So true.