Hello from Cumbria Advice Needed.

[PoppyT]

Hi A short history of myself I am 67 two years ago I went through breast cancer treatment, this in turn led to lymphodema and nerve damage.
Last year I was told I was pre-diabetic my A1c level was 45 a year on I have lost 4 stone and my last bloods last week said the levels were now 42. To say I was upset is an understatement. I am an active 67 now weighing 11stone, I have altered my life style and eating completely hence the weight loss. I should point out my GP is useless they even tried to tell me that I had never had a blood test for diabeties, then suddenly they found it. I am totally lost and confused I have no idea if that drop in my levels is good in that time period, there is just NO help from the medical team. I really feel like saying why bother? If somenone could please tell me if I am heading in the right direction. I do not smoke never have, neither do I drink. I watch my diet, no sugar, plenty of fruit and veg, watch my carbs, no meat, though I do eat cod and tuna. Wholemeal bread, sourdough when I can get it...what am I doing wrong? Many thanks Poppy xx

 

[Martin.A]

Sorry to hear you've had such a torrid time but yes, you are heading in the right direction - still 'at risk' but only just into the zone.

Do you know how many carbs you're having each day? Bread, whether wholemeal or sourdough, tends to be high in carbs. Also, does your fruit mix contain high carb tropical fruits like banana?

 

[Leadinglights]

That result seems perfectly reasonable for someone of your age. If people are diagnosed as Type 2 then the criteria for an acceptable HbA1C is below 48mmol/mol anyway.
Depending on what veg and fruit you eat as some are still high ish carb and how much bread maybe somewhere you could look at. Meat is a good low carb food as well as fish, eggs, dairy, nuts.
If you look at this link there may be some ideas that will help https://lowcarbfreshwell.com/ but it sounds as if you are doing fine.
You may be being a bit too strict which is why you are feeling fed up.

 

[PoppyT]

Thank you my carbs are probably a little more than they should be - but only slightly. Bread is not my staple diet and I do look at carb count on items I buy. My fruit yes I do like a banana, but mainly berries, apples, nectarines, satsumas, blackcurrants and other seasonal berries. My protein comes from eggs, nuts, a little cheese, fish, lentils etc I look for food low on the glycemic scale. I cook all my own meals, slow cooker queen, so no processed meals. I truly am at a loss as to why my count is still high. It is so hard when there is no help from the GPs, I even had to ring to get my blood results, after the nurse had found last years results, her only comment was 'you will get a yearly test from now on'. It is hard going it alone especially with no real support.

 

[PoppyT]

That result seems perfectly reasonable for someone of your age. If people are diagnosed as Type 2 then the criteria for an acceptable HbA1C is below 48mmol/mol anyway.
Depending on what veg and fruit you eat as some are still high ish carb and how much bread maybe somewhere you could look at. Meat is a good low carb food as well as fish, eggs, dairy, nuts.
If you look at this link there may be some ideas that will help https://lowcarbfreshwell.com/ but it sounds as if you are doing fine.
You may be being a bit too strict which is why you are feeling fed up.

Thank you - I think I am feeling fed up because I did not know what to expect I had NO idea outside it takes about 3 months for the levels to start to show signs of improvement.

 

[Leadinglights]

Thank you my carbs are probably a little more than they should be - but only slightly. Bread is not my staple diet and I do look at carb count on items I buy. My fruit yes I do like a banana, but mainly berries, apples, nectarines, satsumas, blackcurrants and other seasonal berries. My protein comes from eggs, nuts, a little cheese, fish, lentils etc I look for food low on the glycemic scale. I cook all my own meals, slow cooker queen, so no processed meals. I truly am at a loss as to why my count is still high. It is so hard when there is no help from the GPs, I even had to ring to get my blood results, after the nurse had found last years results, her only comment was 'you will get a yearly test from now on'. It is hard going it alone especially with no real support.

One thing you can do to help and wouldn't leave you in limbo for a year not knowing if what you are doing is working is to get a home testing blood glucose monitor which by doing a finger prick test you can keep a check on progress. People test in the morning to give a fasting reading which you aim to be 4-7mmol/l and also use the monitor to test the effect of meals when the aim is no more than 8mmol/l 2 hours after eating, if you are than the meal is too carb heavy.
A few foods you mention depending on your portion may be a bit too high carb, bananas are the highest carb fruit, berries except blueberries the lowest, the others somewhere in between. some people find they cannot tolerate lentils, beans, and certainly rice and pasta are high carb.
I don't think your result is particularly high, just 1mmol/mol above normal and in any case don't forget the result is not absolute the 42 could well be 41.
To reassure yourself maybe keep a food diary with an estimate of the carbs in your meals, any snacks and drinks as that may reveal any problem foods.

 

[Drummer]

Thank you - I think I am feeling fed up because I did not know what to expect I had NO idea outside it takes about 3 months for the levels to start to show signs of improvement.

That is so not true. The first meal you eat whare the carb content is lower than the previous one will make a difference to your wellbeing. Go on day by day avoiding spiking your glucose levels and day by day you will be making progress towards remission - as long as there is nothing going on which might be more interesting and requiring other treatment, of course.
I used a glucose tester and found that GI made no difference at all, that I can't eat foods made with grain, and I don't eat high carb fruit or veges.
What I do eat is any meat, fish, cheese, eggs, full fat dairy, because those are the essential foods. I use the fat from the meat because that is the natural source of fats - I don't use seed oils. My intake of fat is fairly low, because I don't regard non natural sources as healthy.
Rather than sugary fruits I eat things which are botanically fruits, cucumbers, avocadoes, courgette, tomatoes, etc.
I found that legumes seem to provide almost twice the listed amount of carbs when I eat them, so I have half portions.
I have lost weight eating low carb, but that was after I got my levels down, not before, so there is a link but perhaps not the one touted as effective.
Although my HbA1c dropped from 91 to 41 I could not push it down further with lower intake of carbs, so it might be more difficult in old age to get into normal HbA1c, but I definitely see normal levels of blood glucose so it might be that my blood corpuscles are having to hang around for longer before being broken down for spare parts. I am 73 now, was diagnosed at 65.

 

[PoppyT]

I noticed you say rice is not good, does that include wholemeal or Basmati rice, as I like rice and often add it to my veg casseroles? I eat lots of fresh toms, and mushrooms they are part of my staple diet. xx

 

[Leadinglights]

I noticed you say rice is not good, does that include wholemeal or Basmati rice, as I like rice and often add it to my veg casseroles? I eat lots of fresh toms, and mushrooms they are part of my staple diet. xx

Rice whatever the type is still high carb, 100g of cooked rice is about 30g carbs so would increase the carbs in your meal quite a bit, quite a few people use cauliflower rice to have with chilli or curry in included in a stir fry.
Tomatoes they are about 3-4g per 100g, mushrooms pretty well zero carbs.
Carbs and Cals book or app is a good guide as it gives carb values of a whole range of foods for various portion sizes so helps making better choices. It was and still is my bible.

 

[Martin.A]

I noticed you say rice is not good, does that include wholemeal or Basmati rice, as I like rice and often add it to my veg casseroles? I eat lots of fresh toms, and mushrooms they are part of my staple diet. xx

If my wife and I have a rice dish, eg Chilli Con Carne, she has a portion on long grain rice (30 carb per 100g) and I have a portion of riced cauliflower (2g carb per 100g). A simple swap but a huge carb saving.

 

[s'nic]

I am totally lost and confused I have no idea if that drop in my levels is good in that time period, there is just NO help from the medical team.

It may not be any consolation, but it's likely this is pretty normal in many surgeries.
I got a prediabeic result at the start of this year, and basically no support, just a print out of a web page to explain what diabetes was. So i was basically left to my own devices for the coming year as my blood test will also be an annual thing.

You are clearly headed in the right direction, so that is a good thing 🙂
It sounds like you have room to tweak your meals a little, the good news is there are a lot of folks here who can provide details of their experiences.

 

[Drummer]

I noticed you say rice is not good, does that include wholemeal or Basmati rice, as I like rice and often add it to my veg casseroles? I eat lots of fresh toms, and mushrooms they are part of my staple diet. xx

Something like chopped cauliflower would be a lot lower in carbs than rice. If you use a blood glucose tester and make adjustments in the meals which cause the highest spikes then with any luck you should see lower results long term. I cook the cauliflower separately, sometimes in two lots of water to reduce the flavour, then chop and use as a base for curry or tip into a casserole or stew.

 

[everydayupsanddowns]

Thank you my carbs are probably a little more than they should be - but only slightly. Bread is not my staple diet and I do look at carb count on items I buy. My fruit yes I do like a banana, but mainly berries, apples, nectarines, satsumas, blackcurrants and other seasonal berries. My protein comes from eggs, nuts, a little cheese, fish, lentils etc I look for food low on the glycemic scale. I cook all my own meals, slow cooker queen, so no processed meals. I truly am at a loss as to why my count is still high.

Sounds like you’ve made some brilliant changes, and your weight loss is great! Sorry to hear you are feeling disappointed with the reduction in your HbA1c, which is now at the lowest possible edge of the ‘at risk’ range (which is why your nurse is relaxed about a only having a yearly check-up).

It might be worth bearing in mind that as you get older your HbA1c naturally rises a little. But I think if you stick with what you’ve been doing, you may well see your levels reduce further.

It is so hard when there is no help from the GPs, I even had to ring to get my blood results, after the nurse had found last years results, her only comment was 'you will get a yearly test from now on'. It is hard going it alone especially with no real support.

Thats’s really tough. But sadly it’s not all that uncommon, and you seem to have developed an effective plan yourself. Hopefully the shared experiences of the forum might give you ideas of some further tweaks you could try?

I noticed you say rice is not good, does that include wholemeal or Basmati rice, as I like rice and often add it to my veg casseroles? I eat lots of fresh toms, and mushrooms they are part of my staple diet. xx

I’d try not to think of it as ‘good’ and ‘bad’ foods. All foods are fine in the right portion sizes and frequencies - and it may well be that your metabolism copes well with rice. Some here find rice tricky, but in the right portion size basmati rice is well tolerated by others.

As @Leadinglights mentioned, one possible way of fine-tuning your meals might be to self-fund an affordable BG meter, and take a reading immediately before and 2hrs after the first bite of a meal. By aiming to keep the ‘meal rise’ down to 2-3mmol/L above the pre-meal reading, you should be able to adjust the portion sizes of carbs in different meals / recipes to reduce the glucose variation in your numbers 🙂

If you need to self fund your BG meter (which seems likely), the most affordable and reliable meters members here have found are the SD Gluco Navii, the Spirit Tee2, or the Contour Blue - which all have test strips at around £10 for 50. Some other brands can be 3x that much!