Hello (Prediabetic)

[RichardJC]

Just joining - I'm prediabetic with my last test at 44. The one before was 41 (I've been checked annually since cancer now a while ago).
My BMI had increased over winter after a rock climbing injury last autumn stopped me running. That's all fixed now so I'm running again and back up to fitness (may even start entering orienteering races again). I peaked at 28kg/m² and am now back to 25.5 aiming to get to my pre-lockdown and university time BMI of 24.

The diagnosis came as a surprise.

I'm now on the Oviva program and have had a very mixed time with it. I do feel like raising a formal complaint somewhere about them. My experiences seem to match many others I've talked to with no human contact now for about 6 weeks. Their new AI based diet coach is not useful as the computer vision system it is based on is not reliable.

I'm also on my local Fit4Life weight loss program which is excellent, though not diabetes specific.

Obviously I'd like to reverse this. It sounds like prospects of that are somewhat uncertain. I'm using the carb/diet guidelines from Oviva's online training materials (seem in line with other information elsewhere) and getting a lot of exercise. I've added weight lifting to my existing running, cycling, hiking, climbing mix.

 

[JITR]

@RichardJC. The question you need to answer is whether you have any visceral fat (fatty liver) to get rid of. Your HbA1c results indicates you have. Waist measurement is a good indicator. You might be able to persuade your GP to arrange an ultrasound scan based on your history.

You have Professor Roy Taylor to thank for this:
- Information for Doctors
- Roy Taylor, Achieving T2D remission (May 2023)
- His book, Life without Diabetes

 

[s'nic]

Welcome to the forum
Overall BMI is good to aim for, however it is weight carried around the waist that can cause or worsen insulin resistance. Figures quoted say your waist circumference should be no more than half your height.
What carb guidelines does Oviva's diet give? A common theme here is 130 carbs a day or less depending on personal situation / preference.
I used to do climbing, mostly indoor, but some outdoor. My arthritis has ruled that out for me these days - I actually had arthritis in the base of my thumbs since I was 12-14, but in the knees and shoulders it's more limiting for climbing.

 

[RichardJC]

@RichardJC. The question you need to answer is whether you have any visceral fat (fatty liver) to get rid of. Your HbA1c results indicates you have. Waist measurement is a good indicator. You might be able to persuade your GP to arrange an ultrasound scan based on your history.

You have Professor Roy Taylor to thank for this:
- Information for Doctors
- Roy Taylor, Achieving T2D remission (May 2023)
- His book, Life without Diabetes

Thanks. The funky electronic scales at the gym (foot pads and hand grips) have indicated my visceral fat dropped from 11 to 8 now in whatever units it uses. My total fat has also dropped nicely on them. I know they're inaccurate though (and wonder if that is more so if diabetes distorts things). I've read the book and already achieved 10% weight loss (his recommendation for prediabetes) and believe 15% (his guideline for diabetes proper) is easily achievable.

My GP has said little other than "what you're doing is fine. It can buy you time but your sugars will creep back up".

I'd read that lipids can also be a problem so when I next have those tested I'll ask the doctor about whether they need action and what action to take. Oviva has encouraged me to increase dairy intake which I've done with cheese which is fatty. On the other hand I'm buying it in 100g blocks and they last a reasonable time in the fridge so I'm having little bits. I'm eating a lot less processed food and a lot more veg.

Welcome to the forum
Overall BMI is good to aim for, however it is weight carried around the waist that can cause or worsen insulin resistance. Figured quoted say your waist circumference should be no more than half your height.
What carb guidelines does Oviva's diet give? A common theme here is 130 carbs a day or less depending on personal situation / preference.
I used to do climbing, mostly indoor, but some outdoor. My arthritis has ruled that out for me these days - I actually had arthritis in the base of my thumbs since I was 12-14, but in the knees and shoulders it's more limiting for climbing.

Sorry to hear about the arthritis.

My waist peaked at 36" which is over half of my height. Back at 34 I'm on that threshold (assuming my metric conversion works). At target weight I'll be down to 31 based on when I was last there.

Oviva say 100g (max 130) of starchy carbs. I can ignore carbs in fibrous veg and protein sources like beans and nuts. A meal is 30 to 50g. A snack is under 15g (which would normally rule out apples, which are OK, but in moderation. Fruit counts towards the limit).

Attached - today's lunch. The bread is oaty, whether based on or just covered in I don't know. One slice not two reduces carbs. I found this very filling.



I've used these for meals (half at a time) and am thinking of taking this on Scout Camp and trying not to burn it to the bottom of a Trangia camp stove. I can mix it with tinned fish.

 

[Martin.A]

En route to remission I shed 17kgs and dropped from a 38" to a 32" waist, which does suggest that most of that weight disappeared from round my middle. I'm a fraction under 6' so on the waist-to-height measure I'm fine now, but beforehand I would have needed to be 6' 4".

 

[Leadinglights]

An approach which many have found successful is one that was developed by a GP surgery who found the standard NHS advice did not work for many of their patients. This is the link which may give you some ideas with some menu plans and do's and don'ts, compare with what you are doing and see if it might suit you better. https://lowcarbfreshwell.com/

 

[RichardJC]

En route to remission I shed 17kgs and dropped from a 38" to a 32" waist, which does suggest that most of that weight disappeared from round my middle. I'm a fraction under 6' so on the waist-to-height measure I'm fine now, but beforehand I would have needed to be 6' 4".

That's a great achievement!

I've just set my climbing harness back to where it was before I switched diet. It's not that much looser than it is now (though I'd not want to climb on it like that)

An approach which many have found successful is one that was developed by a GP surgery who found the standard NHS advice did not work for many of their patients. This is the link which may give you some ideas with some menu plans and do's and don'ts, compare with what you are doing and see if it might suit you better. https://lowcarbfreshwell.com/

Thanks. I'm all for borrowing food ideas (and enjoying trying things)

 

[harbottle]

En route to remission I shed 17kgs and dropped from a 38" to a 32" waist, which does suggest that most of that weight disappeared from round my middle. I'm a fraction under 6' so on the waist-to-height measure I'm fine now, but beforehand I would have needed to be 6' 4".

Snap - same for me, 38 to 32, although I was rotund everywhere (Too many chins and looked a bit like Sontaran from Dr Who.)

I had a pile of band T-shirts from when I was a teenager and in my 20s that I could start wearing again, much to my wife's disgust, as she hates one of my Jethro Tull T-shirts and has a habit of hiding it so I can't wear it!

 

[RichardJC]

I think I've lost more from my hips than my waist by measurement. I'm told I look slimmer all over.

 

[JITR]

I think I've lost more from my hips than my waist by measurement. I'm told I look slimmer all over.

That figures. Focus on nutrionally dense foods (protein, natural fat), you'll find you eat less and feel fuller. For more info see Marty Kendall's Optimising Nutrition website and blog posts about Satiety.

 

[RichardJC]

That figures. Focus on nutrionally dense foods (protein, natural fat), you'll find you eat less and feel fuller. For more info see Marty Kendall's Optimising Nutrition website and blog posts about Satiety.

I've already found with protein that it is filling and stays filling. The Oviva thing suggests more fats like cheese which I double take on. My triglycerides have been slightly high in the past and I'd ready that triglycerides can damage beta cells. Though I've pretty well cut out processed food and who knows what's in that!!

To give an idea of weight loss - here's my harness set to where it was 2 months ago.

 

[RichardJC]

I've been using the free sample CGM from Abbot for 2 weeks now. Things I've picked up:

• The advice I'm given works. But now I've directly experienced it and seen the effect.
• I can control this well with care on my carbs - staying in range (4-9) if I keep "Non-Free¹ Carbs" down to about 30g per meal.
• If I snack then eat a meal in the resulting sugar high, I'll go over-range.
• If I do gentle exercise (a light run) in a sugar crash I'll go under-range. I've done this only once (this morning)
• Both self correct quite quickly.
• My daily average has dropped from 6.8 to 6.0 over the 2 weeks. I can bring it down to 5.4 with great care over food.
• My quiescent level also seems to have dropped.

This morning was my worse spike and crash. I thought I'd see what happened if I had the kind of breakfast I had before diagnosis - Alpen (no sugar), fruit and yoghurt. But various things I think are hopeful

• Overnight I sit around 5.0±0.2
• It does rise toward 6 as I move around. My average pre-breakfast over the 2 weeks is 5.9
• I can restore normal after spikes quite quickly (but I'm on low carbs¹ so maybe there's little there to spike with). Testing before with finger stick I noted it took me a long time to do this.
• I similarly pull back from crashes quickly. While I bottomed out at 3.4 this morning I did a gentle row for 3 minutes and was back in normal.
• I'd have not known about the crash if I didn't see the reading while logging the run.
• If I eat the recommended diet I don't spike or crash at all.
• I'm at 5.6 now. I've done running and gym this morning.

So maybe I've fixed this? My doctor tells me that things will creep up over time, but perhaps I've pulled things low enough I have a lot of headroom now for age to do its thing - if I keep my weight down and keep to a healthy low carb diet. Abbot's software gives 2 different estimates for HB1AC, so I'll have to wait until my next blood tests.

1) I'm using Oviva's definitions of Free and Non-Free Carbs. Starch and sugar (fructose, lactose) are non-free and count. Carbs tied up in fibrous vegetables and nuts are not counted.

 

[everydayupsanddowns]

• Overnight I sit around 5.0±0.2
• It does rise toward 6 as I move around. My average pre-breakfast over the 2 weeks is 5.9
• I can restore normal after spikes quite quickly (but I'm on low carbs¹ so maybe there's little there to spike with). Testing before with finger stick I noted it took me a long time to do this.
• I similarly pull back from crashes quickly. While I bottomed out at 3.4 this morning I did a gentle row for 3 minutes and was back in normal.
• I'd have not known about the crash if I didn't see the reading while logging the run.
• If I eat the recommended diet I don't spike or crash at all.
• I'm at 5.6 now. I've done running and gym this morning.

Sounds like you are doing amazingly well @RichardJC

Keep doing what you are doing! We have a number of members who have been able to hold their diabetes in check for a number of years. It maybe that your diabetes will change over time (that happens too) but developing a maintenance menu that keeps your weight stable, your tastebuds satisfied, and your BGs where you want them 🙂