Living with pre-diabetes long-term

[rad66]

I had a T2 diagnosis 5 years ago with two consecutive 49 HbA1c tests and have been controlling this with diet and exercise since then.

My HbA1c is consistently in the 42-44 range and I buy a Freestyle Libre from time to time to check what is happening when I eat.

This shows my fasting BG is in the 5-6 range and it spikes to 8-10 (depending on carbs in the meal) around 90 mins after eating for a short period before dropping back down again to fasting levels over the next hour.

I am trying to understand whether it is OK to live with this kind of pattern over the long-term as it seems to be my stable non-medicated state?

I would consider medication or make even more drastic dietary changes if these short rises in BG once or twice a day are likely to cause damage but I haven't been able to find clear information on whether they will.

If anyone has good sources of advice on the harm caused by long-term pre-diabetic levels then this would be helpful. Most of what I have seen is focused on the risk of pre-diabetes getting worse rather than on this as a stable state.

 

[Leadinglights]

I had a T2 diagnosis 5 years ago with two consecutive 49 HbA1c tests and have been controlling this with diet and exercise since then.

My HbA1c is consistently in the 42-44 range and I buy a Freestyle Libre from time to time to check what is happening when I eat.

This shows my fasting BG is in the 5-6 range and it spikes to 8-10 (depending on carbs in the meal) around 90 mins after eating for a short period before dropping back down again to fasting levels over the next hour.

I am trying to understand whether it is OK to live with this kind of pattern over the long-term as it seems to be my stable non-medicated state?

I would consider medication or make even more drastic dietary changes if these short rises in BG once or twice a day are likely to cause damage but I haven't been able to find clear information on whether they will.

If anyone has good sources of advice on the harm caused by long-term pre-diabetic levels then this would be helpful. Most of what I have seen is focused on the risk of pre-diabetes getting worse rather than on this as a stable state.

The criteria that people use is to be below 8-8.5mmol/l 2 hours post meal so 120mins so what you are getting would likely be quite normal.
If you feel you want to lower your HbA1C to below prediabetes ie less than 42 mmol/mol then you could make a few tweaks to your carb intake and keep a watchful eye on your day to day, week to week readings so you can take action if things drift upwards.

 

[rad66]

The criteria that people use is to be below 8-8.5mmol/l 2 hours post meal so 120mins so what you are getting would likely be quite normal.
If you feel you want to lower your HbA1C to below prediabetes ie less than 42 mmol/mol then you could make a few tweaks to your carb intake and keep a watchful eye on your day to day, week to week readings so you can take action if things drift upwards.

Thanks. I will check against those criteria as I think I am rarely above 8 after 120 mins even where it has spiked up to 10 before that. My thinking about the CGM monitoring was to test my common food combinations and stop the ones that cause the bigger spikes. This is challenging in reducing my dietary options further, and I do not eat meat so many low-carb options are already off the table, but I guess worth it to avoid medication!

 

[JITR]

If anyone has good sources of advice on the harm caused by long-term pre-diabetic levels then this would be helpful.

This article may help, What is prediabetes?

Remember prediabetes is usually a state of glucose and lipid dysregulation, due to accumulation of fat in the liver and pancreas. If you can, general guidance is to lose a bit more visceral fat and get your HbA1c down into the 30's.

 

[Leadinglights]

Thanks. I will check against those criteria as I think I am rarely above 8 after 120 mins even where it has spiked up to 10 before that. My thinking about the CGM monitoring was to test my common food combinations and stop the ones that cause the bigger spikes. This is challenging in reducing my dietary options further, and I do not eat meat so many low-carb options are already off the table, but I guess worth it to avoid medication!

Do you eat fish? But there are plenty of options which don't involve meat. Check out the veggie meal plan and recipes in this link https://lowcarbfreshwell.com/

 

[everydayupsanddowns]

If anyone has good sources of advice on the harm caused by long-term pre-diabetic levels then this would be helpful. Most of what I have seen is focused on the risk of pre-diabetes getting worse rather than on this as a stable state.

You might find this study helpful @rad66

It’s an analysis of CGM traces from healthy people without diabetes. Perhaps it will allow you to put your results in some sort of context?

Thread 'BG Profiles in Healthy Non-Diabetics'

Apr 11, 2022

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study

This study provides normative sensor glucose data in a healthy, nondiabetic population of children and adults.

academic.oup.com

A fairly large study from 2019 seeking to map out what "normal" BG profiles look like during the day and overnight, using CGM measures; often see it cited. Perhaps useful resource for people looking to benchmark themselves against "normal" etc.

Units are mainly in American for BG (mg/dl: divide by 18 for mmol/l) and for HbA1c (%; easy to find tools on-line for conversion to mmol/mol).

There is some circularity: the main thing for deciding whether somebody is "non-diabetic" is their HbA1c, so no surprise if BG profiles are...

• Eddy Edson
• Replies: 2
• Forum: Links

• 

 

[rad66]

You might find this study helpful @rad66

It’s an analysis of CGM traces from healthy people without diabetes. Perhaps it will allow you to put your results in some sort of context?

Thread 'BG Profiles in Healthy Non-Diabetics'

Apr 11, 2022

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study

This study provides normative sensor glucose data in a healthy, nondiabetic population of children and adults.

academic.oup.com

A fairly large study from 2019 seeking to map out what "normal" BG profiles look like during the day and overnight, using CGM measures; often see it cited. Perhaps useful resource for people looking to benchmark themselves against "normal" etc.

Units are mainly in American for BG (mg/dl: divide by 18 for mmol/l) and for HbA1c (%; easy to find tools on-line for conversion to mmol/mol).

There is some circularity: the main thing for deciding whether somebody is "non-diabetic" is their HbA1c, so no surprise if BG profiles are...

• Eddy Edson
• Replies: 2
• Forum: Links

• 

This is very interesting, thank you. The increase in time above target for older people is especially interesting and something I had heard about but not seen data like this.

I am also curious to see what information we might get from the new dietary advice services that are springing up, like Zoe, which seem to be collecting CGM data from large cohorts of non-diabetic people.