New here - diagnosis 'borderline' or pre-diabetes

[jantinesco]

Hi everyone,

I have recently had two blood tests which indicate I am 'borderline' or pre-diabetes and have today been requested by my GP practice to book a routine telephone appointment with the diabetes nurse. The earliest I could get an appointment is on 10 November. I am wondering what she is likely to tell me and am apprehensive as I also suffer from Asthma, Angina, COPD and a bowel disorder so am not looking forward to yet another potential condition to manage.

I haven't been feeling at all well for the past few weeks - bad days have certainly outweighed the good. In particular, I have been suffering from fatigue, cold feet and hands, an unquenchable thirst at night and problems with my eyes. Could these all be signs associated with diabetes?

I have joined this forum as I feel in need of support and need to educate myself of what I can do to help myself.

Thank you for allowing me to join the group and for listening.

 

[NotPink]

Hallo
Welcome to the forum.
You certainly have a lot on your plate right now. If you have been diagnosed with pre diabetes 2, most similar folk here might want to know your Hbac1 reading that you may have got from your doctor to assess your blood glucose levels. It just helps them to be able to support you knowing the levels you are dealing with.
There are some very experienced people on these forums whose knowledge far outweighs mine and they will be along shortly to respond.
I do hope you get some answers soon.

 

[ianf0ster]

Hi @jantinesco and welcome to the forum.
Type 2 diabetics have an intolerance to the amount of carbohydrates in most people's modern diet. But if you are pre-diabetic then a small adjustment to what you eat should do the trick.
What most don't realise is that the government promoted 'healthy diet' isn't at all healthy for Type 2 diabetics, in fact it's almost guaranteed to make the condition worse. Because Carbs include all common sugars and starches, which means fruits (especially tropical fruit like Banana and all grains (even brown whole ones) like wheat, barley, oats, corn, rice as well as underground veg like potato, parsnip, carrot. Though we are all different in our reactions so some are OK with small quantities of carrots or small quantities of fruit such as apples, pears or even stone fruit like plums.

 

[jantinesco]

Hallo
Welcome to the forum.
You certainly have a lot on your plate right now. If you have been diagnosed with pre diabetes 2, most similar folk here might want to know your Hbac1 reading that you may have got from your doctor to assess your blood glucose levels. It just helps them to be able to support you knowing the levels you are dealing with.
There are some very experienced people on these forums whose knowledge far outweighs mine and they will be along shortly to respond.
I do hope you get some answers soon.

Hello NotPink,

Thank you for your prompt reply and concern. The following information is taken from my patient records and I don't profess to understand it all, but hopefully some members will be able to.


Blood test 26 October 2021
Haemoglobin A1c level - IFCC standardised (XaPbt) 47 mmol/mol [< 41]
Above high reference limit
Diabetes:
Desirable HbA1c <58 mmol/mol
Increased risk of hypoglycaemia if HbA1c <48 mmol/mol.
Non-diabetics:
HbA1c < 42 mmol/mol - norma
HbA1c 42-47 mmol/mol - pre-diabetes. Patient is at
risk of progression to diabetes. Consider referral to
NHS Diabetes Prevention Programme if appropriate.
HbA1c 48 mmol/mol or over - consistent with diabetes
The diagnosis and monitoring of diabetes mellitus using
HbA1c is dependent on normal erythropoiesis, no genetic
or chemically altered haemoglobins, normal glycation
and normal erythrocyte destruction rates. If these
conditions are not met then treatment should be based
on capillary glucose testing.


Blood test 7 October 2021
Haemoglobin A1c level - IFCC standardised (XaPbt) 48 mmol/mol [< 41]
Above high reference limit
Diabetes:
Desirable HbA1c <58 mmol/mol
Increased risk of hypoglycaemia if HbA1c <48 mmol/mol.
Non-diabetics:
HbA1c < 42 mmol/mol - normal
HbA1c 42-47 mmol/mol - pre-diabetes. Patient is at
risk of progression to diabetes. Consider referral to
NHS Diabetes Prevention Programme if appropriate.
HbA1c 48 mmol/mol or over - consistent with diabetes
The diagnosis and monitoring of diabetes mellitus using
HbA1c is dependent on normal erythropoiesis, no genetic
or chemically altered haemoglobins, normal glycation
and normal erythrocyte destruction rates. If these
conditions are not met then treatment should be based
on capillary glucose testing.

 

[ianf0ster]

OK @jantinesco Those HbA1C readings show that you are right at the top of the pre-diabetic range.
So it is worth looking at reducing the amount or type of carbohydrates you eat because you don't want diabetes on top of the conditions you already have.
Look at the list of foods I mentioned above and see if there are any you eat that you can either cut down on or substitute with something lower in carbohydrates.
For example eating 'cauliflower rice' instead of normal or instead of brown rice. Eating MacDonalds burgers inside lettuce leaves instead of the bun (which I'm told they do for people who ask). Eating bean based pasta (Aldi and other supermarkets have it) instead of normal grain based spaghetti, or using courgette spirals (aka courgetti) instead. Eating berries (blue, black, straw or rasp) or watermelon instead of bananas, oranges or other fruit grown in hot climates.

 

[everydayupsanddowns]

I haven't been feeling at all well for the past few weeks - bad days have certainly outweighed the good. In particular, I have been suffering from fatigue, cold feet and hands, an unquenchable thirst at night and problems with my eyes. Could these all be signs associated with diabetes?

Welcome to the forum @jantinesco

Sorry to hear you have been feeling a bit grim of late.

Yes tiredness/fatigue, thirst, increased urination and blurred vision can all be associated with undiagnosed diabetes.

From your HbA1c it does look like you are right on the edge of a formal diagnosis.

However don’t despair, some people get a diagnosis of diabetes with an HbA1c into 3 figures, so it’s quite possible that a modest reduction in carbohydrate portion sizes and a few swaps and changes might be all that your metabolism needs to turn the corner.

Some new members find it can be really helpful to begin by keeping a food diary for a week or two. Be ruthlessly honest, and note down everything you eat and drink, along with a reasonable estimate of the total carbohydrate content (not just ‘of which sugars’). This might sound like a bit of a faff, but it’s a really, really helpful way to start to understand the distribution of carbs in your menu, where they lurk hidden (eg ready made sauce), and which meals/snacks are the ‘big hitters’ carb wise.

Once you can see that, you can consider a few swaps, tweaks, changes, or ask members here for there suggestions. They are an inventive lot!

It’s important to recognise that you don’t need to avpid carbs entirely (which isn’t actually possible - there are tiny amounts even in lettuce) but it’s just balancing your carb intake with your body’s unique, individual capacity to process them and preference of sources for a slow release.

Good luck, and let us know how you get on 🙂

 

[Drummer]

@jantinesco It might be wise to request a thyroid check - one of the few indications I had when my thyroid failed was cold hands and feet when I had previously always had warm extremities - adapted to the chills when in the mountains or at sea.
I can still remember the sensation of warmth, like being in a warm bath, a few days after starting to take Thyroxine.

 

[jantinesco]

@jantinesco It might be wise to request a thyroid check - one of the few indications I had when my thyroid failed was cold hands and feet when I had previously always had warm extremities - adapted to the chills when in the mountains or at sea.
I can still remember the sensation of warmth, like being in a warm bath, a few days after starting to take Thyroxine.

Many thanks for your advice. I have been taking Thyroxine for years and it was my yearly thyroid blood test check up that showed as borderline on the diabetes scale. Hot water bottle or electric blanket is my warm up method these days!

 

[jantinesco]

Welcome to the forum @jantinesco

Sorry to hear you have been feeling a bit grim of late.

Yes tiredness/fatigue, thirst, increased urination and blurred vision can all be associated with undiagnosed diabetes.

From your HbA1c it does look like you are right on the edge of a formal diagnosis.

However don’t despair, some people get a diagnosis of diabetes with an HbA1c into 3 figures, so it’s quite possible that a modest reduction in carbohydrate portion sizes and a few swaps and changes might be all that your metabolism needs to turn the corner.

Some new members find it can be really helpful to begin by keeping a food diary for a week or two. Be ruthlessly honest, and note down everything you eat and drink, along with a reasonable estimate of the total carbohydrate content (not just ‘of which sugars’). This might sound like a bit of a faff, but it’s a really, really helpful way to start to understand the distribution of carbs in your menu, where they lurk hidden (eg ready made sauce), and which meals/snacks are the ‘big hitters’ carb wise.

Once you can see that, you can consider a few swaps, tweaks, changes, or ask members here for there suggestions. They are an inventive lot!

It’s important to recognise that you don’t need to avpid carbs entirely (which isn’t actually possible - there are tiny amounts even in lettuce) but it’s just balancing your carb intake with your body’s unique, individual capacity to process them and preference of sources for a slow release.

Good luck, and let us know how you get on 🙂

Thank you for your encouraging words and I will certainly start keeping a food diary as you suggest. I've never really looked into the carbohydrate content of what I eat and drink so that will be a new learning experience for me.

 

[jantinesco]

OK @jantinesco Those HbA1C readings show that you are right at the top of the pre-diabetic range.
So it is worth looking at reducing the amount or type of carbohydrates you eat because you don't want diabetes on top of the conditions you already have.
Look at the list of foods I mentioned above and see if there are any you eat that you can either cut down on or substitute with something lower in carbohydrates.
For example eating 'cauliflower rice' instead of normal or instead of brown rice. Eating MacDonalds burgers inside lettuce leaves instead of the bun (which I'm told they do for people who ask). Eating bean based pasta (Aldi and other supermarkets have it) instead of normal grain based spaghetti, or using courgette spirals (aka courgetti) instead. Eating berries (blue, black, straw or rasp) or watermelon instead of bananas, oranges or other fruit grown in hot climates.

Very much appreciate you taking the time to respond and for the useful advice. I think I need to put together a list of what is ok to eat and what is a no no. Your recommendations will certainly help me do that.