New member

[Pam01]

Decided to join as my HbA1c has been on the rise for about 10 years. It was 39 then. My Dad had Type 2 . I'm 70, not overweight, active and fit. I try to walk most days and do 2 cardio/ weights fitness classes weekly. I eat a good diet with few ready meals and for the last couple of years have cut down on carbs. I don’t eat much processed sugar ie don’t eat cake and rarely chocolate/ biscuits. HbA1c is now 45. I was told at my GP that the threshold for pre diabetes has gone up by 2 points so I’m not yet in that group.
The doctor I spoke to 10 years ago suggested that I should go on medication sooner rather than later as ‘ You will be getting damaged at a cellular level.’ He then retired and no one else has taken this line since and because I had no symptoms I pushed it to the back of my mind. I recently read an article in The Times about a study which had concluded that current thresholds for diagnosis are not suitable for a lot of women and that cases which should be treated are being missed. I find this particularly concerning as I now seem to be getting pins and needles in my feet and lower legs and find I am sometimes very thirsty in the night. What would anyone advise? The nurse at the surgery just gave a straight no to the idea of treatment. Just another thought- why does there seem to be such a reluctance to medicate?

 

[Martin.A]

HbA1c is now 45. I was told at my GP that the threshold for pre diabetes has gone up by 2 points so I’m not yet in that group.

Really? The threshold is always quoted as 42, so even if it has been raised by 2 points it would still put you into the pre-diabetes range. However, I can't find any references to a change in the definition, on this site nor on the diabetes.co.uk site, both of which still say 42-47.

It seems odd that your surgery is ruling out treatment when the NHS website says "Metformin is used to help prevent type 2 diabetes if you're at high risk of developing it".

 

[Inka]

Welcome @Pam01 🙂 I can understand your worries. Have you adjusted your diet? That can help as much as meds.

Also, have you ruled out other causes of the tingling, eg Vit B deficiency?

 

[childofthesea43]

Do bear in mind that the average A1c for NON-diabetics aged over 65 is about 47.5 (!) and so maybe you need not even be thinking about diabetes. For older people the standard 42-48 thresholds are a lot of nonsense and never had any scientific validity in the first place.

 

[Leadinglights]

There has been some recent guidelines that the thresholds for 'more mature' people should be more lenient if they are not experiencing symptoms.
I would certainly not expect a GP to prescribe medication unless your HbA1C was well into the 50mmol/mol range.
The only way you will know if your symptoms are related to high blood glucose is to ask for an HbA1C or get a home blood glucose monitor and use that to do some strategic testing to see if you are within the expected range 4-7 fasting and before meals and no more than 8mmol/l 2 hours post meal. If you are not within those parameters then an HbA1C would be needed to give a actual diagnosis.
There are other things which could be giving you the symptoms, vitamin deficiency, thyroid and a few others.

 

[rebrascora]

You are fit and healthy by the sound of it and you say you have reduced your carb intake, so these are the important things and an HbA1c of 45 puts you at very, very minimal risk of complications. To put it in perspective my HbA1c was 114 at diagnosis and the very best that I can manage to achieve as a Type 1 is 45 and I have no concerns about complications at that level and my consultant is very happy with that.

Metformin is the first line medication and you really don't want to take that if you don't need to. It can upset your digestive system and it can inhibit the absorption of vitamin B leading to issues with nerves. In fact the pins and needles are more likely to be a consequence of vitamin B12 deficiency than diabetes with an HbA1c of 45, providing your levels have not ever been significantly higher for long periods in the past, which it doesn't sound like. Diet and exercise are far more powerful than Metformin and indeed many other diabetes medications. Some Type 2s can even come off insulin with the right dietary changes, so don't feel that medication is the answer at the HbA1c level you are at.
If you are worried about the pins and needles or it is causing you too much discomfort, ask to have your B12 checked out. Vitamin B12 deficiency is common and easily rectified. Indeed you could try a supplement to see if that helps. If the deficiency occurs when you are taking Metformin, then you have to have regular injections of it to keep your levels up, but since you are not on Metformin, an oral supplement should work fine if that is the problem, unless you are taking other medication which can block it.

If you want to reduce your HbA1c further, a few extra dietary changes should do it and we can help you with that, if you give us an idea of what you typically eat for breakfast, lunch and evening meal. Some very small changes could likely drop it a bit further and it doesn't have to be all sack cloth and ashes. We have members here who bake low carb cakes and muffins and biscuits and bread, if you are missing those things. If you currently still eat bread, swapping to a lower carb option can make a big difference. Personally I gave up on bread as it spikes my levels too much and I can't be bothered to bake. We can give you lots of tips and suggestions if we know the sort of things you currently eat. Just changing your breakfast can make a significant improvement, especially if you currently have toast (even wholemeal) or cereal.

Some people find compression stockings help with the discomfort of pins and needles, cramps or restless leg syndrome, particularly in bed.

 

[Sharron1]

Do bear in mind that the average A1c for NON-diabetics aged over 65 is about 47.5 (!) and so maybe you need not even be thinking about diabetes. For older people the standard 42-48 thresholds are a lot of nonsense and never had any scientific validity in the first place.

That's interesting. Didn't realise that.

 

[Pam01]

Thanks for all your interesting replies. I will certainly look into the B12 thing. I’m comforted to hear that my levels are considered fairly normal for my age.