New to Diabetes - couple of questions

[AstraZer0]

Hi I wonder if people could help me please.
I have a couple conditions which restrict my movement/exercise and when I was tested (HbA1c) last year I was told I was prediabetic with a number of 46. I was sent to food courses etc and was able to lose a stone in weight and brought my number down to 45 (that was July). Had another test in October (had them close together due to checking vit D test as well). Had to have another blood test just to confirm but now it’s 50. I haven’t been extreme in eating and no where near to what it was before, so why the big jump? I can’t exercise much, I get that, but to jump 5 points in such a small amount of time doesn’t make sense. I have my first Diabetes clinic on the 6th. Just wondered has anyone have the same kind of thing happen to them before their diagnosis? Also from other peoples experiences, because I can’t exercise as much, would I be given medication straight away?

 

[rebrascora]

Hi and welcome.

Had you been ill with a virus or other infection in the preceding few weeks of the third test?
Do you mind telling us what your other conditions are and do you perhaps take steroids for them? Steroids can push BG levels up quite significantly.

What sort of advice were you given on the course you went on? Unfortunately the standard NHS advice for dietary changes for diabetes can be unhelpful
If you can give us an idea of your typical breakfast, lunch and evening meals and any snacks, we might be able to spot foods which may be contributing to your increasing BG, if illness or steroids can be ruled out.

 

[Leadinglights]

Unfortunately the advice give on the Diabetes courses for Type2 and prediabetes follow the standard NHS advice and are far to high in carbohydrates for many people to tolerate, eg swapping white bread, rice and pasta for brown, sweet potatoes for potatoes when they are just as high in carbohydrates.
This link explains what a GP surgery found with their Type2 patients and developed the Freshwell program and it is approach which many have found successful https://lowcarbfreshwell.com/
Exercise will help but diet is the most important and anything you can do will be beneficial. There are some Seated exercises on the NHS website which may be suitable for you

 

[AstraZer0]

Hi and welcome.

Had you been ill with a virus or other infection in the preceding few weeks of the third test?
Do you mind telling us what your other conditions are and do you perhaps take steroids for them? Steroids can push BG levels up quite significantly.

What sort of advice were you given on the course you went on? Unfortunately the standard NHS advice for dietary changes for diabetes can be unhelpful
If you can give us an idea of your typical breakfast, lunch and evening meals and any snacks, we might be able to spot foods which may be contributing to your increasing BG, if illness or steroids can be ruled out.

Thanks for replying.

No, no illness/infection. (Edited to add that I have a kidney infection now, but I don’t think I had it when my last blood test was done in early November, just been given antibiotics) I have Functional Neurological Disorder and Fibromyalgia, no medication for them (mainly because I had bad side effects) except pain killers when needed.

When I was first told I had prediabetes the gp suggested the Mediterranean diet, she gave me a fact sheet with suggested servings (portions too) and certain foods etc. which I’ve been doing to a certain extent. I live in Wales and they have a food course called food wise, which is a generic course to help lose weight which I incorporated into what I was already doing. Most of it was the same portion wise.

Typical breakfast is Lizzi’s low sugar granola with either nuts or small apple. Semi skimmed milk or Greek yoghurt

Lunch - depends if I have bread it’s the hovis no added sugar wholemeal small loaf. One piece with sardines or scrambled egg or marmite etc

Dinner - mix of recipes from diabetes website, focusing on chicken, turkey, white fish, oily fish and atleast one vegetarian meal. If I have pasta or rice it’s whole grain. Small portions. For example today I had turkey taco (without the taco) half a wholemeal wrap instead. That was a weight watchers recipe. I don’t have much in the way of potato because I have also ibs which it doesn’t like. I swap for sweet potatoes etc. I know I’m rambling lol.

I’m confused how my HbA1c test went down from 46 (last October to 45 in July to then jump up to 50 this October). I haven’t been given proper guidance yet due to my first clinic being soon. I just thought I was doing ok as I had lost a stone. Just assumed I was going in the right direction. I don’t really do snacks.

 

[AstraZer0]

Unfortunately the advice give on the Diabetes courses for Type2 and prediabetes follow the standard NHS advice and are far to high in carbohydrates for many people to tolerate, eg swapping white bread, rice and pasta for brown, sweet potatoes for potatoes when they are just as high in carbohydrates.
This link explains what a GP surgery found with their Type2 patients and developed the Freshwell program and it is approach which many have found successful https://lowcarbfreshwell.com/
Exercise will help but diet is the most important and anything you can do will be beneficial. There are some Seated exercises on the NHS website which may be suitable for you

That’s probably where I’m going wrong then, as that’s exactly what I was told on the food course I did. I do a lot of Mediterranean recipes though as my gp recommended it. Thanks for the link!

 

[Drummer]

@AstraZer0 I suspect poor advice - carbs are carbs, no matter what colour, and we don't need them - some low carb foods such as salads, stirfries, vege mixtures, give variety, colour and texture, but I don't eat grain, high carb fruit and veges and I restrict beans and peas not in pods as I seem to be able to get extra carbs out of them.
I eat eggs, cheese, full fat yoghurt, meat and fish and seem to be doing well on them.

 

[AstraZer0]

@AstraZer0 I suspect poor advice - carbs are carbs, no matter what colour, and we don't need them - some low carb foods such as salads, stirfries, vege mixtures, give variety, colour and texture, but I don't eat grain, high carb fruit and veges and I restrict beans and peas not in pods as I seem to be able to get extra carbs out of them.
I eat eggs, cheese, full fat yoghurt, meat and fish and seem to be doing well on them.

I’m hoping when I go to the clinic they can give me more specific advice about food then. As the others were more to lose weight in general.

 

[Leadinglights]

I’m hoping when I go to the clinic they can give me more specific advice about food then. As the others were more to lose weight in general.

You may find they will still follow the same NHS rather outdated advice.

 

[rebrascora]

From the menu you have detailed, I don't think that is the issue. I understand and agree with what others above are saying about wholemeal/brown/sweet versions but it sounds like you have reduced portion size of those carb rich foods as well as changed to higher fibre options but it sounds like you are pretty low carb and if you were only prediabetic, then that sort of diet should have turned things around.

The HbA1c results of 46 and 45 are essentially the same, so I would not read anything into a reduction of 1mmol/mol as that will likely be within the error margin of the testing, but an increase to 50 does seem odd considering your weight loss and dietary changes, especially if you were eating a lot more carbs before.

Have they checked your blood for anaemia as that cause a minor increase in HbA1c.

You could certainly try to reduce your carbs a bit further to see if it improves your next HbA1c or get yourself a Blood Glucose (BG) meter and do some testing around meals to see if there is something that you are eating which is raising your levels too much and find an alternative if you do. It might be the granola. It will still have plenty of carbs in it even if it is low sugar and high carb foods on a morning can have the biggest impact on levels especially if you are unable to be active during the day to burn some of that glucose off.

I am not familiar with either of the other conditions you mention. Are either of them autoimmune conditions. I know Polymyalgia Rheumatica (PMR) is as my sister has that but not sure about Fibromyalgia? The reason I ask about autoimmune conditions is that unfortunately, once you get one, you are more at risk of developing others and Type 1 diabetes is autoimmune. Adult onset of Type 1 can be very slow and initially present like Type 2 and many doctors and nurses don't even consider it as a possibility when you are diagnosed with diabetes and just assume you are Type 2 as that is more common. There are also other Types of diabetes like Type 3c where damage is caused to the pancreas from disease or trauma or surgery. If you have had gall bladder issues or had pancreatitis in the past, this is a possibility.

Anyway, in your position I think that I would be inclined to start with some home testing to keep an eye on your levels and see if I could identify any foods which are challenging your body to manage the glucose from them and replace those foods with other lower carb alternatives.
If you decide to go this route, the two most recommended BG meters for reliability and economy of use by people on this forum who self fund are the Gluco Navii or the Spirit Tee2. You would be well advised to get at least a couple of extra pots of test strips as the meter kit only comes with 10 and you will get through those very quickly. Most of us reuse lancets many times so the 10 that come with the kit would last me the best part of 10 years (yes, despite them supposedly being single use, I change my lancet once a year) but that lancet only gets used on me. If I want to check a friend or family member, I use a new lancet and then dispose of it. We will give you advice about a testing strategy if you decide to get a BG meter, so do ask.

 

[AstraZer0]

From the menu you have detailed, I don't think that is the issue. I understand and agree with what others above are saying about wholemeal/brown/sweet versions but it sounds like you have reduced portion size of those carb rich foods as well as changed to higher fibre options but it sounds like you are pretty low carb and if you were only prediabetic, then that sort of diet should have turned things around.

The HbA1c results of 46 and 45 are essentially the same, so I would not read anything into a reduction of 1mmol/mol as that will likely be within the error margin of the testing, but an increase to 50 does seem odd considering your weight loss and dietary changes, especially if you were eating a lot more carbs before.

Have they checked your blood for anaemia as that cause a minor increase in HbA1c.

You could certainly try to reduce your carbs a bit further to see if it improves your next HbA1c or get yourself a Blood Glucose (BG) meter and do some testing around meals to see if there is something that you are eating which is raising your levels too much and find an alternative if you do. It might be the granola. It will still have plenty of carbs in it even if it is low sugar and high carb foods on a morning can have the biggest impact on levels especially if you are unable to be active during the day to burn some of that glucose off.

I am not familiar with either of the other conditions you mention. Are either of them autoimmune conditions. I know Polymyalgia Rheumatica (PMR) is as my sister has that but not sure about Fibromyalgia? The reason I ask about autoimmune conditions is that unfortunately, once you get one, you are more at risk of developing others and Type 1 diabetes is autoimmune. Adult onset of Type 1 can be very slow and initially present like Type 2 and many doctors and nurses don't even consider it as a possibility when you are diagnosed with diabetes and just assume you are Type 2 as that is more common. There are also other Types of diabetes like Type 3c where damage is caused to the pancreas from disease or trauma or surgery. If you have had gall bladder issues or had pancreatitis in the past, this is a possibility.

Anyway, in your position I think that I would be inclined to start with some home testing to keep an eye on your levels and see if I could identify any foods which are challenging your body to manage the glucose from them and replace those foods with other lower carb alternatives.
If you decide to go this route, the two most recommended BG meters for reliability and economy of use by people on this forum who self fund are the Gluco Navii or the Spirit Tee2. You would be well advised to get at least a couple of extra pots of test strips as the meter kit only comes with 10 and you will get through those very quickly. Most of us reuse lancets many times so the 10 that come with the kit would last me the best part of 10 years (yes, despite them supposedly being single use, I change my lancet once a year) but that lancet only gets used on me. If I want to check a friend or family member, I use a new lancet and then dispose of it. We will give you advice about a testing strategy if you decide to get a BG meter, so do ask.

Thanks for the detailed reply. It’s much appreciated.
I haven’t had a blood test for anaemia in a while. Couple of years maybe? Had to take folic acid at the beginning of the year.

Will look more into the food I eat and will definitely look into a monitor, at least it will help show where I’m going wrong.

They did think at first that I might have polymyalgia Rheumatica and I was put on steroids but then decided not as I wasn’t in the right age group although my inflammation markers were slightly elevated.

Fibromyalgia- Maybe a central nervous system problem? Causes a lot of widespread pain and fatigue etc Drs still not really sure how it happens but new research has suggested it could be an autoimmune problem.
Functional Neurological Disorder FND - Again a lot of research needed lol A brain network disorder where the signals in the brain aren’t working properly. Symptoms similar to MS, Parkinson’s, Tourette’s, Epilepsy without the damage (although they have found structural changes in the white matter in the brain recently).

 

[Proud to be erratic]

Hello @AstraZer0, from reading your post I think it could well be that when you said much earlier in the thread that you hadn't had any recent illness or infections, my instinct [absolutely not a medical opinion] is that your ongoing Functional Neurological Disorder and Fibromyalgia could each be factors that affect your BG.

Their effect could be moderately random and the elevated BG would come from your body trying to resist or fight off a new "attack". The timing of that inner defence could precede you being aware that you were about to have a bad spell of either ailment. If this sounds impossible I first bumped into this consequence when I was developing a response to something I knelt on while gardening. I didn't know I had a bad knee infection coming along; my BG went noticeably high, without any obvious reason (then), then my knee stiffened and I subsequently needed A&E intervention, with antibiotics and a knee brace for 3 weeks. I now know this can be quite common - raised BG from a yet to be revealed ailment/illness.

Widespread pain and fatigue would quite naturally elevate your BG anyway, without the association with Fibromyalgia. For someone without Diabetes, their body's auto defence mechanisms could leave them blissfully unaware that this was happening.

Do look into getting a BG test meter, as @rebrascora suggests. But do test systematically; a series of random results will tell you nothing useful. If you decide to proceed with getting a meter and strips tell us and we'll try to help you find a worthwhile routine for becoming your own detective!

 

[gail2]

I’m hoping when I go to the clinic they can give me more specific advice about food then. As the others were more to lose weight in general.

when you go to clinic ask to be referred to a diabetic dietitian

 

[Drummer]

I’m hoping when I go to the clinic they can give me more specific advice about food then. As the others were more to lose weight in general.

I was only concerned with reducing my blood glucose at first - my waist shrank by 12 inches - I was almost spherical at diagnosis, despite trying to follow all the 'good advice' I got for decades.
Suddenly, effortlessly, I shrank down in size - I think I have PTSD after all the abuse about not losing weight on their high carb low fat diets. My clothes started sliding off.
Now, 8 years after diagnosis I am able to work again, I can hoist the knitting machines around to service them, I am more flexible, and doing quite well for someone who will be 74 this year.