I'm a 79 year old female who was been diagnosed with prediabetes 6 years ago and at high risk of type 2 due to family history. I now hover around 41-43 Hb1Ac by having very few refined carbs and not much in the way or unrefined. I wear a CGM every so often to learn about how my blood sugar responds to different foods or meals.
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trophywench
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Welcome from me too. Sounds like you've been doing OK with the changes you've made yourself, so well done you!
Is there any particular reason that made you join now?
Is there any particular reason that made you join now?
rebrascora
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Hi and welcome from me too.
I take exception to this phrase "high risk of Type 2" which I have seen quoted by new members as being used by medical professionals a few times recently and to me it seems to be deliberately scary. I appreciate that some patients ignore the "at risk of diabetes" warning but many doctors seem to ignore it too because often patients are not told until years later when they get a full diabetes diagnosis. However using the "high risk" phrase seems to instill panic in people (it's like a red alert light with a claxon going off in my mind) and that is not right either.
I think you are doing great and clearly being very proactive in using Libre to help you tailor your diet but I would like to put your situation into some sort of context so that you hopefully will be a little less concerned about it.
Firstly, as we get older, our red blood cells are not replaced as quickly as when we were younger and HbA1c is a measure of the amount of glucose stuck to your red blood cells over their lifetime which is usually 2-3 months. If they are in your blood stream for longer then they will naturally attract more glucose, but that doesn't necessarily mean that your glucose levels are elevated. There is a school of thought which suggests that they should increase the diagnostic level of HbA1c for older people.
Secondly, I am Type 1 and have to balance my levels by injecting insulin. This means that I have to balance not going too high with not going too low. It is a tricky balance and my consultant would be quite happy with me achieving an HbA1c in the low 50s. I am nearly 60yrs old, so a bit younger than you but I am aiming for an HbA1c higher than you and if I can hit that target, I don't worry about it, but I would be ecstatic if I was getting results in the low 40s. Many Type 1 diabetics are diagnosed as children and struggle to achieve those sorts of levels over their whole lifetime, so to my mind, as long as you can keep yourself reasonably fit and healthy, those levels you are at or even a bit higher are perfectly acceptable and not going to do you any harm and you should not worry about them.
I am not suggesting you go out and eat cake and chocolate until it comes out of your ears, but be reasonable and allow yourself an occasional treat and don't worry about that "high risk" label. At 79yrs old, there are often limited enjoyments in life and food is one of them, so don't make life less enjoyable by being too strict with your diet.
The risk of complications developing with an HbA1c below 50 are very minimal.
Look after your health, exercise daily if you are able (walking is ideal, but seated exercises are also good) and eat healthily but enjoyably and aim to get to at least 100yrs.
Worry and anxiety about diabetes can have a bigger negative impact on your health than the occasional treat.
Those would be my thoughts.
I take exception to this phrase "high risk of Type 2" which I have seen quoted by new members as being used by medical professionals a few times recently and to me it seems to be deliberately scary. I appreciate that some patients ignore the "at risk of diabetes" warning but many doctors seem to ignore it too because often patients are not told until years later when they get a full diabetes diagnosis. However using the "high risk" phrase seems to instill panic in people (it's like a red alert light with a claxon going off in my mind) and that is not right either.
I think you are doing great and clearly being very proactive in using Libre to help you tailor your diet but I would like to put your situation into some sort of context so that you hopefully will be a little less concerned about it.
Firstly, as we get older, our red blood cells are not replaced as quickly as when we were younger and HbA1c is a measure of the amount of glucose stuck to your red blood cells over their lifetime which is usually 2-3 months. If they are in your blood stream for longer then they will naturally attract more glucose, but that doesn't necessarily mean that your glucose levels are elevated. There is a school of thought which suggests that they should increase the diagnostic level of HbA1c for older people.
Secondly, I am Type 1 and have to balance my levels by injecting insulin. This means that I have to balance not going too high with not going too low. It is a tricky balance and my consultant would be quite happy with me achieving an HbA1c in the low 50s. I am nearly 60yrs old, so a bit younger than you but I am aiming for an HbA1c higher than you and if I can hit that target, I don't worry about it, but I would be ecstatic if I was getting results in the low 40s. Many Type 1 diabetics are diagnosed as children and struggle to achieve those sorts of levels over their whole lifetime, so to my mind, as long as you can keep yourself reasonably fit and healthy, those levels you are at or even a bit higher are perfectly acceptable and not going to do you any harm and you should not worry about them.
I am not suggesting you go out and eat cake and chocolate until it comes out of your ears, but be reasonable and allow yourself an occasional treat and don't worry about that "high risk" label. At 79yrs old, there are often limited enjoyments in life and food is one of them, so don't make life less enjoyable by being too strict with your diet.
The risk of complications developing with an HbA1c below 50 are very minimal.
Look after your health, exercise daily if you are able (walking is ideal, but seated exercises are also good) and eat healthily but enjoyably and aim to get to at least 100yrs.
Worry and anxiety about diabetes can have a bigger negative impact on your health than the occasional treat.
Those would be my thoughts.
Proud to be erratic
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I'm 74 and have it in writing after my consult in Aug '23 that my minor increase in HbA1c to 51 is fine and that I should further relax my efforts to even stay at 51 mmol/L. Not written in the report but most pleasantly and strongly expressed to my wife who was with me was that I should set 8 as my average target for TIR - rather than the 7 I'd recently adopted and have my upper alarm on my CGM well above 10. All of this was confirming that my risks were low from being above the official range of 4-10 and it was far more important to be a bit high rather than low.
This official advice from a knowledgeable Consultant sits comfortably alongside the views expressed a short while ago by @rebrascora.
This official advice from a knowledgeable Consultant sits comfortably alongside the views expressed a short while ago by @rebrascora.
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