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Old Newbie from Yorkshire

W

Will2025

New Member
Relationship to Diabetes
At risk of diabetes
Hi All,

Just been looking around the forum for some ideas of how to best cope with my new diagnosis and current conditions.

Had a small Mi and Stents some 27 years ago, now 76, and used to have regular yearly blood test for the typical heart things including Diabetes and the results were always, " they are fine ".

Last week had a yearly checkup / blood tests ( which seemed to have been a bit disrupted since covid and surgery problems) and have now been told I am prediabetic at 42.
Was given a telehone appointment with a Health Worker who basically said avoid Sugar etc and that they would test me again in 12 months despite me suggesting I would like a test earlier to see how effective any diet changes are .

As my BMI is 24 weight is not that much of a problem, but lengthy exercise is a bit of a problem these days due to some leg and hand Arthritis.
I will be looking at Carb intake and reducing that, though its going to be a pain and last year I had a big problem with Refux which meant going on more medication and changing to a low Acid diet, so already missing many normal everyday foods and drinks.

At my age I really want to reduce any chance of developing full diabetes so would welcome any advice / forum links that will help me as its so far been difficult to establish what I need to do.

Thanks
 
Welcome to the forum @Will2025
Your hbA1c result of 42 only just brings you into the Prediabetes zone. Hopefully a few tweaks to your diet may be all you need to keep you from developing diabetes.

I didn't need to lose weight. The opposite in fact, but I did find reducing my carb intake together with medication and regular exercise did bring my blood glucose down substantially over the last 12 months.
I do a weekly Tai Chi class and our instructor has modified the exercises for anyone with mobility issues. Some do all or part of the class seated.
 
Welcome to the forum.
There are some more recent NICE guidelines that suggest that for more mature people the thresholds for pre diabetes or diabetes should be more lenient and that personalised targets are more appropriate taking into account other risk factors and the overall quality of life so really your 42mmol/mol HbA1C would be acceptable given your age and just making some sensible choices with your diet should be sufficient to maintain status quo.
Probably sensible to cut down on sugary foods and drinks and have plenty of vegetables and be mindful of your portion size of any high carb foods like bread, potatoes, pasta and rice which are the big hitters with little nutritional value.
 
Thanks for the replies , just wish our Surgery could have given a more insiteful response.
As I'm sure you both know it takes some time to handle such an unexpected diagnosis, even a minor one like mine.
Interesting comment from @Leadinglights about the 42 limit, sounds a bit like blood pressure safe limits that can go up with age.

Just one question if I may, know some folk with full Diabetes do Carb counting as it seems 260g per day is mentioned as a maximum, would this be a good target for me or is that too strict for my level ?

Thanks
 
Hi @Will2025 and welcome to the forum.

Hope this helps to get things into prospective for you.

When I was diagnosed T2 my HBA1c was 51 (Diabetic) so decided to just control the controlables

1) Diet, low carb iro 130 gms per day
2) Weight, Reduce BMI below 25 (now 22.7)
3) Exercise, Increase exercise, within my own limits, ie more walking

My next HBA1c test was 3 months later and came back at 46 ie Pre D

I am 72 so similar age to you and my medical records read " safe and satisfactory for this patient".

My aim is of course to reduce it further if possible

Alan 😉
 
Will2025 said:
Thanks for the replies , just wish our Surgery could have given a more insiteful response.
As I'm sure you both know it takes some time to handle such an unexpected diagnosis, even a minor one like mine.
Interesting comment from @Leadinglights about the 42 limit, sounds a bit like blood pressure safe limits that can go up with age.

Just one question if I may, know some folk with full Diabetes do Carb counting as it seems 260g per day is mentioned as a maximum, would this be a good target for me or is that too strict for my level ?

Thanks
Click to expand...
I think 260g and more is what many who are not diabetic would be having and that may well be putting them at risk in the future so when people do get a warning that they are vulnerable then dropping down their carb intake to around 130g is suggested but particularly cutting out sugary foods and making sure the carbs they have have added value for nutrition and enjoyment.
The book or app Carbs and Cals is good for showing portion sizes with carb amounts which makes it easier to see what good choices would be.
 
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Hi @Will2025 and welcome to the forum from an old fella from Lancashire.

As many of the forum will know, I'm not over fond of labels. They have their uses of course but there are times when they can do a disservice, especially when they are applied without any context. For me, the "at risk of diabetes" is just such a label. It needs to be put into context.

For the likes of you me and @Alan44 - 70+, reasonably fit, not excessively overweight, blood pressure and general blood chemistry OK - I take the view that having an HbA1c in the range 41-47 is something to be aware of and not something to react to with any urgency. Very different to somebody much younger with other pointers to their body chemistry showing that if they continue without change, they are building problems for their old age.

My HbA1c hovers around the diagnosis limit (48 +/- a bit) and I can keep it there by watching my weight, watching my carb intake and taking some pills. I do not have the short term inconveniences of diabetes and quite honestly something else will get me before the long term issues come into play. As such, I don't see any value in facing the hassle of trying to get my HbA1c down. My DSN agrees - indeed would like to see my HbA1c a bit higher if anything. She takes the view that the last thing I need is low blood glucose making my balance problems worse. Next time I fall, or trip over nothing, could be a much bigger problem than my diabetes will ever be.

So there is another perspective. My thought for you is to say fair enough, I'm in pretty good nick for an old un, and get on with more interesting things than trying to work out how to get your Hba1c down a bit!
 
Welcome to the forum @Will2025

As others have suggested, it’s common for HbA1c to naturally increase later in life possibly because red blood cells are replenished more slowly.

There’s a discussion about this phenomenon and some research into possible personalisation of higher HbA1c targets for older people here:
J

Post in thread 'Should diabetic thresholds (42/48 mmol/l) be age adjusted?'

Leadinglights said:
I found this among others but it seems to have a useful summery of both medications available and blood glucose 'targets' for different categories of people.
Click to expand...

This link does not work for me:

This link does:

Here below are 2 and 3 of that pdf (page 1 is the summary of anti-diabetic agents LeadingLights mentioned):

Page 2...
  • Like
 
My target when diagnosed at 80 was to get into the trousers I used to wear. Lost some weight, got my HbA1c down to 32-35, and feel all the better for it. Especially after losing that last 5% to reach BMI 22.

I'd suggest your look through the notes in Dr David Unwin's diet sheet, use Dr Kim Andrews' food lists for reference, apply common sense and consider having a go.

Good luck.
 
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