On the verge

[Stravinsky]

Went for a blood test for cardio vascular check and a few days later doctors receptionist called to ask me to go in for another blood test in a few weeks and said to drink more water. I assumed there was a problem with the blood test and needed re doing
Returned from a break a few days later to find a letter telling me my HbA1c result was 46 mmol/mol with some dietary suggestions and telling me I was pre diabetic.

As you can imagine I'm slightly shocked, I'm not overweight and I don't eat processed food if I can help it, some chocolate biscuits in moderation in the evening maybe or a small packet of crisps sometimes. Havent exercised too much over the last 6 or 7 months due to a hernia.

I cant get to the doctors for the second blood test until January so I took matters into my own hands and ordered a Freestyle Libra 2 sensor monitor as I'm uncomfortable with not knowing my levels for the next 2 or three weeks. Has anyone tried these? They are hugely expensive but I feel its the only way to keep a monitor on my blood sugar levels for the short term until I get back to the doctors. Also bought an exercise bike to try and do at least some regular exercise

 

[Martin.A]

Hi, and welcome to the Forum. A diagnosis of pre-diabetes is generally seen as a wake-up call to make some lifestyle changes, specifically around diet. Apart from your chocolate biscuits and occasional crisps how are you with bread, pasta, rice, potatoes and breakfast cereals? If these are a large part of your diet it suggests you're consuming more carbohydrate than your body can handle.

Many forum members are using CGMs and will be better able to comment on your use of a Libra 2. Any reason why you chose that option rather than simple (and cheaper) finger prick testing?

 

[Bruce Stephens]

Has anyone tried these?

About 95% of people with Type 1 diabetes are using a CGM, with a large proportion (including me) using Libre 2. Beware that they're not always accurate (like test strips, but with a test strip you can easily just wash your hands and try another one).

 

[Stravinsky]

Hi, and welcome to the Forum. A diagnosis of pre-diabetes is generally seen as a wake-up call to make some lifestyle changes, specifically around diet. Apart from your chocolate biscuits and occasional crisps how are you with bread, pasta, rice, potatoes and breakfast cereals? If these are a large part of your diet it suggests you're consuming more carbohydrate than your body can handle.

Many forum members are using CGMs and will be better able to comment on your use of a Libra 2. Any reason why you chose that option rather than simple (and cheaper) finger prick testing?

Thanks for replying @Martin.A

The choice of the CGM was mainly to get constant readings in the short term rather than just when the finger prick is done. The sensors cost £50 every 2 weeks so its not affordable in the long term

As regards food, the internet is very confusing. Ive now changed to wholemeal bread from white bread. We eat a lot of pasta, but now Ive changed to wholewheat pasta. Yes we eat Basmati rice which on checking seems to be OK in smaller portions as do smaller portions of potatoes. Breakfast cereal I have been eating home made granola with nuts and dried cranberries but unfortunately it also has honey in it so I am assuming that's not good. Now eating Fruit and Fibre with unsweetened unflavoured Greek Yogurt instead of milk and taking almond milk in my coffee

 

[Leadinglights]

Thanks for replying @Martin.A

The choice of the CGM was mainly to get constant readings in the short term rather than just when the finger prick is done. The sensors cost £50 every 2 weeks so its not affordable in the long term

As regards food, the internet is very confusing. Ive now changed to wholemeal bread from white bread. We eat a lot of pasta, but now Ive changed to wholewheat pasta. Yes we eat Basmati rice which on checking seems to be OK as do smaller portions of potatoes. Breakfast cereal I have been eating home made granola with nuts and dried cranberries but unfortunately it also has honey in it so Ia'm assuming thats not good. Now eating Fruit and Fibre with unsweetened unflavoured Greek Yogurt instead of milk and taking almond milk in my coffee

You are still eating a lot of high carb foods, pasta, breakfast cereals, bread. Pasta made from edamame beans of black beans is much lower carb. Many of us find a good breakfast is full fat Greek yoghurt with berries and then a very small portion of a low sugar or keto granola or eggs in any form with bacon, tomatoes, mushrooms and maybe a small slice of toast.
The cost of a home testing blood glucose monitor and test strips would be much cheaper and certainly give you information about how you tolerate meals by testing before you eat and after 2 hours when an increase of no more than 2-3mmol/l would be acceptable, you can probably extract that info from your Libre data and use that as a basis for modifying your meals if needed.
Have a look at this link for some ideas for modifying your diet and making some substitutions for the high carb foods.

Homepage - Freshwell Health Centre

www.freshwell.co.uk

 

[Stravinsky]

You are still eating a lot of high carb foods, pasta, breakfast cereals, bread. Pasta made from edamame beans of black beans is much lower carb. Many of us find a good breakfast is full fat Greek yoghurt with berries and then a very small portion of a low sugar or keto granola or eggs in any form with bacon, tomatoes, mushrooms and maybe a small slice of toast.
The cost of a home testing blood glucose monitor and test strips would be much cheaper and certainly give you information about how you tolerate meals by testing before you eat and after 2 hours when an increase of no more than 2-3mmol/l would be acceptable, you can probably extract that info from your Libre data and use that as a basis for modifying your meals if needed.
Have a look at this link for some ideas for modifying your diet and making some substitutions for the high carb foods.

Homepage - Freshwell Health Centre

www.freshwell.co.uk

Thank you, that was a very useful link, Ive downloaded the low carb diet book. That@s what I was saying about the internet being confusing, as even the fact sheet from my GP surgery says rice, pasta and potatoes are OK and seems to focus on portion control.

 

[Leadinglights]

Thank you, that was a very useful link, Ive downloaded the low carb diet book. That@s what I was saying about the internet being confusing, as even the fact sheet from my GP surgery says rice, pasta and potatoes are OK and seems to focus on portion control.

That is because many GP surgeries are behind the times in recognising the value of low carbohydrate and still push low fat and more carbs than many can tolerate.

 

[trophywench]

Nowt that wrong with milk from cows! What the body of a person with Type 1 or 2 diabetes has difficulty with processing is ALL carbohydrate and sugar is merely a carbohydrate although its actually a mix of glucose and sucrose, and there are indeed other '~ose's eg maltose, which are also full of carbs. Then there's the starchy carbs - so that's anything with flour in it (eg bread, pasta, pastry, usually cake) and root veg which although spuds aren't roots, they're tubers - are about the worst for carbs though parsnips score pretty high too - but we just don't tend to eat as many parsnips as we do potatoes.

Fruit & Fibre cereal - so Bran flakes and dried fruit. Think about that - starchy carbs in the flakes and sweetness in the dried fruit! (sultanas = dried ie dehydrated, seedless grapes) And what are grapes then? Pretty accurately described by my late mother in law 20 odd years ago, as individual little bags of pure sugar ! (Just easier to eat than spoonfuls of granulated sugar .........)

There again you probably only need to reduce the carbs you consume a bit - or quite a bit! - and lower carb does not by any means, mean NO carb - so just read the labels on packets or look stuff up on the internet to see what the carb value is of things that aren't in packets or tins which usually have that info handily printed on the (back of) labels, to make judgments on whether to buy this, or the other one.

 

[Stravinsky]

Nowt that wrong with milk from cows! What the body of a person with Type 1 or 2 diabetes has difficulty with processing is ALL carbohydrate and sugar is merely a carbohydrate although its actually a mix of glucose and sucrose, and there are indeed other '~ose's eg maltose, which are also full of carbs. Then there's the starchy carbs - so that's anything with flour in it (eg bread, pasta, pastry, usually cake) and root veg which although spuds aren't roots, they're tubers - are about the worst for carbs though parsnips score pretty high too - but we just don't tend to eat as many parsnips as we do potatoes.

Fruit & Fibre cereal - so Bran flakes and dried fruit. Think about that - starchy carbs in the flakes and sweetness in the dried fruit! (sultanas = dried ie dehydrated, seedless grapes) And what are grapes then? Pretty accurately described by my late mother in law 20 odd years ago, as individual little bags of pure sugar ! (Just easier to eat than spoonfuls of granulated sugar .........)

There again you probably only need to reduce the carbs you consume a bit - or quite a bit! - and lower carb does not by any means, mean NO carb - so just read the labels on packets or look stuff up on the internet to see what the carb value is of things that aren't in packets or tins which usually have that info handily printed on the (back of) labels, to make judgments on whether to buy this, or the other one.

Thanks, yes i does make sense in retrospect .... someone who has just been thrown into it finds it very confusing with all the opinions on the internet and thats why I came here to get thoughts from the people who actually experience it

 

[Martin.A]

Thanks for replying @Martin.A

The choice of the CGM was mainly to get constant readings in the short term rather than just when the finger prick is done. The sensors cost £50 every 2 weeks so its not affordable in the long term

As regards food, the internet is very confusing. Ive now changed to wholemeal bread from white bread. We eat a lot of pasta, but now Ive changed to wholewheat pasta. Yes we eat Basmati rice which on checking seems to be OK in smaller portions as do smaller portions of potatoes. Breakfast cereal I have been eating home made granola with nuts and dried cranberries but unfortunately it also has honey in it so I am assuming that's not good. Now eating Fruit and Fibre with unsweetened unflavoured Greek Yogurt instead of milk and taking almond milk in my coffee

As @Leadinglights says there's still a lot of carbohydrate in there. Wholewheat is admittedly a healthier choice, even for non-diabetics, but in terms of carbohydrate there's not a lot of difference between wholewheat and white. so it's best to also reduce portion size. I eat red lentil pasta, for example, but keep my portion size to 40g (uncooked). Unfortunately most breakfast cereals are notoriously high carb, 69% in the case of Fruit & Fibre. Some are even higher than that.

 

[trophywench]

It is much a question of portion size, as it is the carb content. Most breakfast cereals reckon a portion of it is about 30 grams in weight. (not that much over 1 ounce) So - weigh out 30g of it. Someone on here once sarcastically described that amount as 'an elf's portion rather than a normal adult's' - because it really isn't very much at all, to look at. When yer average dinner plate diameter was roughly 9 or 10 inches (not all that long ago, in truth) we did usually consume smaller portions. Now the plates have grown - so have the portion sizes so the food doesn't look 'lost' - and our bodies. So - either reduce the size of the plates and hence the portion sizes and/or fill some of the empty space with extra green leafy (low carb) veg. Protein adult portion = roughly the same size as a standard packet of 20 fags - not 'that much' at all, to look at, really!

 

[Stravinsky]

As @Leadinglights says there's still a lot of carbohydrate in there. Wholewheat is admittedly a healthier choice, even for non-diabetics, but in terms of carbohydrate there's not a lot of difference between wholewheat and white. so it's best to also reduce portion size. I eat red lentil pasta, for example, but keep my portion size to 40g (uncooked). Unfortunately most breakfast cereals are notoriously high carb, 69% in the case of Fruit & Fibre. Some are even higher than that.

Thanks for that @Martin.A that all makes perfect sense

 

[Stravinsky]

It is much a question of portion size, as it is the carb content. Most breakfast cereals reckon a portion of it is about 30 grams in weight. (not that much over 1 ounce) So - weigh out 30g of it. Someone on here once sarcastically described that amount as 'an elf's portion rather than a normal adult's' - because it really isn't very much at all, to look at. When yer average dinner plate diameter was roughly 9 or 10 inches (not all that long ago, in truth) we did usually consume smaller portions. Now the plates have grown - so have the portion sizes so the food doesn't look 'lost' - and our bodies. So - either reduce the size of the plates and hence the portion sizes and/or fill some of the empty space with extra green leafy (low carb) veg. Protein adult portion = roughly the same size as a standard packet of 20 fags - not 'that much' at all, to look at, really!

Thanks @trophywench. It does all begin to make a bit of sense now, for after the Diabetic nurse called this afternoon I questioned their idea that pasta rice and bread in wholegrain / wholemeal form was OK, but she pushed the portion size element as well. As mentioned here though and on the freshwell site that was suggested, there are plenty of alternatives

 

[Stravinsky]

Just an update, Ive been wearing the Libra sensor for the first day today. I accept that its not going to be totally accurate and that its only a day but my glucose level has been showing around 5 to 5.1 mmol/l which I think equates to around 29 hb1ac. In the past Ive been drinking Concentrated Tart Cherry juice for some time daily which I stopped after the blood test ... but I just had a glass of it and its spiked to 8.4 (52 bb1AC). Ive obviously got a lot to learn about all this

 

[Leadinglights]

You can't really convert your finger prick or Libre readings to an HbA1C and as they are measuring something different. Certainly not from a single reading or one days worth.
If you are looking at the effect of food or drink then you would look at the level after a couple of hours not immediately. Liquids will affect blood glucose more quickly than food. 8.4 is not really a spike. It is at a reading of no more than 8 -8.5mmol/l that people would be aiming for 2 hours after a meal.

 

[Stravinsky]

You can't really convert your finger prick or Libre readings to an HbA1C and as they are measuring something different. Certainly not from a single reading or one days worth.
If you are looking at the effect of food or drink then you would look at the level after a couple of hours not immediately. Liquids will affect blood glucose more quickly than food. 8.4 is not really a spike. It is at a reading of no more than 8 -8.5mmol/l that people would be aiming for 2 hours after a meal.

As i said, I have a lot to learn. I found what puported to be a calculator / convertor on line but seems like thats wrong. I'd noticed right away that fruit juice heightens sugar levels quickly, whilst dinner tonight consisting of wheat pasta took it to 7.1mmol/l but over a 25 minute period. Now back to 5 but in between all that it dropped to 3. As you say, over a longer period might give a better insight. Thanks for your comments

 

[Leadinglights]

As i said, I have a lot to learn. I found what puported to be a calculator / convertor on line but seems like thats wrong. I'd noticed right away that fruit juice heightens sugar levels quickly, whilst dinner tonight consisting of wheat pasta took it to 7.1mmol/l but over a 25 minute period. Now back to 5 but in between all that it dropped to 3. As you say, over a longer period might give a better insight. Thanks for your comments

One of the things about having a Libre it can almost give you too much information or at least more than you would be getting from a finger prick testing regime which potentially will cause to to over react about foods that may be perfectly fine.
If you are prediabetic then you are likely still producing enough insulin and your body is using it well enough to cope with a certain amount of carbohydrates and the knack is in finding what that amount is. Your body may react differently to different types of carbs so again it is finding that balance.
When people are using finger prick testing which for many is a very satisfactory method and relatively inexpensive, you can do a lot of testing for the equivalent cost of a sensor. A good testing regime would be a morning test to track progress day to day, week to week, etc when people would be aiming at 4-7mmol/l, also testing the effect of your meal by testing before you eat and after 2 hours when you would be aiming at no more than 8-8.5mmol/l. If levels are higher than that (which yours don't look to be ) then an increase of no more than 2-3mmol/l 2 hours post meal would indicate your meal is OK. Pairs of reading are more useful.
Hopefully you will be able to gain some useful indication of what foods you should reduce or not have from your Libra data. Keeping a food diary along with your blood glucose reading would also be helpful.

 

[Martin.A]

As i said, I have a lot to learn. I found what puported to be a calculator / convertor on line but seems like thats wrong. I'd noticed right away that fruit juice heightens sugar levels quickly, whilst dinner tonight consisting of wheat pasta took it to 7.1mmol/l but over a 25 minute period. Now back to 5 but in between all that it dropped to 3. As you say, over a longer period might give a better insight. Thanks for your comments

The converters can give you a rough idea of where your HbA1c might be but not from a single test, or even from several tests. If you log your results over several weeks and calculate an average, and use that average, it will give you some idea but I've found from experience that I need to allow +/- 2 on whatever the HbA1c suggestion is. For example, for my last HbA1c I estimated that I would be somewhere between 37 and 41 and when I looked up my test result on Patient Access I saw that it was 41.

I log all my finger prick readings on a spreadsheet and it calculates a 7-day moving average for me. If I then tell it to insert a graph of those averages I can see whether my levels are trending upwards (hope not), downwards (ideally) or remaining flat (OK with that).

 

[Stravinsky]

The converters can give you a rough idea of where your HbA1c might be but not from a single test, or even from several tests. If you log your results over several weeks and calculate an average, and use that average, it will give you some idea but I've found from experience that I need to allow +/- 2 on whatever the HbA1c suggestion is. For example, for my last HbA1c I estimated that I would be somewhere between 37 and 41 and when I looked up my test result on Patient Access I saw that it was 41.

I log all my finger prick readings on a spreadsheet and it calculates a 7-week moving average for me. If I then tell it to insert a graph of those averages I can see whether my levels are trending upwards (hope not), downwards (ideally) or remaining flat (OK with that).

One of the things about having a Libre it can almost give you too much information or at least more than you would be getting from a finger prick testing regime which potentially will cause to to over react about foods that may be perfectly fine.
If you are prediabetic then you are likely still producing enough insulin and your body is using it well enough to cope with a certain amount of carbohydrates and the knack is in finding what that amount is. Your body may react differently to different types of carbs so again it is finding that balance.
When people are using finger prick testing which for many is a very satisfactory method and relatively inexpensive, you can do a lot of testing for the equivalent cost of a sensor. A good testing regime would be a morning test to track progress day to day, week to week, etc when people would be aiming at 4-7mmol/l, also testing the effect of your meal by testing before you eat and after 2 hours when you would be aiming at no more than 8-8.5mmol/l. If levels are higher than that (which yours don't look to be ) then an increase of no more than 2-3mmol/l 2 hours post meal would indicate your meal is OK. Pairs of reading are more useful.
Hopefully you will be able to gain some useful indication of what foods you should reduce or not have from your Libra data. Keeping a food diary along with your blood glucose reading would also be helpful.

Thanks, yes I see its not a simple thing. I have 4 weeks worth of sensor (they are £50 each which last 2 weeks!) so hopefully after that I will have some sort of idea as the app takes all the readings and gives a general updated average. I can also add notes on the graph to show what I eat and you can see what affect it has. Early days but so far I seem to be generally around 5 - 5.5 mmol/l and eating pasta, which I guess I should limit, takes it to around 7.

After the sensors run out hopefully I'll have an idea of what I can and cant eat to keep it at an acceptable level

Good idea about the food diary as well.
Thank you both again for your advice and help

 

[Stravinsky]

In trying to discover which foods are most appropriate, and thinking about breakfast today I read on Diabetes UK that seeded grained wholegrain bread was a good option and so eat two pieces with some marmite .... only to discover 45 minutes later that my mmol is currently at 9.1 (from 5.1) and rising. The highest its been since I started. Its very confusing