Possibly pre-diabetic...

[Myci85]

Hello,
I'm new here and currently trying to learn everything I can about managing diabetes, and have found this forum really helpful, thank you.
I had some bloods done recently to figure out why I'm not feeling 'right' (feel very shaky and pale etc at times before eating, despite eating at regular times, and waking with numb/tingly fingers almost like carpal tunnel syndrome) and they came back showing my iron levels are low, and my blood sugar levels are borderline high. They're redoing them again in 6 weeks before classing me as pre-diabetic, but the doctor was less than helpful, simply advising me to consider my diet and exercise in the meantime to try and reduce my levels, with no actual information.
I've a few questions if anyone is able to help.
1) I'm trying to reduce my carbs and sugars substantially (as well as joining a bootcamp exercise class), to see if this has an effect on my levels, but I'm wondering if there is a daily carb amount I should be aiming for?
2) I'm only just 36, and other than being slightly heavier than I used to be (size 12 at max) I have none of the other classic risk factors for Type 2 and don't typically eat a diet high in sugar and fat etc. I'm wondering if there's a chance it's late developing Type 1 - I have Crohns and have read that having any other autoimmune condition predisposes you to late type 1, but equally have read that having IBD can increase your risk of developing type 2. How have others been diagnosed with type 1 later in life than the norm, as I feel the assumption is always that it's type 2 at this age.

Sorry for the long post, thank you for reading if you made it this far!

 

[rebrascora]

Hi and welcome.

To me your low iron is likely responsible for your slightly elevated/borderline HbA1c result. What are they doing to tackle that? HbA1c is the diabetes diagnostic test and measures the amount of glucose stuck to your red blood cells. If you are low on red blood cells (anemia) then there will be proportionally more glucose stuck to the ones you have. At least I think that is the logic of it. The symptoms you describe of feeling shaky and pale are usually associated with hypos in diabetes which are usually caused by injecting too much insulin, so not something we would expect you to experience without medication. There is a condition called Reactive Hypoglycaemia which can be related to diabetes or can be completely separate, but it is more likely that something other than diabetes or RH is causing your symptoms. What you could do is invest in a basic Blood Glucose meter (the Gluco Navii or the Spirit Tee2 are most often recommended for economy of use and reliability here on the forum by people self funding) and test your levels when you get these shaky feellngs before meals to see what is happening. The meter kit comes with just 10 test strips, so you would be well advised to purchase an additional pot of 50 test strips and a box of lancets so that you can do some testing along with a food diary to get a picture of what is going on. You could include some higher carb meals within that testing period to see how your body responds to those as well as testing when you feel wobbly.

I was late developing Type 1 (at 56yrs old) and I had sudden onset symptoms one night when I had been out for a meal. Started to feel thirsty as I was leaving the pub and downed a pint of water when I got home which didn't even take the edge off it. Kept waking up through the night craving water and of course persistent visits to the loo. That went on for 2 weeks before I sought medical help but I realised pretty quickly that it was likely diabetes and started changing my diet and cutting back on sugar during that time, which did help a bit. Then the weight started to drop off me and I was consistently losing 4lbs a week.

Looking back I can remember getting pins and needles in my legs after short periods of hunkering down and my body temperature would fluctuate and make me feel quite ill at times and deep seated pains in my back just below my left shoulder blade which would make me feel really unwell and I now wonder if that was my pancreas feeling the strain. And dropping off to sleep after meals which is a common result of high blood glucose. I was menopausal though, so put it down to that.... aches and pains of getting older etc. That had probably been going on for maybe a couple of years before but those things don't happen anymore so I believe they were an indication that things were failing before my pancreas reached crisis point and could no longer cope.

Anyway, that was my experience and my suggestion for how to investigate your current situation with a view to possibly ruling out diabetes or gaining more evidence that it might be linked to your insulin production.

 

[Myci85]

Hi and welcome.

To me your low iron is likely responsible for your slightly elevated/borderline HbA1c result. What are they doing to tackle that? HbA1c is the diabetes diagnostic test and measures the amount of glucose stuck to your red blood cells. If you are low on red blood cells (anemia) then there will be proportionally more glucose stuck to the ones you have. At least I think that is the logic of it. The symptoms you describe of feeling shaky and pale are usually associated with hypos in diabetes which are usually caused by injecting too much insulin, so not something we would expect you to experience without medication. There is a condition called Reactive Hypoglycaemia which can be related to diabetes or can be completely separate, but it is more likely that something other than diabetes or RH is causing your symptoms. What you could do is invest in a basic Blood Glucose meter (the Gluco Navii or the Spirit Tee2 are most often recommended for economy of use and reliability here on the forum by people self funding) and test your levels when you get these shaky feellngs before meals to see what is happening. The meter kit comes with just 10 test strips, so you would be well advised to purchase an additional pot of 50 test strips and a box of lancets so that you can do some testing along with a food diary to get a picture of what is going on. You could include some higher carb meals within that testing period to see how your body responds to those as well as testing when you feel wobbly.

I was late developing Type 1 (at 56yrs old) and I had sudden onset symptoms one night when I had been out for a meal. Started to feel thirsty as I was leaving the pub and downed a pint of water when I got home which didn't even take the edge off it. Kept waking up through the night craving water and of course persistent visits to the loo. That went on for 2 weeks before I sought medical help but I realised pretty quickly that it was likely diabetes and started changing my diet and cutting back on sugar during that time, which did help a bit. Then the weight started to drop off me and I was consistently losing 4lbs a week.

Looking back I can remember getting pins and needles in my legs after short periods of hunkering down and my body temperature would fluctuate and make me feel quite ill at times and deep seated pains in my back just below my left shoulder blade which would make me feel really unwell and I now wonder if that was my pancreas feeling the strain. And dropping off to sleep after meals which is a common result of high blood glucose. I was menopausal though, so put it down to that.... aches and pains of getting older etc. That had probably been going on for maybe a couple of years before but those things don't happen anymore so I believe they were an indication that things were failing before my pancreas reached crisis point and could no longer cope.

Anyway, that was my experience and my suggestion for how to investigate your current situation with a view to possibly ruling out diabetes or gaining more evidence that it might be linked to your insulin production.

Thank you so much for your in depth reply, that's really helpful. I was completely unaware that anaemia can impact HbA1c results, but have just done some reading on it, and seems there's lots of studies out there that have found this. You would think that if my dr found low iron levels in the same blood tests as finding borderline high blood sugar levels (42mmol), this would have been something she'd consider, and have opted for a glucose test to compare with HbA1c to decide if I actually am pre-diabetic.
This has definitely given me something to think about, whilst following a low carb diet can only help me to lose a few pounds anyway, it would be nice to know if I don't need to be so strict with it, and not worrying about my blood sugar levels.
I had considered buying a blood glucose meter, having used one with a child I used to work with who had diabetes, to monitor the impact of different foods. Do you know if these would also be impacted by low iron levels in the same way as HbA1c, or would they provide a better idea of if my blood sugar levels are indeed too high?
Thank you again for your helpful info, and I'm really glad to see it looks like you've got your diabetes under control now you've been diagnosed correctly.

 

[rebrascora]

I believe that the BG meter will be unaffected by the low iron.
BG levels rise and fall quite significantly throughout the day and night due to a number of factors (about 42 of them) but food and exercise/activity are the main players, so testing before a meal and then 2 hours afterwards will usually show you how well your body coped with the carbs in that meal.
If you have Reactive Hypoglycaemia your levels will go too high and then crash but the highs and lows often cancel each other out so you end up with a fairly moderate HbA1c result even though your body is not coping with carbs very well, because the HbA1c ends up being a sort of 3 monthly average of your BG levels. This is where spot testing with a BG meter can be so helpful and particularly testing when you don't feel right and diabetes is suspected.

Thank you again for your helpful info, and I'm really glad to see it looks like you've got your diabetes under control now you've been diagnosed correctly.

Thanks for that but not feeling terribly well managed just at the moment as I am going through a bit of a difficult spell.
I tend to view it more as a game now, but it's a tricky game where the rules change and the goal posts move just when you think you have the hang of it, which can be quite frustrating sometimes and definitely challenges the old grey matter and keeps you on your toes! I will get back to better results but just going through a period of minor BG turbulence at the moment.😡 it happens because most of those 42 factors I mentioned above, are not actually under our control and you can't even identify which ones are causing the fluctuation. Hormones are a messy system to try to manage. It really makes you appreciate what a fantastic job that blobby little organ did before my overzealous immune system knackered it's insulin producing capability! 🙄

 

[janw]

Hi and welcome
I see you have Crohns, please remember that if you have to take steroids at any time, they will also increase your BG. I have friends with Crohns and I know they needed steroids from time to time. I have a steroid inhaler for daily use for another illness, I check my BG before using it as I know it will give a higher reading otherwise. Just something for you to keep in mind anyhow.

 

[Myci85]

Hi and welcome
I see you have Crohns, please remember that if you have to take steroids at any time, they will also increase your BG. I have friends with Crohns and I know they needed steroids from time to time. I have a steroid inhaler for daily use for another illness, I check my BG before using it as I know it will give a higher reading otherwise. Just something for you to keep in mind anyhow.

Thank you. I'm actually not taking any medication for my crohns, I'm managing it topically as and when needed (I have more extraintestinal symptoms that anything) so this shouldn't impact the BG reading, but is quite probably the cause of the anaemia. Also wondering about b12 levels now too, as some of my symptoms seem to fit for that, and again crohns makes you less able to absorb b12.

 

[EmmaL76]

I believe that the BG meter will be unaffected by the low iron

This is correct rebrascora. An hba1c that is high due to iron deficiency will have no corresponding rise in finger pricks tests. So testing with a meter at home would be a good idea.

 

[starfish212]

Hi there myci85, I’m a prediacetic (at risk of diabetes) too. Reading food labels etc and completely changing the type of food I eat. All is well at the moment, I have another what my GP calls a Birthday Clinic in the spring, so we will know how I’m doing.

 

[everydayupsanddowns]

Maybe ask your Dr about a fructosamine test? This is an alternative to HbA1c, not reliant on red blood cells (the Hb in HbA1c is haemoglobin)