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Pre-diabetes for an 85 year old

H

helli

Well-Known Member
Relationship to Diabetes
Type 1
I am the only person in my family with any form of diabetes so was surprised when my Dad told me he has been diagnosed with pre-diabetes with an HBA1c of 40.
I have read other threads mention that the thresholds are relaxed as you get older so I wondered if any one could provide any insights into why an 85 year old would be told they have pre-diabetes with a lower HBA1c.

It is possible that there was a "translation error" and he has been told he is at risk of pre-diabetes.

Whatever the case, what are the thoughts of the forum's hive mind about trying to reduce the risk in someone of his age?
I am torn between wanting to reduce any chance of diabetes complications and not wanting him to stop things that he loves, especially considering my parents cook most meals from scratch and are not "beige carb lovers". My Mum makes sure their diet is reasonably healthy and already trying to cut down his 2 squares of dark chocolate a day!

Yes, I know all the stuff about slight reductions and have seen the recommendation for https://lowcarbfreshwell.com/ so no need to repeat 😎

I also have a background thought about a (very) late onset Type 1 as he has other auto-immune conditions but happy to monitor that rather than jump to any conclusions.
 
helli said:
I am the only person in my family with any form of diabetes so was surprised when my Dad told me he has been diagnosed with pre-diabetes with an HBA1c of 40.
I have read other threads mention that the thresholds are relaxed as you get older so I wondered if any one could provide any insights into why an 85 year old would be told they have pre-diabetes with a lower HBA1c.

It is possible that there was a "translation error" and he has been told he is at risk of pre-diabetes.

Whatever the case, what are the thoughts of the forum's hive mind about trying to reduce the risk in someone of his age?
I am torn between wanting to reduce any chance of diabetes complications and not wanting him to stop things that he loves, especially considering my parents cook most meals from scratch and are not "beige carb lovers". My Mum makes sure their diet is reasonably healthy and already trying to cut down his 2 squares of dark chocolate a day!

Yes, I know all the stuff about slight reductions and have seen the recommendation for https://lowcarbfreshwell.com/ so no need to repeat 😎

I also have a background thought about a (very) late onset Type 1 as he has other auto-immune conditions but happy to monitor that rather than jump to any conclusions.
Click to expand...
I posted this in another tread as someone was asking
www.verywellhealth.com

What Are Blood Sugar Levels for Older Adults?

The risk of diabetes increases with age, so monitoring blood sugar is important. A blood sugar level chart can help you determine what’s normal for your age.
www.verywellhealth.com www.verywellhealth.com
There is other discussion in their thread https://forum.diabetes.org.uk/boards/threads/pre-diabetes-or-not.117047/
 
Leadinglights said:
I posted this in another tread as someone was asking
www.verywellhealth.com

What Are Blood Sugar Levels for Older Adults?

The risk of diabetes increases with age, so monitoring blood sugar is important. A blood sugar level chart can help you determine what’s normal for your age.
www.verywellhealth.com www.verywellhealth.com
There is other discussion in their thread https://forum.diabetes.org.uk/boards/threads/pre-diabetes-or-not.117047/
Click to expand...
Thanks for that.
As it is American, I had to do some conversions and concluded "thing are different over there" (but not necessarily worse).
It recommends HbA1c target of 5.7% (39) until your 65th birthday when it goes up to 7.5% (58). Although it does seem to suggest a significant decline in health at that point which is certainly not the case with my parents.

From what my Dad said, they are applying the American targets for people under 65 to a British 85 year old!
 
Yes I was going to link to that thread too @Leadinglights

Prediabetes is a term that was once scrupulously avoided by UK medics, but has been so absorbed in common terminology/media etc that many HCPs now use it. As do DUK and the some content on the NHS website. I have heard from some that it’s adoption in the US was partly driven by pharma, and health insurance companies, both to “have a thing to treat”, and also to identify those at risk of future claims.

www.nhs.uk

Diabetes

Read about the main types of diabetes, a condition that causes a person's blood sugar level to become too high.
www.nhs.uk www.nhs.uk

It seems the preferred NHS term is ‘Non-diabetic Hyperglycaemia’.

There’s an interesting summary of the emergence (and uncertainty) over the term prediabetes here:

“treatment of people with prediabetes is uncommon (22,23) as the notion of a “pre” disease presents a clinical and regulatory conundrum.”
 
I assumed i was tested each year for diabetes. I asked for a test last year when I had an appointment about my cholestral and discovered my annual test wasn't being checked for diabetes. I have subsequently discovered I showed 40 on a blood test in 2014. Amazingly I wasn't told nor was I tested again. It still makes me angry.
I thought prediabetes was 42 and in any event they worry about low blood sugar and falls for someone your fathers age. I was 60 with high blood pressure when a test showed 40. I hadn't seen a Doctor for 6 years just a nurse on annual blood test. I am very disappointed I never had any guidance and despite the result in 2014 I had to ask for a repeat and reading was 69.
I assume he doesn't need to change anything though if he has a very carby breakfast a tweak may be helpful.
 
I have had people make a whole days menu just for me and my diabetes, and not one thing was suitable, but it was all 'healthy'.
As your Mum is targeting dark chocolate in small amounts, it might be an idea to check that she is not following accepted guidelines on healthy eating.
 
My gran has it at 92, we just ignore it and she eats whatever. There’s no issue with long term complications at 92!
 
@helli - putting myself in your shoes, I can totally understand how you feel somewhat conflicted on what "best advice" would look like.

My distant self would be thinking,..... "at 85, the majority of life's miles are already on the clock, without (it seems) too much damage along the way, so keep on doing what you're doing but just be mindful of the spuds, pasta etc, and if that means you find yourself hungry, tweak up the proteins and fats".

My close and doting daughter (my relationship to my own father, not assuming your own) would be more "..... please, please be careful."

It's truly difficult, but it really depends on your father's philosophy in life. If he's a "count your life by smiles and not years", then I'd be encouraging to do what brings him joy and just keep a weather eye on the numbers from time to time.

If he is retested at, say 6 months, he could have a better idea of his direction of travel. If his GP won't do it, the places like MonitorMyHealth (run out of Exeter's NHS labs) do A1c tests very reasonably, without needing a venous draw.

May your father have many happy and healthy days to come.
 
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helli said:
I am the only person in my family with any form of diabetes so was surprised when my Dad told me he has been diagnosed with pre-diabetes with an HBA1c of 40.
I have read other threads mention that the thresholds are relaxed as you get older so I wondered if any one could provide any insights into why an 85 year old would be told they have pre-diabetes with a lower HBA1c.

It is possible that there was a "translation error" and he has been told he is at risk of pre-diabetes.

Whatever the case, what are the thoughts of the forum's hive mind about trying to reduce the risk in someone of his age?
I am torn between wanting to reduce any chance of diabetes complications and not wanting him to stop things that he loves, especially considering my parents cook most meals from scratch and are not "beige carb lovers". My Mum makes sure their diet is reasonably healthy and already trying to cut down his 2 squares of dark chocolate a day!

Yes, I know all the stuff about slight reductions and have seen the recommendation for https://lowcarbfreshwell.com/ so no need to repeat 😎

I also have a background thought about a (very) late onset Type 1 as he has other auto-immune conditions but happy to monitor that rather than jump to any conclusions.
Click to expand...
2 squares of dark chocolate should be absolutely fine, from what other posters have suggested.
 
@helli
I'd say it's up to your Dad.

I was diagnosed with T2D (HbA1c: 104) just after my 80th birthday. My immediate reaction was I don't want to put up with it for the rest of my life (as the GP had said), to suffer its complications, or to take medication like Metformin and endure its side effects.

So I took it as an opportunity to lose excess weight by diet and get my body back to normal (HbA1c: 32-35). I was lucky enough to succeed. I feel years younger and I hope my risks of CVD etc are much reduced.

Prediabetes is a condition in itself. Glucose and lipids (fat) become dysregulated, insulin resistance increases and fatty liver develops*. Eating more healthily, taking as much exercise as you can, and losing some weight makes sense.

HbAIc may increase with age in population studies, but I do not think any of us should take our cue from them.

* Something worth watching:
The European Association for the Study of Diabetes (EASD) invited Prof Roy Taylor to give the 56th Claude Bernard lecture at EASD 2024 in Madrid last September about his lifetime achievement in findind the cause of T2D. EASD have published an interesting interview with Vivienne Parry which sets the scene, in addition to Roy Taylor's superb lecture itself.
 
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Thank you everyone for your thoughts.
As @JITR and @AndBreathe say, this is up to my Dad but he is not one for lots of research so I am trying to educate myself on pre-diabetes for "seniors" to assist with his understanding and how much change he needs to make.

After 20 years with Type 1 diabetes, most of it on forums shared with people with all types of diabetes, I am certainly better educated than the average person on the street about a healthy diet for someone with insulin resistance and the relative carb contents within milk and dark chocolate. My comment about the dark chocolate was slightly tongue in cheek but that is hard to portray just using text (I hoped the exclamation mark would show what I meant but I guess it wasn't clear enough).

You have given me further food for thought but I will let my Dad lead the conversation.

As a slight aside, I find links to long research articles or YouTube videos a complete turn off. I may scan the conclusions of a technically opaque research paper but I am not one for watching videos (especially if they are longer than 10 minutes) - it is not the way I learn.
But I appreciate there are all sorts on the forum and we can chose to read/watch or ignore.
 
Lucyr said:
My gran has it at 92, we just ignore it and she eats whatever. There’s no issue with long term complications at 92!
Click to expand...
I am so much happier, fitter, stronger, active and clear headed at almost 74 than at 64 - also up to much more mischief and going to dance up the sun on May Morning, and then play away the day down on Poole Quay with other morris folk.
I'd not want to go back to eating carbs in any quantity.
 
Tbh @helli if it were my father I wouldn't be worried about a hba1c of 40 at 85 years old, it's still below threshold & may never go up.

You seem a sensible person so I'd be inclined to ignore usual hard-core advice about diet given here by some members, examples I don't eat this/Avoid carbs like ...

By cooking from fresh my guess is your parents are eating a well balanced diet getting all the nutrients they need for their age so let them carry on would be my advice.

Hope they both have many more happy years together.
 
If they have a healthy diet then making any changes even if modest could be detrimental and no real need. I would take issue with whoever had made him think that he needs to be concerned.
Just ensuring his diet includes enough protein and healthy fats and he is eating enough. Elderly people are often better with small frequent meals and given enough time to eat.
 
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