Pre-diabetes or Diabetes?

Status
Not open for further replies.
A

AbalancE

Member
I was diagnosed with pre-diabetes 5 years ago (at HbA1c 46 mmol/mol and fasting 6.3). Since then, my HbA1c has been between 43 and 46, but is now 47. I am on the red line, am I now considered diabetic?

Rationally, I want to stay stable in the pre-diabetes zone; motivated to stay reasonably active, careful with my diet and not overweight.
However, I feel like I have been working on this on my own and that support and a full range of regular checks are not available to me because I have managed to stay under 47 up until now.
Initially I was sent on a "healthier you" education programme and I went along to be with others newly diagnosed with pre-diabetes. I am joining in on here for similar reasons as well as for information and views.
So, which category should I place myself in "at risk of diabetes" or "Type 2"?
 
The threshold for type 2 diabetes is 48. 42-47 being prediabetic, so you would be considered prediabetic
 
Officially, I'm pre-diabetic too. But I doubt that diabetes is a 'binary' condition, and more likely 'smears' somewhat across BG levels, according to individual metabolism/physiology.

Other than diet and exercise, the only difference, really is if one is put on medication.

It's similar to high blood pressure - at what readings is one put on bp meds? I doubt that is 'binary' either.

And then again, even if one drops down below the pre-diabetic readings levels into 'non-diabetic', I doubt it's a good idea to revert to high carbs, high weight gain, low exercise 'just because' one's Hba drops below the 'official' figure!!!

All that said, the doctors do need to try and place some degree of categorisation on patients, in order to get a handle on what they should or should not be doing.

Why do you think your HBa levels are creeping back up? Sadly, as we age, we do seem to wring every last calorie out of every gram of food we consume (!) and, too, exercise becomes more of a challenge too, so maybe that is a factor? Or have you been put on any other meds for anything else, or have developed any other health issues to complicate matters?
 
Welcome to the forum @AbalancE

Well done on holding your diabetes at bay for several years, and good to hear that you are keeping active too 🙂

Sorry to hear your HbA1c has been nudging upwards a little recently. Hopefully, with the support of the forum you can make a few additional tweaks to your menu to make it easier for your metabolism to process the foods you are eating.

Since you don't have excess weight to lose it seems likely that moderating your total carbohydrate intake (not just 'of which sugars') might be an effective strategy. Diabetes can be a very fickle and individual thing, so there are no hard and fast rules, or a 'one size fits all' menu that will suit everyone, but some modest adjustments to your way of eating to moderate the carb load of meals have been shown to be highly effective for forum members in the past.
 
AbalancE said:
I was diagnosed with pre-diabetes 5 years ago (at HbA1c 46 mmol/mol and fasting 6.3). Since then, my HbA1c has been between 43 and 46, but is now 47. I am on the red line, am I now considered diabetic?

Rationally, I want to stay stable in the pre-diabetes zone; motivated to stay reasonably active, careful with my diet and not overweight.
However, I feel like I have been working on this on my own and that support and a full range of regular checks are not available to me because I have managed to stay under 47 up until now.
Initially I was sent on a "healthier you" education programme and I went along to be with others newly diagnosed with pre-diabetes. I am joining in on here for similar reasons as well as for information and views.
So, which category should I place myself in "at risk of diabetes" or "Type 2"?
Click to expand...
Treat yourself as T2 Diabetic whatever the numbers say. Have you got a meter ? Perhaps you should buy a cheap model such as Tee2 and the testing strips. Then find out how each carb - bread, flour, pasta, spuds, rice, fruit etc affect you and what portion size of them you can tolerate. Then 'eat to your meter'. Alan S's 'Test, Review, Adjust' advice is a starter.
Some Blue Sky Thinkers are suggesting 'pre-diabetics- should start injecting insulin to rest the Beta Cells, to stop them destroying themselves trying overcome Insulin Resistance, and ward off a diagnosis of full blown diabetes.
How are the other aspects of the Metabolic Syndrome doing - blood pressure and cholesterol ?
 
I agree that treatment for pre-diabetics and those just into the diabetic range does seem to vary from GP surgery to surgery. Just recently I read here of a pre-diabetic being put straight onto Metformin (with unfortunate side effects). My surgery is much more enlightened, as are others, where a newly diagnosed Type 2 just into the range, is given the opportunity to reduce their glucose levels with lifestyle changes.
It might be worth checking your portion sizes of carbs, to see if there has been a size increase - so easy to do!!! You might just need some minor reductions.
And unless one has severe restrictive medical conditions, age is no barrier to exercise. At 72 I'm one of the youngest members of my aquafit classes, and members have a number of conditions: MS, arthritis, hip/knee degeneration/replacements, even a heart condition (OK'd by their GP to exercise), to name a few. Even stuck indoors, it is possible to exercise: sitting in a chair; a mini exercise bike; stretching/twisting exercises whilst lying in your bed (for those like me who can't get up off the floor!).
 
Callista said:
Officially, I'm pre-diabetic too. But I doubt that diabetes is a 'binary' condition, and more likely 'smears' somewhat across BG levels, according to individual metabolism/physiology.

Other than diet and exercise, the only difference, really is if one is put on medication.

It's similar to high blood pressure - at what readings is one put on bp meds? I doubt that is 'binary' either.

And then again, even if one drops down below the pre-diabetic readings levels into 'non-diabetic', I doubt it's a good idea to revert to high carbs, high weight gain, low exercise 'just because' one's Hba drops below the 'official' figure!!!

All that said, the doctors do need to try and place some degree of categorisation on patients, in order to get a handle on what they should or should not be doing.

Why do you think your HBa levels are creeping back up? Sadly, as we age, we do seem to wring every last calorie out of every gram of food we consume (!) and, too, exercise becomes more of a challenge too, so maybe that is a factor? Or have you been put on any other meds for anything else, or have developed any other health issues to complicate matters?
Click to expand...
Thank you.
I think my system is quite sensitive, so even small changes can have an affect. Recently I have felt more stressed and know that alters my metabolism. Also I am at my "winter weight" of 53-54kg. I feel better at 52-53kg. So, I may still be able to stop the HbA1c creeping any higher this year with lifestyle choices, but it involves careful planning. I can feel "hangry" if meals are delayed and wobbly at the end of a walk (occasionally very weak, clammy and anxious), probably hypo, so carry small snacks.
I agree with you that the boundaries between "pre" and "diabetes" are blurred. I feel "slightly diabetic".
I do not take any medication and would prefer to stay that way as long as possible. The medical centre has suggested that I make a phone appointment with GP. I am to be offered statins I think. From my research so far, I gather that statins can raise blood sugar, so want to have a thorough discussion about what is right for me. I will look for further threads on the topic of statins on here.
 
Burylancs said:
Treat yourself as T2 Diabetic whatever the numbers say. Have you got a meter ? Perhaps you should buy a cheap model such as Tee2 and the testing strips. Then find out how each carb - bread, flour, pasta, spuds, rice, fruit etc affect you and what portion size of them you can tolerate. Then 'eat to your meter'. Alan S's 'Test, Review, Adjust' advice is a starter.
Some Blue Sky Thinkers are suggesting 'pre-diabetics- should start injecting insulin to rest the Beta Cells, to stop them destroying themselves trying overcome Insulin Resistance, and ward off a diagnosis of full blown diabetes.
How are the other aspects of the Metabolic Syndrome doing - blood pressure and cholesterol ?
Click to expand...
Thank you. Interesting questions and ideas. I wanted to start testing when I was first diagnosed with pre-diabetes, but was told it was unnecessary. I will consider it again now, at the very least I would like to know just how low and how high I go in a normal day.
My blood pressure is normal/low.
Cholesterol and triglycerides have been flagged up. I am about to be offered statins I think, but will be doing a lot of my own research before having that discussion with the GP.
 
everydayupsanddowns said:
Welcome to the forum @AbalancE

Well done on holding your diabetes at bay for several years, and good to hear that you are keeping active too 🙂

Sorry to hear your HbA1c has been nudging upwards a little recently. Hopefully, with the support of the forum you can make a few additional tweaks to your menu to make it easier for your metabolism to process the foods you are eating.

Since you don't have excess weight to lose it seems likely that moderating your total carbohydrate intake (not just 'of which sugars') might be an effective strategy. Diabetes can be a very fickle and individual thing, so there are no hard and fast rules, or a 'one size fits all' menu that will suit everyone, but some modest adjustments to your way of eating to moderate the carb load of meals have been shown to be highly effective for forum members in the past.
Click to expand...
Thank you.
Taking a closer look at carbs, seems like the next step for me.
Until recently, I assumed that my general understanding of starches, sugars, fibre, proteins, fats/oils would be enough. Thank you for the nudge to look further at carb load. Considering the numbers, portion sizes, weights is likely to highlight some meals that could be improved.
 
Felinia said:
I agree that treatment for pre-diabetics and those just into the diabetic range does seem to vary from GP surgery to surgery. Just recently I read here of a pre-diabetic being put straight onto Metformin (with unfortunate side effects). My surgery is much more enlightened, as are others, where a newly diagnosed Type 2 just into the range, is given the opportunity to reduce their glucose levels with lifestyle changes.
It might be worth checking your portion sizes of carbs, to see if there has been a size increase - so easy to do!!! You might just need some minor reductions.
And unless one has severe restrictive medical conditions, age is no barrier to exercise. At 72 I'm one of the youngest members of my aquafit classes, and members have a number of conditions: MS, arthritis, hip/knee degeneration/replacements, even a heart condition (OK'd by their GP to exercise), to name a few. Even stuck indoors, it is possible to exercise: sitting in a chair; a mini exercise bike; stretching/twisting exercises whilst lying in your bed (for those like me who can't get up off the floor!).
Click to expand...
Thank you for the suggestion to check portion sizes of carbs. Yes, "some minor reductions" are probably in order after the winter.
I like your attitude to age and exercise! I teach a few Tai Chi classes each week and have some people in my classes in their late 80's and early 90's, with similar range of conditions.
Being able to walk regularly makes a big difference to me and having company helps keep me motivated to go out. I need to get back to swimming...especially if I am to try SUP this summer (Stand Up Paddleboarding). I will be 65 soon.
 
AbalancE said:
Thank you.
Taking a closer look at carbs, seems like the next step for me.
Until recently, I assumed that my general understanding of starches, sugars, fibre, proteins, fats/oils would be enough. Thank you for the nudge to look further at carb load. Considering the numbers, portion sizes, weights is likely to highlight some meals that could be improved.
Click to expand...
Check out the Glycemic Index and Glycemic Load concepts as well. And the Mediterranean Diet
 
Glad you're checking out statins before accepting them. I think they are a Big Step, and not to be undertaken lightly.
 
AbalancE said:
I can feel "hangry" if meals are delayed and wobbly at the end of a walk (occasionally very weak, clammy and anxious), probably hypo, so carry small snacks.
I agree with you that the boundaries between "pre" and "diabetes" are blurred. I feel "slightly diabetic".
Click to expand...
If you have untreated diabetes, your blood glucose levels are likely to be too high rather than too low.
Typically, hypos are cause by medication for diabetes such as insulin unless you are experiencing reactive hypoglycemia which is not diabetes.

If you are feel wobbly when walking, you may want to discuss this with your doctor as it may be symptomatic of something else but it is very unlikely to be a hypo.
 
When I was first diagnosed my HbA1C was 80, clearly diabetic, then I got it down to 50 in 3 months with diet alone, my GP said that this was prediabetic (which I know is incorrect from this forum) then I reduced it further to 40 and am now below the pre-diabetic range, but I still follow the same eating pattern that helped me lose weight and get my BG down as when I was at the highest number. Like others have said, a low carb healthy diet is a good standard to follow, especially as we get older, our metabolims slow down and weight tends to accumulate on our middle. I just wanted to agree with other people on here, the results you get seem to be interpreted differently by different doctors, and in my case I believe it was because my GP thought the positive reinforcement, together with the knowledge I was aiming to lose another 2 stone when it was at 50, that the changes I had made would have a good impact with my next test, which they did.

I think I have a more open GP though, he will discuss medication with me and is understanding when I ask to be allowed to try and reduce it myself first. I hope you get it lowered, this place was a godsend to me, the nicest forum I am on 🙂 x
 
AbalancE said:
I was diagnosed with pre-diabetes 5 years ago (at HbA1c 46 mmol/mol and fasting 6.3). Since then, my HbA1c has been between 43 and 46, but is now 47. I am on the red line, am I now considered diabetic?

Rationally, I want to stay stable in the pre-diabetes zone; motivated to stay reasonably active, careful with my diet and not overweight.
However, I feel like I have been working on this on my own and that support and a full range of regular checks are not available to me because I have managed to stay under 47 up until now.
Initially I was sent on a "healthier you" education programme and I went along to be with others newly diagnosed with pre-diabetes. I am joining in on here for similar reasons as well as for information and views.
So, which category should I place myself in "at risk of diabetes" or "Type 2"?
Click to expand...
Hiya There @AbalancE , Sorry to hear your diagnosis , based on your HbA1c you are in fact at risk of diabetes therefore I would suggest looking at our information on how to prevent diabetes here :https://www.diabetes.org.uk/preventing-type-2-diabetes/can-diabetes-be-prevented
We also have many free booklets on dietary plans and what to do when your at risk in the Diabetes UK shop here: https://shop.diabetes.org.uk/collections/know-your-risk
Wish you all the best , Nile
 
Jenny65 said:
When I was first diagnosed my HbA1C was 80, clearly diabetic, then I got it down to 50 in 3 months with diet alone, my GP said that this was prediabetic (which I know is incorrect from this forum) then I reduced it further to 40 and am now below the pre-diabetic range, but I still follow the same eating pattern that helped me lose weight and get my BG down as when I was at the highest number. Like others have said, a low carb healthy diet is a good standard to follow, especially as we get older, our metabolims slow down and weight tends to accumulate on our middle. I just wanted to agree with other people on here, the results you get seem to be interpreted differently by different doctors, and in my case I believe it was because my GP thought the positive reinforcement, together with the knowledge I was aiming to lose another 2 stone when it was at 50, that the changes I had made would have a good impact with my next test, which they did.

I think I have a more open GP though, he will discuss medication with me and is understanding when I ask to be allowed to try and reduce it myself first. I hope you get it lowered, this place was a godsend to me, the nicest forum I am on 🙂 x
Click to expand...
Thank you Jenny65. I am pleased that I joined this community. People are offering practical suggestions, information I can check out and I feel supported already. It is good to hear about your experience and I may expect/request more from my GP in terms of proper discussion about me as an individual. My starting point is different from yours, at about 8st 8lb few would suggest that I need to lose weight, though I will be happier when I am 3-4 lb lighter again and that may hold my HbA1C steady a bit longer. I felt that I was running out of lifestyle changes that I could make, but am going to shift my "heathy diet" in a low carb direction. Thanks again for encouragement.
 
helli said:
If you have untreated diabetes, your blood glucose levels are likely to be too high rather than too low.
Typically, hypos are cause by medication for diabetes such as insulin unless you are experiencing reactive hypoglycemia which is not diabetes.

If you are feel wobbly when walking, you may want to discuss this with your doctor as it may be symptomatic of something else but it is very unlikely to be a hypo.
Click to expand...
That is interesting. Someone else suggested to me that I was unlikely to go hypo unless on medication. I wonder what other physiological changes fit that kind of pattern? Thank you for encouragement to discuss this with my GP. I am going to have a long list of questions!
 
Status
Not open for further replies.
Back
Top