Pre Diabetic diagnosis

[Bobbinc]

So, just diagosed pre-diabetic after a health check at the Doctors and a little frustrated. it seems the diagnosis for diabetes is very subjective but essentially require similar actions on diet,exercise and longevity

Ive seen some really helpful posts on here which has encouraged me to join the forum

First measurement was recorded as 46 mmol/m so I was booked in for a HbA1c blood test which came out at 51 (In diabetic range?) then referred for another a month later that was 46.

Looking back over the past few months there are potential symptoms I have experienced which, reading throough bits on this site and the internet could be related to the condition which may well swing the diagnosis to type 2 rather than pre? but, here is one of my frustrations, I havent actually seen a doctor.

All interaction has been through texts and calls/tests with the blood people. When I tried to contact my doctor, I was met by the "wall" of reception who initially said my readings were down and no further action was needed before being contacted by another part of the surgury suggesting a referral to the NHS prevention programme - so many mixed messages and no chance to discuss things from my side.

I am going to try to get to see my doctor to ask a few questions but one of my other problems is that I am Rubbish at communicating health concerns to Doctors. I tend to feel like I am making a big thing of nothing and wasting their time - something I need to overcome if I can get that appointment (and not just put it off)

Reading through alot of the advice on food, again a weakness of mine. I like cake, dairy, sweets, chocolate and all those things needed to cut down on and havent a clue on how much of each I eat apart from too much and also I see the task of normalising a healthly balanced diet a little daunting. I have in the distant past been succesful in losing weight with gradual reverting back to old habits 😉

So far I know just statements of fact but a few questions.

Is the NHS prevention programme worth persuing?

Is there anywhere that will give proper easy meal suggestions with the "right" food contents?

Am I correct that even with the "pre" in the diagnosis, I am effectively in for a lifestyle change

 

[ColinUK]

Yes it’s worth engaging with the NHS prevention program. If nothing else it’ll educate you more.

As for communicating concerns with your doctor know that you’re never wasting their time.

Try writing things down beforehand maybe and also book a double appointment to give you more time. You’ll have to tell the receptionist that you want to talk about two issues of course.

And keep engaging with the forum!

 

[JITR]

A copy of a recent post that may help.
One to read (Harcombe Diet link): https://www.zoeharcombe.com/2021/08/what-should-we-eat/

Here are some links to diets which may help you put your T2 into remission and then, if you need/wish, lose some more weight to revert to your former self and the size of clothes you used to wear.

Dr David Unwin
Here is a link to Dr David Unwin's low carb diet leaflet from the Public Health Collaboration website. It answers the question of what to eat for breakfast, lunch and dinner as well as giving lots of useful information:
phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf

Most of those diagnosed T2D at Dr Unwin's Norwood Surgery opt for diet rather than medication. Over 130 of them have gone inro remission in the past ten years. 93% of their pre-diabetic patients return to normal following the Norwood guidelines.

Dr Unwin explained the nuts & bolts of drug free T2 diabetes remission, and how he lost weight, in this presentation last year:youtube.com/watch?v=t9Nvj2lfs2Y

Zoe Harcombe
The Norwood Diet is remarkably similarl to the Harcombe Diet. After suffering various eating disorders and years of yo-yo dieting, Zoe Harcombe devised her diet to cut out cravings, lose weight, and sustain weight loss for the future. It is based on her detailed understanding of the best nutritional research. Dozens of positive reviews on Amazon US and Amazon UK from people who have lost weight prove the diet is successful in practice.

Here is a link to my blog post of an article on the Harcombe Diet with some useful added links at the end:
The Harcombe Diet: How to eat your favourite foods and still lose weight
The Harcombe Diet: How to eat your favourite foods and still lose weight By Prima Team PUBLISHED: 21 APRIL 2016 Do you dream of a weight l...

diabetes-type2-remission.blogspot.com

Having lost 22 kg, I am adopting the princople of this diet to ensure I don't put it all back on again.

Dr Kim Andrews
The Freshwell Low Carb project has a really clear explanation of why the lo-carb approach is good for most people, best I've seen: https://lowcarbfreshwell.com/going-low-carb/

Dr Andrews' 4 Week Meal Planners may be just what you are looking for. You can download them here: https://lowcarbfreshwell.com/resources/meal-planners/

 

[Leadinglights]

Welcome to the forum from me also.
Your diagnosis although unwelcome may spur you into making some positive changes which will reduce your blood glucose and keep you at more normal levels.
I am a fan of the Freshwell approach (link above) and followed the principals rather than the varied meal plans and recipes but having something more defined suits some people.

 

[Drummer]

@Bobbinc it isn't so much what you can't eat, as excluding the bad stuff and eat everything else.
If you want cake there are lots of recipes for baked goods on the web Sugarfreelondoner has lots of good stuff.
Dairy - full fat dairy is good, no worries about that.
Sweets - best avoided as they can be full of sugar alcohols and they can be a bit explosive.
Chocolate, fine if it high cocoa not sugary stuff.
I found that once I got my blood glucose into normal numbers my weight reduced without effort and I continue to shrink down bit by bit year by year. Regaining has never featured in the last 7 years.

 

[PerSpinasAdAstra]

In my view prediabetes is, in most cases, Type 2 diabetes that hasn't gotten bad enough to need medication yet. From everything I've read and learned so far there is absolutely good reason to hope that you can at the very least delay the onset of Type 2, and every year you can push it back is good news for your health in years to come. As regards diet, others have provided good links though I would caution while reading some of that information to ask yourself whether the author believes that cholesterol and cardiovascular disease are linked. Personally I don't see much point in going to such extremes with low-carb dieting in order to control my diabetes that I end up having a stroke or heart attack in future due to eating a diet that leads to very high cholesterol levels. I believe in balance and in hedging my bets, and any advice that I should be eating loads of butter, cheese and cream because saturated fat is supposedly just fine, while I should stop eating carrots and apples because carbs are terribly bad, seems a risky approach in itself to me.

If you have weight to lose my advice is to try to lose it, by whatever combination of diet and exercise suits you best. This long interview with Roy Taylor, a professor of medicine and diabetes researcher, contains pretty much all you need to know about how weight loss can help get your HbA1c down and maybe even keep it down. Diet alone can address your HbA1c, but unless it results in weight loss it will likely not address the underlying condition.

There is hope, and time to act. The very best of luck 🙂

 

[everydayupsanddowns]

Is there anywhere that will give proper easy meal suggestions with the "right" food contents?

You might like to browse the Diabetes UK meal plans for a few suggestions too.

There are a variety of different options focussed on either low calorie, low carb, or other popular healthy eating styles such as a mediterranean diet.

Meal plans and diabetes

Eating nutritious, healthy and downright delicious food is that bit easier with our meal planners. We've created multiple different weekly meal plans to suit all types and tastes. They're nutritionally balanced, are calorie and carb counted, and can help if you want to lose weight. They also...

www.diabetes.org.uk

Welcome to the forum 🙂

 

[JITR]

Good post - a few comments:

In my view prediabetes is, in most cases, Type 2 diabetes that hasn't gotten bad enough to need medication yet. From everything I've read and learned so far there is absolutely good reason to hope that you can at the very least delay the onset of Type 2, and every year you can push it back is good news for your health in years to come.

Dr David Unwin's Norwood surgery has achieved 93% success with prediabetics. No reason to suppose T2 will return to anyone who keeps their weight down.

As regards diet, others have provided good links though I would caution while reading some of that information to ask yourself whether the author believes that cholesterol and cardiovascular disease are linked. Personally I don't see much point in going to such extremes with low-carb dieting in order to control my diabetes that I end up having a stroke or heart attack in future due to eating a diet that leads to very high cholesterol levels. I believe in balance and in hedging my bets, and any advice that I should be eating loads of butter, cheese and cream because saturated fat is supposedly just fine, while I should stop eating carrots and apples because carbs are terribly bad, seems a risky approach in itself to me..

Fatty liver is at the root of T2D and many macrovascular conditions. The liver produces all the cholesterol the body needs and, for all I know, this could be affected when the body's signalling goes awry as it does with T2D. From what I have just read there is no link between cholesterol ingestion and cholesterol levels in the blood. I think you are being a little alarmist about that Harcombe Diet if you are referring to that. Carrots are not excluded and fruit only for Phase 1 for a week or two. Official advice about saturated fats dating back to the 1970s is known to be flawed but still persists in some guidelines and people's minds.

If you have weight to lose my advice is to try to lose it, by whatever combination of diet and exercise suits you best. This long interview with Roy Taylor, a professor of medicine and diabetes researcher, contains pretty much all you need to know about how weight loss can help get your HbA1c down and maybe even keep it down. Diet alone can address your HbA1c, but unless it results in weight loss it will likely not address the underlying condition.

Completely agree: I lost 22kg following my own real food version of the Newcastle diet, using this leaflet as a guide:
Newcastle Diet leaflet: https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/201809 Sample Recipes & meal plans.pdf

The big cons are slower metabolism, which may persist for years, and too much muscle loss which is not easy to restore. If I were doing it again I would probably do 2-4 weeks on meal replacement shakes then switch to the Harcombe Diet for weight loss and future maintenance. As it happens I was pretty much following it for six months before I started looking for a reliable way to avoid weight gain.

 

[rebrascora]

My experience ties in with the above that dietary cholesterol does not increase blood cholesterol. I have been following a low carb higher fat way of eating for 5 years and my cholesterol has reduced slightly from 5.2 at diagnosis to 4.5 now, despite eating a lot more saturated fats than I ever did before, including double cream in my morning coffee, creamy Greek natural yoghurt, lots of lovely cheeses, I cook my veg with a knob of butter, I fry in animal fat rendered from the meat and I eat fatty meat and eggs. I also ensure that I have plenty of fibre in my diet and particularly soluble fibre which I believe is important for gut health and cholesterol and I make sure I do exercise or physical activity regularly, even if it is just running up and down stairs 20 times on the trot.

 

[snowball12]

A copy of a recent post that may help.
One to read (Harcombe Diet link): https://www.zoeharcombe.com/2021/08/what-should-we-eat/

Here are some links to diets which may help you put your T2 into remission and then, if you need/wish, lose some more weight to revert to your former self and the size of clothes you used to wear.

Dr David Unwin
Here is a link to Dr David Unwin's low carb diet leaflet from the Public Health Collaboration website. It answers the question of what to eat for breakfast, lunch and dinner as well as giving lots of useful information:
phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf

Most of those diagnosed T2D at Dr Unwin's Norwood Surgery opt for diet rather than medication. Over 130 of them have gone inro remission in the past ten years. 93% of their pre-diabetic patients return to normal following the Norwood guidelines.

Dr Unwin explained the nuts & bolts of drug free T2 diabetes remission, and how he lost weight, in this presentation last year:youtube.com/watch?v=t9Nvj2lfs2Y

Zoe Harcombe
The Norwood Diet is remarkably similarl to the Harcombe Diet. After suffering various eating disorders and years of yo-yo dieting, Zoe Harcombe devised her diet to cut out cravings, lose weight, and sustain weight loss for the future. It is based on her detailed understanding of the best nutritional research. Dozens of positive reviews on Amazon US and Amazon UK from people who have lost weight prove the diet is successful in practice.

Here is a link to my blog post of an article on the Harcombe Diet with some useful added links at the end:
The Harcombe Diet: How to eat your favourite foods and still lose weight
The Harcombe Diet: How to eat your favourite foods and still lose weight By Prima Team PUBLISHED: 21 APRIL 2016 Do you dream of a weight l...

diabetes-type2-remission.blogspot.com

Having lost 22 kg, I am adopting the princople of this diet to ensure I don't put it all back on again.

Dr Kim Andrews
The Freshwell Low Carb project has a really clear explanation of why the lo-carb approach is good for most people, best I've seen: https://lowcarbfreshwell.com/going-low-carb/

Dr Andrews' 4 Week Meal Planners may be just what you are looking for. You can download them here: https://

 

[PerSpinasAdAstra]

The big cons are slower metabolism, which may persist for years, and too much muscle loss which is not easy to restore.

The issue of slower metabolism lasting years is probably a myth. Basal Metabolic Rate will decrease with body size and reduced muscle mass certainly. The concept of 'metabolic damage' though, that rapid weight loss leads to years of slower metabolism, is likely false. Increasing levels of exercise and/or decreasing energy intake causes the body to adapt, lowering energy expenditure in a number of ways including reducing resting heart rate, in order to maintain energy stores (body fat). It appears that observations that many people have a lower BMR after rapid weight loss is much more tightly correlated with the amount of exercise they do after losing the weight, than the speed or method by which they lost the weight. The amount of muscle mass lost, in heavy people, appears to have more to do with reduction in muscles needed to keep a heavy person upright and mobile, than the rate or method of weight loss. This will occur regardless of the diet used to achieve weight loss. Perhaps there is a benefit to gradual weight loss for preserving overall muscle mass - I have no idea - though I believe the benefits of getting my diabetes under control quickly outweigh the potential issues with reduced muscle mass.

And you're correct - dietary cholesterol, the raw cholesterol in food, appears to have little to do with levels of cholesterol in the blood. If you eat two eggs in a day for example, the liver appears to reduce cholesterol production by two eggs worth. The advice about saturated fat does indeed date back a long time and over time has seemed to show that it is associated with higher LDL (bad) cholesterol levels. There are a small number of very recent studies that question the link between saturated fat and blood cholesterol, and between cholesterol and cardiovascular health, and these are often referenced by advocates of low-carb, high-fat diets. However there are studies that seem to prove just about any fringe scientific theory. Whenever an advocate of a fringe theory says, and I'm paraphrasing - 'This vast mountain of evidence going back decades says I'm wrong, but this one shiny new study over here says I'm right, and it's newer, so I must be right' - then I'm always inclined toward caution. Maybe the newer study is correct, time will tell, but in the meantime I prefer to hedge my bets and not ignore the mountain.

 

[JITR]

The issue of slower metabolism lasting years is probably a myth. Basal Metabolic Rate will decrease with body size and reduced muscle mass certainly. The concept of 'metabolic damage' though, that rapid weight loss leads to years of slower metabolism, is likely false. Increasing levels of exercise and/or decreasing energy intake causes the body to adapt, lowering energy expenditure in a number of ways including reducing resting heart rate, in order to maintain energy stores (body fat). It appears that observations that many people have a lower BMR after rapid weight loss is much more tightly correlated with the amount of exercise they do after losing the weight, than the speed or method by which they lost the weight. The amount of muscle mass lost, in heavy people, appears to have more to do with reduction in muscles needed to keep a heavy person upright and mobile, than the rate or method of weight loss. This will occur regardless of the diet used to achieve weight loss. Perhaps there is a benefit to gradual weight loss for preserving overall muscle mass - I have no idea - though I believe the benefits of getting my diabetes under control quickly outweigh the potential issues with reduced muscle mass.

And you're correct - dietary cholesterol, the raw cholesterol in food, appears to have little to do with levels of cholesterol in the blood. If you eat two eggs in a day for example, the liver appears to reduce cholesterol production by two eggs worth. The advice about saturated fat does indeed date back a long time and over time has seemed to show that it is associated with higher LDL (bad) cholesterol levels. There are a small number of very recent studies that question the link between saturated fat and blood cholesterol, and between cholesterol and cardiovascular health, and these are often referenced by advocates of low-carb, high-fat diets. However there are studies that seem to prove just about any fringe scientific theory. Whenever an advocate of a fringe theory says, and I'm paraphrasing - 'This vast mountain of evidence going back decades says I'm wrong, but this one shiny new study over here says I'm right, and it's newer, so I must be right' - then I'm always inclined toward caution. Maybe the newer study is correct, time will tell, but in the meantime I prefer to hedge my bets and not ignore the mountain.

Thanks for all this. I too wanted to get rid of excess fat rapidly but, in retrospect, a gentler method would have been better, at least after the first 2-4 weeks which account for about 50-75% of excess liver fat.
The situation on cholesterol and saturated fats is horribly confused thanks to scientists leaping to wrong conclusions, misguided official guidance that takes years and decades to revise, and diffusion of information via the press, the internet and the population.
I picked up a copy of 'French women don't get fat' in a charity shop yesterday - its soup recipes caught my eye. In her introduction Mireille Guiliano observes the Americans and British go to extremes when it comes to diet. The French have retained their traditional values or at least they had 20 years ago when she wrote the book.
Oh, almosf forgot to say press ups are my measure of muscle tone and metabolism before and after losing weight. Before, I could manage about 30 quite quickly. After, about 8 quite slowly. Since learning a bit about mitochondria I have been taking more breaths after the first half dozen or so. Now up to 14 but much slower progress than before.