Pre-diabetic Newbie

[Geronimo]

Hi

I was diagnosed with pre-diabetes in January 2023 when a routine blood test gave me a result of 44. I have been a bit in denial about it, however, had another blood test in August, and without really changing diet very much, result had come down to 42 but still in the pre-diabetic range. I've now decided I need to do more.

I'm still relatively young but I think I'm in the same place where my father was when he was my age and he could have done something about it and didn't with the result he had a miserable last 10 years of life living with diabetes. I can see myself going the same way if I don't make a resolve to sort myself out now.

I am overweight and in the past have done Slimming World ('SW') to lose several stones weight, only to put it back on again initially slowly but then it piled on during the pandemic. I blame the majority of that on simply not doing the same level of exercise I was doing pre-pandemic when I would go for long walks over the weekend and shorter walks in the evenings after work.

I have been wondering if I need to go back to SW but not sure based on what I've read about having diabetes it's not ideal as SW as a lot of emphasis is on eating 'free' foods which can consist of lots of potatoes and pasta. I also remember when going to SW that they advised the diabetics that they couldn't do 'speed' days where carbs were heavily cut out, which seems contrary to what I've read about managing blood sugars by keeping carb intake low. Bit confusing so wondering if anybody who has pre-diabetes or diabetes is doing SW and what the current advice is around carbs and eating pasta and potatoes as 'free' foods.

A question about blood tests - should I expect to have a blood test every six months from my GP to monitor my HbA1c numbers? I got recalled in August for another blood test without any prompts so wondered if this is standard.

 

[Leadinglights]

Welcome to the forum
If you have a good GP then hopefully you will get an annual blood test for checking your HbA1C however people find it useful to have a home blood glucose monitor so they can keep an ongoing eye on their blood glucose so they can modify their diet if things start to go awry in the meantime.
Getting your blood glucose down to normal should not take much but modifying your diet to cut down on some of the high carb foods which you have already mentioned. Some people find that SW can work for them but you would need to tell your SW consultant that you are prediabetic and they do say they have meal plans which are suitable and by careful selection of meals it may well be sufficient for what you need.
Alternatively have a look at this link which is a low carbohydrate approach which many have found successful. https://lowcarbfreshwell.com/
As you have already found it is very easy to slip back into old ways so whatever you choose has to be enjoyable and become a new way of eating for life.

 

[nonethewiser]

Well wife did SW after being told she was prediabetic, key factor for her was losing weight & visceral fat around organs as after losing 5 stone in weight her bloods since have been normal, so you know what to do @Geronimo

 

[childofthesea43]

The top-level decision, I believe, is whether to aim for normalising blood glucose by simply eating fewer carbs and/or taking meds, or to do it by restoring correct metabolic functioning- that is, remedying the underlying pathology and becoming truly non-diabetic again (albeit with enduring susceptibility to relapse). The second option, which is not everyone’s cup of tea and is not always effective, is to lose excess weight and then keep it off. For this option, low carbing can be helpful for weight loss but is not essential. The first option controls the fire - for a while, but not for ever (if the pathology is not fixed then the pancreas will pack in sooner or later), whereas the second option puts the fire out. I took the second option three years ago, have been non-diabetic ever since and for me the carbs business is a total irrelevance now - BUT did help at the beginning. Every newbie should be made clearly aware from the start of these distinct options and further advised of the science behind the second one - which DUK funded and takes pride in - although largely unmentioned in this forum, which is both bizarre and regrettable.

 

[Geronimo]

Welcome to the forum
If you have a good GP then hopefully you will get an annual blood test for checking your HbA1C however people find it useful to have a home blood glucose monitor so they can keep an ongoing eye on their blood glucose so they can modify their diet if things start to go awry in the meantime.
Getting your blood glucose down to normal should not take much but modifying your diet to cut down on some of the high carb foods which you have already mentioned. Some people find that SW can work for them but you would need to tell your SW consultant that you are prediabetic and they do say they have meal plans which are suitable and by careful selection of meals it may well be sufficient for what you need.
Alternatively have a look at this link which is a low carbohydrate approach which many have found successful. https://lowcarbfreshwell.com/
As you have already found it is very easy to slip back into old ways so whatever you choose has to be enjoyable and become a new way of eating for life.

Have downloaded the list of green, amber and red foods. Thanks for the link. Makes sense for green and red, however, for amber foods it says, 'eat in moderation'. What defines moderation? For example, I routinely have two apples a day most days, but is that considered 'in moderation' or am I over doing it? Also, carrots in the amber list - I probably have them most days with an evening meal. Again, is the too much or is every day fine? I tend to stick to a normal portion size of around 80-100g. Just trying to get a sense of what defines moderation.

 

[Leadinglights]

Have downloaded the list of green, amber and red foods. Thanks for the link. Makes sense for green and red, however, for amber foods it says, 'eat in moderation'. What defines moderation? For example, I routinely have two apples a day most days, but is that considered 'in moderation' or am I over doing it? Also, carrots in the amber list - I probably have them most days with an evening meal. Again, is the too much or is every day fine? I tend to stick to a normal portion size of around 80-100g. Just trying to get a sense of what defines moderation.

It is difficult to be too definitive as to what moderation is as everybody's tolerance to carbohydrates and even the type of carbs is different.
For example some people can tolerate a 30g portion of carb if it bread but not if it is rice or pasta and for others it is visa versa.
Apples for example are medium carb in terms of fruit and it can very much depend on the size of apple and the variety but a medium size apple can well be 16g of carbs so 2 per day would be quite a chunk of your carb allowance if you were aiming at no more than 130g per day. Maybe a portion of strawberries or raspberries would be better instead.
You need to look at your overall carbs for each meal plus drinks and any snacks. Similarly veg like carrots are medium carbs so if part of the meal with other veg like broccoli or cabbage but not potatoes or peas are likely to be fine.
The only way you will know how well you tolerate foods is to test before you eat and after 2 hours aiming for an increase of no more than 2-3mmol/l or no more than 8-8.5mmol/l after 2 hours.

 

[childofthesea43]

1400 calories per day, 130g carbs per day, moderate walk once per day, do for 3 months, measure and record things to be sure. For three out of four T2s this will fix the pathology. And that’s it.

 

[rebrascora]

Have downloaded the list of green, amber and red foods. Thanks for the link. Makes sense for green and red, however, for amber foods it says, 'eat in moderation'. What defines moderation? For example, I routinely have two apples a day most days, but is that considered 'in moderation' or am I over doing it? Also, carrots in the amber list - I probably have them most days with an evening meal. Again, is the too much or is every day fine? I tend to stick to a normal portion size of around 80-100g. Just trying to get a sense of what defines moderation.

One apple a day is moderation in my opinion. However, if you would rather forego carbs in other foodsinstead so that you can have 2 apples....say not have any bread because you like apples more then that would not be unreasonable and probably better for you.
I wonder if it helps you to view your carbs for the day as an allowance or pocket money. You only have a small amount to spend so decide wisely what you want to spend them on, based on what your preferences but bearing in mind that when you have spent your daily allowance that is it and you have to get through the rest of the day without if you blew them all at breakfast and/or lunch or in snacks.
Personally I consider having half an apple most days constitutes moderation for me and I have it with a chunk of nice cheese. Very occasionally I will be decadent and have a whole one but mostly I stick to a half and usually a slightly tart one from my own trees.

 

[everydayupsanddowns]

Every newbie should be made clearly aware from the start of these distinct options and further advised of the science behind the second one - which DUK funded and takes pride in - although largely unmentioned in this forum, which is both bizarre and regrettable.

I’m sad to see you say this. There’s a whole section on remission, and the Newcastle / soup and shake diet gets mentioned very often. Including multiple forum members who have used weight loss / very low calorie / meal replacement options with great success.

We do also have several members who frequently post about low carb, but that is because that is an approach that has worked well for them.

And part of the richness of the forum is about people sharing their own experiences, and about there being multiple options that people can consider.

 

[childofthesea43]

I’m sad to see you say this. There’s a whole section on remission, and the Newcastle / soup and shake diet gets mentioned very often. Including multiple forum members who have used weight loss / very low calorie / meal replacement options with great success.

We do also have several members who frequently post about low carb, but that is because that is an approach that has worked well for them.

And part of the richness of the forum is about people sharing their own experiences, and about there being multiple options that people can consider.

I am very familiar of course with the website’s sections on T2 advice and the remission forum and so on. But I invite you to look at the first responses people give to newbies arriving at the Newbies forum, for you will see that the research is seldom mentioned and instead they are almost always directed to the freshwell low carbs site. I get the impression that these responders do not buy into Taylor’s work and would be content if the NHS just gave every new T2 a card bearing the freshwell URL but nothing more.

 

[rebrascora]

I am very familiar of course with the website’s sections on T2 advice and the remission forum and so on. But I invite you to look at the first responses people give to newbies arriving at the Newbies forum, for you will see that the research is seldom mentioned and instead they are almost always directed to the freshwell low carbs site. I get the impression that these responders do not buy into Taylor’s work and would be content if the NHS just gave every new T2 a card bearing the freshwell URL but nothing more.

I believe the forum has historically been independent of DUK but very kindly hosted by the charity and I greatly value that independence, much as I appreciate the charity hosting it, as it would struggle to exist without.

Members of the forum are however free to post whatever they wish about what works for them, so if the majority find that low carb works for them, then that is what they will post to others. I try to mention both main options at least some of the time but my feeling is that a lot of people struggle with weight loss and YoYo dieting, and the Newcastle may just lead to the same and may be why long term, the numbers in remission diminish, because people find it hard to keep the weight off several years down the line, once they resume "normal" eating. For me knowing from the start that I am changing my approach to food for life and finding ways to make low carb enjoyable has more appeal because it is a completely new way of eating rather than a short term quick fix diet. Not that I am saying the Newcastle is that, but it starts out like that. Low carb is about forming new eating habits from the start. I also don't like the idea of putting people on highly processed shakes based meal replacements for a period of time. We are learning more and more about UPFs and these shakes have to come under that umbrella. The Freshwell is encouraging the consumption of real foods.
My view is that it appears from forum membership that more people find low carb successful and because it is successful it is recommended. Why would you not recommend something which works for you?
What I would like to see is DUK putting money into Low Carb research. I am absolutely not knocking the work of Professor Roy Taylor and his colleagues which was a major breakthrough in changing opinions about Type 2 diabetes and I think there is undoubtedly a place for it, but as individual members of the forum, we have a right to encourage people to try what works for us.

I would also say that much as I am a low carb enthusiast, I have looked at the Freshwell link a couple of times and don't find it appealing to me, in fact I keep wondering if I am missing something, so I don't personally recommend it, but then I have always been one for finding my own way. Other people want a diet plan to follow.

You are perfectly at liberty to link the Newcastle/Fast 800 diet to every newbie post if it is something you recommend yourself and have the time to do so.

 

[everydayupsanddowns]

I think it’s important that these are seen as options and alternatives, rather than competitors. Remission results from cohorts of Freshwell / Low Carb GP, and Newcastle / soup-shake are really impressive, and personally I think it is brilliant that we have two established and evidenced approaches that people can consider.

I think both approaches require the attitude that @rebrascora mentions of changing your way of eating for life when it comes to the maintenance phase.

The Aussie re-run of DIRECT shows an incredible 87% of participants in remission who achieve greater than 15% weight loss, but the original UK trial follow-ups show how challenging many find it to maintain that lost weight when transitioning back to normal eating. So a long term change in eating habits is an essential part of the picture. Former member Travellor used to talk about how the Newcastle diet had ‘reset’ his relationship to food, and how he now enjoyed eating well, but in a very different way to before he achieved remission.

And yes, please do share your positive experiences of remission with newcomers 🙂

 

[rebrascora]

Former member Travellor used to talk about how the Newcastle diet had ‘reset’ his relationship to food, and how he now enjoyed eating well, but in a very different way to before he achieved remission.

Travellor used to post photos and text on the forum about the junk food he had eaten almost as if to boast and then in other posts talk about going back on the Newcastle to lose some of the weight he had gained. I personally felt he was not a good example of how to do it. He would talk the talk about following the Mediterranean diet although rarely seemed to post photos of those healthy options. Instead he seemed to take delight in posting provocative photos and descriptions of doughnuts and MacDonalds he had eaten.... because he could. I personally did not find him inspiring.

 

[nonethewiser]

I am very familiar of course with the website’s sections on T2 advice and the remission forum and so on. But I invite you to look at the first responses people give to newbies arriving at the Newbies forum, for you will see that the research is seldom mentioned and instead they are almost always directed to the freshwell low carbs site. I get the impression that these responders do not buy into Taylor’s work and would be content if the NHS just gave every new T2 a card bearing the freshwell URL but nothing more.

Wife didn't exactly use Taylors methods but did follow his principle in that losing weight, particularly visceral fat around organs can reverse prediabetes & in those who are newly diagnosed type 2, 5 years later her blood results are still in normal range.

Occasionally I mention it on here but I'm not on forum all the time & often have long breaks for days on end, so for those who low carb & do it successfully & spend 24/7 on forum their replies will obviously be more dominant than others, it how things work in world of social media.

Earlier in year on holiday spoke with lady who was newly diagnosed & told her about Newcastle Diet & Prof Taylor, she was very interested so would like to think she followed it up & has managed to reverse condition, but who knows.

 

[everydayupsanddowns]

Travellor used to post photos and text on the forum about the junk food he had eaten almost as if to boast and then in other posts talk about going back on the Newcastle to lose some of the weight he had gained. I personally felt he was not a good example of how to do it. He would talk the talk about following the Mediterranean diet although rarely seemed to post photos of those healthy options. Instead he seemed to take delight in posting provocative photos and descriptions of doughnuts and MacDonalds he had eaten.... because he could. I personally did not find him inspiring.

Well yes, I remember that too, unfortunately. But I thought the idea of the shake diet forming a break between ways of eating was an encouraging one.

As @Eddy Edson says, keeping the weight off is really hard, and no one lifestyle intervention (lowering calories or carbs) seems to do well across the board over time.

And yet we have examples of members here who have been able to maintain various dietary strategies in the medium-long term. So it is possible for some. So there is hope!

 

[childofthesea43]

Although I took Taylor’s main thesis to heart I also noted him confirming that provided the excess fat was cleared the outcome would be much the same whichever method one chose. I felt his severe calorie restriction would be a tough ask so, like many others, created and stuck to my own gentler and durable regimen. I have found maintaining the reduced weight a complete doddle but that has been with benefit of not having to deal also with comorbidities or any other major dispiriting circumstances. I thought the NHS soups and shakes would encounter major problems of non-compliance and very poor fulfilment of the objective, but the figures coming out are proving me wrong, so far.

 

[rebrascora]

Well yes, I remember that too, unfortunately. But I thought the idea of the shake diet forming a break between ways of eating was an encouraging one.

As @Eddy Edson says, keeping the weight off is really hard, and no one lifestyle intervention (lowering calories or carbs) seems to do well across the board over time.

And yet we have examples of members here who have been able to maintain various dietary strategies in the medium-long term. So it is possible for some. So there is hope!

I think the success here is down to mutual support and sharing of food/recipe ideas, tips and tricks and probably that the regulars here are perhaps more motivated than the average diabetic. Whether that is because once you come and join in and read other people's stories of success here, it is inspiring and you want to be part of it or whether it is simply that the people who find the forum are already self motivated or a combination of both, I don't know, but I do believe that having good support is vital and that is unfortunately lacking within the NHS for the majority of Type 2 diabetics.
By support, I mean sympathetic and encouraging support as oppose to blaming and shaming and pessimistic opinions on diabetes being progressive, but also lack of support with testing which we recognize here is invaluable in adjusting diet for the individual to manage their diabetes well. And I don't necessarily mean prescribing meters and test strips but there are many doctors and nurses who actively discourage self testing, even when people are prepared to self fund. So yes, I think ongoing positive support is vital for success.

 

[Drummer]

I wish I could give more help on the weightloss side of treatment of type 2, but I was in such a state about my weight that I couldn't cope with knowing how much I weighed, and I had to steel myself to step on the scales in the GPs surgery - simply because I was pushed so hard to lose weight on low fat low calorie high carb diets - which never worked.
When I found out how much less than my highest recorded weight I had come to, I was astonished, because I had stopped trying, all I did was reduce the carbs right down, abandon anything high carb and check that my blood glucose was normal - under 8 at the 2 hour point.
As I was perfectly happy eating that way, I just went on, and on.
I am still finding that when I take out my winter clothes each year, they are too large around the waist. My natural shape was very slender waisted, like all my family so it is just trying to get back to normal too - but I doubt I'll ever see 24inches again.

 

[childofthesea43]

I was very disappointed to have had no NHS support of the kind I felt would help at the beginning. However, this was when the NHS was getting bogged down with Covid. I just wanted 3-monthly HbA1c tests for the first year and those would cost the NHS very little. I also wanted just one chat with a dietitian but was told that could happen only if I were already on insulin. I got my important support from a number of specialists in the field such as Dr David Cavan (my special hero), Dr Nicola Guess and even from Roy Taylor and Mike Lean on several occasions , in addition to exchanges on the forum. Yes, support is vital to all this.

 

[everydayupsanddowns]

So yes, I think ongoing positive support is vital for success.

Completely agree @rebrascora

There can be something very powerful about peer-support, shared experiences, and the moral and emotional support of other PWD alongside.