Pre-diabetic - not what I wanted to hear!

[Pidgeonpost]

'Evening all. Hope you all had a good and stress-free Christmas on the blood glucose level. 🙂
It's a few weeks now since I was last on here, and I needed to re-read some of the recommendations to try to stay heading in the right direction.

Sorry to say, but I haven't begun monitoring BG levels after 2 hours, as was recommended. It's been a busy time, so for no good reason I've stuck with the wakening 'fasting' finger-prick readings. Over the last 14 days, the average has been 5.7mmol/mol, which is pretty near the middle of the 'OK' range I believe. There was a high of 6.3, and a low of 4.9.
As @Drummer above says, these may be the last to reduce, so maybe I shouldn't worry about them at this stage.
I'll make a start on logging the '2 hours after meals' readings tomorrow and report back in a week or two.

Getting a handle on how many carbs I was consuming was proving a bit frustrating. I'd downloaded various tables, charts, and other reference documents to my phone and pc, but this has lead to too many options and places to look. It was often the case that I had to search several of these documents and/or use Google to bring together all the individual components of a meal or recipe. Instead I've reverted to the 'My Fitness Pal' which I've seen mentioned elsewhere on the Forum. I've used it off and on for years to keep an eye on weight (usually at this time of year!) and it's pretty good at that, but I think I'll be using it as my main application for monitoring carbs as well as calories. It's available as a phone app too.

All the best for 2023. 🙂

 

[Drummer]

'Evening all. Hope you all had a good and stress-free Christmas on the blood glucose level. 🙂
It's a few weeks now since I was last on here, and I needed to re-read some of the recommendations to try to stay heading in the right direction.

Sorry to say, but I haven't begun monitoring BG levels after 2 hours, as was recommended. It's been a busy time, so for no good reason I've stuck with the wakening 'fasting' finger-prick readings. Over the last 14 days, the average has been 5.7mmol/mol, which is pretty near the middle of the 'OK' range I believe. There was a high of 6.3, and a low of 4.9.
As @Drummer above says, these may be the last to reduce, so maybe I shouldn't worry about them at this stage.
I'll make a start on logging the '2 hours after meals' readings tomorrow and report back in a week or two.

Getting a handle on how many carbs I was consuming was proving a bit frustrating. I'd downloaded various tables, charts, and other reference documents to my phone and pc, but this has lead to too many options and places to look. It was often the case that I had to search several of these documents and/or use Google to bring together all the individual components of a meal or recipe. Instead I've reverted to the 'My Fitness Pal' which I've seen mentioned elsewhere on the Forum. I've used it off and on for years to keep an eye on weight (usually at this time of year!) and it's pretty good at that, but I think I'll be using it as my main application for monitoring carbs as well as calories. It's available as a phone app too.

All the best for 2023. 🙂

I have a little notebook in which I listed the carb values of things I was likely to think of eating, which I started off in pencil and some items did get erased as I found that beans and peas seem to have about 80% more carbs than listed on the internet sites - some other people have reported the same thing , and I suspect that we can digest them better than those who get a normal reaction to them.

 

[Leadinglights]

I have a little notebook in which I listed the carb values of things I was likely to think of eating, which I started off in pencil and some items did get erased as I found that beans and peas seem to have about 80% more carbs than listed on the internet sites - some other people have reported the same thing , and I suspect that we can digest them better than those who get a normal reaction to them.

I think that is very true as people have different gut bacteria and levels of acidity in the stomach and that plays a big part in how foods are digested. Hence the GI and GL classification are of limited value.
It can work for some people but not all.
I was surprised when reading Anthony Worrel Thompson book, The GI diet that you can make high GI foods lower by adding fats and protein. It was a way he had successfully used when diagnosed with Type 2 diabetes even though his list of low GI foods had lots of things like peas and beans.

 

[Drummer]

I think that is very true as people have different gut bacteria and levels of acidity in the stomach and that plays a big part in how foods are digested. Hence the GI and GL classification are of limited value.
It can work for some people but not all.
I was surprised when reading Anthony Worrel Thompson book, The GI diet that you can make high GI foods lower by adding fats and protein. It was a way he had successfully used when diagnosed with Type 2 diabetes even though his list of low GI foods had lots of things like peas and beans.

I think that anything with a possibility of carbs - my gut just views it as a challenge and goes for the throat - if there was a memo about low and high GI - it ate that too......

 

[Pidgeonpost]

I have a little notebook in which I listed the carb values of things I was likely to think of eating, which I started off in pencil and some items did get erased as I found that beans and peas seem to have about 80% more carbs than listed on the internet sites - some other people have reported the same thing , and I suspect that we can digest them better than those who get a normal reaction t

I think that is very true as people have different gut bacteria and levels of acidity in the stomach and that plays a big part in how foods are digested. Hence the GI and GL classification are of limited value.
It can work for some people but not all.
I was surprised when reading Anthony Worrel Thompson book, The GI diet that you can make high GI foods lower by adding fats and protein. It was a way he had successfully used when diagnosed with Type 2 diabetes even though his list of low GI foods had lots of things like peas and beans.

By 'beans and peas' do you mean the dried variety? I was reading yesterday that soaking before cooking can make a big difference to how easy they are to digest.

 

[Drummer]

Any legumes, peas or beans - I usually get fresh but dried such as lentils still give the anomalous effect.
I was very puzzled at first, but after a few trials I realised that it was the carb content information which was wrong for me.

 

[Pidgeonpost]

After my earlier post on around 2 weeks of fasting finger-prick testing (5.7), I've now done a further couple of weeks of 'post prandial' testing, mostly done after our main meal of the day.

Over 14 days and 18 FP tests the average reading was 6.7 mmol/l, with a high of 8.5 and low of 5.4. All these FP tests were taken between 2 and 2½ hours after eating.

Since beginning my dietary changes I've more than halved my intake of bread and spuds - beer too. I've lost 4.5kg in weight, but to be honest I'm still not confident that the changes I've made are good enough if I'm to avoid Type 2.

The main website says that the figures set out in its tables are general, and that individuals should agree their personal targets with their Health Team. I was pinged as pre-diabetic at the beginning of October and have been recording blood glucose levels since, but have had no feedback from my GP practice despite delivering logs to them. I'm not due another HbA1c test until March, but is it reasonable to push for one sooner? I don't want to badger an already hard-pressed service unnecessarily. Any thoughts?

 

[Leadinglights]

After my earlier post on around 2 weeks of fasting finger-prick testing (5.7), I've now done a further couple of weeks of 'post prandial' testing, mostly done after our main meal of the day.

Over 14 days and 18 FP tests the average reading was 6.7 mmol/l, with a high of 8.5 and low of 5.4. All these FP tests were taken between 2 and 2½ hours after eating.

Since beginning my dietary changes I've more than halved my intake of bread and spuds - beer too. I've lost 4.5kg in weight, but to be honest I'm still not confident that the changes I've made are good enough if I'm to avoid Type 2.

The main website says that the figures set out in its tables are general, and that individuals should agree their personal targets with their Health Team. I was pinged aspre-diabetic at the beginning of October and have been recording blood glucose levels since, but have had no feedback from my GP practice despite delivering logs to them. I'm not due another HbA1c test until March, but is it reasonable to push for one sooner? I don't want to badger an already hard-pressed service unnecessarily. Any thoughts?

Those levels look pretty good and if typical over the period of time the HbA1C test is covering (2-3 months) then you might expect a normal result. I would feel inclined to wait until March so you can see the full effect of the changes you have made. But obviously that is up to you.

 

[Pidgeonpost]

Thanks. I'm still very much trying to get a feel for how things are going and what else I need to do. I suppose I'm also going to have to get used to the idea that changes aren't linear, there are peaks and troughs.

 

[childofthesea43]

Evening all, and thanks for having me!

A routine blood test in September resulted in the following entry in my patient record - "Haemoglobin A1C level - IFCC standardised (XaPbt) 43 mmol/mol", and a call from the nurse with the glad tidings.
At her suggestion I have joined a support group, and also bought a blood glucose meter - Sinocare Accu2 bargain bundle including test strips and lancets.

I've been monitoring the readings for a couple of weeks now, but I can't see where the 43 mmol/mol fits in the chart that came with the meter as the chart only shows mmol/L and mg/dL. The readings I've taken and compared to the chart show that 75% of the time I'm in the 'Normal' range (4.0 to 7.0mmol/L), the remaining readings have all been in the 'Borderline' range (7.1 to 10.0mmol/L). All a bit confusing. This chart enables me to convert 43mmol/mol to Average Blood Glucose by a bit of guesswork. Maybe I need 'The Ladybird Book for Pre-diabetics'.

Me? I'm 74, 6 feet in height, 13st 4lb (about 2lb above my normal weight). I'm pretty active on the wrinkly scale, though aerobic exercise has taken a hit as the pandemic caused two of the dance groups we belonged to to fold. We continued to walk 4-5 days a week for an hour or more, but not enough to raise a sweat due to my wife's dodgy hip. We walk the dog, but she's a very slow-walker more interested in sniffing than speed.
Diet - pretty healthy I thought - loads of veg, pulses, very little meat, though I have been known to cast caution to the wind with a sausage or bacon butty.

Got my first 1-to-1 session on Saturday, so will report back. 🙂

I would just mention that the standard thresholds of 42 and 48 for pre-diabetes and full-blown Type 2 were shown some time ago in a large study to be appropriate to those aged around 40 or below, but for people in your age group they are not. HbA1c rises naturally with age even for those with healthy metabolism and for you at 74 (and me at 75) we should not be regarded as even pre-diabetic until our HbA1c becomes at least 48. This inadequacy in the standard reference ranges is unknown to most HCPs, nor do they know that those ranges were set on the basis of a tiny study done decades ago on a cohort none of whom was aged above 39. One has to read the research but most GPs and nurses haven’t the time and are in any case glued to established guidelines.

 

[Pidgeonpost]

I would just mention that the standard thresholds of 42 and 48 for pre-diabetes and full-blown Type 2 were shown some time ago in a large study to be appropriate to those aged around 40 or below, but for people in your age group they are not. HbA1c rises naturally with age even for those with healthy metabolism and for you at 74 (and me at 75) we should not be regarded as even pre-diabetic until our HbA1c becomes at least 48. This inadequacy in the standard reference ranges is unknown to most HCPs, nor do they know that those ranges were set on the basis of a tiny study done decades ago on a cohort none of whom was aged above 39. One has to read the research but most GPs and nurses haven’t the time and are in any case glued to established guidelines.

Well, it's good to know that perhaps I'm in a slightly better place than I thought I was! Small wonder that people are confused or overwhelmed by data, tables, facts, and figures!
I'm going to continue to review and tweak my diet until my next review in March as I can feel the benefit of losing a bit of weight.
Thanks for your reply.

 

[Bonzo]

After my earlier post on around 2 weeks of fasting finger-prick testing (5.7), I've now done a further couple of weeks of 'post prandial' testing, mostly done after our main meal of the day.

Over 14 days and 18 FP tests the average reading was 6.7 mmol/l, with a high of 8.5 and low of 5.4. All these FP tests were taken between 2 and 2½ hours after eating.

Since beginning my dietary changes I've more than halved my intake of bread and spuds - beer too. I've lost 4.5kg in weight, but to be honest I'm still not confident that the changes I've made are good enough if I'm to avoid Type 2.

The main website says that the figures set out in its tables are general, and that individuals should agree their personal targets with their Health Team. I was pinged as pre-diabetic at the beginning of October and have been recording blood glucose levels since, but have had no feedback from my GP practice despite delivering logs to them. I'm not due another HbA1c test until March, but is it reasonable to push for one sooner? I don't want to badger an already hard-pressed service unnecessarily. Any thoughts?

Hello @Pidgeonpost I'm in a very similar position. I was diagnosed prediabetic (42mmol/mol) October last year. I made changes to my diet and have conducted finger prick tests since - readings seem to be in normal range but as I did not do tests before diet change I can't compare before/after diet change results.

Contacted my GP practice last week asking if I could have another Hba1c test as 3 months had passed and I wanted to know if the diet changes had worked, they said I would not be retested until October this year - annual review.

I've sent off for a private test, it's only £29 from Monitor my Health, but haven't received it yet. As far as I know the private tests are as accurate as the NHS ones but would be grateful if someone could confirm that.

 

[everydayupsanddowns]

As far as I know the private tests are as accurate as the NHS ones but would be grateful if someone could confirm that.

Welcome to the forum @Bonzo 🙂

As far as I know all HbA1c checks from a vial of blood taken from the arm should be processed by a certified machine / lab.

NICE recommends “Measure HbA1c using methods calibrated according to International Federation of Clinical Chemistry (IFCC) standardisation.”

I’m not sure if the newer machines that can give an instant HbA1c from a fingerprick have more leeway. I had one done once at a conference, and it seemed a bit of an outlier compared to the normal ‘vial of blood’ checks I had either side?

 

[Pidgeonpost]

Just noticed that it's 5 months today since I gave a blood sample which in turn got me flagged as pre-diabetic. Since then I've been doing very regular finger-prick tests to try to get a better understanding of how my blood sugar level fluctuates according to when I take it and the foods/meals that I eat. I've also been attending regular sessions run for the NHS by Xyla Health and Wellbeing the next one is on Saturday.
One of the things that became apparent was that some attendees were able to get a HbA1c test after 3 months rather than the 6 months I was told I would have to wait. I had also been told at my GP surgery that I should have a cholesterol check as I hadn't had one recently.
With these things in mind I rang the surgery and they arranged for a further Hba1C test and for cholesterol levels to be checked. This week I got the results and was pretty pleased! I'd dropped back to 41mmol/mol , just under the pre-diabetic level I'd been flagged at earlier. The cholesterol level (last checked in 2006 apparently!) was also pronounced as OK at 4mmol/l, and I'd lost a little over a stone in weight. Blood pressure was OK too.
So that's it then - panic over? No. The dietary changes I've made (mostly reducing carbs in their various forms and eating more veg) are going to be with me for life I think. I'll still be doing regular tests for blood sugar levels and blood pressure to try and make sure I stay in the right place - and I'll be checking in here from time to time too. 🙂

 

[Leadinglights]

Just noticed that it's 5 months today since I gave a blood sample which in turn got me flagged as pre-diabetic. Since then I've been doing very regular finger-prick tests to try to get a better understanding of how my blood sugar level fluctuates according to when I take it and the foods/meals that I eat. I've also been attending regular sessions run for the NHS by Xyla Health and Wellbeing the next one is on Saturday.
One of the things that became apparent was that some attendees were able to get a HbA1c test after 3 months rather than the 6 months I was told I would have to wait. I had also been told at my GP surgery that I should have a cholesterol check as I hadn't had one recently.
With these things in mind I rang the surgery and they arranged for a further Hba1C test and for cholesterol levels to be checked. This week I got the results and was pretty pleased! I'd dropped back to 41mmol/mol , just under the pre-diabetic level I'd been flagged at earlier. The cholesterol level (last checked in 2006 apparently!) was also pronounced as OK at 4mmol/l, and I'd lost a little over a stone in weight. Blood pressure was OK too.
So that's it then - panic over? No. The dietary changes I've made (mostly reducing carbs in their various forms and eating more veg) are going to be with me for life I think. I'll still be doing regular tests for blood sugar levels and blood pressure to try and make sure I stay in the right place - and I'll be checking in here from time to time too. 🙂

Fantastic result, well done. I find my low carb way is one that is now my new normal.

 

[Bonzo]

Just noticed that it's 5 months today since I gave a blood sample which in turn got me flagged as pre-diabetic. Since then I've been doing very regular finger-prick tests to try to get a better understanding of how my blood sugar level fluctuates according to when I take it and the foods/meals that I eat. I've also been attending regular sessions run for the NHS by Xyla Health and Wellbeing the next one is on Saturday.
One of the things that became apparent was that some attendees were able to get a HbA1c test after 3 months rather than the 6 months I was told I would have to wait. I had also been told at my GP surgery that I should have a cholesterol check as I hadn't had one recently.
With these things in mind I rang the surgery and they arranged for a further Hba1C test and for cholesterol levels to be checked. This week I got the results and was pretty pleased! I'd dropped back to 41mmol/mol , just under the pre-diabetic level I'd been flagged at earlier. The cholesterol level (last checked in 2006 apparently!) was also pronounced as OK at 4mmol/l, and I'd lost a little over a stone in weight. Blood pressure was OK too.
So that's it then - panic over? No. The dietary changes I've made (mostly reducing carbs in their various forms and eating more veg) are going to be with me for life I think. I'll still be doing regular tests for blood sugar levels and blood pressure to try and make sure I stay in the right place - and I'll be checking in here from time to time too. 🙂

I'm in a very similar position. My score ( somehow "score" makes it sound more positive 🙂 ) last November was 42. I adjusted my diet in much the same way you have. Couple of weeks ago I paid for a private Hba1C test, the GP wouldn't do one until my next annual review in October, and it was down to 36. Most of my calories used to come from refined carbs and sugars so I guess that was causing the problem - all other factors were normal. My BMI was 22.5 but has fallen to 21.5 where I've managed to stabilize it. Much the same as you the dietary changes are for life and I will continue with FP tests, though less often than I have been doing. The Hba1C test was with Monitor My Health who say they are an NHS approved lab and work for the NHS.

On a related topic, when diagnosed I was offered a place on the Oviva/Xyla program. I opted for the online version. I completed the initial assessment then heard nothing from them for 2 months, despite contacting them several times. They eventually got in touch and apologised saying they had been recruiting more staff. By that time I had all the information I needed so their involvement was a bit pointless. I have found that the information available on this website and forum was better and more complete than the information Oviva provided, so in some respects their initial foul up was probably for the best.

 

[everydayupsanddowns]

Lovely to hear your update @Pidgeonpost

Congratulations on your terrific results! Good to bear that you’ll be keeping with the positive changes you’ve made, and still occasionally keeping an eye on your levels to check you are still on track 🙂

 

[Pidgeonpost]

Thanks for your replies everyone! 🙂 And well done Bonzo as your efforts have clearly paid off too.
Must admit that although my progress so far hasn't been easy, neither has it been as hard as I feared it might be at the outset. I still find that I'm in a spot for eating the most appropriate foods, standing in front of the fridge or pantry looking vacantly and wondering what to have. Planning sometimes let's me down, but I try not to beat myself up if a get a few hiccups as tomorrow is another day. Will check in again later, but in the meantime good luck everyone!

 

[Pidgeonpost]

Funny thing happened on Monday. Well, not so funny actually.

Was having a normal day, just before 3pm I took dog out. Feeling a bit cold but it was a cold day.
During the walk I began to feel slightly off-colour, nothing much, like I might be coming down with a cold or something.
Drove home just before 4pm OK, but began going downhill quickly getting from car to house, like I was going to pass out. All a bit hazy after that. I must have fallen at some point as I have a large painful bruise on the bum but no recollection how it got there!
Managed to get indoors and upstairs but pretty much passed out on the bed feeling generally horrible.

My wife came home about 4.30 and later rang 111 as I was hot/cold sweaty, nauseous, confused, couldn't sit on edge of bed without feeling very unpleasant, risk of falling. It was rather like the worst sort of hangover feeling. The 111 call got upgraded and paramedics arrived.
After initial checks (but not BS afaik) they thought I might be dehydrated as my BP was low (though at 102/64 still in the normal range I think). This came up after drinking water, but my intake for the day was about typical up to the point where I began to feel ill. Pulse 92. Taken to A&E.

Various tests repeated and blood sample taken. Blood sugar not checked AFAIK. A&E doctor said tests revealed nothing significant. Discharged Tuesday am, spent most of the day catching up on sleep, been slowly recovering since and now about 98% for what passes as normal for me!

It was only after the event that I was able to reflect on events and symptoms and the similarities with a hypo? At 0800 Monday morning (after a cuppa) my BS was 6.4 mmol/L, so not low at that point. Between then and the onset of 'whatever it was' I'd had my usual breakfast porridge, followed by soup with wholemeal bread for lunch, with coffee and a couple of plain biscuits in between. With that in mind I'd have expected my BS to be up rather than down and a hypo seems an unlikely cause perhaps?
That was my feeling anyway, but yesterday I was surprised by one of my BS readings. My fasting level was 4.9, but later in the evening I was interested to see the effect of a pasta meal (100g spag, pesto, bit of parmesan) on my BS 2½ hours after eating. I was expecting it to be raised, but again it was 4.9.
That reading in itself was OK, but it has made me wonder whether, despite an early reading of 6.4 on Monday, my BS might have dipped despite a good breakfast and lunch, and going for a walk tipped me over the edge? I really don't know. Speculation of course, but there was definitely something very odd going on, and with no obvious cause I'm a bit concerned it's going to happen again.
Sorry for the long ramble, but this was most unexpected and most unwelcome!

 

[Lucyr]

The paramedics will have tested bg, it’s a standard check. If you’re not on medication that can cause hypos then it’s extremely unlikely to have been a hypo that caused your symptoms.