Pre-pre diabetic??

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knittedowl

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Hi,
39F here. I've been morbidly obese quite a lot of my adult life, reaching my biggest weight of 25st6 (161kg) in summer 2022, height of 5'5" (165cm). Since then I've lost over 7 stone (~45kg) and have improved my fitness significantly. In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since even though I've lost 4 stone since then, especially as I know that if I lived elsewhere in the world that would be defined as prediabetes. Should I be eliminating carbs more specifically? I love potatoes in particular so I would find that difficult as I'm already in a significant calorie deficit and have been for 18 months. Should I ask my GP to be retested?

Any advice or thoughts very welcome!
 
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knittedowl said:
Hi,
39F here. I've been morbidly obese quite a lot of my adult life, reaching my biggest weight of 25st6 (159kg) in summer 2022, height of 5'5" (1.65cm). Since then I've lost over 7 stone (~45kg) and have improved my fitness significantly. In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since even though I've lost 4 stone since then, especially as I know that if I lived elsewhere in the world that would be defined as prediabetes. Should I be eliminating carbs more specifically? I love potatoes in particular so I would find that difficult as I'm already in a significant calorie deficit and have been for 18 months. Should I ask my GP to be retested?

Any advice or thoughts very welcome!
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HbA1c of 41 is just at the top of normal, and the lowest I have got to in testing - but I feel fine at that level and by eating low carb I continue to become physically fitter and feel better than I did for a long time when my weight was out of my control due to the constant nagging to eat carbs.
The plain and simple fact, told to my GP and other HCPs since I left home at 18 is that I cannot deal with carbs - no one in the family can, we never had cereal for breakfast but others in the family were becoming wider every year despite their 'healthy' diets.
I will be 73 in April, and over 7 years normal numbers so I eat whatever I like when I like - but that is two meals a day at 12 hourly intervals with nothing low fat or high carb. If I'd been able to avoid all the good advice I'd have never gained all the weight or become fully diabetic - I used to have a 24 inch waist back in the 1970s. Some of my skirts from back then would make really nice handbags....
Rather than potatoes I eat swede or cauliflower, sometimes courgette occasionally parsnip.
I just opened my storage box to bring out some lighter clothes and find that my waist has shrunk down again and I need to start making alterations to my kilts and other skirts to hoist them up off my hips.
 
knittedowl said:
Hi,
39F here. I've been morbidly obese quite a lot of my adult life, reaching my biggest weight of 25st6 (159kg) in summer 2022, height of 5'5" (1.65cm). Since then I've lost over 7 stone (~45kg) and have improved my fitness significantly. In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since even though I've lost 4 stone since then, especially as I know that if I lived elsewhere in the world that would be defined as prediabetes. Should I be eliminating carbs more specifically? I love potatoes in particular so I would find that difficult as I'm already in a significant calorie deficit and have been for 18 months. Should I ask my GP to be retested?

Any advice or thoughts very welcome!
Click to expand...
Welcome to the forum
You are just below the prediabetic threshold however it would do no harm to be more careful of your carb intake so you do not slide up into that zone. It would also help with weight loss. Even if you go with a low carb regime it does not mean NO/ carbs but worth looking at what carbs you have and making them worth it for flavour and enjoyment rather than 'empty' carbs used as carriers for other foods or keep them for 'treats' rather than regular foods.
Some ideas for tasty lower carb meals in this link which may help. https://lowcarbfreshwell.com/
 
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knittedowl said:
In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since
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Well done on what you've achieved so far - that's amazing. As others have said an HbA1c of 41 is below pre-diabetes and getting below 42 is often the target for T2s aiming to get things under control. In fact my last three HbA1c results were 41, 41 and 40 and I'm OK sitting there, especially considering where I started from.

I swapped potatoes, in all its forms, for celeriac (as chips or mashed) and cauliflower (mashed) and they are now just an occasional treat, eg if we eat out.
 
Martin.A said:
Well done on what you've achieved so far - that's amazing. As others have said an HbA1c of 41 is below pre-diabetes and getting below 42 is often the target for T2s aiming to get things under control. In fact my last three HbA1c results were 41, 41 and 40 and I'm OK sitting there, especially considering where I started from.

I swapped potatoes, in all its forms, for celeriac (as chips or mashed) and cauliflower (mashed) and they are now just an occasional treat, eg if we eat out.
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Celeriac has been such a fail for me, when mashed it became the stuff you could hang 1970's anaglypta with. I don't suppose you'd tell me how you cook celeriac so I could have another go please?
 
Janmh said:
Celeriac has been such a fail for me, when mashed it became the stuff you could hang 1970's anaglypta with. I don't suppose you'd tell me how you cook celeriac so I could have another go please?
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For chips I cut it into finger-sized pieces, soften them by boiling for 3 or 4 minutes, put them in a small roasting dish with olive oil, season with sea salt and ground black pepper and then stick them in the oven for 40 minutes at 180. I use 180 because I usually have the chips with a salmon steak which I cook at the same temperature (though not for as long).

I've also seen celeriac steak on restaurant menus but never been tempted.

I agree that mashed celeriac is not as light as mashed cauli but I've found that if I cut it into small chunks, simmer for 20 minutes in salted water and then mash with Benecol spread (I use that instead of butter) it's generally fine.
 
I used to make Air Fried celeriac chips using smoked Paprika and olive oil.
 
knittedowl said:
In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since even though I've lost 4 stone since then, especially as I know that if I lived elsewhere in the world that would be defined as prediabetes. Should I be eliminating carbs more specifically?
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Honestly, I wouldn’t change anything I’d just continue working on losing weight.

If cutting carbs would be difficult for you, and would potentially jeopardise your weight loss progress then don’t risk it. Losing weight is the best thing you can do to reduce the risks, so keep on at that however works best for you.
 
Not a doctor obviously, with no medical knowledge, and I know a lot less than most on this forum, but if you're HbA1c was 41 and you've lost 4 stone since then, it would not be a surprise if it's gone down since then (that was my experience certainly). If so, then I don't think you would need to cut carbs as a proportion of your calories?
 
Thanks everyone for your thoughts, all very insightful. In a 4 week average I'm eating about 200g carbs per day and I can definitely lower this over time while I continue to lose weight. I may also ask for another reading with my GP as it's been a year and I'd like to know if I've made some progress! I've also increased my physical activity a lot and I've read on here that can help lower BG levels too.
 
knittedowl said:
Thanks everyone for your thoughts, all very insightful. In a 4 week average I'm eating about 200g carbs per day and I can definitely lower this over time while I continue to lose weight. I may also ask for another reading with my GP as it's been a year and I'd like to know if I've made some progress! I've also increased my physical activity a lot and I've read on here that can help lower BG levels too.
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If people are in the diabetic range or even prediabetic than reducing carbs to no more than 130g per day is where a good starting point is for reducing carbs. I'm not suggesting you need to go as far as that but at 200g you could perhaps trim a bit off that. If it is a year since your last HbA1C then it would be a good idea to get one done as with as many carbs as 200g you may have slipped over the threshold but better to know now than find you have spiralled
 
Lucyr said:
Honestly, I wouldn’t change anything I’d just continue working on losing weight.

If cutting carbs would be difficult for you, and would potentially jeopardise your weight loss progress then don’t risk it. Losing weight is the best thing you can do to reduce the risks, so keep on at that however works best for you.
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Agree with above, losing more weight & ridding your body of more visceral fat around organs may just be enough.

After losing 5 stone my wife eats a near enough normal diet after previously been told she was prediabetic.
 
Welcome to the forum @knittedowl (lovely username!)

Well done on your terrific weight loss, and good to hear that your HbA1c is just below the ‘at risk of diabetes’ dividing line (which is of course completely artificial, but helps as a reference guide).

A combination of maitaining your weight loss, and perhaps reducing your daily carb intake by a proportion should help to keep your numbers moving in the right direction 🙂

Keep going!
 
knittedowl said:
Hi,
39F here. I've been morbidly obese quite a lot of my adult life, reaching my biggest weight of 25st6 (161kg) in summer 2022, height of 5'5" (165cm). Since then I've lost over 7 stone (~45kg) and have improved my fitness significantly. In March 2023 I had a full blood panel that returned an A1C of 41. My GP was not concerned and just said that I was not diabetic or prediabetic. I've worried about it ever since even though I've lost 4 stone since then, especially as I know that if I lived elsewhere in the world that would be defined as prediabetes. Should I be eliminating carbs more specifically? I love potatoes in particular so I would find that difficult as I'm already in a significant calorie deficit and have been for 18 months. Should I ask my GP to be retested?

Any advice or thoughts very welcome!
Click to expand...
41 is not pre-diabetic or diabetic. It is a normal result. It is the higher side of normal but that does not mean, as far as I am aware, that you are more likely to have an increase in the hba1c.
 
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