Prediabetes and confused

[chris62]

Hi,

Firstly, hello! It's lovely to be here. It looks like a great place to get information 🙂
Can anyone help clarify something please? A recent blood test put me in the pre-diabetes range (43mmol/mol) so obviously I need to get it back down to a normal level. This happened once before a couple of years ago when I was at 45mmol and managed to get it down to 42.
My question is about fruit. I’ve read so much about the sugar in fruit being ok to have and not affecting the blood sugar level, so that’s all good. The problem I have is that I don’t really like fruit that much on its own so I bought a blender. I’ve heard various comments about blended fruit. Some saying that the sugars in the fruit are just as healthy as when the fruit is whole, others saying that you should not eat blended fruit as the sugars are then too high. I’m not talking about shop bought smoothies of course. I know these are ridiculously high in added sugar. I’ve found so many recipes that I find delicious and filling, for example a blend of skimmed milk, banana, frozen fruit, peanut butter & oats, but I worry when I see how much sugar is shown for this, and other similar things, in the app that I use (NutraCheck calorie counter). I've attached a screenshot of yesterday's daily total. As you can see, my sugar intake looks ridiculous! But if it's mostly fruit and dairy then I presume this is okay?
I’ve also seen confusing comments about grapes. Some saying that grapes, especially red ones, are extremely good for you, but others saying they are like “mini sugar bombs” and they should be avoided.
I’m so confused and worried that I’m doing this all wrong

 

[rebrascora]

All carbohydrates raise your blood glucose levels if you have diabetes to a greater or lesser extent, so we are not just talking sugar but starchy carbohydrates too, like bread and pasta and potatoes and rice and oats. Sugars are the quickest and easiest for the body to break down and the sugars in fruit are combined with fibre which slows down their release. Unfortunately if you blend them finely that breaks down the fibre and allows the sugars to be released and absorbed into the blood stream more quickly than eating the fruit whole. It is also quicker and less satisfying drinking a smoothie than chewing and eating that fruit. Bananas are one of the highest carb fruits, so generally that is more likely to raise your BG levels higher than a few berries, even without blending it and many of us here who follow a low carb diet would only have banana very occasionally as a treat and perhaps have half or a third of one and share it with a partner or save the rest for another day.
Your smoothie is therefore unfortunately not a great choice and to be honest, your diabetes is better served by only eating a small amount of fruit and more low carb veg.
However, you are only at risk of developing diabetes so perhaps your body can cope with your smoothie at the moment, and the only way to tell would be to get yourself a Blood glucose meter and do some testing just before drinking it and then 2 hours afterwards to see if your body managed to deal with the glucose release from that fruit and oats. If it raised your levels by more than 3mmols 2 hours after drinking it, then it was too much and you need to reconsider of just use half a banana or less oats.
Testing other meals which contain carb rich foods like bread and pasta and rice and potatoes and anything made with flour (pastry, dumplings etc) in the same way ie. before eating and then 2 hours afterwards will help you to tailor your diet to the amount of carbohydrates your body can manage. You will likely find that some forms of carbs are more spikey than others. For instance, despite their slow release reputation, some of us find oats/porridge spikes us nearly as badly as sugar and mashed potatoes can be a problem food for others... again mashing breaks down the structure of the fibre and enables the carbs to be broken down more easily, but a couple of roast potatoes might be tolerated better. Bread, even wholemeal can be troublesome for many people, but some can get away with a small slice or two a day. It really is very individual hence testing being so helpful in allowing you to tailor your diet to your body's response.

 

[rebrascora]

I should also say that there are lots of tasty low carb foods like meat and fish and eggs and cheese and green leafy veg (cabbage/kale/broccoli etc) and cauliflower is low carb and mushrooms and add in some tomatoes and onion and peppers which are not too high carb and you can have lots of tasty meals.

 

[chris62]

I should also say that there are lots of tasty low carb foods like meat and fish and eggs and cheese and green leafy veg (cabbage/kale/broccoli etc) and cauliflower is low carb and mushrooms and add in some tomatoes and onion and peppers which are not too high carb and you can have lots of tasty meals.

Great advice from both your posts. Thank you so much. That makes everything a lot clearer!

 

[Proud to be erratic]

To supplement @rebrascora's terrific replies just above: blending increases the glucose outcome in 2 ways;

Fibres are indigestible carbs - once blended they then become extra digestible carbs.​

​

[Digression: Fibres (the English spelling) are not included in the total carbs shown in nutritional info on packaging. Fibers (the US spelling) are included in US nutritional info and must be deducted from the total carb info provided. So check the spelling of Fibres/ Fibers when internet searching for carb content of a new food, in case you've been taken to a US site; or specify your search to UK sites. Digression over.]​

​

In general any blended foods raise the Glycaemic Index (GI) of that food, causing it to digest and convert into glucose far more quickly. This creates a bigger glucose hit arriving rapidly that the insulin can have more of a struggle to manage. This is great for a 15gm hypo response, but a lot less helpful for BG management.​

​

For T2s it just worsens their predicament of their bodies natural increased insulin resistance not being able to manage the arriving glucose.​

​

For those of us who are insulin dependent, at the very least, it changes the way we try to manage timings, whereby we aspire to get injected insulin to arrive into our blood at the same time as the digested glucose.​

General advice is reduce portion sizes and consequently reduce the carbs getting converted by digestion into glucose. Easy to put less potatoes, pasta, rice or cake on your plate, but half a banana is a bit more of a hassle.

Regarding mini sugar bombs: Grapes are typically 15% carbohydrate (if not blended); the actual % varies according to type, colour, ripeness, even skin toughness. But 15% may be at the higher end of fruit carb contents, but still not huge. At +/- 15% if each grape is large, each grape is a potential mini glucose bombshell. But in truth no more so than many, many other foods; so I always think that description is unnecessarily over the top. At the end of the day it comes down to the weight of all the grapes you are eating. I use grapes as a useful food to nudge my BG up when I'm a little low. Chewing toffees are far worse mini sugar bombs: the chewing ensures best digestion and the sweet from the outset is effectively pure glucose anyway.

 

[chris62]

To supplement @rebrascora's terrific replies just above: blending increases the glucose outcome in 2 ways;

Fibres are indigestible carbs - once blended they then become extra digestible carbs.​

​

[Digression: Fibres (the English spelling) are not included in the total carbs shown in nutritional info on packaging. Fibers (the US spelling) are included in US nutritional info and must be deducted from the total carb info provided. So check the spelling of Fibres/ Fibers when internet searching for carb content of a new food, in case you've been taken to a US site; or specify your search to UK sites. Digression over.]​

​

In general any blended foods raise the Glycaemic Index (GI) of that food, causing it to digest and convert into glucose far more quickly. This creates a bigger glucose hit arriving rapidly that the insulin can have more of a struggle to manage. This is great for a 15gm hypo response, but a lot less helpful for BG management.​

​

For T2s it just worsens their predicament of their bodies natural increased insulin resistance not being able to manage the arriving glucose.​

​

For those of us who are insulin dependent, at the very least, it changes the way we try to manage timings, whereby we aspire to get injected insulin to arrive into our blood at the same time as the digested glucose.​

General advice is reduce portion sizes and consequently reduce the carbs getting converted by digestion into glucose. Easy to put less potatoes, pasta, rice or cake on your plate, but half a banana is a bit more of a hassle.

Regarding mini sugar bombs: Grapes are typically 15% carbohydrate (if not blended); the actual % varies according to type, colour, ripeness, even skin toughness. But 15% may be at the higher end of fruit carb contents, but still not huge. At +/- 15% if each grape is large, each grape is a potential mini glucose bombshell. But in truth no more so than many, many other foods; so I always think that description is unnecessarily over the top. At the end of the day it comes down to the weight of all the grapes you are eating. I use grapes as a useful food to nudge my BG up when I'm a little low. Chewing toffees are far worse mini sugar bombs: the chewing ensures best digestion and the sweet from the outset is effectively pure glucose anyway.

Thanks 🙂

 

[everydayupsanddowns]

My question is about fruit. I’ve read so much about the sugar in fruit being ok to have and not affecting the blood sugar level, so that’s all good

Welcome to the forum @chris62

Good luck with your efforts to reduce your HbA1c back down a few notches.

Of the fruits berries are generally found to have the lowest impact on BG levels by members here. As an example I would need to be having quite a few to make me think I needed to add extra insulin to balance them. Usually I can just eat a handful and not worry about them raising my levels.

Personally that would not be the case for me with many fruits like apples, pears, oranges. Those do have a noticeable impact on my BG levels, and I need to balance them with insulin - which makes me think that they would need to be eaten in moderation by someone with T2 managing their diabetes by diet alone.

If my blood glucose were low, and I needed a rapid boost in glucose levels, if there were no full sugar cola or Lucozade available natural fruit juice would do perfectly well. By which I guess I’m illustrating that fruits made into a drink (smoothie or juice) have rapidly accessible sources of glucose in them.

So for me the “sugar in fruit being ok to have and not affecting the blood sugar level” you mention is only really applicable to berries, and my general mind-map of likely glucose-boosting qualities from least to most probably goes something like:

berries… apple/pear… kiwi… orange… banana (getting trickier now)… grapes… mango/pineapple

 

[JITR]

Have a look at the Glucose Goddess web site (Instagram). She shows examples of combining foods to reduce sugar spikes. My example: fruit v the same fruit in a smoothie with milk/yog/kefir (chopped fruit milk/yog/kefir may be better still). Did someone say this already?

 

[chris62]

Have a look at the Glucose Goddess web site (Instagram). She shows examples of combining foods to reduce sugar spikes. My example: fruit v the same fruit in a smoothie with milk/yog/kefir (chopped fruit milk/yog/kefir may be better still). Did someone say this already?

Thanks! I'll take a look.

 

[chris62]

Welcome to the forum @chris62

Good luck with your efforts to reduce your HbA1c back down a few notches.

Of the fruits berries are generally found to have the lowest impact on BG levels by members here. As an example I would need to be having quite a few to make me think I needed to add extra insulin to balance them. Usually I can just eat a handful and not worry about them raising my levels.

Personally that would not be the case for me with many fruits like apples, pears, oranges. Those do have a noticeable impact on my BG levels, and I need to balance them with insulin - which makes me think that they would need to be eaten in moderation by someone with T2 managing their diabetes by diet alone.

If my blood glucose were low, and I needed a rapid boost in glucose levels, if there were no full sugar cola or Lucozade available natural fruit juice would do perfectly well. By which I guess I’m illustrating that fruits made into a drink (smoothie or juice) have rapidly accessible sources of glucose in them.

So for me the “sugar in fruit being ok to have and not affecting the blood sugar level” you mention is only really applicable to berries, and my general mind-map of likely glucose-boosting qualities from least to most probably goes something like:

berries… apple/pear… kiwi… orange… banana (getting trickier now)… grapes… mango/pineapple

Very useful and detailed info again! Thanks! So pleased I joined this community 🙂