Prediabetes symptoms and advice

[KenG]

Hi, I am new to the forum.

I don’t know what I am looking here, perhaps to understand if anyone went through anything similar? To also know where to start with getting a grip on what I should be eating.

I have been back and fourth to the GP for the last 3 years with symptoms (I am 44yrs, 14st 9lbs, 5ft 9 male). Headaches, tiredness, fatigue, stool related issues, abdominal pains, going to the toilet multiple times throughout the night, 2 x UTIs (that cannot be down to other reasons), heartburn type pain/ pain in the lower sternum. Most recently the heartburn/sternum type pain has become almost permanent, as have the headaches and tiredness/fatigue.

I’ve had various tests over the 3 years (including blood tests). However, 2 weeks ago was the first time the GP requested a fasted blood test, and I have been told by GP that I am prediabetic - I understand I can change this with lifestyle changes (I have a 100% home based very high pressure job, long-hours at my desk, sedentary, no exercise at all, I wasn’t eating enough most days but would drink tea and snack on lots of biscuits, crunchy nut cornflakes, sugar free red bull and even kids sweets, during the day whilst working).

For info results my results came back as:

• HBA1C was 43 - Above high reference limit of 26 - 41] (not much higher, but higher).
• Serum TSH level was 5.9 miu/L - Above high reference limit of 0.34 - 5.6.
• Serum cholesterol level was 6.1 mmol/L - Above high reference limit of 1.5 - 5.5.
• Mean cell haemoglobin level ae32.5 pg - just outside the reference range of 27 - 32.
• Blood Pressure Average over 7 days was 133 / 95 mmHg.

I am referred for further ECG, ACR, Bloods and Ultrasound, and referred to national diabetes prevention programme.

Ironically, I had made a conscious effort to change my habits a few weeks ago and had registered on a 13 week fitness and health programme (but GP asked me to put it on hold, and just get my steps in, until all results were in - so haven’t been able to start it).

I am getting my steps in now (I barley moved most days before, working 12 to 14hr days at home). I have started eating better (I’ve dropped the biscuits, breakfast cereal and kids sweets and the weekend wine), but I am struggling to get my calories in (anywhere between 1200 and 1700 a day. I am also struggling to keep carbs down, I never really ate bread before, nor pastries, cakes etc… (the occasional ice cream - which I have dropped from my diet for now).

I am eating berries & yoghurt for breakfast, beans (various types), water based protein shakes with PBFit nut powder in, Trek Protein Bars, fish, chicken, lean ham, salad leaves, tomatoes, beetroot, low fat cottage cheese etc… I was eating quiet a few bananas but also dropped those now.

Too much info warning, but my stools have changed in the last few days, and no longer solid.

Any advice or information is welcomed.

 

[rebrascora]

Hi and welcome.

Sorry to hear of the symptoms you are suffering. With an HbA1c of 43 I would be really very surprised if your symptoms are down to diabetes as generally symptoms do not occur until levels are much higher. Of the tests that are scheduled, I think the ultrasound might prove most helpful. I am wondering if there is a gall stone or possibly pancreatic cyst causing your problems, particularly the pain and stool issues.
Your dietary changes sound good although I am not personally a fan of protein shakes and I have stopped buying protein bars as both are what can be classed as Ultra Processed Foods. The rest of it seems great. If you can add in some green veg like broccoli, cauliflower and cabbage that will bulk things out. A knob of butter or some grated cheese will greatly enhance the flavour and don't forget eggs are a wonderful food, particularly for us diabetics. So versatile and pretty well carb free and tasty and quick and easy to cook.

 

[ianf0ster]

Hi @KenG and welcome to the forum.
I'm surprised that you have such a low fibre diet and eat high carb foods like protein bars. All the Trek bars I googled are quite high in carbohydrates. Unprocessed food (food you could make from scratch in a domestic kitchen) is much better for us than commercial powders and shakes. It's best to try to eat foods which are below 20gms of carbs per 100 gms. In general, for foods under 5gms of carbohydrates are mostly foods you can eat as much as you like, except for high calorie food like full fat hard cheese and nuts which are best to keep down to only 100gms per day in order to keep losing weight.

Mainstays of low carb eating are above ground veg (such as broccoli or cauliflower or french beans, mange tout - not beans or peas without the pods) and high protein natural foods which come with natural fats, because when you reduce carbs, you need to increase both proteins and fats in order to avoid hunger. Although Fasting is good for weight loss, constant hunger isn't because it puts your body into starvation mode reducing your metabolism - which is the last thing you want. Natural fats rarely cause weight gain unless combined with carbs because they don't boost insulin (the Fat Storage hormone) like carbs do.
So chicken thighs or turkey are better than chicken breast as are beef, lamb, pork , salmon, mackerel, trout (not just lean cuts. Eggs are almost a perfect food for diabetics since they are high protein, quite high in natural fats and very low in carbs.

Extra fibre may help with the loose stools, adding chia seed to your breakfast ( you can add other seed or chopped nuts as well) should help that. Chia seeds are good for treating both loose stools and also for the opposite - constipation, because of the way they absorb water when they turn gloopy.

 

[KenG]

@ianf0ster I am very greatful for this post. It is what I needed to hear. I do need to pay more attention to what I am eating. I have dropped the Trek bars a couple of days ago, and also limited the shake to one every other day - when I’m working longer hours. Are you saying beans - like the Tesco Four Bean salad are not that great for people trying to manage their HbA1C?

 

[KenG]

Hi and welcome.

Sorry to hear of the symptoms you are suffering. With an HbA1c of 43 I would be really very surprised if your symptoms are down to diabetes as generally symptoms do not occur until levels are much higher. Of the tests that are scheduled, I think the ultrasound might prove most helpful. I am wondering if there is a gall stone or possibly pancreatic cyst causing your problems, particularly the pain and stool issues.
Your dietary changes sound good although I am not personally a fan of protein shakes and I have stopped buying protein bars as both are what can be classed as Ultra Processed Foods. The rest of it seems great. If you can add in some green veg like broccoli, cauliflower and cabbage that will bulk things out. A knob of butter or some grated cheese will greatly enhance the flavour and don't forget eggs are a wonderful food, particularly for us diabetics. So versatile and pretty well carb free and tasty and quick and easy to cook.

Thank you, I am slightly worried it is not diabetes, but perhaps my lack of fibre is impacting my stools. I should have more answers next week.

 

[trophywench]

Leguminous veg in general aren't great when you're trying to limit your carbohydrate intake so 4 bean salad from a supermarket won't be much different to eating a drained can of haricot beans or baked beans with the tomato sauce washed off them.. Yes there is some fibre in the skins of individual peas and beans, but not enough to compensate for the amount of carbohydrate, runner beans are a bit different cos there's more 'pod' to eat normally than the actual leguminous beans themseves, Ditto mange tout or sugarsnap peas - the peas inside the pods not being anywhere near fully developed, most of the nutrition we can get from eating them comes from the fibrous pods.

Bit of a nightmare if you happen to be vegetarian because it's easy to sorce vegetarian protein from legumes, but you can't only eat the protein without the carbs.

 

[rebrascora]

Thank you, I am slightly worried it is not diabetes, but perhaps my lack of fibre is impacting my stools. I should have more answers next week.

I find fibre supplements really helpful. In particular psyllium husk and whole chia seeds. I mix a teaspoon of each into a glass of water with a dash of Apple Cider vinegar and a dash of balsamic vinegar, give it a stir and drink it down. We have a member who puts his chia seeds in his morning coffee. Do be aware that they absorb water and go sort of gelatinous which is pretty much how they work my forming a mass of gel which moves through your digestive system taking everything with it. Chia seeds are also a bit of a super food being high in Omega 3 Fatty Acids which is what makes fish oils so good for us. Neither psyllium or chia seem to taste of anything much so not unpleasant to use but it is important to take fluid with them otherwise you can end up constipated, because they need to have enough liquid to absorb and become a gel. These soluble fibres are also helpful in reducing cholesterol, so lots of benefits and no particular drawback from what I can tell. My gut is certainly the happiest it has been probably all of my life, since I reduced my carbs and started with chia seeds.

 

[Leadinglights]

The description of your symptoms do point to some sort of gut issues rather than diabetes. Some things to try to improve your gut microbiome would be things like probiotic yoghurt or fermented foods like Kimchi.
It is good some more investigations are being done so I hope that resolves things.
This link https://gutscharity.org.uk/ describes the multitude of possible gut issues which sometimes are notoriously difficult to diagnose. You may recognise your symptoms.
My other half has been told he has Crohn's disease but it is largely asymptomatic so when he was really unwell 6 months ago put it down to a flare up but it turned out the be what is called stump appendicitis. He had his appendix removed over 50 years ago but a bit had got left behind and had perforated. 2 weeks of IV antibiotics in hospital and it has caused no further problem, touch wood.

 

[ColinUK]

Further to the chia seeds comment I generally have one small pot of Yeo Valley Greek yogurt (the full fat, live version) with between 30-50g of blueberries at some point during each day. I cover the whole lot with a generous amount of chia seeds.

 

[childofthesea43]

From the symptoms described I think it exceedingly unlikely they have anything to do with mild diabetes. If that were so then half the nation would be presenting similarly. By all means attend to the prediabetes but I think a serious investigation (which sounds three years overdue) will yield a different conclusion.

 

[everydayupsanddowns]

@ianf0ster I am very greatful for this post. It is what I needed to hear. I do need to pay more attention to what I am eating. I have dropped the Trek bars a couple of days ago, and also limited the shake to one every other day - when I’m working longer hours. Are you saying beans - like the Tesco Four Bean salad are not that great for people trying to manage their HbA1C?

Welcome to the forum @KenG 🙂

As with most food-based discussions here, there’s a significant amount of ‘it depends’. Because digestion is complex, and different people absorb the same food in quite different ways, meaning what works well for one person may not for another, and what’s difficult for one may be absolutely fine for another.

I generally find pulses to be fairly modest in their impact on my blood glucose. I have a link saved somewhere that explains the way carbohydrates in pulses are broken down differently to those in say, wheat. A proportion of the carbohydrate in pulses and beans will pass through the small intestine unabsorbed (which is why beans have a reputation for making you windy - the bacteria in the lower intestine feast in them and give off CO2!)

As an insulin user I have found I need to be quite careful not to allow the ‘full‘ amount of carbohydrate in pulses, beans, lentils and even pearl barley in my dose estimates - because I can end up with my glucose levels crashing if I’m not careful.

But others don’t seem to experience this! And have to be more careful where beans and pulses are concerned. It may be that those on a lower carbohydrate intake find that their bodies seize the carbs in pulses more eagerly?

Hope the further investigations and scans provide helpful information to point the way forward.

Let us know how you get on.

 

[KenG]

Leguminous veg in general aren't great when you're trying to limit your carbohydrate intake so 4 bean salad from a supermarket won't be much different to eating a drained can of haricot beans or baked beans with the tomato sauce washed off them.. Yes there is some fibre in the skins of individual peas and beans, but not enough to compensate for the amount of carbohydrate, runner beans are a bit different cos there's more 'pod' to eat normally than the actual leguminous beans themseves, Ditto mange tout or sugarsnap peas - the peas inside the pods not being anywhere near fully developed, most of the nutrition we can get from eating them comes from the fibrous pods.

Bit of a nightmare if you happen to be vegetarian because it's easy to sorce vegetarian protein from legumes, but you can't only eat the protein without the carbs.

Thank you, much appreciated, this is very useful information.

 

[KenG]

From the symptoms described I think it exceedingly unlikely they have anything to do with mild diabetes. If that were so then half the nation would be presenting similarly. By all means attend to the prediabetes but I think a serious investigation (which sounds three years overdue) will yield a different conclusion.

Thank you. The symptoms come and go, but worse lately. Over last 3 years I have had 2 CT scans, x-rays, ultrasounds, multi bloods, and lots of other prodding and poking (most of this was over 2 years ago now). None of which has resulted in any meaningful outcome. I have gone through periods of eating better (or so I think), restricting certain foods to check for allergy/intolerance, working less (averaging 10 hour days instead of 12 to 14), moving more etc… but none of this has correlated with periods of feeling better.

The prediabetes has really given me rocket up the bottom so to speak. Like a lot people, I know what I shouldn’t be doing, but I was still doing it. I am working on lowering my carbs, cholesterol, blood pressure and weight down, but struggling to get the right balance each day - and enough calories, as I get to know what works.

Yesterday was a great example, 1,084 calories, 27% carbs, 38% fat, 35% protein. Low fat yoghurt and berries for breakfast. Homemade chicken, prawn, lean ham salad for lunch. Harissa baked eggs (has chopped tomatoes, olive oil, garlic, eggs, peppers) with garlic and chilli broccoli for dinner, and handful of Honest Bean Fava Beans to snack on.

 

[KenG]

Further to the chia seeds comment I generally have one small pot of Yeo Valley Greek yogurt (the full fat, live version) with between 30-50g of blueberries at some point during each day. I cover the whole lot with a generous amount of chia seeds.

Thanks, adding the seeds sounds great.

 

[KenG]

Welcome to the forum @KenG 🙂

As with most food-based discussions here, there’s a significant amount of ‘it depends’. Because digestion is complex, and different people absorb the same food in quite different ways, meaning what works well for one person may not for another, and what’s difficult for one may be absolutely fine for another.

I generally find pulses to be fairly modest in their impact on my blood glucose. I have a link saved somewhere that explains the way carbohydrates in pulses are broken down differently to those in say, wheat. A proportion of the carbohydrate in pulses and beans will pass through the small intestine unabsorbed (which is why beans have a reputation for making you windy - the bacteria in the lower intestine feast in them and give off CO2!)

As an insulin user I have found I need to be quite careful not to allow the ‘full‘ amount of carbohydrate in pulses, beans, lentils and even pearl barley in my dose estimates - because I can end up with my glucose levels crashing if I’m not careful.

But others don’t seem to experience this! And have to be more careful where beans and pulses are concerned. It may be that those on a lower carbohydrate intake find that their bodies seize the carbs in pulses more eagerly?

Hope the further investigations and scans provide helpful information to point the way forward.

Let us know how you get on.

Thank you for the information, if you do have the link about pulses it would be useful. If not, don’t worry, I’m sure I will find it on Google.

 

[everydayupsanddowns]

Thank you for the information, if you do have the link about pulses it would be useful. If not, don’t worry, I’m sure I will find it on Google.

Seems that it is related to amylopectin-c - the least digestible form

All Complex Carbohydrates Are Not Created Equal - Cholesterol

Conventional wisdom proclaims that “complex” carbohydrates, such as whole grains and beans, are good for you, better than “simple” carbohydrates like white flour and sucrose. Is that true? Complex carbohydrates have greater fiber and nutrient content…

www.healthcentral.com

 

[childofthesea43]

Thank you. The symptoms come and go, but worse lately. Over last 3 years I have had 2 CT scans, x-rays, ultrasounds, multi bloods, and lots of other prodding and poking (most of this was over 2 years ago now). None of which has resulted in any meaningful outcome. I have gone through periods of eating better (or so I think), restricting certain foods to check for allergy/intolerance, working less (averaging 10 hour days instead of 12 to 14), moving more etc… but none of this has correlated with periods of feeling better.

The prediabetes has really given me rocket up the bottom so to speak. Like a lot people, I know what I shouldn’t be doing, but I was still doing it. I am working on lowering my carbs, cholesterol, blood pressure and weight down, but struggling to get the right balance each day - and enough calories, as I get to know what works.

Yesterday was a great example, 1,084 calories, 27% carbs, 38% fat, 35% protein. Low fat yoghurt and berries for breakfast. Homemade chicken, prawn, lean ham salad for lunch. Harissa baked eggs (has chopped tomatoes, olive oil, garlic, eggs, peppers) with garlic and chilli broccoli for dinner, and handful of Honest Bean Fava Beans to snack on.

Right, so a lot of testing already done and more to come. We cannot diagnose here but it would not surprise me if the answer turned out along one or other of the lines that Rebrascora and LeadingLights have suggested. I hope you get that answer as you’ve clearly had a rough three years. As for the prediabetes remediation your macronutrient balance is almost exactly my own but you may be driving calories lower than necessary. My initial A1c was hugely higher than yours but was brought down to normality over a few months through low carbs and about 1500 cals. Good luck in the journey to getting better.

 

[Leadinglights]

Just to add to my previous post, my other half was advised to follow a low residue/ fibre diet during his recovery as this pits less pressure on your guts.

 

[ColinUK]

Thanks, adding the seeds sounds great.

I bought a big tub of them that was called a Chia Sprinkle pot something like that. Now I just buy bags of them and refill the tub.

 

[KenG]

Just to add to my previous post, my other half was advised to follow a low residue/ fibre diet during his recovery as this pits less pressure on your guts.

Thank you, looking at this diet fills me with dread - I’m wondering how to do low carb but low residue / low fibre dieting. It looks like one almost a counteracts the other.