PreDiabetes with Diabetes symptoms?

[PJ_in_MK]

Hi, I'm new here. I am 6 foot male and underweight (57kg). I've been struggling with needing to eat more food during the last year approx and it's very strange because my activity levels have not gone up. Recently I had the Hba1c test which has been confirmed by a second test with 6.2% result. My GP was adamant that I couldn't have Diabetes symptoms when I am only PreDiabetic, but could this still be a probable explanation for my weight loss? What can I do to try to confirm or refute the hypothesis that my unwanted weight loss has been Diabetes-related? Sometimes I have periods of urinating a lot, during which my weight plummets by a pound a day. I have had antibiotics for suspected UTIs because of this but I am not convinced about that diagnosis because a) the urine does not normally seem cloudy or 'wrong' and b) when tested, the urine has not shown signs of infection.
I'm desperate to know what is wrong with me!
Edit: I also have likely Irritable Bowel Syndrome and have had many tests in the last year for inflammation, blood in stool, kidney/liver scans, blood tests etc. The most significant positive results were only slight hydrophrenosis in one kidney and my kidney/liver function is borderline.

 

[Leadinglights]

Hi, I'm new here. I am 6 foot male and underweight (57kg). I've been struggling with needing to eat more food during the last year approx and it's very strange because my activity levels have not gone up. Recently I had the Hba1c test which has been confirmed by a second test with 6.2% result. My GP was adamant that I couldn't have Diabetes symptoms when I am only PreDiabetic, but could this still be a probable explanation for my weight loss? What can I do to try to confirm or refute the hypothesis that my unwanted weight loss has been Diabetes-related? Sometimes I have periods of urinating a lot, during which my weight plummets by a pound a day. I have had antibiotics for suspected UTIs because of this but I am not convinced about that diagnosis because a) the urine does not normally seem cloudy or 'wrong' and b) when tested, the urine has not shown signs of infection.
I'm desperate to know what is wrong with me!
Edit: I also have likely Irritable Bowel Syndrome and have had many tests in the last year for inflammation, blood in stool, kidney/liver scans, blood tests etc. The most significant positive results were only slight hydrophrenosis in one kidney and my kidney/liver function is borderline.

Welcome to the forum, it must be very frustrating to have what seem to be symptoms of diabetes but not have that reflected in an Hba1C test.
Weight loss generally send up red flags for possible Type 1 diabetes but that does not fit with a blood glucose level which is prediabetic. Have you had other blood tests as anaemia can make the HbA1C less accurate but perhaps not that much.
What foods have you been eating to try to prevent weight loss as if it is high carb and your body is struggling to cope with the amount of carb in your meal that could make you thirsty and peeing a lot.
It may be worth you getting a home testing blood glucose monitor so you can do some finger prick tests to check your fasting blood glucose which should be between 4-7mmol/l and then test how your body copes with the carbs in your meal by testing before you eat and after 2 hours when you would want a reading of less than 8mmol/l or no more than 2mmol/l increase from the meal.
If you also keep a food diary of everything you eat and drink with an estimate of the amount of carbs not just sugar that could be helpful in pinning down what may be going on.
A couple of inexpensive monitors can be bought on line, the GlucoNavii, TEE2 or Contour Blue are ones with the cheaper test strips.

 

[rebrascora]

Hi and welcome.

Have you had a full blood count done? Anaemia would cause fatigue and a marginally elevated HbA1c result and if you are having problems with blood in your stools then you are obviously losing blood which could lead to anaemia.
The other thought is an issue with your pancreas which would affect your ability to digest food and result in digestive issues, usually unpredictable and urgent bowel movements which are loose sometimes explosive and perhaps yellow coloured and generally quite greasy causing them to float. This will lead to weight loss because your body is unable to access the nutrients in your food and is referred to as Pancreatic Enzyme Insufficiency or PEI. The test for this is a Faecal Elastase test on a stool sample. We have several members here on the forum whose diabetes is related to damage, disease or surgical removal (partial or total) of their pancreas due to pancreatitis, or cysts or cancer which can lead to this problem and they are referred to as having Type 3c diabetes. If you have had problems with your gall bladder in the past or a history of pancreatitis, this can lead to this PEI issue. It is something to perhaps discus with your GP if it has not been considered or tested for and might explain a lot of your issues, although not usually blood in stools I think.

I would agree with your doctor that symptoms of diabetes usually occur when HbA1c results are quite high and being between 42 and 47mmols/mol which is the current units of measure rather than % which is the prediabetes range would be very unlikely to trigger symptoms, so I suspect your symptoms have another cause.

 

[PJ_in_MK]

Hi and welcome.

Have you had a full blood count done? Anaemia would cause fatigue and a marginally elevated HbA1c result and if you are having problems with blood in your stools then you are obviously losing blood which could lead to anaemia.
The other thought is an issue with your pancreas which would affect your ability to digest food and result in digestive issues, usually unpredictable and urgent bowel movements which are loose sometimes explosive and perhaps yellow coloured and generally quite greasy causing them to float. This will lead to weight loss because your body is unable to access the nutrients in your food and is referred to as Pancreatic Enzyme Insufficiency or PEI. The test for this is a Faecal Elastase test on a stool sample. We have several members here on the forum whose diabetes is related to damage, disease or surgical removal (partial or total) of their pancreas due to pancreatitis, or cysts or cancer which can lead to this problem and they are referred to as having Type 3c diabetes. If you have had problems with your gall bladder in the past or a history of pancreatitis, this can lead to this PEI issue. It is something to perhaps discus with your GP if it has not been considered or tested for and might explain a lot of your issues, although not usually blood in stools I think.

I would agree with your doctor that symptoms of diabetes usually occur when HbA1c results are quite high and being between 42 and 47mmols/mol which is the current units of measure rather than % which is the prediabetes range would be very unlikely to trigger symptoms, so I suspect your symptoms have another cause.

Hi, thanks for replying. Sorry, I meant I was tested for blood in stool, none was found. Also I have had the Faecal Elastase Test, which came back negative. My stools don't generally float etc. as you described, but there is often some undigested food (Irritable Bowel, probably). In the warm weather I have to be more careful of my food intolerances etc. as far as diarrhoea is concerned, but constipation is more normal for me with the IBS. I have had full blood count done, at one stage I had a B12 deficiency but I was able to fix that with a supplement. However, anaemia was not found.

 

[PJ_in_MK]

Welcome to the forum, it must be very frustrating to have what seem to be symptoms of diabetes but not have that reflected in an Hba1C test.
Weight loss generally send up red flags for possible Type 1 diabetes but that does not fit with a blood glucose level which is prediabetic. Have you had other blood tests as anaemia can make the HbA1C less accurate but perhaps not that much.
What foods have you been eating to try to prevent weight loss as if it is high carb and your body is struggling to cope with the amount of carb in your meal that could make you thirsty and peeing a lot.
It may be worth you getting a home testing blood glucose monitor so you can do some finger prick tests to check your fasting blood glucose which should be between 4-7mmol/l and then test how your body copes with the carbs in your meal by testing before you eat and after 2 hours when you would want a reading of less than 8mmol/l or no more than 2mmol/l increase from the meal.
If you also keep a food diary of everything you eat and drink with an estimate of the amount of carbs not just sugar that could be helpful in pinning down what may be going on.
A couple of inexpensive monitors can be bought on line, the GlucoNavii, TEE2 or Contour Blue are ones with the cheaper test strips.

Thanks for replying, my full blood count did not find anaemia but I had a B12 deficiency which I corrected with a supplement. I also have persistent bloating. I have cut down my bread intake but I do enjoy a lot of potatoes with my biggest meal of the day. What alternative to the potato could I try? I am tempted to monitor my blood glucose myself, thanks for the information re equipment.

 

[Leadinglights]

Thanks for replying, my full blood count did not find anaemia but I had a B12 deficiency which I corrected with a supplement. I also have persistent bloating. I have cut down my bread intake but I do enjoy a lot of potatoes with my biggest meal of the day. What alternative to the potato could I try? I am tempted to monitor my blood glucose myself, thanks for the information re equipment.

Potatoes are high carb food so many who are Type 2 have in very reduced portions or substitutes with other lower carb veg, butternut squash, swede, celeriac but will often just have extra veg and make sure they are having enough protein and healthy fats as they need to get energy from somewhere other than carbohydrates.
The other big hitters are rice, pasta, bread, breakfast cereals as well as the more obvious cakes, biscuits and sugary drinks including fruit juice.
If you have persistent bloating that suggests you gut bacterial flora may be unbalanced so full fat yoghurt with live cultures can help and would also give you some healthy fats to help with the weight.
You are quite young to have low vit B12 so have you been on any medication like esomeprazole for your IBS as that can affect the ability to absorb vit B12 from foods so injections are needed as the same will be the case with oral B12.
I certainly think a home monitor would help both you and your GP to resolve the problem./

 

[PJ_in_MK]

Hi, I know underweight people with PreDiabetes/Diabetes are often advised dairy fats but I have a milk intolerance that seems to have gotten worse this year. I haven't had any medication like esomeprazole, but the B12 supplement has corrected that issue. I'm not sure how hard it could be to replace the calories from the potatoes.

 

[rebrascora]

Nuts and avocado are both high in fats and low in carbs. Cashews are the least good choice as have more carbs than walnuts, hazelnuts, brazils and almonds, but still not bad as long as you don't eat too many. Obviously honey roasted nuts are not a good choice. Nut butters like peanut butter can be incorporated into meals to add calories. Some people really enjoy it on celery or I have a spoon with a square of dark 70% chocolate as a sweet treat.
Many who are lactose intolerant can still cope with cheese because the lactose is removed in the whey. Olives are really good for you and high in oil.
Pork scratchings are a good mix of fat and protein with no carbs if your teeth can stand up to them.
I cook my cabbage, courgettes and mushrooms with a knob of butter... again should be very little lactose in butter, because it is water soluble and butter is fat, but if butter is a problem for you frying or roasting food instead of boiling or steaming will add calories.

 

[Leadinglights]

Hi, I know underweight people with PreDiabetes/Diabetes are often advised dairy fats but I have a milk intolerance that seems to have gotten worse this year. I haven't had any medication like esomeprazole, but the B12 supplement has corrected that issue. I'm not sure how hard it could be to replace the calories from the potatoes.

That is why testing might be helpful as you will be able to find out what foods your body is tolerating.
Eggs, avocados, nuts. There are lactose free products if those are suitable for your milk intolerance.
How many potatoes do you have?
Can you associate the symptoms to when you have eaten a high carb meal?

 

[PJ_in_MK]

Wow, everyone is being so helpful! Unfortunately it seems that it is dairy itself I am intolerant of, although I have tried lactose-free milk I still have to heavily restrict how much I have of it, even more than I used to. Also rapeseed oil accumulates in my system with diarrhoea as the result --- I tried an oily spread once when I couldn't buy my favourite butter and after 2 days of having it on sandwiches the result was not pretty! Cheese aggravated me pretty badly last year so I haven't eaten it since. At one meal I often have 300+ grams of potato. The symptoms of urinating a lot are quite mysterious in terms of timing, not easy to pin down. I have been triggered by bananas quite often, though. I have started enjoying peanut butter recently with sliced meat packets (although processed, I go for ones with 98 per cent chicken, beef or turkey). I usually boil my potatoes with carrots and peas.

 

[PJ_in_MK]

Welcome to the forum, it must be very frustrating to have what seem to be symptoms of diabetes but not have that reflected in an Hba1C test.
Weight loss generally send up red flags for possible Type 1 diabetes but that does not fit with a blood glucose level which is prediabetic. Have you had other blood tests as anaemia can make the HbA1C less accurate but perhaps not that much.
What foods have you been eating to try to prevent weight loss as if it is high carb and your body is struggling to cope with the amount of carb in your meal that could make you thirsty and peeing a lot.
It may be worth you getting a home testing blood glucose monitor so you can do some finger prick tests to check your fasting blood glucose which should be between 4-7mmol/l and then test how your body copes with the carbs in your meal by testing before you eat and after 2 hours when you would want a reading of less than 8mmol/l or no more than 2mmol/l increase from the meal.
If you also keep a food diary of everything you eat and drink with an estimate of the amount of carbs not just sugar that could be helpful in pinning down what may be going on.
A couple of inexpensive monitors can be bought on line, the GlucoNavii, TEE2 or Contour Blue are ones with the cheaper test strips.

Hi, I am considering buying the Contour Blue Plus Meter Kit available at https://shop.diabetes.org.uk/collections/glucometer/products/contour-plus-blue-meter-kit
Also the test strips at https://shop.diabetes.org.uk/products/contour-plus-blue-test-strips-50
For the lancets, would these be compatible?

Microlet Lancets 100

Available at Diabetes UK Online Shop, the box of 100 Microlet lancets can be used with your Microlet 2 or Microlet Next lancing device from Ascensia Diabetes Care.

shop.diabetes.org.uk

I just want to make sure I have everything working well together so I can monitor my blood glucose correctly.

 

[Leadinglights]

Hi, I am considering buying the Contour Blue Plus Meter Kit available at https://shop.diabetes.org.uk/collections/glucometer/products/contour-plus-blue-meter-kit
Also the test strips at https://shop.diabetes.org.uk/products/contour-plus-blue-test-strips-50
For the lancets, would these be compatible?

Microlet Lancets 100

Available at Diabetes UK Online Shop, the box of 100 Microlet lancets can be used with your Microlet 2 or Microlet Next lancing device from Ascensia Diabetes Care.

shop.diabetes.org.uk

I just want to make sure I have everything working well together so I can monitor my blood glucose correctly.

It doesn't matter what lancing device or lancets you use, they are just to produce the drop of blood to apply to the end of the test strip. It is the strips that are specific to the monitor.
Some find some devices easier to use than others, I have no opinion on that as I go off piste and just hold the lancet in my fingers and prick. Un officially you can reuse lancets.

 

[Tdm]

Ha ha, i think is more true to say there are unsubstantiated rumours you should only use a lancet once....