Prediabetes

[Carrie B]

Hi everyone, and Happy New Year.
I’ve just joined to pick your brains and pick up some useful tips. I’m currently on the NHS/LIVA programme for prediabetes since late August 2023. My score was 42 then and the range was 42-47. I’ve just had my blood results back for December and I’m now 43 and the range is 42-44. I am awaiting a phone call from my doctor regarding same and to query if the results are correct or even mine – because I lost 6lbs, exercise as in walking briskly every day, no alcohol or fizzy drinks, grow and cook my own vegetables, minimum sugar intake and I never was obese just a few pounds over recommended levels for my size– I’m quite exasperated amongst other things. Also minimal red meat per week and low salt and sugar intake and no medical issues bar I'm on statins and no one in my large family has diabetes.

Any thoughts would be appreciated.

 

[Inka]

Welcome @Carrie B 🙂 You mention eating minimal sugar - have you also reduced your carbs (all carbs not just sugar)?

 

[Carrie B]

Welcome @Carrie B 🙂 You mention eating minimal sugar - have you also reduced your carbs (all carbs not just sugar)?

Yes Inka, specifically bread and potatoes. I even make brown bread with added chopped mixed nuts. I'm not a big fan of beans. It's really interesting to read about low carb on any forum as in the 80-90s' the Dr. Atkins diet promoted low carb intake.

 

[Inka]

Could you write down an average day’s food for you @Carrie B ? It’s still early days so don’t be put off. Perhaps a little more tweaks and a little longer will bring your HbA1C down.

 

[Carrie B]

Could you write down an average day’s food for you @Carrie B ? It’s still early days so don’t be put off. Perhaps a little more tweaks and a little longer will bring your HbA1C down.

B 8-9am) poached egg with salad and small slice homemade wholemeal nutty bread. (I gave up cereals)
D 1.30pm) Most meats or fish (no more than 100gms) with 2 veg and medium potato - not big on gravy or sauces
Tea 6-6.30pm) mixed salad with cheese and some meat and a slice bread.

4 months devotion to the LIVA programme and results are disappointing, but I definitely feel better and very happy I lost a few pounds to boot. I'll wait for my doctors phone call on 15th January to hear his point of view.

 

[Leadinglights]

Yes Inka, specifically bread and potatoes. I even make brown bread with added chopped mixed nuts. I'm not a big fan of beans. It's really interesting to read about low carb on any forum as in the 80-90s' the Dr. Atkins diet promoted low carb intake.

Looks like you may need to look at your carb intake a bit more closely if there is no change from August.
I have found a low carb approach worked for me, I followed the principals in the link. https://lowcarbfreshwell.com/. Not the menu plans as such but based meals on meat, fish, eggs, cheese with veg and salads. Low carb is suggested as being no more than 130g per day but some do go lower. Keeping a food diary with an estimate of the carbs would help you see how close you are to that.
Some of the NHS programs are still too high in carbs for many to tolerate.

 

[Carrie B]

Looks like you may need to look at your carb intake a bit more closely if there is no change from August.
I have found a low carb approach worked for me, I followed the principals in the link. https://lowcarbfreshwell.com/. Not the menu plans as such but based meals on meat, fish, eggs, cheese with veg and salads. Low carb is suggested as being no more than 130g per day but some do go lower. Keeping a food diary with an estimate of the carbs would help you see how close you are to that.
Some of the NHS programs are still too high in carbs for many to tolerate.

thank you, i'll look at your link

 

[Drummer]

@Carrie B I'm afraid that the advice on diet from the NHS can be way off target. I'm not the only one to discover that the usual advice to eat good carbs just doesn't work - Dr Atkins way of eating is far easier to do and get good results.
My own results are close to yours now, 7 years on, but I was very overweight and way into type 2 when told I was diabetic.
Sugar free fizzy drinks or squash is fine. I do drink alcohol three or four times a year - modest amounts seem to be no problem, I eat low carb veges, lots of meat of any colour, also fish, cheese, eggs and full fat dairy, I need to remember to add salt to some foods several times a week or I get cramp, no statins as they did dreadful things to memory and muscles when taken along with Metformin.
I do make and buy some bread, but not very often and the home made is very low in carbs as I add so much low carb stuff into a part proved bread dough, then allow it to rise again. My carb intake is under 40 gm a day.

 

[Carrie B]

@Carrie B I'm afraid that the advice on diet from the NHS can be way off target. I'm not the only one to discover that the usual advice to eat good carbs just doesn't work - Dr Atkins way of eating is far easier to do and get good results.
My own results are close to yours now, 7 years on, but I was very overweight and way into type 2 when told I was diabetic.
Sugar free fizzy drinks or squash is fine. I do drink alcohol three or four times a year - modest amounts seem to be no problem, I eat low carb veges, lots of meat of any colour, also fish, cheese, eggs and full fat dairy, I need to remember to add salt to some foods several times a week or I get cramp, no statins as they did dreadful things to memory and muscles when taken along with Metformin.
I do make and buy some bread, but not very often and the home made is very low in carbs as I add so much low carb stuff into a part proved bread dough, then allow it to rise again. My carb intake is under 40 gm a day.

Thank you Drummer. About 25 years ago I did Dr. Atkins diet and though not really overweight I dropped to 9 1/2 stone but actually felt too thin. So I'm quite happy to stay at 10St and having lost 6lbs I really felt 'clensed' of my stodge. So I'm hoping the results put on my Med Record are someone elses.

I've emailed my doctor and told him the situation. Have a call appointment with him on 15th Jan. Lo and behold I had a text from the Medical Centre this morning to book another HbA1c blood test. (So somebody has taken my message seriously) Also it will be interesting to see what my NHS/LIVA coach says tomorrow as I have messaged him too.

 

[Drummer]

Thank you Drummer. About 25 years ago I did Dr. Atkins diet and though not really overweight I dropped to 9 1/2 stone but actually felt too thin. So I'm quite happy to stay at 10St and having lost 6lbs I really felt 'clensed' of my stodge. So I'm hoping the results put on my Med Record are someone elses.

I've emailed my doctor and told him the situation. Have a call appointment with him on 15th Jan. Lo and behold I had a text from the Medical Centre this morning to book another HbA1c blood test. (So somebody has taken my message seriously) Also it will be interesting to see what my NHS/LIVA coach says tomorrow as I have messaged him too.

More protein and natural fats should be helpful.
I have been able to resume work servicing knitting machines as I am so much stronger than I was at diagnosis. My legs were strong enough as I was very overweight and had been struggling along for years under the strain, but my arms and back became very weak. Muscle is protein, we need to have it in our diet or we become gradually weaker as we age.

 

[rebrascora]

The HbA1c blood test measures the number of glucose molecules which have stuck to your red blood cells (Haemaglobin) over their lifetime. Red blood cells generally "live" 2-3 months before they are replaced, but apparently as we get older they are not replaced as quickly and therefore stay in the blood stream longer and can attract more glucose molecules because they are exposed to them for longer, even if your BG levels are well controlled. Similarly if you are anaemic, there are less red blood cells and that can also impact your HbA1c result. So your very slightly inflated HbA1c results may in fact just be normal (as oppose to prediabetic) for you at your stage in life and pose minimal risk of complications over the next 20-30 years if you can maintain that sort of level.

I am Type 1 and just about to turn 60. I use insulin and diet to control my levels and the best HbA1c result I can get is 45 (without having too many hypos) and I don't foresee this causing me any complications if I can maintain my fitness and that sort of HbA1c result. In fact my consultant would be happier if my result was a bit higher in the low 50s as I would be having less hypos still at that level. I appreciate that you are not at risk of hypos because you are not on medication which can cause them, but HbA1c results simply measure the glucose stuck to our blood cells and it doesn't matter if we are Type 1 or Type 2 in that respect, so it is not unreasonable to compare them in this situation.

What I am saying is that you should not be overly concerned if your repeat result comes back at the same sort of level as the previous ones as this may just be normal for you. Obviously you have put some effort into changing your diet and doing the course and that has improved your weight and wellbeing so don't feel like you have failed or anything and I would certainly continue with the changes you have made and if you want to make more cuts, perhaps have less of your home made bread. I am guessing it is still mostly wholemeal wheat flour with a few nuts added, so probably not that low carb. I gave up on bread altogether as it spikes me quite badly and it also makes me crave more carbs, so easier not to have it. I also only rarely have potatoes and don't bother with rice or pasta as I just don't need them to enjoy my food. Often I have curry or chilli or bolognaise on a bed of cooked shredded cabbage or broccoli or very occasionally konjac rice or noodles which are pretty well carb free and mostly fibre, but serve the purpose of providing a "bed" for the tasty stuff. You can mash cauliflower instead of potato if you drain it well after boiling and add a dollop of cream cheese and I like a spoon of wholegrain mustard in it. You can also make chips from celeriac instead of potatoes as a lower carb option and people use grated cauli as a rice substitute. There are lots of different options to reduce carbs further but to be honest with an HbA1c of 43 I don't think there is any great need or benefit in pushing your diet much further, as it sounds pretty healthy.

 

[Carrie B]

More protein and natural fats should be helpful.
I have been able to resume work servicing knitting machines as I am so much stronger than I was at diagnosis. My legs were strong enough as I was very overweight and had been struggling along for years under the strain, but my arms and back became very weak. Muscle is protein, we need to have it in our diet or we become gradually weaker as we age.

It is great to feel back in control well done. It makes life worthwhile and enjoyable.

 

[everydayupsanddowns]

I've emailed my doctor and told him the situation. Have a call appointment with him on 15th Jan. Lo and behold I had a text from the Medical Centre this morning to book another HbA1c blood test. (So somebody has taken my message seriously) Also it will be interesting to see what my NHS/LIVA coach says tomorrow as I have messaged him too.

Congrats on your weight loss @Carrie B

Hope your latest HbA1c reflects your efforts.

It is worth remembering that HbA1c both in people with diabetes and without, will fluctuate and wobble up and down, and that the tests themselves most likely have a degree of ’acceptable variation’ built in. Personally, over the years, I have found it helpful to focus on general direction of travel and count results within a few digits as being pretty much the same. 🙂

 

[Carrie B]

Thank you. I accept the fluctuations as since 2016 I've gone from 39 to 46 in 2022. Interesting that the range has been changed again on my medical records showing it as 20 - 41. I'm not too worried and await my next results around 19th Jan.
Thank you all for your comments, much appreciated. C