Prediabetic - glucose monitor question

[Pumpkinface]

Hi , hope I can ask this here . I was diagnosed prediabetic before Xmas with a glucose level of 42 . I followed the advice re cutting white carbs, reducing portion size etc and followed the diabetes prevention scheme advice regarding food , my counsellor can no longer add any more advice apparently! I wasn’t over weight and I am now underweight . After 3 months my level was 40 , then 3 months later ( I didn’t request that test they did it with a bank of other tests I’m up to 41) obviously I’m not pre diabetic any more but I’m mindful I’m just about hanging on ! My diet is the same as it was and I’m struggling without the carbs to maintain my weight . Even though the diabetes nurse told me not to I feel that monitoring glucose levels might be helpful . I’m wondering if there are some things I can’t tolerate that maybe I should be able to like porridge.
could anyone advise of a decent cost effective machine as I’m obviously and rightly self funding . I don’t want to make things worse by getting an unreliable machine . My aim is to identify safe meals and also ones that may be less so . Otherwise I can feel myself getting very afraid of food leading to further weight loss which in itself isn’t healthy .

 

[Ljc]

Hi welcome to the forum.
Yes we are all different in what and how many carbohydrates we can and can’t tolerate, so is possible you can be cutting out things you don’t need to.

But you may not need to increase carbohydrates to gain a little weight . So long as you don’t have a health condition that requires you to reduce fats, I am not necessarily talking about high cholesterol levels, then you could increase your intake of good fats
ie a few unsalted nuts , ie walnuts , almonds , how about a bit of cheese.

As you are not on meads that can cause hypo’s you don’t need an all singing and dancing glucose meter which uses test strips that cost £15 to £25 for a potif 50 .
No meters available for home use are dead accurate but those sold in the uk do have to comply to certain standards.

Many here use the Gluco navii and it’s testing strips as they are around £8 for 50
We use the mmol/l measurement in the uk and you can claim vat relief.
If you decide to buy one you’ll need to buy more test strips and a box of lancets , as they only provide 10 in starter packs.

To find out which carbohydrates we can and can’t tolerate too well
You test just before eating then two hours after the first bite.
If you are no more than 3.0 mmol/l higher then that meal was fine .

 

[Pumpkinface]

Hi thanks for your reply , I am eating cheese and a few nuts ( not a fan ) nut butters , avocado and olives and sun dried tomatoes to try and increase my calories .
I was very much a carb girl before and while I’m not vegetarian I’m not super keen on meat or fish .
im trying to learn a new way of eating . A good amount of my carb intake comes from veg and pulses and full fat Greek yoghurt .
as you say I don’t need actual values but it would be interesting to see if there is a difference in my reponse to a small bowl of porridge which I’ve been advised to eat especially as it is cholesterol lowering and an egg and avocado on low carb toast or even yoghurt nut butter and a few berries .

currently I’m using the t plate method for my meals as advised and I’m eating 80-115g of carbs spread through the day ( usually the lower ). I’m getting lot of advice from everyone around me medical and not medical to increase carbs . I would like to be in control a bit more .

to be honest I’ve gone from eating 70% white carbs - my go to was white toast for all meals ! And having a level of 42 to eating no white carbs , no processed food etc and my carb levels are around 30% all wholegrain or veg or pulse and I’m down to 41!! Something doesn’t seem right to me .

 

[Ljc]

Yes i see what you mean, with all the changes you expected your Hb1ac to be a little bit lower than 41.
However 41 is not to be sneezed at.

A few questions for you , hope you don’t mind Also some things can affect your Hb1ac
Are you Anaemic.
Were you losing weight unexpectedly pre your diagnosis.
Are you sure you are taking in enough calories.
I have found that wholemeal things I call them brown carbs, turn into glucose inside me, just as quickly and as high As the white versions.
If you try porridge, some folks are fine with it I am. Make sure it’s proper porridge, ie rolled oats , you could add some cream to it, more calories and the fat helps to slow down the absorption of glucose, perhaps a few berries too.

 

[Leadinglights]

From the monitor suggested you will get actual values which will be accurate to the required standard. You seem to be doing all the right things and are able to tolerate pulses which quite a few people can't. As suggested just increasing fats and protein but a bit hopefully will stop any further weight loss.

 

[Pumpkinface]

Hi ,
no not anaemic
yes I was losing weight before diagnosis I was doing intermittent fasting , I generally ate ok not brilliant but better than friends and family ! My weight loss has continued along the same path not massive but slow and steady .
im not eating enough calories but there is only so much meat and veg I can eat ! I find it hard to eat fatty food as I’ve spent my whole life avoiding it . I do understand good and bad fat and can eat nut butters by the spoonful.
I eat proper porridge with oat milk and loads of almond butter and a few raspberries literally my favourite meal of the day - I’ve stopped now until I can work out if it’s spiking my sugar .

 

[Pumpkinface]

Hi leadinglights when you say people can’t tolerate pulses do you mean they cause sugar spikes ?

 

[Leadinglights]

Hi leadinglights when you say people can’t tolerate pulses do you mean they cause sugar spikes ?

Yes pulses are one of the many carbohydrates that will increase blood glucose more than desirable, that is where testing 2 hours after eating can be very informative in telling you what portion of those pulses you can allow yourself.
As you don't like meat and fish very much then it is more difficult to have variety in your meals, but for ideas look for low carb or keto veggie recipes.
If you haven't already got it the book or app Carbs and Cals is a useful guide for carb value of various meals and foods.
Raspberries, blackberries and strawberries are some of the lowest carb fruits, blueberries are not quite so good but people do find they are tolerated OK with Greek yoghurt.
Don't be too despondent at your HbA1C as you are still below prediabetic. It maybe you have just cut out too many carbs without replacing with protein and fats which is why you are struggling to maintain your weight.

 

[SB2015]

Welcome to the forum @Pumpkinface .
Pleased that you have found the forum.

Each of us reacts to different carbs in different ways. I do focus on the size of the spikes after meals, and was amazed at the impact that porridge had on me. Others can tolerate it. I am fine with pulses and find that they raise my glucose levels more slowly. Blood glucose testing before and after meals can help to identify what works for you, regarding specific foods and portion sizes.

You have caught this early and you are still in the prediabetic zone. It is worth continuing the successful work that you have done already.

 

[everydayupsanddowns]

Hi leadinglights when you say people can’t tolerate pulses do you mean they cause sugar spikes ?

It’s a very individual thing. Most people tolerate pulses very well. The way the carbohydrate in them is structured makes it particularly hard for the gut to break down - some of it ends up in the lower intestine intact where bacteria feast on it and give off CO2 (hence beans’ farty reputation)

For many T1s who carb count, it’s important to only allow part of the amount of carbs for the insulin dose, so as not to go low.

However as @Leadinglights says, some people’s metabolism and gut biome didn’t seem to get the message, and they find pulses absorb more rapidly.

If your HbA1c is 41 @Pumpkinface I don’t believe that puts you over the threshold for a diabetes diagnosis. 42-47mmol/mol seems to be considered ‘at risk of diabetes’. And above 48mmol/mol crosses the line into a diabetes diagnosis.

With the profound menu changes you have made with little apparent reduction, your being not overweight, and losing weight, I am just wondering if they had ever considered if you might be a different type of diabetes - like slow-onset form of T1 called LADA. This can look quite a lot like T2 to start with, but as the beta cells are gradually destroyed your body with still struggle however few carbs you eat.

GAD antibody and cPeptide tests, along with the clinical factors
at diagnosis might help shed light on things?

 

[pm133]

Hi , hope I can ask this here . I was diagnosed prediabetic before Xmas with a glucose level of 42 . I followed the advice re cutting white carbs, reducing portion size etc and followed the diabetes prevention scheme advice regarding food , my counsellor can no longer add any more advice apparently! I wasn’t over weight and I am now underweight . After 3 months my level was 40 , then 3 months later ( I didn’t request that test they did it with a bank of other tests I’m up to 41) obviously I’m not pre diabetic any more but I’m mindful I’m just about hanging on ! My diet is the same as it was and I’m struggling without the carbs to maintain my weight . Even though the diabetes nurse told me not to I feel that monitoring glucose levels might be helpful . I’m wondering if there are some things I can’t tolerate that maybe I should be able to like porridge.
could anyone advise of a decent cost effective machine as I’m obviously and rightly self funding . I don’t want to make things worse by getting an unreliable machine . My aim is to identify safe meals and also ones that may be less so . Otherwise I can feel myself getting very afraid of food leading to further weight loss which in itself isn’t healthy .

Hi welcome to the forum,

The good news is that you have an HbA1c reading which is normal.
It might be pushing to the top level of normal but it is normal.
That's good news because it means you are neither diabetic nor at risk of diabetes (pre-diabetic).

So, I think first and most importantly, you need to put your mind at ease on that score. Your previous reading has obviously given you a bit of a fright and you have rightly done everything you reasonably can to avoid tipping into full-on diabetes.

It may be, as others have suggested, that you are building a level of carb intolerance but it may also be nothing to worry about at all.

The problem is that the worry about this is affecting your diet and your health and, in my opinion, this is your priority at the moment rather than diabetes itself.

I genuinely don't know whether there is any mileage in a non-diabetic avoiding or lowering their carb intake. Nor am I convinced there's necessarily any mileage in testing yourself. My feeling is that you risk obsessing over food when it might not be necessary. You want to avoid doing anything which might provoke an eating disorder like the plague. This is maybe why the nurse helping you has advised against monitoring your glucose levels. It's very easy to misinterpret the results. Even non-diabetics can see wild swings in their levels. Testing isn't necessarily going to put your mind at ease. It could instead make any anxiety considerably worse.

Bearing all that in mind, I actually don't feel personally qualified to offer you advice on what to do. I just wanted to make a few comments that that might be worth considering when you decide where to take things.
You are, of course, always welcome to come on here for support. We're quite a friendly bunch. 🙂