Prediabetic

[Sophie_]

Hello, first I want to say that I'm very glad to have found this forum because the last few weeks have been full of confusing and conflicting information

Let me start with this: I've been diagnosed with prediabetes. A couple of months ago I had slightly high fasting levels (around 6). When I checked again after a few weeks, they were even higher (7.0, 7.8).
My doctor advised to do OGTT and I did. Results were as follows:

fasting: 6.9
1 hour: 10.8
2 hours: 9.7

Hb1AC: 46

(I did eat around 300gr carbs for a week before the test was done)
Also my diet was normal (balanced) at that time already. Already eating more than 200gr carbs on a daily basis for a few months.

I bought a glucose monitor and I've been testing after eating my usual meals. I've seen readings as high as 11 2 hours after eating a sandwich, or 10 after steak and potatoes
I'm not overweight by all means (naturally skinny all my life), very active ( I was into sports earlier but now I still do jogging/walking on a regular basis). Not sedentary lifestyle by all means.
Fasting levels go up to 8 or even 9.
I'm scared.

I have diabetic relatives (type 1 as well as type 2) on both sides of my family.

And also let me mention something very important: Before all this happened I was eating low carb and even keto at some point, even though I didn't have weight to lose or any health issues. I was following some internet 'gurus' that were touting this diet as very healthy. I lost so much weight (and even a lot of muscle) despite exercising and eating enough calories. While eating low carb, I first noticed the elevated fasting levels!

I reintroduced carbs and after that, and now around 6 months after eating a balanced diet, I have this problems.

So what should I do? My doctor told me that my glucose tolerance is very low and if my readings keep getting worse, I might be put on medication very soon.

 

[Inka]

A very low carb diet causes insulin resistance. You say you’ve stopped that though and have been eating normally. Perhaps your body is taking longer to adjust? I can understand why you’re worried though.

In your position, I’d reduce the carbs but not too low and see how that goes.

 

[Sophie_]

A very low carb diet causes insulin resistance. You say you’ve stopped that though and have been eating normally. Perhaps your body is taking longer to adjust? I can understand why you’re worried though.

In your position, I’d reduce the carbs but not too low and see how that goes.

It's definitely taking too long. As I've read, it usually takes a few weeks at most to adjust. For me, soon it is going to be almost a year. At this point, I have a gut feeling that this is permanent.

I don't think that going back to low carb would be the solution for my problem, because it is how it all started. It is literally such an irony: Reducing carbs to prevent diabetes and other health problems (I have family history as a risk factor), and at the end, I might have 'given myself' the exact same problem I've been running from.

My doctor said to keep eating balanced, but if my readings don't improve until my next appointment, they will put me on meds

 

[Drummer]

@Sophie_ If your reaction to a low carb diet is not the usual one seen by an ordinary type 2 diabetic then it ought to be setting off alarms and more tests should be done.
You cannot give yourself an intolerance for carbs long term - eating low carb can mean that a sudden intake of carbs is not dealt with at all well - but that is simply how our bodies work - high doses of sugars are not our natural diet after all.
For me my natural diet is under 50 gm of carbs a day, and these days I usually stay under 40 gm.
At those levels I see normal levels of glucose, Hba1c just at the top end of normal, and I feel well - plus I continue to gradually reduce in size now that 'healthy' wholegrain is not in my life.
As you have family with type 1 as well as type 2 I would have thought that you need tests to find out the root of the problem, not just the assumption that you will be type 2.

 

[Sophie_]

@Sophie_ If your reaction to a low carb diet is not the usual one seen by an ordinary type 2 diabetic then it ought to be setting off alarms and more tests should be done.
You cannot give yourself an intolerance for carbs long term - eating low carb can mean that a sudden intake of carbs is not dealt with at all well - but that is simply how our bodies work - high doses of sugars are not our natural diet after all.
For me my natural diet is under 50 gm of carbs a day, and these days I usually stay under 40 gm.
At those levels I see normal levels of glucose, Hba1c just at the top end of normal, and I feel well - plus I continue to gradually reduce in size now that 'healthy' wholegrain is not in my life.
As you have family with type 1 as well as type 2 I would have thought that you need tests to find out the root of the problem, not just the assumption that you will be type 2.

The thing is, before starting my 'low carb experiment' I was eating carbs all my life (simple, complex, even junk on occasions) and I had perfect labs. Not only glucose levels, everything. So I was by no means glucose intolerant back then.

Low carb way of eating triggered that. I'm not an expert or a doctor and I don't know the exact mechanism behind it, but it is evident that it is when my issues started.

You have found the way of eating that works for you, that's great. However, maybe low carb is not for everyone.

What kind of further test are you referring to?

 

[Leadinglights]

You are in a quandary but if your body is struggling with carbs which is indicated by the higher than desirable blood glucose levels then reducing them seems the logical answer however low carb is not NO carbs and many people find that 130g per day is a good starting point but making sure that you have enough protein and healthy fats especially if you don't need to lose weight.
Possibly the tests mentioned are ones that would indicate Type 1 diabetes but usually the symptoms are suden weight loss and very high HbA1C which yours isn't.

 

[Drummer]

The thing is, before starting my 'low carb experiment' I was eating carbs all my life (simple, complex, even junk on occasions) and I had perfect labs. Not only glucose levels, everything. So I was by no means glucose intolerant back then.

Low carb way of eating triggered that. I'm not an expert or a doctor and I don't know the exact mechanism behind it, but it is evident that it is when my issues started.

You have found the way of eating that works for you, that's great. However, maybe low carb is not for everyone.

What kind of further test are you referring to?

Tests to check if you have one of the other forms of diabetes.

 

[Sophie_]

You are in a quandary but if your body is struggling with carbs which is indicated by the higher than desirable blood glucose levels then reducing them seems the logical answer however low carb is not NO carbs and many people find that 130g per day is a good starting point but making sure that you have enough protein and healthy fats especially if you don't need to lose weight.
Possibly the tests mentioned are ones that would indicate Type 1 diabetes but usually the symptoms are suden weight loss and very high HbA1C which yours isn't.

130g is a more reasonable amount. That sounds doable.

It is true that my HbA1C is not (that) high. However, I'm losing weight steadily and I'm in fact underweight by BMI. At the moment I'm eating normally, not restricting calories nor carbs/fats/protein.

 

[Drummer]

130g is a more reasonable amount. That sounds doable.

It is true that my HbA1C is not (that) high. However, I'm losing weight steadily and I'm in fact underweight by BMI. At the moment I'm eating normally, not restricting calories nor carbs/fats/protein.

That is not what happens with type 2 diabetes.
I suggest getting in touch with the surgery and asking for an urgent appointment to discuss weightloss increasing glucose levels and no improvement on a low carb diet.

 

[Inka]

“I don't think that going back to low carb would be the solution for my problem, because it is how it all started. It is literally such an irony: Reducing carbs to prevent diabetes and other health problems (I have family history as a risk factor), and at the end, I might have 'given myself' the exact same problem I've been running from.”

@Sophie_ I didn’t say to go back to your low carb diet, I said to reduce the carbs slightly from 200/300g - ie somewhere between your two diets.

But, as you’ve mentioned, weight loss and a low BMI, it’s possible you might be in the early stages of Type 1 and it would be wise to have this ruled out. Type 1 comes on more slowly in adults. There could, of course, be other reasons too, eg malabsorption, thyroid, etc.

 

[Sophie_]

That is not what happens with type 2 diabetes.
I suggest getting in touch with the surgery and asking for an urgent appointment to discuss weightloss increasing glucose levels and no improvement on a low carb diet.

Thank you. I already got in touch with them, made a phone call and I will get tested as soon as possible.

 

[Sophie_]

“I don't think that going back to low carb would be the solution for my problem, because it is how it all started. It is literally such an irony: Reducing carbs to prevent diabetes and other health problems (I have family history as a risk factor), and at the end, I might have 'given myself' the exact same problem I've been running from.”

@Sophie_ I didn’t say to go back to your low carb diet, I said to reduce the carbs slightly from 200/300g - ie somewhere between your two diets.

But, as you’ve mentioned, weight loss and a low BMI, it’s possible you might be in the early stages of Type 1 and it would be wise to have this ruled out. Type 1 comes on more slowly in adults. There could, of course, be other reasons too, eg malabsorption, thyroid, etc.

I apologize, I didn't understand quite well obviously. Sorry
Everything else has been ruled out (eg. thyroid is completely fine, no digestive issues etc.)

I have to admit now I'm even more panicked, i've read quite a lot about type 1 in adults and even though it is slow onset I'm scared of ketoacidosis and all that...

 

[Inka]

I apologize, I didn't understand quite well obviously. Sorry
Everything else has been ruled out (eg. thyroid is completely fine, no digestive issues etc.)

I have to admit now I'm even more panicked, i've read quite a lot about type 1 in adults and even though it is slow onset I'm scared of ketoacidosis and all that...

Don’t panic. Keep a clear head and work things through systematically. You can buy Ketostix (to check for impending ketoacidosis and ketones in general) for around £5. There are tests you can have to look for the Type 1 antibodies. These do take a while to come back though.

In the meantime, keep testing your blood sugar.