Well I'm prediabetic :-(

[Ccash]

Hi,

I had gestational diabetes with both my babies. By the end of my second pregnancy I was having 70 units of insulin a day and 3 metformin tabs a day.

I have been monitored closely since my second was born (she is 2 on Sunday) for one reason and another. My HBA1C has remained stubbornly at 47 for 9 months. I'm due my next 3 monthly test anytime now. I have been told by a DN that they are worried I am developing type 1. Just curious has anyone else been in this position?

I test my blood sugars once a week first thing in the morning. Today it was 8.7. I made an appointment with my GP in November because two hours after eating my blood glucose were 12.8. She said 'they wouldn't be worried unless they reach the mid/late twenties' and that blood sugars do vary. How much can blood sugars vary in a non diabetic person? How much should they vary in a prediabetic?

 

[trophywench]

The answer to that question is 'Not that flippin much!' IMHO.

Who are 'they' ? Cos you are the patient and if YOU are worried then as far as I understand things - 'they' are supposed to help you!

 

[Ljc]

Hello @Ccash welcome to the forum. With advise like that Gp gave you I would be very worried.
TBH I have no real idea how high a healthy non diabetic persons blood glucose would go up but I am pretty sure it would not go up into the 20s.
GPs as the name says are general practitioners, they have to know enough about a huge variety of medical conditions etc , so they know when to refer people to the experts. I am sorry to say that Gp imo sounds rather lacking in knowledge about Diabetes.
Many of us see the practices diabetes nurse (DN) rather than the Gp about our diabetes , if your practice has one, I would see them instead or perhaps their is another Gp who is more knowledgeable.
Some practices have a Gp who has a special interest in diabetes, that might be worth checking out, the receptionists will know.

I must say I agree with Jenny.
Imo in this case it’s more important what you are worried about rather than what the doc is not worried about , as it won’t be her that suffers the consequences.

Would you mind telling us what changes you have made to your diet, as we may well be able to give you some good ideas on changes and swaps that has helped us.

 

[Ccash]

I have seen the diabetes nurse at our GP surgery she told me that mars bars contain sugar. Oh and that cake does to. I just felt like saying 'well thanks for that illuminating guidance'. She then tried to put me on a course about losing weight. I asked 'do you think I need to lose weight?' she said 'definitely not'

 

[Toucan]

Hello @Ccash and welcome to the forum
I am sorry to hear that you are having such a worrying time with your blood sugar reading, and having difficulties getting support form your local medical team.
As @Ljc says if you can tell us a little more about your current eating plan we may be able to suggest some changes.
It may also be useful to phone the Diabetes UK helpline( 0345 123 2399, Monday to Friday, 9am to 6pm) and talk about your concerns and readings.
Also as you say your HBA1c test is due soon, can you ask to have the blood test done immediatly, to get an up to date reading. Then is there a different doctors at he practice that you could ask to see?
Best wishes, and there are a lot of us on the forum to try and help if we can, so please keep posting.

 

[rebrascora]

Hi and welcome

That is disappointing to hear that the DN was equally ignorant and unsupportive. Thankfully you have found the right place for advice knowledge, experience and support with this forum.

You mention that you were on a pretty high dose of insulin as well as metformin at the end of your pregnancy but I am guessing that you are no longer on any diabetes medication at this time. Is that correct?

Can you give us an idea of what your average daily menu consists of ie. what you have for breakfast lunch and dinner as well as what you drink. As a pre diabetic, adjusting your diet a bit should push you back down into the normal range. Carbohydrates are the issue with us diabetics and that not only includes the mars bars and cakes as the DN so unhelpfully mentioned but also surprisingly, fruit and fruit juice but also and probably most importantly, starchy carbs like bread, pasta, rice, potatoes, breakfast cereals including otherwise "healthy" porridge. Many of us here follow a low carb, higher fat diet which involves dramatically reducing our carb intake to the point that some of us no longer eat bread, rice, pasta etc and just a few berries when it comes to fruit, but we eat more fat to provide us with calories and make up for the other nice things we can't have anymore. For instance, many of us start the day with coffee made with cream. Cream contains less carbs than milk. We have creamy Greek natural yoghurt with a few berries, mixed seeds and chopped nuts or a cooked breakfast involving eggs... I love a mushroom onion and cheese omelette with side salad and maybe cheese coleslaw, but bacon, eggs, sausage and mushrooms is equally low carb. Many of us use cauliflower in place of potatoes or rice.... it can be cooked and mashed with a good dollop of cream cheese and a spoon of mustard in place of mashed potato with bangers or used to top a cottage or fish pie.... with a liberal sprinkling of grated cheese of course. Or it can be grated and cooked as a rice or couscous alternative.

From your comment about losing weight, can I assume that you are quite slim? There are some Type 2 diabetics who are thin outside fat inside (TOFI) , who are carrying fat internally around their visceral organs, so that is a possibility but it is also possible that you might be developing Type 1.
I think at this stage it would be a question of adjusting your diet and monitoring your BG (and HbA1c) and if it doesn't respond to cutting carbs or continues to increase, then Type 1 may be the reason and further testing (GAD antibody and C-peptide tests) should be requested (or referral to a consultant), in which case insulin will no doubt become necessary.

 

[Ccash]

A couple of you have asked for an idea of my diet so here's today's food:

Breakfast: almost a whole grapefruit, small bowl of fruit and fibre with walnuts and milk

Lunch: small portion of beef stew, three small new potatoes and green beans.

Snack: chocolate digestive (I know bad but was hungry at work and forgot to pack snacks so had to go for goodies of that shelf. Other options were an enormous chocolate muffin or stale doughnut so thought it was the best of a bad bunch)

Dinner: 4 Ryevita with butter, chease and marmite.

I find breakfasts difficult. I can't eat yoghurt it's a massive trigger for my IBS. I wondered if lacto free milk was lower carb as there is no lactose? I tried a low carb granola that was tasty. Would berries cream and low carb granola work? I really cannot stomach eggs everyday at breakfast but worry coffee and cream just wouldnt be enough.

Other meals are difficult to I have two picky toddlers and a husband who is not terribly adventurous with food. I struggle for time to prep food. I would love for ideas n simple quick go to foods to replace sandwiches. The time I have in the evening tends to be sat exhausted in front of TV. When I have tried low carb meals I just get so incredibly tired and hungry all the time. Not sure I'm doing it right :-( do you slowly reduce carbs or go cold turkey? If people can suggest ideas but portion sizes to that you be fab.

 

[Tee G]

Hi @Ccash welcome. Dont know if you have poked around the forum yet, but there is a topic here under FOOD/CARB QUERIES called 'What did you eat yesterday' --- I love going there and looking down the list at what people eat (most people on here have it highlighted whether they are TI T2 or like be neither, but controlling withing with diet so far) Its very interesting how everyone cope with their particular brand of diabetes. Its a very unique thing to each of us and we have to find what suits our bodies, time and abilities. Hope you take a look and get some good ideas about possible eats -

 

[rebrascora]

Lidl do little individual frittata that are only 10g carbs each and I have them with half a bag of salad and some of their cheese coleslaw as an easy lunch option or a couple of boiled eggs... I often boil a dozen at a time as they make great low carb snacks for if you get the munchies. I think it does take time to work your way down to low carb but if you don't need to lose any or much weight then increasing your fat intake at the same time will make it easier. Cheese, avocado and nuts are all easy ways to include extra fat which will keep you fuller for longer than carbs, provide slow release energy and make the whole thing more enjoyable.
I can't advise on lacto free milk as I have no knowledge of it, you really need to read the label on the back of the packet and just look at the carbohydrate content, not the sugars.
As regards the Low Carb Granola, I have started eating the Eat Natural brand as it is by far the lowest carb granola I have found @34g carbs per 100g. I have 45g with a few raspberries, mixed seeds which I also buy from Lidl along with big 200g bags of nuts (brazils or walnuts or mixed nuts) That will be a lot lower carb than your Fruit and Fibre but is still more carby than some Type 2 diabetics here can afford to eat.... but then I am Type 1 so can inject insulin to cover it and it is my main carbs of the day.... but you are just prediabetic so making smaller changes may be enough to push your levels back into the normal range, therefore worth a try.

 

[Ljc]

I have seen the diabetes nurse at our GP surgery she told me that mars bars contain sugar. Oh and that cake does to. I just felt like saying 'well thanks for that illuminating guidance'. She then tried to put me on a course about losing weight. I asked 'do you think I need to lose weight?' she said 'definitely not'

Oh dear, I can see you are going to get a lot of helpful info there 😱.

Is their any chance of changing to a different practice

 

[trophywench]

I love Ryvita - but not all Ryvita are equal - think the Sesame seed type are about the lowest carb. I make proper sandwiches with them for me, meaning cooked meat plus whatever salady type things I might fancy. Enough filling and I won't want any snack between that and dinner.

Nobody's BG should be what yours is, with that diet, Madam!

 

[Drummer]

When diagnosed my blood glucose was 17.1 - and I was told off for being a very bad diabetic - these days I think that over 7 after eating is high.
I eat low carb foods all the time now, but replace the lost glucose with fats - fats and protein are the necessary components of our diet, carbs are not. These days I am out playing music three nights during the week and at least once at the weekend. losing the carbs can be very draining if you do not change to another source of energy.

 

[Deleted member 25429]

I have seen the diabetes nurse at our GP surgery she told me that mars bars contain sugar. Oh and that cake does to. I just felt like saying 'well thanks for that illuminating guidance'. She then tried to put me on a course about losing weight. I asked 'do you think I need to lose weight?' she said 'definitely not'

I wish they wouldn’t treat us as if we were thick . People visiting the surgery sometimes feel overwhelmed and very low . Comments like this nurse make causes so much upset . I’m lucky I have an amazing specialist nurse , I dread going to my surgery and try and avoid it as much as possible

 

[Ccash]

I was under the hospital team while pregnant and there were amazing. I came away from seeing the diabetes nurse at my GP thinking well I could do her job. She quoted NICE guidelines that I corrected her on. I asked her about 'the healthy plate' she said that's a good idea. She went onto the computer search healthy plate and printed me a picture of a healthy plate.

Here's what I've eaten today (I won't do this everyday but at the moment telling someone helps me be more sensible).

Breakfast: fruit and fibre with walnuts
Snack: home made low carb bread with butter
Lunch: veg stir fry with egg chucked over it and another piece of the bread (cause it was there)
Dinner: pulled aubergine curry and cauliflower rice
Might have a couple of squares of very dark choc with a cup of tea in a bit

 

[Drummer]

There are some high carb foods there - Fruit and fibre is about 2/3rds carbohydrate by weight - possibly a little more. Ordinary bread is about half carbs, so swapping them for lower carb options particularity early in the day, as many people can cope better with carbs later on.

 

[everydayupsanddowns]

Welcome to the forum @Ccash

Sorry to hear you have had slightly less than sparkling support from your surgery.

Having had gestational diabetes does put you at increased risk of developing T2, but from what you’ve said it sounds like your case may be a little more unusual. Other forms of diabetes are quite rare. 90% of people living with diabetes have T2, around 8% have T1 and the balance is made up of the other types. Additionally is it increasingly recognised that ‘T2’ is an umbrella term for a wide variety of sub-types which can behave quite differently. A GP can go through their whole career and only deal with one or two T1 cases, so any of the other types like LADA and MODY may not be on their radar much.

It might be worth asking for a referral back to the specialists at the hospital, who will be in a much better position to make a clinical diagnosis and/or request any additional tests that might help clarify your situation. Getting an accurate diagnosis is really important - as the different types can require very different treatments and approaches.

It's interesting that you use the term ‘prediabetes’, because while it’s a common term, it’s not actually officially recognised as a condition, and doesn’t really exist. It is often just used as short hand for ‘at risk of diabetes’. Was that something your GP/nurse said?

 

[Ccash]

I use prediabetesas a phrase I've heard others use. The diabetes team and GP I guess have used the phrase impaired glucose tolerance.

 

[everydayupsanddowns]

I use prediabetesas a phrase I've heard others use. The diabetes team and GP I guess have used the phrase impaired glucose tolerance.

Yes it’s very much in common usage. Both by some HCPs and more widely. And it kinda makes sense and sums up the situation, but i find it interesting that it’s not medically recognised. I wonder if that will change?

 

[grovesy]

I use prediabetesas a phrase I've heard others use. The diabetes team and GP I guess have used the phrase impaired glucose tolerance.

I thought the term Prediabetes had replaced the term Impaired Glucose Tolerance, which was the term used over 20 years ago when I was first diagnosed. I had a Glucose Tolerence Test then not a Hba1c too.

 

[everydayupsanddowns]

I thought the term Prediabetes had replaced the term Impaired Glucose Tolerance, which was the term used over 20 years ago when I was first diagnosed. I had a Glucose Tolerence Test then not a Hba1c too.

I think prediabetes is used a lot in the US, but I was given to believe this week that it has no official recognition as a condition in the UK.