Pre-diabetes

[Gettingoldergettingdiseases]

I was annoyed at getting hypertension considering I’m a healthy weight with BMI of 21-22, I don’t smoke, I don’t drink, I’ve been vegetarian most of my life and don’t eat much ultra processed food, I’m very active and do lots of cardio exercise daily but need to build in some resistance work. I’ve never been obese or even approaching obese. The GP says it’s genetic and down to stress. I’m now post-menopausal and have been told I’m pre-diabetic with an HbA1c of 44. I’m not happy and want to do something about it. There’s no diabetes in the family. I’m white British and score low on the risk scale but I’m
determined to do what I can to fix this.

If you had/have pre-diabetes how did you manage to reverse it or reduce your blood result numbers? I’m worried what I can eat and already have a very restricted diet due to autism.

I’ll be seeing the GP practice about it but I know they aren’t always great with dietary stuff. They sent my result and diagnosis by email so I’ve not spoken to anyone yet.

What can I do?

Go on the diabetes U.K. site. They have lots of advice & diet info for pre diabetes

I was diagnosed as type 2 just before lock down, I was overweight and it runs in my family. I have been able to reverse it and remain in remission. I did this by losing weight and I did this by watching my carbs, I kept them to 100g per day. I increased my water intake and increased my exercise.

@IggyAcethats great, well done! I could lose weight but exercising more isn’t much of an option because I already spend 3 hours a day walking and not meandering, walking with purpose and quickly up and down bastard hills. I can make time for weights in the evening. What does 100g carbs look like in terms of meals?

Have a look at books by Michael Mosley.

https://www.amazon.co.uk/s?k=michael+mosley+reversing+diabetes&adgrpid=160484174821&gad_source=1&hvadid=703029896768&hvdev=m&hvexpln=0&hvlocphy=1007446&hvnetw=g&hvocijid=12274853371758518792--&hvqmt=e&hvrand=12274853371758518792&hvtargid=kwd-2314314009530&hydadcr=21142_2251512&mcid=08c7e9b4034b398a9f334bb48c85e0c6&tag=hydrukspg-21&ref=pd_sl_2pqcktu4k9_e

Chronic stress can increase blood sugar and also cause insulin resistance.

So, this is easier said than done, but firstly see if you can reduce the stress in your life. You can try to reduce the impact of things that cause you stress (such as delegating more, saying no to things more often, even a change of career) and you can learn stress reduction techniques like breathing and mindfulness online or via apps. It's also important to make sure you have something fun or interesting in your life that brings you joy and meaning, whether a hobby, a craft, a social group.

Regarding exercising, at a certain point, overtraining (as in exercising too much) increases stress on the body which can increase stress hormones which, as mentioned, affect blood sugar. Even aside from the potential stress of overtraining, I wonder, with you doing a large amount of cardio/three hours of intense walking every single day, whether you have any time for peaceful and calming activities too? The kind that would lower your stress levels and by extension your blood sugar levels.

I only wonder this because if I spent that amount of time exercising every day, all I'd do on weekdays is go to work and exercise, and I know that that would make me miserable and stressed.

@RitaFromThePitCanteen thank you, that’s some food for thought. I’m a single parent to 3 ND children and a carer to my elderly mother. I walk so much because I can’t drive. I can’t afford a car either. Walking is something I enjoy but I’d appreciate the morning school run being less rushed. Ds needs a lot of support getting ready on time and we never leave on time to walk more leisurely. I’m working on it but in reality it means giving up some sleep to give me
more time to focus on him. I enjoy gardening as part of my caring role and have an extensive Lego hobby. It helps my ADHD calm the fuck down. I’ve recentky gone to a couple of gigs either ds and that’s been good fun but also stressful as the only parent and travelling on trains to get there, meeting people etc. Mainly I sleep and walk though.

I’ve also had a lot of steroids in the last ten years due to asthma.

Ah, steroids mess with your blood sugar. You should discuss the steroid/ blood sugar issue with your gp, and take advice from the diabetic nurse, if you have one. It’s much more complicated if you need steroids for a medical condition.

My (female) partner is lighter than me (we're both in healthy BMI range), we eat a similar diet but she was diagnosed pre-diabetic 18 months ago. She agreed to do the almost year-long course* the NHS buys into and found it very useful in understanding carbs, low (and high) GI foods and has changed her diet as a result. She would recommend it.

She was still pre-diabetic in January after a year of this. There's clearly a big genetic component but she's not able to get the sort of daily, cardiovascular exercise she needs owing to a hip issue.

I'm going to add my late Dad's story. He was diagnosed pre-diabetic about 10 years before he died aged 89 (after a lifetime on the northern working class diet of refined carbs, animal fat including lard and as much sugar as possible). Did he change his doet? Yes, he ate MORE sugar and carbs! He never became diabetic, remaining in the pre- range for those 10 years.

*The NHS should've given you a link to join the XYLA course ask about it.

@VickyEadieofThighthats very helpful, thank you. There is a course that was mentioned in the email. My diet is carb heavy and always has been but it’s only since starting on BP meds that my bloods have been raised. There appears to be no correlation according to Google. I’ve not had steroids since last year but I have had a lot of them over the last decade. More than a decade actually.

I’m thinking of booking in with a private dietician to go through a diet plan that takes into account what I’ll eat. I can’t eat eggs unless they are in something like cake but I don’t eat cake often and would need to be made by me and I don’t make cake often. I’ll change my homemade bread to have more wholemeal flour in it. I have ibs so too much fibre gives me cramps and severe bloating. I made lentil soup last week which is a soup I’ve been making since I was 14 and a family favourite and my god, the bloating. I’ll get back to having proper Greek yogurt for lunch with berries. I just need to cut down on the honey but it’s so sour and strawberries and raspberries have been pretty rubbish lately. Maybe I’ll get used to the sour. Dinner I’ll go back to soups. I’m not a fan of sweets anymore but do eat a fair bit of chocolate. I give it up for lent so I can stop eating it. I’m an all or nothing person and as is often the case with someone with autism had an eating disorder for decades so I’m worried about triggering that again if I start restricting things. It’s going to take some careful planning I think and a dietician might be the way to go. There’s a few private ones locally.

I’m filling my online shopping basket with lots of veg and healthier stuff. I like asparagus, carrots, tenderstem broccoli, peas, sweetcorn, butternut squash, onions, leeks, peppers, cucumber, courgette if roasted, sweet potato, broad beans without their skins, mange tout. I’m fancying a risotto but would use less rice and make it more veg than rice.

Have you tried any of the following? They really make a huge difference to your glucose response. I got my hba1c down from 38 to 30 in a couple of months by:

1. Moving after eating. 20 squats or a short walk
2. Food ordering, eat fats/protein first carbs last
3. Only eat fruit after meals and don't snack on it
4. Add vinegar to dressings. Some people drink acv before which also helps.
5. Cut out all processed refined carbs including flour.
6. If eating potatoes or rice cool and reheat as this increases resistant starch decreasing the glucose response.
7. Building muscle as this acts as a glucose store

A glucose monitor for a couple of weeks is really useful in working out what spikes you and what helps lower you glucose.

I would also suggest asking chatgbt for menu ideas based on your current health concerns.

Regarding your blood pressure, mine has been high for decades despite 3 different medications, I found information online about a supplement called TMG ,trimethylglycine and researched it thoroughly and thought I would give it a go , I still take my 3 medications but within 3 days my blood pressure was the lower end of normal, do your own research
I'm also type 2 diabetic but really struggle with it

We've got into making scones, muffins and cakes with almond flour and Stevia - they don't rise as much but are a game-changer for pre/diabetics. We recently made Delia Smith's 4 nut chocolate brownies using these substitutes and they were fabulous - we used 70% cocoa chocolate from Lidl (my partner likes a bit of this chocolate and has attuned her sweet tooth to it now).

Bread with a lot of seeds is what you want as well as the whole grains. If you freeze bread - and cook, cool and freeze other carbs like pasta and potatoes - it reduces their GI value.

I would recommend you get your b12 levels checked if you haven't already. I had prediabetes and fatty liver, and both were linked to my low b12.

My B12 has always been ok but I’ll ask for it to be checked.
I’m currently waiting for nut allergy testing for one more thing that’s gone wrong 😩

Have you tried myo-inositol? I'm not suggesting it as a miracle cure, but it's worth a try just because it's cheap and otherwise harmless. It's long been used by women with PCOS (also an insulin resistant condition) and there is evidence of it's usefulness against gestational diabetes. And now there are some studies which indicate it's useful for T2 diabetes too, like this one

https://pmc.ncbi.nlm.nih.gov/articles/PMC5078644/

I’ve just worked out the carb content of meals I like and make at home and actually they are pretty good on the carb front if I reduce things like the amount of pasta or rice and have carrot and red pepper with my hummus instead of breadsticks. It’s my snacks that are the problem. I’m currently eating a lot of Proper Chips, often instead of a proper meal due to my executive function being minimal. I’ve not even ordered any with my shop this time. I’m going to get some sunflower seeds and pumpkin seeds to roast and salt. Pumpkin seeds are much higher in carbs than sunflower so I’ll keep the mix on a 2 parts sunflower to 1 part pumpkin. I’ll see what seeds I can add up bread too although the children won’t eat it then. I adore Poppy seeds on my homemade loaves but they go everywhere. The children rarely eat their crusts so I might get away with a mixed seeds crust. It’s such a shame I can’t do eggs or eat nuts. I’m 99% sure I’m not allergic to nuts but the GP wants to make sure. Until then they are off the menu.

Sorry you’re going through this. Check out The Glucose Goddess - she has a book of recipes and ‘hacks’ for managing blood glucose. I second the advice of investing in a glucose monitor like the freestyle libre if you can afford it. It really gives you insight into how your body is responding to different foods.