Recently learned that I'm pre-diabetic and I'm worried

[prediabetic]

I am in my early 30s and recent blood tests showed that my HbA1c is 44. Anything between 42 and 48 is considered to be pre-diabetic according to the NHS guidelines. My only symptom has been increased thirst, which I understand is a classic symptom of diabetes. I am also slightly overweight. I understand that I have the options to either attempt to lower it myself with lifestyle changes, or take medication. I would like to try Metformin, but for some reason my GP won't prescribe it until I'm "fully diabetic". I personally would prefer to get on it as soon as possible, and I'm looking at trying to get it privately if they won't prescribe it. I'm also looking into dietary changes. It seems that anything at all with sugar in it should be avoided, as well as carbohydrates. I typically only drink tea with sweeteners or Diet Coke.

I'm curious if anyone has been able to get their HbA1c down without taking metformin. What do you typically eat and drink? I'm honestly not sure how I'm going to get it down on my own without starving myself, which I don't really want to do.

Honestly you do not want or need metformin until such time as you become diabetic. Weight loss, more activity, a healthier diet can all lower your blood sugar levels.

How overweight are you, OP?

My dad & step-mum both got a pre-diab diagnosis about 14 years ago (age about 68?). For about 18m they were utter purists in their diet, no added sugar foods, most of each meal was salad & veg, whole grain not white grains. Only indulgences were diet sodas, beer, wine. Big on portion control. Step-mum eventually went almost vegan (+fish), but that was mostly to keep her cholesterol down. She's less purist about that now.

The habits have persisted in that they still keep to small portions and almost never have anything sugary. Their numbers improved. Neither of them started out with a BMI > 25, which probably helped. Step-mum did & still walks 1-2 hours every day.

My HbA1c went from 43 to 39 with dietary changes. A GP friend advised doing 16:8 intermittent fasting, cutting down carbs and cutting out as much sugar as possible. I also did the Second Nature course.

My brother has diabetes and is on Metformin. The side effects are horrible.

Please try the diet and exercise option.

As others have said, low carbing, lose some weight even if you are not particularly overweight, there is some evidence about the persons individual weight point (too long to describe)

But also, if no one else has said this yet, havent read the full thread, cut out those sweetners, they have an effect on the bodys to regulate itself, there is also research about that and I probably havent explained it right

Metformin can give you the runs by the way, not for everyone, but if you can fix this with diet rather than going on the meds its a good idea.

My dad was told he was pre diabetic in his late 70s. He did an nhs course, mainly on line as it was during Covid. And he’s done really well. He’s always been a bit overweight but he’s cut out the biscuits and cheese and been better on portion size.

Give it a go. You’ve got a long life ahead of you and instilling better eating patterns/exercise makes sense.

Sorry to be crude but a relative of mine had bad "gastric distress" on metformin and farted really loudly in an embarrassing situation in public. So that's one reason to avoid it unless necessary/recommended by your doctor.

You're actually very lucky: it's been found before you have developed full blown type 2 and you have the opportunity to stop that. This is your wake up call to lose weight and get fit (unless you are one of the few who are not overweight, in which case I'm sorry).

Read what Dr Micheal Mosely did to put his diabetes into remission. Low carb, some fasting etc. Do not under any circumstances follow the NHS's healthy plate guidelines as it is wrong and damaging advice.

Eat less carbs and move more is the brief summary - avoid meds if you can.
Look up the various (and many) low carb recipe sites for those with diabetes - there’s a lot out there.

Long term metformin use and not making an effort with food is a terrible idea. My older siblings were both pre diabetic in their late forties. My sister made an effort and the other just couldn’t be bothered, he died prematurely from diabetic complications and I just feel very sorry for his widow. He never got to see his grandchildren. My family are genetically predisposed, my Mother kept type 2 at bay for decades by being really careful with what she ate. I have a blood test every year and apart from Christmas I’m also careful.

Metformin was the worst medication I've ever been on ( and l take loads for other ailments).. .l was on the loo just about 24/7 with diahorrea .. stomach cramps.. was horrific.
You're very low pre diabetic .. easily fixed with diet ..

Sorry, I forgot to mention I also had a high HbA1c in the past.

What I did was treat it as though I had been diagnosed in the sense that I decided it was better to do the things now that would be healthier and reduce my HbA1c before reaching a full blown diagnosis, when I would have to follow the steps anyway if that makes sense.

I now largely exercise and avoid sugar as though I were fully type 2 diabetic, but I know I can break the "rules" if I want because I'm not diabetic and I was lucky enough to catch it in time.

I do take metformin but I have managed to get my A1C down from 66 to 39.

I follow two rules.

1. protein for breakfast
2. eat low carb but not no carb

When I was first diagnosed I got a free sample of a Libra 2 glucose monitor and tracked what I was eating over two weeks. I found out bananas spike my blood sugar. Not something I expected.

The only side effect I have had from metformin is larger softer stools, but I only go once a day. I know some people have unpleasant side effects but I have been OK.

@prediabetic I encounter many people with prediabetes and, yes, you absolutely can improve your HbA1c with lifestyle changes. Diabetes UK has got lots of info about how you can improve your health, and I strongly advise you seriously make efforts to do so.

So often I see people with type 2 diabetes who have ignored multiple test results warning them to do something, and are now in a bad place health-wise. People seem to think that just because diabetes is common that it's not serious, but that's not the case, so please don't adopt a laissez-faire attitude with your health. Make some changes. If you're struggling with doing that then speak with your GP and see what support services are available.
https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/prediabetes

What is your diet like now? Get yourself a cheap BM machine and track your blood glucose levels after meals. You'll get a sense of what your body can tolerate and what it cant.

F

I'd like to thank everyone for their supportive comments. There are a few things that are making me a bit despondent about the situation with my pre-diabetes. I've just spent some time checking the labels for what I typically eat and nearly everything has sugar and carbohydrates in. My breakfast cereal has sugar and carbs. Bread has carbs. Soup in a carton has carbs and sugar (even though it's advertised as a healthy option). Biscuits have carbs and sugar. I eat pasta ready meals from M&S and they have sugar and carbs. Bananas, pears and oranges have sugar, so I can't eat those either. I can't have tea with sweeteners because sweeteners are apparently bad as well. It's looking like I'd have to eat foods that I either don't like or have never eaten in my life to get my blood sugar down naturally. I feel as though I'm better off just accepting that I need to be on Metformin. The thought of living off just water, almonds, oats and sunflower seeds and such makes me depressed. Also my BMI is 25.8. I know people who are significantly heavier than me (including obese in some cases) and they aren't diabetic or pre-diabetic. Just feeling a bit demoralised by it all.

Metformin can kill your kidneys, you don't want that unless it is a last resort. Cut your carbs & increase your protein.

Sweeteners are fine. The only ones you need to avoid are fruit sugars. Do you not do any cooking from scratch? Make your own pasta dinners, that way you can control how much pasta you're eating. Bulk them out with veg. Don't add extra sugar.

Whether you're given metformin or not, you will still have to make these changes because your heart, kidneys and cholesterol won't do well long term with all that processed stuff. The metformin won't stop you becoming diabetic anyway if that's the trajectory your diet has you on.

There are different types of sugars OP and your body processes them to get glucose. Obviously it doesn't need to do that with glucose.

I try for 20g or less of carb per meal if it is pre prepared, for fruit and veg I don't count.

Typical day for me:

Breakfast, black coffee (lactose intolerant) some form of protein, that might be full fat greek yoghurt with nuts, scrambled eggs with cheese, hard boiled eggs with ham.

Mid morning fruit / nuts / salt and vinegar chickpeas / pork scratchings

Lunch (I have my main meal at lunch) steak with mushrooms and onions, lamb chops with green beans and carrots, chicken with lemon and pepper and cheesy croquet potatoes (yes I do eat some potatoes) curry

Snack as mid day but I normally don't snack in the afternoon.

Dinner I do a bento / tapas type thing so hummus, 1 pita bread (I freeze them and toast from frozen) salad of some type, cheese or meat (often meatballs) pate, olives

Or soup with a single bread roll

Stir fried chicken and veg

For ready meals have a look at Iceland. They do things like curry without the rice. The croquette potatoes I get are from there and Cathedral City cheesy potato gratins have 15g of carb so they fit into my 20g or less per meal.

You can do this OP

Dp is diabetic he follows a low carb diet and is monitored by a consultant in the lipid clinic.

He ate today: eggs mushrooms and tomatoes for breakfast (it's the weekend) he'd normally have yogurt and berries or make chia pudding or make breakfast muffins with egg and bacon.

For lunch he had mackerel and avocado and salad

For dinner we all had roast chicken with veg - he didn't have roasties or root veg but had broccoli, sprouts with bacon, cauli, leeks and courgettes.

No sunflowers in sight but he will snack on a few nuts or cheese or the small lunch tins of fish or pork scratchings or hard boiled eggs etc (not all at the same time!)

Pasta- he has sauce with veg instead, makes cauli rice instead of normal rice.
You could reduce the amount of pasta you have to start with and bulk it with veg instead of dropping it completely.

Bread he makes chaffles in the waffle maker or cooks a thin omelette to use as a wrap.

You can get low carb granola in Tesco but he found it easier to cut out processed food and sweeteners and soon lost the craving for sugar and carbs.

Metformin isn't normally prescribed for pre diabetics as you don't need it. It has some horrendous side effects and really isn't a good option. It's better to put diabetes into remission to prevent further health problems.

That's not to say it's been easy- it hasn't, it's been tricky if we've gone out for meals or if we're too tired or been ill ti cook and he has slipped along the way. But he has managed to put his diabetes into remission. He wasn't over weight either but his diet now gives him more energy and his bloods for cholesterol etc have been good too.

Michael Moselys fast 800 book is hood to start with, it has a meal plan and recipes that are pretty easy to follow, There's also useful info on the diabetes website about low carb and there's loads of threads on here for a low carb or keto diet

Greef Chef do low carb range, if you don't want to order a box you can still look at the website for ideas.

Just another thing I forgot to mention - a blood glucose monitor itself is fairly cheap, but the cost of the strips looks like it would get expensive quite quickly. You can't get them on the NHS unless you're fully diabetic. I checked Amazon and a month's supply of testing strips would cost nearly as much as the machine itself.

I know they can be expensive, as my A1C is under control I can't get them on the NHS any more.

But you don't need to keep testing, yes use the monitor to see how your glucose behaves for a couple of weeks but once you start making the changes you shouldn't need to keep checking.

I realise you’re adjusting to this OP, and it’s hard, but (pre)diabetes isn’t some sort of just desserts for people who are fat, some sort of punishment for failing in some way. Try to see it as neutral - no it doesn’t feel “fair”, but health doesn’t work that way, you have to get past that feeling. Hopefully when you’ve had a chance to get used to it a bit more, you’ll find that there are things beyond “water, almonds, oats and sunflower seeds” (and oats spike my blood sugars, so I don’t eat those!) that you do enjoy and that won’t raise your blood sugars to dangerous levels too frequently.

Just deserts!

I had to correct that several times and STILL it autocorrected back!