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.

Making dietary and lifestyle changes doesn’t mean having to live off rabbit food. There will be positive changes you can make and plenty of advice online. Lose the ready meals, make home made soup rather than using tins, no biscuit's or snacking on rubbish between meals.

My situation was worse than yours OP. My blood sugars were far higher, my bmi was 24, I didn't eat a particularly high carb diet and I'm 57.

I now have my sugars in the normal range and one more good reading in a few months time and I'll have the diabetic marker removed from my health file. No metformin.

At your stage you don't need to panic. You need to make changes.

Ditch the added sugar. Establish if your body tolerates stevia based sweeteners and you can use that in your tea or to make biscuits with for sweet treats.

You need to replace your carbs with other things or at least have better carbs. Instead of a full bowl of pasta I now have 30g of whole wheat pasta, instead of white rice, I now have a small amount of brown rice. Add in extra veg such as brocolli and cabbage.

I still have a little bread but again, choose a small amount of a whole wheat option.

Soups I make my own. I even have lentil. It has carbs but again they are better carbs.

I've learned to enjoy 90% dark chocolate and have a couple of squares of that.

Berries (I get frozen) in full fat Greek yoghurt are good for dessert or breakfast.

Eggs are your friends.

I eat apples but will usually have half a granny Smith with peanut butter. Having fats with your carbs helps slow the absorbtion and stop blood sugar spikes.

I can also have a small baked potato without effect. I have it with butter, cheese, tuna mayo or prawn cocktail.

And the other thing is exercise. Doesn't have to be intense, just getting in some steps is good.

This is not a life sentence OP. You just need to follow a sensible lower carb diet and I'm sure you will get your levels where they need to be.

Good luck.

You seem to be talking about metformin as a magic pill with no ill effects that will allow you to continue with your carb heavy diet and not take any action, but that's categorically not the case. Read what people who have direct experience of it have said on this thread again and really take it in.

I managed to bring down my reading without a glucose monitor, if that helps. I also eat delicious food including treats, so there are no worries on that front. I eat better than 95% of people.

There's no need to be fatalistic and negative about this. You have been given a golden opportunity to turn things around and you are very lucky.

By the way, have you recently had covid as that seems to have triggered type 2 in some susceptible people. It might explain why this is happening for you at this BMI.

Also, just edited to mention that @BigBoysDontCry 's advice is spot on.

Have a look at this for tips https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/preventing/ten-tips-for-healthy-eating

and also they have some very good meal plans . You don’t have to cut out all carbs and all sugars just cut down .

Also to add that I think nhs class anything under 150g carbs a day as low carb. For me that's too high and I stick to 70-90. Keto is seen as under 20g. I did keto but it ultimately didn't suit me and I nearly developed an eating disorder. I think for short term it's a means to an end but can become obsessive. My bmi dropped below 18 but I've gradually managed to get it to normal while sticking to low carb and this works for me.

Make some changes and up your activity levels OP and I'm sure that will get you where you need to be.

Loads of good advice on this thread for you. Remember that white bread, white rice and white pasta are not your friends.

Potatoes and carrots have similar amounts of carbs but carrots are better for you.

Fibre is good.

Apparently cooking, cooling and reheating starchy carbs makes a difference to the carb content but I've not really tested this on my blood sugar.

Diet and exercise will almost certainly bring your blood sugar levels down.

Metformin is the "easy" option that doesn't actually solve the problem, which is almost certainly you eating too much sugar/carbs and not doing enough exercise.

If you go onto Metformin, you're less likely to make the diet and exercise changes you need and it becomes a slippery slope. You'll start on one tablet per day, then the blood sugar levels will creep up again, and it'll be 2 tablets in a couple of years, then, a few years later, it'll be 4 tablets. Then a few years later, they'll bring a second drug into play, typically Gliclizide, one tablet at first, then 2, then 4.

The drugs "cure" the symptoms, not the cause!

low carb doesn't mean no carb, you can still have some some fruits like berries apples pears and citrus fruits have much less sugar than grapes and tropical fruit like bananas and mangoes, you can have the odd potato and granary bread just not 6-8 portions a day, my husband got his down he cut out chocolate except occasionally at weekend, he changed to sugar free cereal and less of it still carbs but better he works manually so needs more food than most but since he lost the weight he now maintains on something like

breakfast smoked mackerel very small bowl of cereals with milk
lunch soup with granary toast followed by large salad with hard boiled egg and either cold meat or cheese
mid afternoon snack apple ot orange
dinner normally the same as everyone else but just a small portion of potatoes ( he doesn't like pasta or rice) or maybe he will have butter beans or lentils instead of potatoes or both if a particularlily physical day followed by greek yogurt and fruit, he still drinks sugar free fanta as doesn't like tea coffee or water very much

type 2 is not like type 1 you can get away with the odd splurge when we eat out he has what he wants so the occasional fish supper or slice of cake won't wrecjk it but it can't happen every day

you could probabyl just get away with halving your portion of carbs and replacing with vegetables

I was pre-diabetic two years ago and did the ‘Second Nature’ programme. I lost 1.5 stone and my hbac was normal again within a few weeks of eating low carb. My cholesterol also reduced a lot. I took it as a kick up the backside to change my lifestyle and it has worked. Interestingly, I was offered metformin and statins but refused them. I’m really glad now that I did.

small amounts of carbs in soup from vegetables don't matter it is the big picture
it is not NO CARBS but lower carbs especially lower sugar,
yes research does show that sweeteners keep the sugar craving going so make it harder but they can still be a useful stepping stone see if you can get Giancarlo Caldesi's book it explains it really well once your blood sugar is down maintaining it is not quite as strict there is a bit of leeway

Just for general reference, blended soups are worse for blood sugar than the ones where the vegetables are left whole. Anything blended like smoothies, blended soup or mashed potato spikes blood sugar more than their alternatives which are eating whole fruit, non-blended soup and boiled potatoes.

You need to overhaul your diet anyway. It’s pretty bad & way too carb heavy.

You’ve had a wake up call. You need to embrace the opportunity to get healthy. Yes it will take some effort, but If you keep eating the way you are, you’re in for a life of poor health.

Ditch the sweeteners, they can affect your blood sugar and gut health in a negative manner. There are a number of lower sugar non sweetener drinks by Calstons Press, or gave fizzy water.

Search for low glycaemic load foods. The good news is posh ice cream is low glycaemic load so it’s definitely not all rabbit food. Swap out potatoes for sweet potatoes but watch portion sizes. Basmati rice is better than white rice. No alcohol other than red wine.

This is an interesting article OP, it's about reversing type 2 diabetes in people who didn't start overweight.

It really reflects my own experience

www.diabetes.org.uk/about-us/news-and-views/dukpc-digest-day-5-retune-study-lower-body-weight

Your thought processes are a bit extreme!!

Carbs and sugars can be the same but they can also be different

Everyone eats carbs, unless they literally live on meat and fish alone

Vegetables, milk, natural yoghurt, beans/peas/legumes, oats, fruit all have carbs, but they are good for you.

Low carb diets mean you just eat a lower amount. I try to stick to around 100g a day but at times Ive done about 50g a day

I have porridge oats for breakfast and then the reast of the carbs in my day come from milk, veg and pulses/legumes

Just cut out the obvious processed ones like biscuits, sweets, cakes, too much bread. Aim to have berries rather than bananas and oranges for example

Up your veg intake

You are being defeatist and talking yourself into medication that you really don't need. There is a way to consume healthy carbs so that you don't spike your blood sugar. The best reference for this is Jesse Inchauspe aka The Glucose Goddess. No faddy dieting, just a way to make healthy choices for someone with blood sugar issues. Also, if you want to learn exactly which foods cause your blood sugar to rise the most you need a continuous glucose monitor. You can get them on Amazon and they give readings on your phone. One only lasts 2 weeks but it might be instructive. Your diet doesn't sound too healthy and you could be doing far better for yourself if you cooked from scratch.

I'm not diabetic but have done Zoe personalised nutrition and know that I don't handle sugar too well. I have learnt how to eat to manage this and have lost a few kg as well.

5 years ago hba1c of 88. Went on low carb and increased exercise and within 3 months down to 36. Have been in remission with no meds ever since just on low carb diet .

It can be done and although type 2 cannot be cured and if I changed my way of eating my hba1c would shoot up again I would rather substitute rice, potatoes, bread , oats etc than take meds for as long as I can.

Your diet sounds utterly shocking to be frank and you should sort it out not just for blood sugar but lots of others things too.

Aim for improvement not perfection, OP.
What soup do you eat (brand, flavour) that is high carb?

I am wondering if you are being too stringent about carbs.

Too stringent? Are you joking?

Diabetic groups online are full of people that want to just take the medication and continue to eat the diet that got them into trouble in the first place. It’s depressing knowing how that ends. Take heed to the wake up call.

How are things with you now OP?

You’ve got lots of advice here, good luck.

I’ve seen a podcast with a French woman going by the name Glucose Goddess. She doesn’t talk about diabetes but general health affected by sugar/carbs. One thing that stood out to me- if sugar is in the first 5 ingredients it’s a “pudding”. One example, I checked baked beans and sugar is the third ingredient. So beans on toast, for example, is not a good meal.

You will likely feel better and have more energy if you eat properly, regardless of whether you medicate or not. Just make a few healthy swaps to start with that fit your lifestyle. For example, aim to change breakfast https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/healthy-swaps/healthy-swaps-breakfast