Diabetes/ Pre Diabetes Experts- Step This Way!

[BurnDownTheDiscoHangTheDJ]

Hello all

Wondering if anyone has any expertise in this area.

I have several health issues, including lupus and fibromyalgia. I'm classed BMI as the top end of 'overweight', verging into obese. Unfit. Always been a bit of a fat bastard, even as a kid, but never hugely overweight... you'd just say I was a bigger girl. Size 14-16, 18 on top sometimes (big boobs).

I know I'm unfit, so have started swimming this summer. Am around eight weeks in and feeling loads better. But prior to that I had talked to my doctor about my poor fitness and had blood tests. These were in July but have only just had the appointment with GP to discuss.

On 21st July, the first day it hit 40 degrees here in London, I had a fasting blood test for diabetes and cholesterol. Diabetes test has come back as "45"- classed as pre diabetes. That day, due to the intense heat, I had a drink before I went to the blood test, a big one... a 2 pint glass of squash. Thought it was sugar free but husband, who made it for me, realised he had made a mistake and it was sugar squash. Asked the blood tester at the clinic if it mattered, she said no as it's not the same as the kind of GTT you have when pregnant etc.

So fast forward to now... pre diabetic. Doctor also said squash wouldnt have given false result. Doctor advised me to buy a blood glucose machine and test my blood sugar, fasting, pre meals etc. Have now been doing this for a week and my blood sugar seems normal enough. Varies fasting in the morning between 4.2ish and 6.5ish and has never gone above 6.7 two hours after meals.

Have I just had a lucky week, I am eating better and have been swimming for eight weeks since that blood test, or has the test been skewed by that massive drink of sugary ribena? I'll keep testing until my next appointment in just under a month, but I'm a bit confused.

Thanks in advance for any advise!

You are comparing two different types of tests, I think.

The one your doctor did that came back as 45 was likely HbA1C and reflects levels in the blood over a longer period, like 6-8 weeks, I think.

The blood sugar readings that you take before and after meals are more immediate measures. Those would be affected by the Ribena, but the other one not.

It could well be that you are coping with the sugar in food OK at the moment, but the fact that your HbA1C is high might mean that you are getting resistant to insulin and eventually you won't be able to, which would then tip over into type 2 diabetes.

This is how I understand it. I was also given a 'pre diabetes' result, but am trying to reduce carbs and exercise more to get it down.

Indeed the result of 45 is a HbA1C which reflects your blood sugars over a three month period. It would not have been thrown off by one glass of squash. There is a lot of exciting work at the moment showing that reducing carbohydrate intake and losing weight can even put diabetes into remission. So it would seem logical that these same changes could also stop the progress from prediabetes to actual type 2 diabetes.

Lots of good information on the diet doctor website, diabetes uk website and a book called “Life without diabetes” is also a really well written, accessible account of lots of the research. It explains really well how some people can be “too heavy for their pancreas” without being really overweight

Good luck with making some positive changes

Also - when you are researching and reading about glucose levels, you have to really watch what units things are being presented in. Your results (the '45') would likely be in mmol/mol. Many of the charts (especially American ones) use % values, or mg/dL, or mmol/L or whatever. So you will get charts saying that 5% or 80 or 4.7 are all 'good' values, for example, and then your own HbA1C results don't seem to make much sense compared to these. But when you look up the mmol/mol values, then they do.

And the immediate glucose meters will measure a different scale to that as well. So just be sure that you are comparing like for like.

What I'm interested in finding out is whether reducing carbs for a time can actually 'reverse' insulin resistance, rather than just sort of avoiding the need for insulin. That is, whether after a period of time with low carbs, whether you could then start eating a moderate amount of them again without the glucose levels going up as a result. Or whether it really just something that has to be done permanently to avoid the problem, which is still good in that that it is a workable treatment, is slightly different in my mind to 'reversing' it.

Your blood test was your HbA1c. It looks at how much glucose your red cells have been carrying around your body. As your red cells have a life of 2-3 months, this blood test gives an average blood glucose level for the past 2-3 months. It isn’t looking at what your actual glucose level was at the time of the test. You could have had a giant glass of full sugar cola and 10 donuts before hand and it would not have made a difference to the result. The fasting for the test was relevant for the cholesterol test, not HbA1c.

The fact you have increased your activity levels and improved your diet post the blood test will likely have reduced any insulin resistance you might have been experiencing before hand, which would have led to the pre diabetes test result. The blood glucose finger prick tests are a great way to get a snapshot of what your levels are doing at that moment in time, and it sounds like what you are doing/eating right now is working. Did your GP say they would repeat the blood test in a few months time? It would be nice for you to see a comparison level after a few months of your lifestyle changes for motivation to keep it up. Well done for putting in the hard work and sticking with it.