Prediabetic

[Lynn1966]

Has anyone else been told since their heart attack that they are prediabetic. I had a letter from my G.P today saying this. It seems I'm getting over one hurdle then another one comes along .x

[Sususulio]

Lynn there’s a link in terms of statin use 😕 It is one of my worries as there is some family disposition and it seems to relate to the high doses (80mg). It is fairly widely reported and I think the official stance is that it probably hastens a condition that would have occurred in any event. There are however a lot of examples of lawsuits in USA - particular issues for women, post menopause 😕.

[Lynn1966]

I thought there may have been a link susieAG. My mum was a diabetic and on insulin 😬😬Iv been going through the menopause for the last 8 years. The joys 😂😂xx

[Inamoment]

I got one of those. I was invited to a weight reduction and exercise class by a practice nurse who could clearly see i was underweight and on full time oxygen! More practice maybe. I ignored it. I am actually folate deficient and now take folic acid, three month course.

[Chappychap]

Diabetes and heart disease are frequent co-morbidities.

Dr JR Kraft, a pioneer into heart disease, believed the relationship between the two illnesses was so strong that he said, "those with cardiovascular disease not identified with diabetes...are simply undiagnosed". Other researchers into heart disease are saying something very similar, claiming insulin resistance, a precursor to diabetes, is often the key, root cause of heart disease.

I suspect this may also be behind the fierce arguments you'll sometimes encounter regarding the optimum diet for people with heart disease.

On the one hand you have the plant based/Vegan diet traditionally seen as the best way of reducing cholesterol. But another camp say the role of cholesterol is overstated, and eating to combat heart disease should be the same as eating to reverse prediabetes, in other words an ultra low carb or Keto diet. The two camps sometimes also put different emphasis on exercise, plant based tend to downplay the role of exercise. Low carb adherents tend to say frequent and vigorous aerobic exercise can be pivotal to achieving results.

[HB-HB in reply to Chappychap]

I'm on low fat, plant based diet (about 90%) but I exercise a lot. I also fast till about 1 or 2pm most days and I think fasting is good for not becoming diabetic. A few hours a day of slight hunger can't be that harmful for most people and I'm sure we are eating too much anyway and a lot of health issues are stemming from over indulgence, not just wrong types of food.

[Hidden in reply to Chappychap]

Surely such polarised debate is the opposite of individualised care? The promotion of “ pet theories “ by clinicians really irritates me and ignores the multifactorial nature of disease including genetics and environment.

[Chappychap in reply to Hidden]

Couldn't agree more.

I've read powerful arguments for why defining which of the three variants of the Apo-E gene an individual carries is an important piece of information for determining what is their optimum diet. But how many people who bang on about one diet or another actually know that about themselves?

[Moonflower76 in reply to Chappychap]

Why does it have to be one extreme or the other ? If its plant based vegan , then its basically high carbohydrate, virtually no protein ,low fat. On the other hand low carb advocates basically no carbohydrate , high amounts of saturated fat and relatively high protein. Both high fat diet and high sugar diet have been proven bad for heart health. So why not go middle way and eat a moderate amount of carbohydrate, protein and healthy fat?

[Chappychap in reply to Moonflower76]

I don't think I ever suggested it had to be one extreme or the other!

On the contrary, I'm saying there's no one single diet that's best for everyone. Different people will benefit from different diets, some of them quite radically different diets.

[Moonflower76 in reply to Chappychap]

Yes I think you are right different people need different diets. Personally I am pescatarian , because I can't stomach eating a pig or cow. But there are benefits like higher iron content in meat . I think the Blue Zones diet is quite good ( based on what the longest living cultures ate ) which is a lot of fruit and vegetables ,some meat , fish and carbs and fat. But yes each to their own.

[controlcause in reply to Chappychap]

During a recent survey both diets were joint topper health.usnews.com/best-diet...

[isobelhannah18]

Thanks everyone for this informative debate. As usual on this forum I've learnt something.

[Ell27]

I had a second heart attack in July 2018 and was diagnosed then as type 2 diabetic. The consultant said the diabetes was the probable cause for the heart attack as glucose thickens your blood hence the blocked arteries. Iv been put on insulin and now tablets so they can wean me off the insulin. Was a tough time getting my head around the shock of both conditions I had no idea i was diabetic and no symptoms to say my sugars were so high other than a thirst but we d had a lovely summer and i just put that down to the heat

[AFTadcaster]

Yes. At 69 years old I was diagnosed in August 2018 with AF and the drs thought I had a mini stroke. On a follow up visit to my GP following a blood test she gave me a leaflet and said that my blood test result indicates that I am border-line for diabetes. The NHS have some sort of guideline to adhere to and the figures mean that if your number is 42-47 you are pre diabetic. Anything over that number you are diabetic already. I have no idea what that number represents and was told it was from the blood test.

GP gave me a leaflet to sign up for a 6 week 2 hour session to attend a special meeting with a view to re educating me on diet, nutrition, exercise etc. I had my first one to one consultation meeting with the person that is going to be running the group in Tadcaster. He took another blood test and after all the discussion signing up etc told me the result of the blood test he had just taken my count was below 42! However he said I think you should still attend these group sessions to get your numbers even lower. The drawback is that you have to commit to attending every single session or you get thrown out of the group!

My conclusion is that this is an NHS drive to be seen to be doing something to combat diabetes in the UK and not necessarily because you are border-line diabetic but that they can show that they are Re-educating the public.

I suffer from BAM (bile re-absorption malfunction) for which I have to take daily medication and changing my diet for plant based foods (ie raw salads and vegetables) has a detrimental affect on this disorder and the medication I have been given for the AF prevents me from doing any cardio exercises as I just get out of breath so quite how I am going to get on with this regime I don’t know. I’m still waiting to hear from the programme when the first session will be only having had the consultation at the end of December.

In my view GPs just follow the NHS guidelines and the fact that they gave you a leaflet means they can note your records that they’ve followed orders. I would be a lot happier if I knew there was some programme that was set up to discuss how certain medication affects people differently. The NHS are not interested in knowing this. They just pay off the drug barons and shove them down our throats. Pays their wages.

Needless to say since my follow up to the GP after my stroke which was at the beginning of August I have not heard a thing from my GP surgery. No results for my last blood test given in October relayed back to me. No follow up appointment to see if drugs are OK for me. I can see why most people head straight to A&E when sick because it seems to be the only way to get to the front of the queue! If I feel unwell today the chances of me getting an appointment at the GP surgery before a week today are zilch by which time I will either be dead or better!

[NorthantsSteve]

Hi Lynn. That just happened to me 2 years post HA in October. It was pretty depressing. If it’s not one thing, it’s another, as you say.

My HbA1c results came out at 42 so I’m just in the pre diabetic range (the new name for Impaired Glucose Tolerance or Impaired Fasting Glucose). The nurse and Doc were pretty relaxed (but I did have to point out the link between Statins and T2 diabetes to the Doc). There is a big push at the moment to raise diabetes awareness and provide support at this early stage to avoid full blown diabetes. The nurse said they’d had a lot more tests come back in this range than previously and she was speculating that they’d changed the testing process behind the scenes. As luck would have it my cholesterol is low so I reduced statins from 80Mg to 40Mg. I also realised that I was probably taking unnecessary sugar on board (I like orange juice for example). I’m going to go back in Feb and I’m hoping that these changes will have helped. And that’s probably the aim of this big NHS push - so in my case it has worked.

Thanks for asking the question, Lynn. As usual the answers are really informative. And they’ve certainly helped me.

[Handel]

Hello Lynn.

Gosh, I've learned so much from ChappyChap and others! I've no more input other than as an insulin dependent diabetic of almost 40 years, the workings of my heart are regularly checked (as yet no heart disease at all, thank goodness). BP and cholesterol levels are regularly monitored.

However, Susie's comment about high statin dose worries me - not for me but for hubby who was put on a high 80mg a day statin by the hospital following a diagnosis of blocked arteries. He still takes this high dose.

I think I've already posted that our GP put him on 20mg before the blockages diagnosis as his cholesterol level was 5 (not excessively high, I didn't think)!

Good luck and please don't get down about this. I really do understand when things are just thrown at you while you're down!

Major worries about hubby and his heart, me, a type one diabetic with dodgy thyroid and a very recent cancer scare (is it back?). This just made me more resilient!!! xxx

[panda22]

My bff varies between 29 - 44. At the moment I am 40. My nurse told me that I was high risk of becoming diabetic. She wanted me to go on a course. I declined. I have so many health problems I'm at the stage of what will be will be. I know this is negative but I'm fed up specialists, doctor's blood tests. By the way I am 70

[panda22]

Sorry should be grf

[Pommel]

Hi Lynn, I'm interested in your post as in October I also have been told I'm prediabetic. It did feel like another blinkin thing to worry about at the time and, as I've mostly been more on the skinny side for most of my life and not a real sugar junkie, I was a bit surprised! I'm keen to get back to below the range though so I've cut out most sugar (except what's in extra dark chocolate!) and cut right down on carbs. I don't know what else to do. It's interesting what is being said in posts about links with heart problems and diabetes. I've a different condition to you and according to the MRI and angiogram my arteries are clear, I'm not on statins. I feel a bit more relaxed about it all now after a couple of months and I hope you will too! Take care!

[Milkfairy Heart Star]

Hi Lynn

You might find this interesting from Diabetes UK

diabetes.co.uk/pre-diabetes...

The definition of diabetes and the terminology has changed and I am sure will continue to evolve with more research knowledge overtime.

The impact of diabetes on the inner lining of every single blood vessel in our body is the issue...endothelial dysfunction.

diabetes.co.uk/diabetes-com...

We all need to be able to make informed choices about the care we are offered such as statins following an open and honest discussion with the healthcare professionals responsible for our care.

Not sure if this is possible in today's hard pressed over stretched NHS?

I live with Microvascular endothelial dysfunction and this is thought to be the underlying cause of my vasospastic angina, migraine and Raynauds phenomenon. Not a condition I would wish on anyone.

Guard the lining of your blood vessels well the best you can through sensible life style changes but also supported by appropriate medication if required.

[Chappychap in reply to Milkfairy]

"Guard the lining of your blood vessels well the best you can"

That was pretty much my understanding too.

However a recent post about the rotoblation procedure, basically drilling out the linings of blocked arteries, has left me struggling to reconcile that super aggressive technique with our more fragile interpretation of arterial anatomy!

You seem a well informed poster, how do you square this particular circle?

[Milkfairy Heart Star in reply to Chappychap]

I agree it can be a challenge!

Any intervention even an angiogram and the dyes injected can damage the inner lining of the blood vessels. They are not without risk.

I am a bit of a research geek and will always research the evidence base of any intervention. In an emergency you have to go with the flow and trust those caring for you.

Here is what I consider when discussing or considering any treatment or intervention.

B What is the benefit?

R What are the risks?

A Is there an alternative?

I What is your instinct?

N What happens if you do nothing?

Interventional Cardiologists are really micro surgeons. They like to fix us and send us on our way.

Some procedures have been adopted without adequate evidence base and are not uniformly offered in all of the NHS. It depends where a particular Cardiologist trained and who their mentors were.

With this intervention it will be a case of weighing up the risks and benefits of the procedure.

The NHS England have just finished a consultation with the public about Evidence based interventions.

england.nhs.uk/evidence-bas...

[Chappychap]

But we're not THAT alike are we. The evidence of our own eyes tells us that some 40 a day smokers have heart attacks yet others don't! You could say that simple observation is also something "we know", and that it deserves to be acted upon. In this case by accepting genetic differences are critically important and can actually shape the clinical response.