Any advice? I’m 71 9st 12 lbs, exercise every day and can run 5k and now have been told I have pre diabetes!!! My diet is pretty good low carb generally not much bread or root veg, and no cakes or sweet stuff, alcohol-14 -16 units a week. So what next I ask? You can consider the above a bit rhetorical.
What next - pre diabetes!!!??? - British Heart Fou...
What next - pre diabetes!!!???
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Misstibbs
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Kristin1812Heart Star
Not sure you want replies…..was it just rhetorical? I too was surprised to be told I was pre diabetic. But I did the course (you didn’t mention if you have been offered one), and made lots of changes….lost 10K, gave up sugar, take much more liquid (alcohol was minimal to non-existent anyway), exercise 5/7 days regularly, and am still working on stress.No idea what effect on my blood sugar level, but I’m also getting less angina and, feel sooooo much better!
Thanks Kristin seems like you have a good routine 👍
Sorry if it sounded self-satisfied. I just wondered if you might be offered the course, as rather unexpectedly, I found it v helpful.
Hi,I was offered the course but another health issue got in the way so will pick it up again soon, over what period of time was your weight loss etc?
Thanks
Neil my weight hasn’t varied too much heaviest 11st 5lbs now say 10 st after cutting out carbs to an extent?
It took about a year for the changes, which now (another year later) seems to have maintained. No harm in giving it a try, I gather it’s not for everyone.
👍
Your pre- diabetes condition is pathological to you rather than through apparent lifestyle. From what you have told us about your lifestyle at present, any further changes will make little if any difference so I suggest you carry on as you are, but obviously take up whatever monitoring is offered to you. If your condition does deteriorate there are well known treatment options available, which are used for folks who have diabetes, to help them have a normal life.
Misstibbs in reply to
LowerField you have reiterated my thinking, I’ll keep monitoring but won’t loose too much sleep over it!
Is your response about Type 2 diabetes?
in reply to Kristin1812
If that question is addressed to me about my response above, it only covers the pre-diabetes condition applied to what the OP told us. No mention of Type 2.
Lucymoo in reply to
In pre diabetic situation lifestyle has been proven to have a impact. We can all do more about our lifestyle to try to avoid diabetes …….alcohol at 14-16 units is high and may help if reduced.
Hi Lucymoo I thought 14 - 16 units was ok (red wine) I guess the other point is “ you have to live and enjoy life along the way” thanks
14 units is the maximum recommendation per week plus two consecutive days off to allow the liver to clear out any toxins. Red wine is very high in carbs sadly. I was diagnosed with prediabetes with a similar lifestyle to you. I went very consciously low carb as opposed to cutting out bread and rice and hoping for the best and my HBA1c has dropped as a consequence. I’m no longer in the prediabetic zone My diabetes is a genetic risk due to being part Indian but I still managed to reverse it. As a pharmacist I’m not willing to allow diabetes be the cause of my own demise if I can change it. I couldn’t enjoy life when I felt at risk and I’ve found ways of being low carb that don’t feel like deprivation. Off to make some keto chocolate brownies……
Hi JennyRx you have been very successful, so you still have bread and rice, I’ve virtually cut those out and only have sourdough occasionally. Wine is my guilty pleasure on alternate days
No bread, no rice, no pasta, no potatoes, now mainly green veg, lots of raw salads, salmon, evoo, chocolate treat is 85%, steamed veg. Very simple but tasty I meant I’d previously made a half arsed attempt cutting out bread and rice and it wasn’t enough. Needed a proper concerted low carb approach to make a dent in the HBA1c. That had also been affected by chemo and immunotherapy. So taking myself in hand was important for many reasons. I have very high lipoprotein (a) which is my big risk factor but it all needs the same approach. Some people are TOFI- thin on the outside, fat on the inside with fat sitting around their organs. I’m taking myself off for a private insulin resistance test soon as it’s not done on NHS and I get my HBA1c done privately every 3 months just to ensure I’m still on track - just tested as 38.
Brilliant well done JennyRx, I appreciate your advice, the bread thing is such a habit to break after over 65 years eating it! But cut down to a few slices of sourdough a week is a start.
We all make choices I’ve given up alcohol as a trigger for AF which is well known. Each glass of red wine will have up to two teaspoon of sugar in it….and an average glass of red wine is 2 units so combine the two and you are having 14-16 spoonfuls of sugar in a week so hence may not be a good idea for someone whose pre diabetic hence the comment. We all make our own choices
The sugar content of each glass of red wine is around two teaspoons so you are looking at rather a lot of sugar in your 7-8 glasses a week. I gave up alcohol as it was a trigger for my AF and a couple of years later cannt say I miss it. We all have choices to make and lifestyle changes on the health information we are given
GardenRed in reply to
Not everything needs or has a medical solution. My husband was listed as pre-diabetic (which translated into actual Diabetes in hid hospital notes!). Missitibbs sounds very balanced weight and diet wise. Drs do not know it all. I could say more (write a book). Basically you have replied most sensibly.
The best thing I did was to ignore my GP’s advice not to buy a finger prick tester. In the early stages test regularly and keep a diary - food, snacks, exercise etc. Main meals test before and two hours after.
It is a faff, but you’ll learn what does and doesn’t affect your BG. Also ask your GP to monitor your HbA1c every three months.
I did something similar, I invested in the Freestyle Libre system. And I discovered what many people have reported, namely that what causes our glucose to spike is often deeply personal and unique to us. We all process and metabolise food differently, and therefore it shouldn't come as any surprise to find out that blanket statements like "avoid carbs" don't always apply.
For example I found that beer (and to a lesser extent fruit juice) was absolutely lethal for me, generating huge and enduring glucose spikes. But sourdough bread and boiled potatoes weren't nearly so damaging.
Sure, cutting out all carbs would still have covered it, but thanks to the real time feedback I got from the Freestyle Libre system I've arrived at a diet that's a little easier to implement while still keeping my HbA1c scores well down in the safe zone.
HenryTudor thank you, I’ll take your advice and won’t buy any testers but rely on my GP for regular blood tests.
in reply to Misstibbs
Probably the best course of action. I recently found out that finger prick tests are only useful for measuring your sugar at the time the test was taken. This can vary (as I found out). What is far more indicative of your condition is the HbA1c test which gives your average 'score' over a number of weeks and which your GP should arrange.
RufusScamp in reply to
The finger prick test can help you identify the things that affect your blood sugar levels. The HbA1c test gives an average over several months.
Good point thanks RufusScamp
You will be lucky if your GP agrees to test your blood every 3 months. That is how things used to be. I was diagnosed with Type 2 20 years ago, was given a testing kit by the hospital and encouraged to test my self regularly. Diabetic clinic follow up with my GP was every 3 months with an HbA1c giving the average blood glucose for the previous 3 months. Annually there was the usual, plus examination by the doctor and an ECG. Things changed some years ago when it was decided that Type 2s didn't need to test their own blood at all, twice yearly HbA1c was sufficient. Diabetic clinic follow up is also twice a year, but with the Practice Nurse, not the doctor. My testing kit (not the the original after all these years) has been my best friend. It has kept me on track and helped me to control my condition. I would advise you to have one. If you do progress to Type 2 you should also have a diabetic eye check once a year which is a photograph of the retinas. Mine are still ok after 20 years. Good luck, and remember diabetes, whether pre or full, is not in charge, you are.
I found myself in a similar situation, with a combination of heart disease and borderline insulin resistance.
My reaction was also to cite my lifestyle. But that's like yelling "it's not fair"...and here's all the lifestyle evidence why it's not fair!
Then I realised something, heart disease and diabetes really couldn't care less about what's fair.
Heart disease and diabetes will just keep coming after us unless we stop them. And the only things we have in our armoury to do that are medication and life style changes. That's it.
Personally I didn't fancy the common T2 diabetes medication of yet more insulin, it just doesn't sit easily with me that if the problem is too much insulin in my body that the cure might be to add yet more insulin? So I decided to go all out on the life style options in order to combat my pre-diabetes.
Happy to report that, three years down the road, my HbA1c scores are back down in the safe zone, as indeed are all my heart disease metrics...although for heart disease I do take the full cocktail of medication.
My advice would be to give yourself some time to process the deep and abiding injustice of the universe, but having gone through that you need to move on from appeals for fairness and decide what you personally are going to do about it. And that's almost certainly going to require you making lifestyle choices that you really, really don't want.
For some people that might involve zero snacking and only eating in an eight hour window each day, for other people it might mean looking hard at those 14-16 units of alcohol.
Heart disease and diabetes couldn't care less how hard these choices are, all that matters is the result. If we make the right choices then there's every chance we'll be left alone to live our lives. If we don't then our diseases will just keep getting worse.
For the majority of us (not all of us but the majority of us) it's mainly down to our personal choices.
Good luck!
Thank you Chappychap - much that’s sound realistic advice 👍
A perfect summary.
If it is insulin resistance, doctors do not tend to prescribe insulin straight off. The usual medication is something like metformin
I appreciate that, but T2 Diabetes is a progressive disease, so medication won't necessarily stop with Metformin.
Also, and especially relevant as this a heart forum, is that there are certain heart conditions where Metformin won't be prescribed as it can exacerbate the patients heart problem.
Yes it is progressive, mine got a bit worse over the 40 years. But still plenty of diabetes meds to use if not able to take metformin for some reason. Insulin is reserved for when the pancreas can no longer produce it. Also as this is a heart forum, there are medicines prescribed - as "Gold Standard" treatments which reduce blood sugar significantly. e.g. dapagliflozin. It really smashed my HbA1c levels and as a result I significantly reduced my diabetes meds
On the alcohol front... beer significantly raises blood sugar levels and red wine reduces them.
I wonder if a few endocrinologists automatically say we are pre- diabetic when we get to a certain age 🤔. I went to see one a few years back about my thyroid ( benign nodules) and she spent 40 minutes discussing my pre- diabetes ignoring the main reason I was there. My GP and cardiologist have never mentioned anything nor has my new Endocrinologist. My Cholesterol is a bit high but all my other tests are good. I have in the meantime drastically reduced sugar in my diet for my arrythmia ( didn't make any difference - my episodes continue to increase) but I lost a little weight. I hardly eat carbs and have been vegetarian for 32 years. If you are worried perhaps see a different Endocrinologist for a second opinion as your lifestyle seems excellent. This post is only my own opinion and experience of course!Quite frankly after a certain age we are " pre-" everything 😂
Take care
Hi Lilypocket I like your sense of humour, yes I guess if you live long enough your pre everything 🤣🤣🤣
The first thing I looked for on your profile was whether you were taking a statin. I see you are.I also developed pre-diabetes while on Atorvastatin following aortic valve replacement. Fortunately my GP was aware that pre-diabetes can be triggered by statins in post-menopausal women and the risk is very substantial. As Michael Caine would say: "Not a lot of people know that." GP advised me to stop the statin and presto! next set of blood tests indicated I was no longer pre-diabetic. Do check it out; the jury's out whether or not the benefits of statins outweight the pre-diabetes effects.
There is always the fact that you attract a higher financial tag at your GP surgery when diagnosed with anything 'pre' but you are worth more to your GP when you are pre-diabetic.
I doubt very much that financial issues will affect a GPs diagnosis. There is a well-defined chart of HbA1c readings and their labels (pre-diabetic, diabetic etc.) If you look at the report containing the results, this is produced by the lab performing the tests on your blood samples, you will see there the interpretation.
Thanks, I am well aware of HbA1c results and their interpretation having been a Practice Nurse for many years, it also qualifies me to remark on income generation in a GP practice. Individualised assessment is what should take place (statin dose being a good example as stated in other comments) rather than the label a patient 'pre-diabetic' which ultimately generates the next tier of QOF points (linked to targets) points translate into payment. The system is complicated and includes other variable such as geographical area and levels of deprivation for example.
Hello. I am wondering, do you take medications? Some medications will cause pre diabetes and high cholesterol too. (Although, most doctors and medical staff tend to dismiss this)
I am also pre diabetic and it’s not from lifestyle. A huge well done for being so fit and healthy as well, that’s very impressive. Kind wishes Debbie
Hi Glastonburylady yes that’s a good point, statins apparently can increase insulin
Hello, you have not mentioned about your height and your BMI and family history of sugar diabetes. It also mention about your truncal obesity which in other words are you apple or pear shaped.? If you are apple shaped which means weight around the waist, there is pressure on the pancreas and release of insulin into system is impaired. That is pre-diabetes - next stage is type 2 diabetes and when the pancreas has depleted it's store of insulin - next stage is insulin dependent diabetes. That was the outcome of my discussion with a diabetologist many years ago and I think it still holds true.
Hi nilmoniskdar my BMI is 20, I’m not aware of any family history of diabetes. Shape pretty flat!
"the pancreas has depleted its store of insulin" Suggests that the pancreas cannot make any more. The pancreas unable to make insulin is type 1. Type 2 is more about the body cells being resistant to the effects of the insulin. A long way down the line the pancreas may give up on producing the hormone in sufficient quantities, but many other drug therapies are used before that. One useful drug is the one used in heart failure, dapagliflozin for example.
I'm another one who's been told they are pre diabetic. I'm 5' 10'' weigh 10st, but 5 of my meds increase blood sugar! My last HbA1c was 50 despite my statin dose being reduced and on Dapaglaflozin, I don't drink, have a healthy diet....can't win
Yeah, you don't have to be overweight to have diabetes. I am surprised the dapa isn't helping more. With me it meant I had to drop my gliclazide from 3 a day to 1 a day. But then all our circumstances are different
You are on the max nearly for alcohol per week - you could reduce that 
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