PRE-DIABETES

[GRUMBLE-GRUMBLE]

After having routine bloods 2 months ago I was diagnosed with Pre-diabetes, can someone please explain as 77 and have no family and Doctors do not have the time to explain things these days. I have lost a stone in weight and I think with the aid of green tea and feel better for it but cannot take fresh fruit because of I.B.S. Any ideas/guidance please?

[Vicky68]

You can look up many diets to follow for diabetes. They will help you a lot and then hopefully the next blood check will be better

[Activity2004 Administrator]

Are you on any medications? Are you counting carbs for each meal and snack? Do you do any exercise routines?

[Hidden]

Discuss treatment with your doctor. Emerging research is showing the Metformin can protect against heart disease and some cancers. If you can tolerate Metformin, why would you not want it’s emerging benefits.

[Hidden in reply to Hidden]

While metformin is fine for some people, it is not for everyone, particularly as there are interactions with other drugs and some other health conditions it can make worse. Also evidence is that, without a carb restricted diet, the dose has to be increased over time and then people often end up on other drugs.

[Hidden in reply to Hidden]

I did say if it could be tolerated!!! A lower carb diet is going to help a lot of people with diabetes. My HbA1c results are in normal range and my endocrinologist advised me to maintain the max dosage of Metformin (it has no adverse effects for me). I have had Type 2 Diabetes for 20 years with no complications.

As to drug interactions:

“Metformin is a cationic (positively charged) molecule and may compete with other cationic drugs for renal secretion through organic cation transporters in the kidneys.17 Procainamide, digoxin, quinidine, trimethoprim, and vancomycin are all cationic drugs that have the potential to interact with metformin, but only cimetidine, which is available over the counter for heart-burn, has been implicated in one case of metformin-associated lactic acidosis (MALA)”

There is the possibility of Metformin reducing B12 but that can be supplemented. My regular blood screening always includes B12 levels and I have had no problems.

Some people have gastro-intestinal issues with standard formulation Metformin but a number of those can well tolerate extended release Metformin.

Given the benefits emerging in current research - I am a researcher - this is, in my view, a useful drug in the diabetes arsenal. Vague warnings are not helpful!!

[Hidden in reply to Hidden]

I didn't want to get too technical on some else's blog, so I didn't quote the research. I'm glad you do well on it.

However, I am hearing about GPs who prescribe medium to large doses of Metformin at the first visit after diagnostic results indicate BG levels even slightly into the range or in the 'grey area'. With very little advice about diet control. For someone who is just below the range for diabetes, better diet advice could reverse it.

As for Metformin, because it interacts with anticholinergic medications, and according to NICE: "Manufacturer advises caution in chronic stable heart failure (monitor cardiac function), and concomitant use of drugs that can acutely impair renal function; interrupt treatment if dehydration occurs, and avoid in conditions that can acutely worsen renal function, or cause tissue hypoxia." I would be concerned that GPs who haven't been able to keep up with latest research on reversing early signs and on getting type 2 into remission if picked up early enough are just prescribing this instead instead.

[Hidden in reply to Hidden]

I think you will find that one of the things that GPs will be aware of in drug prescribing is the effect on those with reduced renal function. It is a common concern for many drugs. Virtually all drugs come with *possible* side effects but they are not experienced by all or to the same degree. Doctor’s will often turn to Metformin as a first line medication for type 2 diabetes as that is what they are advised to do unless it is contraindicated. All people should be given dietary advice following diagnosis and drug use can be reviewed following any good results form that advice.

If you actually know of any GPs who are not prescribing responsibly in accordance with Diabetes Care Pathways, then there are things you can do about it. Diabetes U.K. is always looking for people to promote the better care of people with diabetes.

[suramo Star in reply to Hidden]

It'd be better to control your blood sugar with idm than with medications. Since you are a pre-diabetic, you would be able to get results better and sooner.

[Matrix]

Hi if you follow low carb it’s very effective and you will keep diabetes away also cut sugar . I use a app for low carb counting if you stick to it I promise it will work x

[suramo Star in reply to Matrix]

Which application do you use for carb counting?

[Matrix in reply to suramo]

It’s for both the Iphone and Ipad. It’s called carbs and cals.. It’s free and you can also work out your own foods. Hope that helps 😜

[Hidden]

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

[Hidden]

As some of the others have said, there is lots of evidence that following a low carb programme will help, the diabetes.uk lowcarbprogram has shown how people can reduce their blood sugar levels. There is no need to eat fruit, in fact some fruits are very high in sugar, but do have plenty of green veg and salads, along with meat, eggs, cheese, fish, nuts, etc.

[Activity2004 Administrator]

Hidden ,

Please check your private messages. I just sent you a note right now. It's okay.

[Gambit62]

grumble-grumble,

HbA1c is a protein that provides a good indicator of whether the processes that allow you to regulate your blood sugar levels have been operating well over the last month. When it starts to creep up - that's known as pre-diabetes, ie an indicator that your body is struggling to control your blood sugar levels and without intervention you are likely to develop diabetes.

There are things you can do that put more pressure on your body to regulate blood sugars - basically eating a lot of foods that contain dietary sugars (carbohydrates), or not using the sugars you are consuming through exercise so the body is storing a lot of the extra energy as fat.

So, losing weight and cutting down on carbohydrates - particularly refined carbohydrates such as sugar, white bread and highly refined foods - is one way of correcting the imbalance that is starting to make your body struggle. Taking more exercise is also useful.

You can also look at your lifestyle and particularly your eating habits and the food you are eating and move away from foods that are likely to produce a 'sugar spike' in your blood - ie carbohydrates that are very easy to digest and quickly converted to sugars in your digestive system. This includes all the refined sugars and processed foods that seem to increasingly have become a part of our diets.

You do need some carbohydrate in your diet but preference should be for those that are digested more slowly - this includes most vegatables (though be careful with very starchy vegetables such as potato). Porridge is a good breakfast choice - its carbs but they are digested very slowly. Probably better than toast - even wholemeal - which is quite refined and digested quite quickly. Vegetables tend to require more digestion than fruit so not sure how that will go down with the IBS - though sometimes high fibre diets do seem to be good way to go with IBS.

[suramo Star in reply to Gambit62]

>>You do need some carbohydrate in your diet …

I've a different view. True that carbs. should be complex, but we don't need any carbs. in our diet. Our body can produce required carbs. itself by gng.10% of the fats and 56% of the protein can get converted into carbs.. Also, fructose if have been eaten also gets converted to carbs. up to 56-60%.

[Hidden]

Hi Grumble - I can understand your frustration with other problems as well as pre diabetes. To my knowledge pre diabetes is an indicator that your blood sugar is raised, but is at the lower end of normal. I have a testing kit on nhs, which is very helpful.

With IBS I find certain vegetables and fruit can irritate the bowel. You might find citric fruits, and those with extra roughage such as raw cabbage in coleslaw might upset you.

If you have vinegar especially malt, then if you have malt it is made from barley found in beer, soft drinks biscuits and canned food. Even maltesers contain it. Certain foods advertised as sugar free such as jams and chocolates with sorbitol can raise your blood sugar as sorbitol is made from corn syrup! Other sweeteners in drinks such as sucralose convert to sugar in the liver even when they are listed as no calorie drinks. When you cut out all the usual food sweets, biscuits, cakes, it takes a lot of mental persuasion to accept that flour used in pastry, is a high carb. Those savoury sausage rolls, and even rice and potato are very high in carbs. However since removing all those grains from food and avoiding too much fruit, watching fruit and tomato juice, eating savoy cabbage, spinach, broccoli, kurky kale cooked my blood sugar levels are normal. I was told I would have to go on insulin injections. I can say finding out about food intolerances has made me much fitter. Research on the amounts of vitamins and iron in cooked broccoli shows this vegetable is high in iron and vitamins A and C even when cooked. Hope you get the help you need with your problems.