Hba1c now 43 - Prediabetic?: When I was really ill... - PMRGCAuk

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Hba1c now 43 - Prediabetic?

HappyDiamonds profile image
24 Replies

When I was really ill I lost 3 stone in weight in a few months as I was unable to eat or even drink a cup of tea. This was the only upside as I had tried to lose weight in the past with only moderate success. When I first started being able to eat again my taste buds had totally changed and I craved things like crisps, ritz biscuits and those little cheddar biscuits, all things I wouldn't normally have touched or been tempted with. That was on 60mg Pred. Now on 25mg I am like a woman possessed and all I want to eat is sugar - chocolate, biscuits, cake, ice-cream, the cravings are there and Im afraid I have been giving in, even started on mince pies and Christmas Cake. So when I had my blood test this week I asked for Hba1c to be done again. In July I was 39 which is high for me but I had been on steroids for 3 months, now 3 months later I am 43 which Im informed is pre diabetic. So I have started low carb eating and so far doing very well as Im a bit all or nothing. I have counted calories as well as Carbs on an app on my phone currently having 1400 cals and 50g carb. I don't really want to lose any more weight but would like to control blood sugar and not become diabetic. Im also worried that if I do the Rheumy will further press me to have methodextrate to lower the steroid quicker as she has already recommended it because I found tapering by 10mg and 5mg every 2 weeks a challenge. My GP hasn't offered any advice only said to have blood tested again in 12 months which I think is far too long to wait.

I have had a good look at the diet doctor website but would appreciate any advice or hearing from anyone who has experienced the same thing. It seems as though I am starting to get side effects from the Pred now I have been on it almost 6 months although in truth I do feel well and Im back to walking 4, 5 or 6 miles most days so I can't complain.

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PMRpro profile image
PMRproAmbassador

Sometimes I am aghast at the attitude of some GPs to blood tests - anyone would think they had to pay for them out of their own pocket! Your Hba1c should be checked every 6 months as long as it remains stable and normal range. When it rises - every 3 months is called for. 43 may be pre-diabetic but 42 wouldn't be - less carbs for the next few months will bring it down again!

Anyone would find changing dose every 2 weeks a challenge - and it is unlikely that mtx would change that! Anyway, now you are down to 25mg you shouldn't be reducing more than 2.5mg at a time.

If I were you, since weight loss is less of a concern, I would stop being so harsh on the calories and fill up with more protein and fat. And I will be harsh - stop the cakes and stuff. If you can't stop eating them, don't buy them. Or if others in the family want them, put them in a locked cupboard and give them the key with instructions not to give it back to you. Unless things change a lot and quickly it is unlikely you will need the megastocks of sugar packed xmas stuff you usually do for visitors, so don't buy it in the first place!

When the sugar crave hits - have a drink of water, go for a walk, find something else to do with your hands. It takes discipline for a few weeks but you soon lose your taste for sweet stuff. I can't eat a whole piece of cake - Often I cut it in at least 2 and sometimes 3 and freeze the rest - then you have time to deploy other distractions ;)

HappyDiamonds profile image
HappyDiamonds in reply to PMRpro

Thank you for your sound advice. I have an M & S delivery from Ocado every week and yesterday I cleared out all of my high carb food from cupboards and Freezer and gave it away. Tomorrows delivery is all healthy stuff as I appreciate the importance of taking back control. My halo will shine.

In all honesty I don't know how I would have managed without this friendly and supportive forum as I feel cast adrift at times even though the Hospital has been very good. I certainly couldn't rely on my GP Surgery they virtually just send bloods off to the Hospital and fulfil my prescriptions. Whats worrying is that I don't think GPs services will ever go back to what they were.

PMRpro profile image
PMRproAmbassador in reply to HappyDiamonds

Given the combi of Covid and the b-word sending many doctors home you are probably right. Though from what my daughter tells me, having a load of older paramedics in as emergency practitioners might not be a bad thing - she's biased as she is a paramedic but has found the practice paramedic far more thoughtful and proactive than many of the 16 doctors. Some of whom are married couples job-sharing! Obviously over-paid ...

SnazzyD profile image
SnazzyD in reply to HappyDiamonds

Well done for the restrained M&S order; if you don’t get it in, you won’t put it in! I hope after a couple of weeks the craving will calm down, it did for me. I do think it rather cavalier of the GP to go to annual testing. They have no idea if your rising sugars are just due to your snack attacks plus the Pred glucose raising properties most of the time. Or, whether you just can’t make enough insulin because your pancreas is a bit whacked out from working so hard already. My sister’s pancreas packed up due to autoimmune attack alone. You don’t fit the usual type 2 picture to be so sure that in a year’s time you’ll be much the same, you have no track record in these circumstances to be confident.

tangocharlie profile image
tangocharlie in reply to PMRpro

I totally agree with that - I just don't have sweet stuff in the house. I do get some 70% dark choc but find if it's there I'll even over-eat that. I don't buy into the nonsense some diabetic people spout of 'everything in moderation' . Why eat something that is poisonous to your body and made you diabetic iin the first place?!

PMRpro profile image
PMRproAmbassador in reply to tangocharlie

I remember the period when the dietary advice was a minimum of however many slices of bread - the nurse couldn't understand the logical argument I put forward of why eat something that will mean you need more medication? I had a similar experience with the dietician on weight control advice - she insisted I NEEDED 4 slices of bread I think it was. If I ate 4 slices of bread in a day I'd never manage to eat good food! I'd be full ...

tangocharlie profile image
tangocharlie in reply to PMRpro

There's a thread running on Facebook at the moment from diabetes.co.uk, supposedly myth-busting about can diabetics eat cake etc and I can't believe the amount of idiots who say they eat what they like and just increase their insulin 'because they need a treat'. It's self-harm. And so selfish expecting the NHS to just keep treating them and picking up the bill when they don't help themselves.

PMRpro profile image
PMRproAmbassador in reply to tangocharlie

Couldn't agree more. Having seen what poorly controlled diet does to diabetics ...

agingfeminist profile image
agingfeminist in reply to tangocharlie

You are so right. Would anyone take medication that was damaging to their health?...We need to think about food in the same way. The sugar craving is forgotten by our food 'memory' after a few weeks...similarly salt. Salt is of course easily replaced with herbs and spices...and a lot of home cooking!

Don't replace the sugar with artificial sweeteners it seems that they might also be implicated in diabetes.

Here is a recipe for sugar free cookies:

Rolled oats (about half a cup plus) mixed with one egg, almond butter (a bit expensive but worth it). Forms a thick mix. Add frozen blueberries. Make into small balls and bake.

tangocharlie profile image
tangocharlie in reply to agingfeminist

I have a fair bit of salt to make sure I don't get dehydrated on low-carbs and whenever my electrolytes are tested they are spot on. I use good ground salt. Thanks for the tip on sugar cravings

agingfeminist profile image
agingfeminist in reply to tangocharlie

I eat a lot cheese and that is high in salt...also used tinned beans, tuna. Always assumed I get enough without adding...but now you have made me think about it..............

tangocharlie profile image
tangocharlie in reply to agingfeminist

I think salt gets a bad press but is actually quite good for you. I've got a book called 'Lies my doctor told me' and it has a chapter on it. Ditto butter and other fats

agingfeminist profile image
agingfeminist in reply to tangocharlie

In terms of reducing blood pressure I think you are right. But I think fluid retention with pred might be a different kettle of (salty?) fish.

tangocharlie profile image
tangocharlie in reply to agingfeminist

Good point. I'll try cutting it down and seeing what happens.

SnazzyD profile image
SnazzyD in reply to tangocharlie

On Pred I found a direct correlation between salt intake and amount of fluid retention within hours. The only time I brought it in was when I had adrenal insufficiency because low sodium is a problem.

tangocharlie profile image
tangocharlie in reply to SnazzyD

I've had adrenal and recently fatigue problems so kept up the salt intake, and when I have had electrolyte tests they have shown good levels of everything. I have got oedema in my legs so maybe reducing salt might help. Worth a try, thanks

PMRpro profile image
PMRproAmbassador in reply to tangocharlie

I'm like Snazzy - one meal out and I can feel the difference. Three days in a row on holiday and my feet are like footballs!!

Devoid profile image
Devoid

Hi I had the pre diabetes diagnosis in August,it turned out to be the kick up the back side I needed to really get on with low carb diet. I do find sugar free jelly just gets me through the times I fancy something sweet

HappyDiamonds profile image
HappyDiamonds in reply to Devoid

Thank you for that tip I think I might try it with a little greek yoghurt on top. Strangely I really found it hard today even though I have had perfect low carb meals. Yesterday and the day before was easy but I suppose its early days and old habits are hard to change.

Hope its helping you.

Devoid profile image
Devoid in reply to HappyDiamonds

The mad thing is clotted cream is less carbs than Greek yoghurt! That really makes the jelly a treat 😊

HappyDiamonds profile image
HappyDiamonds in reply to Devoid

Now your talking my kind of language - clotted cream!

MrsNails profile image
MrsNails in reply to Devoid

Me too Devoid! My favourite cousin (Male Category) has developed Type2 recently but still the Carbs are his weakness, l lost two stone in 5months after getting my Hb1Ac result, it certainly was the incentive l needed.....

Mack100 profile image
Mack100

I was diagnosed as having non-diabetic hyperglycaemia ( NDH is a better description of pre-diabetes) last December after being on prednisolone for about 10 weeks. I formulated an plan of action to start immediately in the new year to tackle this as best I could.

In this I was guided by the books of Dr.Michael Mosley, in particular the "8 week blood sugar diet".

Over the next 8 weeks, without even following the diet to the letter, we each lost 10 kilos but in the absence of a further HbA1c test since then I am unsure of my blood glucose status. The GP, while being supportive of me guiding my own pathway through PMR, seems reluctant to order blood tests and I confess I have not pushed the issue.

We both keep a low carb ( or "good" carb) diet where possible, absolutely avoiding what the Americans call the the 3 C's, Cookies, Cakes and Candies! I do a weekly fasting blood glucose test myself which puts me still slightly into the NDH range as I was originally, but I am sceptical of the value of self testing for glucose when not "properly" diabetic.

I have adopted a slightly fatalistic attitude towards this, as long as I am taking steroids I know I am at risk of NDH but I am confident that what I am doing now in terms of diet and exercise is the best I can possibly do, there's no point in beating myself up over what is not in my control.

Just 2 more things, chocolate and cider vinegar! Someone mentioned dark chocolate earlier, the lowest carb chocolate is 90% and I find that if I have a post-meal sweet craving then 1 square will satisfy me at the cost of only 4 gm of carb!

Check out what Dr.Michael Mosley says about apple cider vinegar and blood glucose control. There is quite a bit of data on this and there are some videos to be seen on YouTube.

HappyDiamonds profile image
HappyDiamonds in reply to Mack100

Thank you. I have discovered Aldi Moser Roth chocolate and its absolutely lovely. Its 85% cocoa dark chocolate, looks like a huge bar but actually has 5 individual bars inside, has 152 calories and 4.6 grams of carb. Also not as bitter as some. I also have one small slice of Livlife seeded half carb bread a day that has 83 calories and 3.8 grams of carb. Can buy Waitrose or Ocado. Most of my carbs come from milk though as I just can't give up my cup of tea. Looking in to Arla lacto free milk to see if I can save carbs that way. Have much to learn so will have a look at Michael Mosley.

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