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Confused Prediabetic
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SoCalBrian posted:
Hi everyone,

My doctor diagnosed me last week as prediabetic with a HgBA1C of 6.2. I had been unaware that it had been rising for the past 12 years or so until my doctor finally decided to inform me about the results of this test. Evidently my HgBA1C was 5.6 in 2001, 6.0 in 2006, and now it is at 6.2.

He says he is not worried and there is no cause for concern on my part, and he will have it rechecked in a year. I am 52 years old, 5'11'', weigh 155, and have been an avid runner/hiker most of my life, with no family history of diabetes. My cholesterol is 174, HDL is 68, LDL is 93. Fasting glucose was 90.

After researching prediabetes, I decided that I am not so sure everything is "ok", and do not want to wait a year for another check of my HgBA1C. I bought a blood glucose monitoring kit and have been checking my glucose levels for the past few days. I am hoping that someone can advise me on what to ask my doctor to do. I am definitely going to continue to monitor my levels. Here is what they have been and thank you for taking the time to look at this:

Wed. 86 before dinner
121 (45 min. after dinner - chicken, potatoes, broccoli)

Thurs. 86 (before breakfast - 5 mile run before test)
87 (1 hr. after breakfast - Cheerios, orange juice, tea)
86 (2 hrs. after breakfast)
95 (1 hr. after lunch - peanut butter/jelly sand., 3 Chips ahoy, 23 almonds, apple)
114 (before bed at 10:30 - dinner was hamburger, baked potato at 7:00; ate cracker jacks, fish crackers at 8:30)

Fri. 95 before breakfast
92 (1 1/2 hr. after breakfast - Cheerios, orange juice, tea)
97 (before dinner - 6:47 pm)
99 (1 hr. after dinner - pizza, garlic bread, blueberries, tea)

Sat. 79 (before breakfast at 9:30 - 9 mile run before test)
110 (1 hr. after breakfast - Cherrios, orange juice, tea)
103 (1 1/2 hr. after lunch - pb j, 3 chips ahoy, almonds, baked potato, apple)
124 (1 hr. after dinner - Chinese food w/ lots of noodles)

I realize that this is only for a few days, but since I actually eat the same thing for breakfast and lunch every day, I think this is pretty close to my normal diet. A lot of my dinners consist of some type of pasta, and once a week I will usually have some type of dessert to satisfy my sweet tooth after dinner - which I have not had, so I do not know how that will affect my glucose levels.

So that is why I am confused. I do not see a large upswing or downswing in my numbers, so far. Can anyone help me out with what I need to ask my doctor to do, or why my HgBA1C might be going up? I don't know if this matters, but my platelets/hemoglobin have dropped from 207/15.3 in 2006 to 147/13.6 in 2013. Okay, sorry about the long question, and any help will be appreciated - thanks!
Brian [a style="cursor:pointer;color:#006699;">


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An_252626 responded:
As a diabetic educator I would advise you to switch out some of your morning carbs like the Cheerios and orange juice for something like a high fiber cereal such as fiber one or steel cut oatmeal and switch the juice for low fat milk. I realize your fasting numbers are good but with the A1c rising you need to control some of your carbs. That is what causes blood sugar elevations. Chinese noodles are also very high in carbs. Bottom line more fiber less carbs and healthy protein will all help. Good news is you are an avid runner that is a big plus in your favor!!! Good luck
 
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brunosbud responded:
Do you smoke, drink or have problems sleeping? Do you snore badly at night? Do you take any medications for allergies, depression or inflammation? Have you had your eyes checked, recently? Blood pressure? Do you exercise, daily?
 
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SoCalBrian replied to An_252626's response:
Thank you for your reply! From what I have read you are right on about the carbs. However, I have read inconsistent information concerning what a safe blood sugar level is. In your opinion, are my blood sugar levels after my meals a concern? What additional tests, if any, should I be pursuing?
Thanks!
Brian
 
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auriga1 responded:
A non-diabetic's A1C will average between 4.5 - 5.7. You are above that.

Doesn't matter if there is a large upswing in BS numbers. Obviously, you were averaging higher than normal blood glucose levels during the time before your A1c.

A 6.2 A1c averages to a 143 blood glucose number. A non-diabetic's average is 85.

Your A1c is going up because you are eating the wrong things. You are ingesting more carbs that your body can handle. Diabetes is a disease of carbohydrate metabolism. Your body is not utilizing the carbs you eat.

Glad you will continue to monitor your levels. As Anon said, you will have to switch out your carbs for high-complex ones. Do more research. Take a look at the index glucose chart. This will give you a start on which carbs are high on that list and which ones are better for you. The lower the number on that list, the better the food is for you. Moderation is key.

If you don't watch your carb ingestion, your A1c will continue to rise.

I have had diabetes since 2007. My A1c is 5.6. I'm at that number because I eat less carbs than I ever did and am physically active. I have to use two insulins to keep my numbers in line. My BS would be high, even with eating if I didn't use insulin. Some of us are like that.

I do believe a lot of change in your eating habits is in order to keep your A1c from going up.
 
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SoCalBrian replied to auriga1's response:
Thank you, auriga1! I am not trying to be difficult, but I must be missing something. Since a 6.2 A1c averages out to a 143, why have I not had any blood glucose numbers close to that? I literally eat the same thing, every day, for breakfast and lunch (I know, my wife says I'm weird) - Cheerios, oj/ pb j, cookies, apple. I have done this for years, but since I have started to check my glucose numbers, the highest I have had after breakfast or lunch is 110.
If you'll review my numbers from my first post (thanks again for taking the time!) nothing is close to 143. I know I've only been checking a few days, but what I eat for breakfast and lunch does not change. Even with my dinners the numbers are not close to 143. I know the A1c is over a 3 month period, but since my diet only varies at dinner, I am confused as to why my levels are not near 143. Thanks, again!
Brian
 
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An_245101 replied to SoCalBrian's response:
The A1c blood test takes a look at all the blood over a three month period not just a couple of days.

I know you have been testing a lot lately but why are you testing 1 hr after eating? We as diabetics are told to test before eating in the AM a fasting of about 8 to 10 hrs and 2 hrs after eating.

You say your highest reading after eating is 110 - but you don't know what it is the rest of the time that is why the A1c was done, though it is not high at 6.2 it should be a walk up call to change your eating habits.

oj is not on my list of beverages except when I run low, cookies no for me as well. You need to look at all the carbs you consume at any one meal.

Your breakfast has no protein, lunch you said you had pb j, 3 chips ahoy, almonds, baked potato, apple, one dinner you had Chinese food with lots of noodles.

You eat Cracker Jacks, baked potatoes, pizza and garlic bread though all this seems okay to you - but to someone who is pre-diabetic not so good. Where's the protein and fiber.
 
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SoCalBrian replied to An_245101's response:
Thank you for your suggestions! I have been testing in the morning before breakfast (a fast of 8 - 10 hours) and and 1 hour after breakfast. I have also tested before other meals and 1 hour after (please see my numbers from my first post.) Some of the info. I have found (internet) says to test 1 hour after and then 2 hours after. I did that on Thursday and had 86 before breakfast, 87 1 hour after, 86 2 hours after - this was my Cheerios/orange juice breakfast. Friday was 95 before breakfast and 92 1 1/2 hour after. - same breakfast.
Other info. I have found says that before meals and 1 hour after is the best time. You're right, I have been testing a lot, but would like to be more accurate so I can see what is causing the high A1c. Should I just stick to before breakfast and then 2 hours after every breakfast, lunch, and dinner? I want to get a few more days' numbers before seeing my doctor. Should I ask for the oral glucose tolerance test? Thank you, again, for your help!
Brian
 
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flutetooter replied to SoCalBrian's response:
Hi & Welcome. I am in the prediabetic range for the past four years (one excursion up to 6.6, and then back to 6.2 three mos. later). I have also been as low as 5.7 recently. I am an active female, 74 yrs. old, 5'5", weight 135. Looking back on old blood test from physicals years ago, once my fasting sugar was 118, and once maybe 30 years ago and much heavier I had an A1c of 6.9 . Back then, the guide lines were much higher and that was not even prediabetic. No doctor ever rasied the red flag.

Four years ago I ocasionally got very lightheaded after eating. I bought a meter and found that my numbers within 1/2 hours after a reasonable meal for most people could go up to 185. Some chips and salsa while playing bridge sent it up to 225. By two hours after meals, it was back down to 95-100. That is why some people test at sooner intervals after a meal ---- to see how high it actually goes up before it comes down. The A1c is an average of all minutes, all meals, even while you sleep. I found my blood sugar was going up at night after dinner and not coming down all the way until morning. That wa a whole lot of higher number not cought by the fasting blood sugar test.

You obviously have enough beta cells still alive in your pancreas to create a whole slew of insulin in bring down you sugars. High sugars in a person who genetically has the tendency toward diabetes, however, will slowly kill off those betacells. Your fast blood sugar is the LAST number to go up, while show damage has been goin on especially to your nerves, eyes, and heart.

I changed my eating drastically away from the "complex carbs - oatmeal, whole wheat bread, brown rice -- all HIGH carbs) to mosty lean meats, good oils, and veggies, veggies, veggies, with a small amount of fruit and no dessert. I am still on NO meds!!!!! You are very wise to begin making changes now, and I know you will succeed. Check out www.bloodsugar101 for great info.
If at first you don't succeed, try, try again!
 
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SoCalBrian replied to flutetooter's response:
Thanks, flutetooter! So do you recommend that I test test 30 minutes and 60 minutes after a meal? That's great you have stayed off the meds!
Brian
 
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An_245101 replied to SoCalBrian's response:
Brian like flute says test often. If the foods you eat raise your sugars than avoid that food or eat a small amount to see what it will do.

I was thinking about a diabetic, we are told to test 2 hrs after a meal. but I guess you can test as often as 1/2 after just to see what will happen.

Good Luck.
 
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flutetooter replied to SoCalBrian's response:
Brian, I still do quite a bit of testing and self pay for my strips. I use "TRUEtrack" from Walgreens. Walmart also has reasonable brands. My strips are about 22 cents each from Amazon.com, and have been accurate enough for me.

I used to test for fasting daily, but am now not needing to, since my numbers, like yours, are all pretty much the same there. (My breakfast, unlike yours, is usually 1/4 cup canned wild salmon on a slice of 5 carb bread with 1/2 cup fruit and coffee. Two hours later it add 1/2 cup Greek plain yogurt with 1/2 cup fruit...and more coffee!)
So ... that tells me my problem is somewhere else. Try doing only before and after lunch one day, before and after dinner another day. If your doctor know you are willing to monitor your foods and make some changes, you can probably put off needing meds ----maybe for a long time. If you can keep your remaining beta cells from dying off, you can "limp along" on what you have left. I figure that I have only 40% of my beta cells left (by some complex tests) but that works for me since I really like veggies, and am very active, and love my clothes in the size I wore in high school.
If at first you don't succeed, try, try again!
 
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SoCalBrian replied to flutetooter's response:
Okay, so taking your advice, I tested before dinner and had 81. I ate a dinner of chicken marinara (lots of pasta), garlic bread, and salad to see what would happen since my breakfast and lunches don't appear to be the problem. 1 hour after dinner I tested 162. 2 hours after dinner I tested 100. Is this okay since it dropped? Should I be pushing my doctor to give me the glucose tolerance test? I will continue to monitor and thank you flutetooter and An_245101! You have given me some good information to take to my doctor.
Brian
 
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flutetooter replied to SoCalBrian's response:
Brian, that was some good information. Now you know more about where your A1c of 6.2 came from. In my A1c-blood average glucose conversion charts, an A1c of 6.2 equals about an average blood sugar of 131, not 143 as mentioned in a previous post. For example, with your dinner numbers only, the average of 100 and 162 would be exactly that! Many diabetics don't look at those high numbers if it comes down, but in my readings the high number after a meal does more damage than a constant middle range number--keeping your blood sugar more even is better. The glucose tolerance test for you may turn out the same way your meals do - - coming back down to normal or even below after your remaining beta cells push out a lot of insulin. That constant pushing out of more insulin to cover high carb meals is what wears them out! If you really want to get your body in condition (sugar wise) cut out that pasta and garlic bread and eat only the amount of sugars that it can handle with your remaining beta cells. This is called "eating to your meter" and is recommended in www.bloodsugar101.com . That is one way of dealing with prediabetes. Others prefer to eat whatever they want and taking increasingly more meds.
If at first you don't succeed, try, try again!
 
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An_252626 replied to An_252626's response:
Following the thread of all these posts flute is right the parameters for blood glucose numbers were much different years ago and she is also probably right about how much beta cell function she has left. Therein lies the key to prevention of medication. I have been a strong proponent for lifestyle modification and she is also right that you need to drastically reduce your carbs some carbs are fine however and frankly it's what gives us the fuel to keep going.

Diabetes is a progressive illness and at diagnosis most experts agree that at least 50% of beta cell function is lost, preserving this is essential. So eating food in lean protein and high fiber carbs will help keep your sugars more stable. If you have to have pasta switch to the healthier variety like whole grain, there is a newer one on the market called dream fields pasta which is supposed to be lower on the glycemic index. Remember portion control is essential . Try to keep each meal to no more than 45-60 carbs per meal. If for example you drink a 12 oz glass of OJ it is equal to 45 gm of carbs right there add in your Cheerios depending on how much you eat could be anywhere from 30- 60 gm of carbs as well. You will have then exceeded the carbs for that meal.. Hope that helps somewhat


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