How did this happen?

[monty]

Hi All
I have just been told by my doctor that I'm pre-diabetic. I had my annual physical last week and just got my blood results back, my FBG was 110. A few months ago I had a unrelated blood test without fasting and my BG was 95. My doc said it was a little high but she wasn't too worried (because I hadn't fasted). She is now concerned and wants to retest me in 3 months.

I'm an active 37 year old male. I run around 8 miles a week plus have 3 weight sessions with a personal trainer and do yoga twice weekly. At my last check I was 16% body fat, I'm 6 foot and weigh 173 lbs. I eat no junk food, almost all organic, am on a low fat diet, eat no red meat, no dairy and eat massive amounts of raw vegetables and fresh fruit. I EAT NO PROCESSED SUGARS (I use honey in my decaf herbal tea and morning oatmeal). I have also stopped all caffine over the last month.

After the initial shock I started reading stuff online and bought a pre-diabetes book. Everything I read tells me to loose weight, exercise and eat right! I don't believe I can do much more to improve my lifestyle, except probably give up a few beers at Friday happy hour. I have no genetic history in my family of diabetes. I have no diabetic symptoms and according to my doctor am in great shape. So what happened to my blood sugar, how did it get like this?

I would appreciate any advice on where to look for help for someone with my particular profile.

Thanks for any help!!!!!

[MJB]

Hi monty.

Massive amounts of vegetables and fruits can have massive amounts of carbs, especially fruit juice because it is so concentrated.

Your weight and exercise regimen seem to be very good. Try logging how many carbs you're eating daily. I assume you have some sort of protein source as part of your diet.

You may wish to see a dietician, one that is a certified diabetes educator.

[Cyborg]

You don't always get diabetes for the stereotypical reasons, such as being overweight, lack of exercise and not eating healthy. If you really are diabetic or pre-diabetic, it could be type 1 or type 2. Each seem to come about for different reasons. There are more tests that need to be done to confirm not only that you may have diabetes, but also what type.

Good luck and welcome aboard...

[Ronin]

Hi Monty!

I would tend to disagree with your MD's (knee-jerk) diagnosis based on a single FBG test. Yeah, the ADA and others have cited any FBG greter than 100 to be the diagnosis of Pre-Diabetic but that is not 100% true.

To be sure, an FBG over 100 is a cause for concern but it only indicates a need for additional testing. For starters you should get an HbA1c test to determine your " weighted average" BG levels for the past three months (actually weighted towards the past four-weeks). This is a much more accurate test of how your body is managing glucose.

A high FBG can, and often is, the result of what is called the Dawn Phenomenon/Effect where your liver dumps glucose into your bloodsteam to provide the energy needed to keep going until you provide outside fuel. I one time cycled to my clinic had a blood test and was told that my BG was high (in the 130 range) on an empty stomach. Fortunately, I knew that it was probably due to a liver-dump -- my bad for screwing up the test but it was my only opportunity to bicycle that day and seeing as I'm addicted to cycling,...

I have personally found that people who are active have a stronger DP than couch potatoes because their muscles require more energy than a non-fit person. This is also why many people have higher BG levels following exercise than they have before exercise.

The crux of this is that the Pre-D diagnosis is very new and is intended to capture people who might become Type-2 diabetic before the body developes the condition. (Note: this is based on the environmental theory of the onset of Type-2 diabetes -- there is a compelling genetic theory as well.)

Bottom line: get the HbA1c (which does not require fasting, and does not require another 30 day waiting period and can be done using a home test kit that costs less than $30) to determine what your weighted average BG levels are. If they are below 6.0% you are probably not Pre-D. If they are below 5.0% you are definately not Pre-D.

[jerryn]

Only one of the causes is a sedentary life style. And not all of us sit around all the time. In fact, many of us are active. I do a lot of stuff... I think if I was inactive my glucose would be higher than it is now. It takes several fasting tests to determine if your diabetic. My first test was 20 minutes after breakfast, a free screening where I worked. I was at 327. My Dr. had me take a fasting test and I was 126. So instead of waiting my Dr. ordered an A1C. This will give you a 6 month average. I was at 11. So.. that def diabetic. Now after on the meds and eating low carb.. and yes active... I'm around
6.8 . 6.8 is livable but this disease tends to progress a bit.
I know it's going to be harder to keep my A1C around this number as time goes on.

I wish my bg reading was 110 in the morning.

No worries, ask you Dr. for an A1C, and you will know for sure.

[xMenace]

Sometimes the pacreas just can't keep up. You are almost ... 40! ;) Does your family have a history?

[susique333]

Monty, my grandmother became diabetic when she was 40, she was a skinny 1st grade school teacher who ran her tiny little pratt off Monday thru Friday. I used to love to eat at her house cause she was a real meat and salad person (I on the other hand grew up on starches and plenty of them, they made the meal stretch when you have 6 siblings.) So who knows how this happens? My baby sister is type 2 as well. 15yrs ago I had a glucose tolerance test as my fasting was a little high, I got pregnant a few months later and was on insulin by the time I was 3 months along. I was stunned! Good luck to you, youre going to find lots of wonderful people here.

[owlyn]

You could very well have a history of it in your family and not know about it. In your grandparents day, diabetes was never listed as the cause of death- it was usually a complication, such as heart disease that was listed. I thought I didn't have a history till I was diagnosed. then someone says, oh yeah, your grandmother's sister had it. I was diagnosed at around 40, and it turned out that I had type 1, not type 2. I had about a 6 month warning. My triglycerides were very high, and the doctor said that we would watch it- come back in 6 months. It could be that your pancreas is starting to give up, or it could just be as others have said- just dawn phenomena in an otherwise normal person. You need the A1C test. If insurance is covering the tests, you may as well ask for a c-peptide test as well to find out if you are still making enough insulin. Might be too soon for that one, but it can't hurt.

[monty]

Wow, thank you all who replied with some great info. My doctor has booked an A1C for me in 3 months, I might try and get one before that. I bought a glucose meter today and am going to start monitoring my glucose daily. I'm going to switch my diet to more protein (which means eating more red meat) and lower my carbs. Again I appreciate all the input from the group.
Cheers

[monty]

I had a long chat to my mother this morning who lives in South Africa and just found out that her mother is a T2 diabetic and has been medically controlled for many years. In fact a large part of her side of the family are T2 diabetics. I'm also the same blood type as my grandmother, I'm not sure what it is but it is a rare negative (1 in 25) type. My grandmother is a very fiesty 84 years old but has been loosing her sight for the past 10 years and now is clinically blind.

Needless to say I lectured my Mother about getting tested, her weight has had massive fluctuations for years as has my grandmother's. My Mother has also had classic signs of diabetes and has not been tested. Although shocked to find all this out, it's given me new insight into the possible genetic cause for what's happened to me. Thanks again for all the great reply's above.

[xMenace]

I'm going to switch my diet to more protein (which means eating more red meat)

Not necessarily. To :puke: Fu anyone?

[Montana1]

Hello Monty,
Have you checked your bs with your new meter? How are they?
Montana

[monty]

I bought a meter and strips, got home and found I had the non code strips with a coded meter. Long story short, I called the help line and they are going to Fedex me an upgraded meter free of charge to match the strips. I won't be able to test my FBS until Wednesday. I'm also going to order a A1C meter to test my own A1C this week so I have a baseline before I change my diet, give up my beers on a Friday (I say as tears well up in my eyes) and generally remove any remaining non essential carbs from my life! I'm looking at going on the South Beach diet, any advice? Hardcore diets don't bother me, I eat a very regulated diet out of choice right now, it's just a case of tweaking it to match my blood sugar needs.

It's almost ironic, one of the joys I get from my training program is the opportunity to monitor my progress. Every morning I weigh myself, take my blood pressure and record my base pulse. Every time I exercise I wear a heart rate monitor and record my heart rate, training effectiveness and VO2. This I download to my computer and can plot graphs of my progress. What can I say, I'm an input kinda guy. I'm looking forward to adding my BS to my daily stats.

In fact on researching pre-diabetes I found a great site in which the author said something along the lines of pre-diabetes being paradoxical. I now because of it have a strong reason to look after myself like never before putting me in a position to enjoy all the benefits of healthy living. If one day I require medication, so be it, I will deal with it, if and when it happens. For now I'm going down kicking and screaming!

[CaptainMike]

You are fortunate to catch it this early. I too was diagnosed (At 40) while very active and at ideal weight (13% body fat) though I was already fully diabetic. I was on a (doctor recommended) low-fat, low-meat, zero cholesterol (And thus high-carb) diet trying to get cholesterol down to avoid starting statins. Some heredity at play in my case as well. You sound very motivated and organized, I'm sure you'll cope with this quite well.
Mike

[Montana1]

Great attitude Monty. For me it has become an obsession and in a morbid way, I am enjoying it.
Montana

[monty]

Hey All, wow what a roller coaster week! My FBG's this week have been around 80 with full day averages between 75 and 85 (my arms are black and blue from testing every few hours). I got my HbA1c today and it's 5.1, which includes the holiday period of drinking and eating BADLY!!! From this info I don't think I'm PD? So why the FBG the other day of 110? I also went back to a blood panel I had done in October last year and my non fasting BG was 102 and since then another test was 95.

I don't know if it's related but on my routine physical 2 years ago my liver enzymes were very high, my doc was freaked and sent me for an ultra sound which was totally normal for both my gall bladder and liver, no inflamation , stones or fatty liver. Two days later my enzymes were totally normal. My doc since has been paranoid about my liver, I've probably had 5 or 6 blood tests and everyone since has been perfect, even one after spending a month on a friends wine farm in the south of France (lets just say I didn't drink much water).

So after that I get that 1 high FBG, I wonder if they are related. I still think my sugar is higher than it should be and I'm going to continue checking my FBG and A1c. I think this was a great wake up call to learn about my genetic exposure to diabetes and make sure I never take it for granted. It's been really inspirational reading so many posts about how people deal with this every day. Many thanks to all who contributed to my posts.

BTW, with all the BG testing I did over the last few days, I found some interesting trends with regards exercise. Weight and anaerobic exercise rocketed my BG and kept is up for over 12 hours. Aerobic exercise (spinning) dropped it tremendously with a difference of 15 mg in the daily averages depending on the type of exercise I did that day?

[Real4]

give up my beers on a Friday (I say as tears well up in my eyes)
The beer is an issue only because of the carbs, a dry wine, or a mixed drink (with a no-carb mixer, bourbon and soda, for example) have little or no carbs and are not an issue (unless you overindulge, but that's a different story).

[Ronin]

Hi Monty!

Wow! You did have quite a week. You have responded well to the wake-up-call that the high FBG gave you. I also note that you must like expensive toys -- I looked into the home A1c meter and figured that it is a very expensive device with limited use, or did you find one where the strips don't expire in three months? If so, some additional information will be useful to all of us.

We all have different reactions to exercise but overall exercise will draw down BG levels. Of course your body's reaction is yours alone. I'm thinking that the C-Peptide test may be of value to you as your pancreas may be slowing down as it would seem that you are not insulin resistant (lots of exercise tends to lessen the probability of IR).

[monty]

Hey Ronin
Yes, I'm glad to have got the wake up call and intend to make full use of it. The A1c meter I got is an A1CNow meter , results in 4 minutes. There are 10 tests in a kit and it's valid for a year. I got it from Amazon for $144, which is just over $14 a test, my doc is a $20 co-pay to see her so I did the math and this works out as a great deal if I want to test myself ever 12 weeks or so.

Thanks again for all your input, I'm sure I will be back on a regular basis for more advice. I'm keeping my appointment with my doc for three months and am going to get the C-Peptide.
Cheers

[monty]

Hey All
I spent a week checking my BS about 10 times a day. That week MY FBS was between 75-90. I did my A1c and it came out at 5.1. I concluded that it must have been an anomaly during my medical, which started this whole thing and I didn't have PD. I anyway bought a mountain of "diabetes" supplements recommended in a pre diabetes book I bought. A day or two after starting these supplements my FBS shot up to between 100-118 and remained there all day. I stayed on them for a week and had the same results. I then stopped all supplements including my multi vit. Within 2 days my FBS dropped back around 90 (85-95) and has stayed there for the last few days. I also have very little movement in my daily BS tests. If I wake up and say test a 90 FBS in the morning, I remain within 10 mg/dl of that number all day, pre-meal, post meal, 2 hour post meal etc. If I wake up with a high FBS say 115 it stays very close to that number all day no matter what I do. Surely my sugar should change when I eat? I tested my wife after dinner one night out of curiosity. We ate the same meal at the same time, I was 95 she was 137. I have never tested over 118 at any time of day or night in the last 3 weeks since I started testing. I also found out some other interesting things. I tried testing my bodies reaction to beer. I started testing at 4 in the afternoon, I was 85, I had 5 low carb beers in 3 hours. I then checked my BS it was 90. I checked it before bed, 2 hours later it was back to 85. My FBS in the morning was 87, (who would have thought that beer is better for my BS than health supplements). I'm going to reintroduce them 1 at a time and see if I can find the one that may have caused the spike. Any observations anyone might have about my experiments would really be appreciated.
Many thanks.

[Eddy]

That week MY FBS was between 75-90. I did my A1c and it came out at 5.1.


Nice.


I also have very little movement in my daily BS tests. If I wake up and say test a 90 FBS in the morning, I remain within 10 mg/dl of that number all day, pre-meal, post meal, 2 hour post meal etc. If I wake up with a high FBS say 115 it stays very close to that number all day no matter what I do.


On a good day, my high/low are 50-60 mg/dL apart.


Surely my sugar should change when I eat?


Unless you have a happy pancreas that tightly regulates your BG. :)

[missusg]

Hi You sound alot like me. I am only 28 years old, walk everyday for at least 30 minutes, clean house for hours, never sit still, not overweight, and no history of diabetes anywhere! Im a non smoker, non drinker, and ate only whole wheat/pasta bread veggies, etc. I didn't even drink coffee until this year and my diagnosis, but cut that out as well! I am so upset. I did have gestational diabetes, and have been pre diabetic for 5 years (since I was 23) and I'm a triplet and no other sister or brother (in the triplets) has it! I don't know why this happened. My doctor and diabetic dietician are very outdated, and know nothing to help me. I was also hypoglycemic for a few years before this. It's been quite a road of blood sugar mess!

[missusg]

Also, if anyone could recommend what to eat in a typical day to sustain me from having low sugars? that would be great, I have problems with either too low or too high, they're going sky rocketing one way and then the other (24 morning, 2.4 afternoon) ughh...please help

[amyjo29]

I'm sorry to hear your frustration. There is no real cause as to why we get diabetes. I was diagnosed when I was pregnant and was perfectly fine before hand. It doesn't make since to me that my numbers never returned to normal after giving birth but it is what it is. I have gone through the same questions as you...how could this happen? I don't have a history of diabetes either. Keep doing what you do and as a few people have said talk to a CDE to get more information on how you might improve your diet even though it sounds pretty healthy to me.