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new_user

Totally don't fit the profile

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new_user

I am  66 y/o man.  I swim 6 miles a week.  I am and have always been thin.  I never eat processed or sugary foods.  There is no history of diabetes in my family.   By nature I eat healthily.  (I'm a very good cook and make almost all meals from scratch).  I don't even eat much meat.

 

But not long ago I was diagnosed with prediabetes despite have no, zip, zero, nada risk factors.   

 

I religiously keep my carb intake to under 225 grams a day yet my A1C still creeps up.  I started on metformin (500mg) two months ago yet my A1C increased from 5.9 to 6.0

 

This situation totally sucks.

 

Oddly my blood sugar in the morning is often counter-intuitive.  Lower carb days often result in a 115 - 125.  High carbs days are often yield lower readings the next day.  The other day I had a bowl of cereal (cheerios) at 3:30 am yet my BS at 7:00 was just 107.  Go figure.  It's maddening.   (Perhaps a cortisol rush upon waking is a factor but I get up at the same time and test at about the same time each day.

 

I'm really not interested in another article telling me to reduce sugary drinks etc.  How I'm gonna get my A1C back down consumes my thoughts. 

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Moonpie

If you want to get your A1C down, maybe you can reduce your carbs, many people on here do less than a hundred on a daily basis. Welcome.

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meyery2k

Many here have managed their diabetes by reducing overall carbohydrate intake.  Many here consume 50g a day or less of total carbohydrate.  It is possible this might help in your case as well.  Possibly even to the point where Metformin would not be needed.

 

The carbohydrates that are consumed come mainly from green leafy  and non-root vegetables.  Fat to help curb appetite.

 

You will find many threads and anecdotes here regarding this topic.

 

You can actually actively observe how carbohydrates work in your body.  We call this eating to your meter.

 

Measure right before eating, measure at 60-90 minutes.  If you go over 140 then this is an indication that you are either insulin resistant, not producing enough insulin, or possibly both.  In general, a person with sufficient insulin that they are not resistant to will not go over 140.  You are doing this to learn right now but many here actually try to not go over 120 in the first 90 minutes.  If you do spike then a smaller portion of the food or, if that is not practical, no eating it is the answer.  Measure again at 2 hours and you should be near your starting point.  If you are not then measure again at hour 3.  If you are still elevated this can be due to excessive protein since that will also be converted into glucose, albeit at a slower rate.  Eventually you should find which foods are compatible with your plan for glucose control.

 

Usually foods like cereal, grains, pasta, fruit, breads, potatoes, and rice are not compatible with diabetics or pre-diabetics.  You may find, however some exceptions to this which is why the "Can I eat <fill in the blank>?" is answered with test, eat, test, learn which breaks back down to eat to your meter.

 

I hope you will decide to become a member of our community. ~ Mike

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samuraiguy

Welcome to the forums. Unfortunately just being over the age of 40 can trigger insulin resistance, especially if you have a family history. For me getting my A1C is a combined effort of diet, exercise and meds if needed, but diet has the biggest impact so I just found lower carb equivalents to carby things I like to lower my overall blood glucose levels and thus A1C.

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Fraser

New user,

I

I have Never been obese, my last sugary drink was 1971. I cook all my own food., only one other diabetic in the family etc. I run 3 or for times a week

but still I was diagnose 8 years ago with an A1c of 12.0. My current A1c is 5.6 ( no meds).

What has worked for me at least is keeping my carb intake the same at each day and same at each meal. There is never a High carb

Day. Typically for me I keep my daily carb intake 50 maybe 70 on a day to run.

In the past if I had a higher carb day, I would tend to go lower. I still produce insulin, but the first phase reaction is slow, then I start pumping out insulin and it is in over drive and doesn't shut off appropriately. I did a test. and ate half a bagel (really bad for a diabetic)

So of course my BG sugar jumped to over 200, then I tracked it and in 3 hours it was down to 70, no meds just over production

of insulin.

A couple of years ago I had been stuck at 6.0 for years.

So I made everything as even as possible, and tried to elimnate as much of the spiking as I could. I went from 6.0 to 5.6 in three months and have stayed there. Anyway it has worked for me. FYI now 71

Hope it helps

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NoraWI

Ask for a GAD65 antibody test. It's a test for T1. You may be LADA, a slow onset adult T1. You may have been misdiagnosed.

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hexex0

You definitely fit the ideal profile of LADA with your fitness level and the fact that the metformin isn't affecting you at all.

 

Not to say it can't be insulin resistance / type 2 because it can, especially after 40.  But I'd get tested for antibodies.

 

Aside from that, as others have suggested, carbohydrate restriction is the key to control of insulin resistance, with or without meds.  You could try cutting back to 100g and see if you notice a change (over a longer period of time.)

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new_user

If you want to get your A1C down, maybe you can reduce your carbs, many people on here do less than a hundred on a daily basis. Welcome.

Thanks for the suggestion.  My weight has been dropping like a stone on 200-250 g of carbs and day and I eat fat, fiber, and protein like there is no tomorrow.   If I cut back to 100 I'd be grazing on carrots all day long and still be hungry :-).

 

I may have to increase how much meat I eat -- not that that appeals to me for lots of reasons.

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new_user

Ask for a GAD65 antibody test. It's a test for T1. You may be LADA, a slow onset adult T1. You may have been misdiagnosed.

I'd never heard the term LADA before now.   

 

Let's assume that I am in that category.  What does it practically mean?  5 minutes of Googleing suggests that lifestyle modification are one and the same.  

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Cora

Ask for a GAD65 antibody test. It's a test for T1. You may be LADA, a slow onset adult T1. You may have been misdiagnosed.

I agree. LADA aka Latent Autoimmune Diabetes in Adults, also known as T1.5 (type 1.5). It is basically type 1 diabetes (formerly known as "juvenile") but is often characterized by a much slower onset than when it happens in kids.

 

If it is LADA, ultimately you will require insulin (as with all type 1s). The honeymoon in LADA can last as long as 6 years or so. In the meantime, you do the best you can to control blood sugars which ultimately means cutting back on your carbs. In the early stages, sometimes metformin seems to help, but not always.

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NoraWI

Let's assume that I am in that category.  What does it practically mean?  5 minutes of Googleing suggests that lifestyle modification are one and the same.

It means you should probably go directly to insulin use to preserve beta cells and that none of the T2 drugs will do you any good.

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NoraWI

Thanks for the suggestion.  My weight has been dropping like a stone on 200-250 g of carbs and day and I eat fat, fiber, and protein like there is no tomorrow.   If I cut back to 100 I'd be grazing on carrots all day long and still be hungry :-).

 

I may have to increase how much meat I eat -- not that that appeals to me for lots of reasons.

If you have been losing weight, all the more reason to suspect that you are T1 (LADA)

 

Cutting carbohydrates isn't the same as cutting calories. Eating more good fats actually helps because fat has no carbohydrate but does have more calories. You just have to be selective of your food. Adding more meat may be counterproductive because protein also converts to some carbohydrate but over a longer period of time (several hours). We are not suggesting that you graze on carrots all day. There are low carb foods that are very satisfying but better processed by our diabetic bodies. If you are LADA and go on insulin, then you will have more leeway in what you eat because you will be able to dose for it.

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Fraser

Yes you could be LADA.

But my personal experience including my DX Doctor that said LADA was possible, is that fitting the profile is not a diagnosis.

I fit the profile took all the test , all negative, dropped metformin because it was pushing my exercise numbers to 50.

It's been 8 years now without meds. Nope don't think I was LADA, I am just what ever kind of diabetic I am.

Well controlled on diet an exercise only.

But I admit I don't eat 200 carbs a day.

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funkynassau

Lots of good advice here, and it's carbs that matter, so try to get yours down.

 

My mother was a lot like you, tall, thin, ate very well, very carefully.  No junk food for her, she cooked all the meals, there was no ready made food in her house!  Yet she ended up with t2 at age 79.  Totally out of the blue.  

 

I have t2 but so did my dad, he was diagnosed at 65.  He drank beer, but not to excess, and he did eat mother's meals.  

 

So you never know.  You do everything as correct as you can and it still gets you.

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jwags

Many Type 2's don't fit the profile. I am a thin type 2 who exercises with no family history. I gave up all processed food 25 years ago and still got Type 2. Sometimes our livers just convert too much Glucose. I did 30-40 csrbs a day for 9 years and have just added some carbs back. So I am now doing. 75-120 carbs most days. I usually get a fasting around 100. Do you check your BGS after meals? many of us can't handle rice, pasta,,any cereal or bread.

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DanG

diabetesforums is my primary care physician.

 

new_user - you can learn very much from many experienced people here.  Good information in the 15 responses already in this topic.  An off-the-wall idea might be to treat your situation as if you are the LADA that has been suggested.  For less than 35 dollars you can do some experimentation to see... if you want to be brave, or stupid-foolish - you decide.

 

Lessee... Cora said that you would eventually be using insulin if you are LADA.  Also, you told us that you cannot afford to lose more carbs from your diet.  Think about it... insulin works against carbs... essentially.  Eat carbs, insulin comes to the rescue to let the system assimilate sugar to your body.  Somehow, you notice this is not happening as it seems it should, i.e. weight loss, carbs push blood sugar down, etc.  Assume you are LADA and treat yourself as LADA... maybe - you decide.  For 35 dollars you can purchase a vial of Novolin R and a bag of syringes from the pharmacy at the bigbox run by the family in Arkansas and ubiquitous in every town and borough in the world.  The test objective is to see if additional insulin injected in to your system will let you increase your use of the 225 carbs that you consume.  Metformin may not be your friend? but insulin might accomplish the task better?

 

Should you decide to go down the path of this Mission Impossible suggestion, it will cost you less than doctor office visit and these supplies may cover your needs for over a month.  Get back to us if you want, or, offlist to see suggestions of amount and when - we don't want any emergencies,here.  We have each been there/done that.  This contribution is... remember... off-the-wall, but there are many off-the-wall things to learn here at diabetesforums.  BigPharma and the entire Medical-Industrial-Complex really are not friends to some of us that appear to be luddite and work to fix things ourself.

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NoraWI

That's a pretty dangerous thing DanG is suggesting. Without carefully investigating and learning about insulin use, trying it without some kind of health professional guidance is a BIG risk. Reading material that will help you if you decide to go down that road:

 

Using Insulin by John Walsh

Think Like a Pancreas by Gary Scheiner

 

Those two will do. It will take you quite a while to plow through and assimilate the information they offer. I suggest you read and reread and ask us questions BEFORE you try it.

 

Have you linked up with a CDE (Certified Diabetes Educator). You should see if there is a good one available where you live. Also an endocrinologist who specializes in diabetes may be very helpful. Don't have to do all of them. Just go to the one who makes sense.

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jwags

While diabetes forums may be good for diet advice and support, you need to be working with a good Endo or PCP to help manage your diabetes. It is never advised to go on any medication or Insulin without your doctor's knowledge. If you think you are LADA which may or may not be the case let your ENDO run a full Antibody panel and a c-peptide. At the end of the day there are Many of us thin, fit, athletic diabetics out here. I did very low carb 40 carbs a day for 9 years and now I do around 75-100 carbs a day. Yes I have to avoid most grains and sugar and all processed foods but I can eat unlimited veggies, beans, sprouted grains, nuts and seeds. I can maintain my weight or even gain weight in less than 100 carbs a day. I use the walk 5 miles a day. Now that I am going through chemo I try to walk 3 miles most days and do 45 minutes of PT exercises.

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leosmith

I'm really not interested in another article telling me to reduce sugary drinks etc.  How I'm gonna get my A1C back down consumes my thoughts. 

It sounds like you're asking for advice that doesn't involve diet. But I'm going to talk about diet a little anyway, so feel free to ignore my post.

 

I've always been thin, healthy and done regular cardiovascular exercise. At age 54 I went through a similar situation; A1C fluctuating in a range between 5.7 and 6.0 over the course of about a year. I never took medication though. I tried low and very low carb diets. My daily bg readings lowered, but A1C didn't budge. My cholesterol sky rocketed, so I went to see my family doctor. He said I should stop worrying about my A1C for the time being, and start worrying about my cholesterol. So I went on a different diet. High complex carb, low fat, no grains, no junk food, everything made from scratch, beans and nuts daily, tons of vegetables and a moderate amount of fruit and animal products. My A1C was still at 5.7 this August, and I don't think it will go anywhere. My cholesterol dropped back to normal levels.

 

The A1C isn't always an accurate measurement. There are better tests out there. And having a perpetual reading in the pre-diabetic range can be acceptable, depending on the individual. I'm not saying this true in your case; I'm just saying this is something you might want to look into.

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