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Medical Forum / Diseases and Disorders / Diabetes / April 2006

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Not yet diagnosed - on the borderline

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systemswamper - 04 Apr 2006 23:55 GMT
Hi

Last FBG level came at 6.0 mmol per litre exactly.  Physician does not
diagnose me yet, but range of 6.1 to 6.9 means suboptimal usage of
chemistry.

To me, being on the borderline like this means that I can (and I
probably do) go over the threshold often.

I am looking for advice - what can I do at this stage to increase my
chances of NOT crossing this threshold ?  Can this in fact, be
prevented ? The physician has already told me that my condition will
deteriorate over the years no matter what I do.  Is this true ?  Sorry
- I dont know much about diabetes.

I eat virtually nothing betwen supper and going to bed, and I do my
blood test as soon as I get up, before breakfast and after a shower. Am
I missing something ?  Thanks again for your kind help.
Susan - 05 Apr 2006 00:01 GMT
> Hi
>
[quoted text clipped - 14 lines]
> blood test as soon as I get up, before breakfast and after a shower. Am
> I missing something ?  Thanks again for your kind help.

Start here for managing your blood glucose:

http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

And here for straight talk and good research to help you understand
diabetes:

http://www.phlaunt.com/diabetes/

And take heart; your doctor is wrong about inevitable progressive
deterioration.  Many folks find that diabetes is a wake up call that
causes us to develop healthier habits and more fitness than we ever had.

Susan
Loretta Eisenberg - 05 Apr 2006 00:56 GMT
I dont know if you are diabetic,  Is borderline like almost pregnant,
Please go to alt-support-diabetes.org and read about our standard
testing procedures.  You should ask your doctor for an affirmative test
to know if you are or you are not.  You sure are creeping there and
since it is a progressive disease, I dont know if it can be stopped in
its tracks.

Give us some information as to your age, your weight without being
specific and what you are eating at your mealtimes.

Good luck and follow the advice on our website,  It wont steer you
wrong.

Loretta

--
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.
systemswamper - 05 Apr 2006 02:27 GMT
Hi,

I am almost 46 years old, I weigh about 179 pounds fully clothed.
Mealtimes:  Breakfast is generally 1 or 2 toast, and/or a boiled egg
(about 4-6 eggs per week, maximum).  Lunch is usually a large salad
with french dressing 2 times a week, or a tuna sandwich, or, a smoked
meat sandwich.  I usually drink about 2-3 mugs of sugarless tea a day.
I rarely drin juice,but I eat about 5-8 bananas per week as well as the
same number of oranges.

Supper:  Usually 1 to 2 indian bread with curried vegetables, or dal,
chinese noodles stir-fry with lots of veggies and chicken breasts, fish
at least once a week, etc.   When I have a relapse, I eat 2 donuts a
week without icing (classic donuts) etc.......

Today, I had chinese noodel stir fry.  At 1 hour post meal, I hit 8.3
mmol per litre.  2 hours later, I dropped to 5.4 mmol per litre.

I am confused by something ... the web site
http://www.phlaunt.com/diabetes/14045621.php

talks about the 7.8 mmol per litre target 2 hours after meals, but the
web site

http://alt-support-diabetes.org/NewlyDiagnosed.htm

talks about this target 1 hour after meals.  What am I missing here -
is one for non-diabetics and the other for diabetics ?

Thanks again for your kind help.
Alan S - 05 Apr 2006 03:19 GMT
>Hi,
>
[quoted text clipped - 26 lines]
>
>Thanks again for your kind help.

Glad to see you read them. And it's excellent to see good
questions coming as a result.

Answering the last question first. 7.8(140) in the
http://www.phlaunt.com/diabetes/14045621.php link is based
on data from scientists who, for some inexplicable reason,
rarely test at one hour but only at two.

The advice in
http://alt-support-diabetes.org/NewlyDiagnosed.htm is based
on experience by past posters here as well as other
references - hopefully the author may answer that herself.

My own take is that whether it is at one hour or two is
irrelevant - just try not to exceed it at any time. That's
why, after a period of learning, instead of testing at one
or two hours you will test at the time you have discovered
when your post-meal peak occurs.

Of course that is a goal, not a mandatory threshold. If you
do go over that, don't panic but use the experience to learn
why and try not to repeat it.

Now, back to your menu. Little things that you might check
on once you start testing.

"Breakfast is generally 1 or 2 toast, and/or a boiled egg
(about 4-6 eggs per week, maximum)."
Eggs - no problem. However - many of us have problems with
carbs at breakfast. I doubt that you'll still be eating two
pieces of toast after you start testing. I don't even eat
one. To compensate for the loss of calories (if you need to)
add sauteed veges - onions, mushrooms, capsicum etc or meat
or fish as fillers to an omelette or as a side.

"Lunch is usually a large salad with french dressing 2 times
a week, or a tuna sandwich, or, a smoked meat sandwich."
Again, no problem with the filling. However - the bread and
rolls are a possible difficulty; similarly, the level of
sugars in your brand of french dressing may need
investigation. My lunch sandwiches are double filling, open
no one slice of multigrain. Eat them carefully:-)

"I rarely drink juice,but I eat about 5-8 bananas per week
as well as the same number of oranges."

I haven't eaten bananas, oranges or drunk juice since I
started testing - except to treat hypos.

I do eat fruit, in small portions (usually halves) as snacks
between meals. By testing I have found when, and in what
portion size, I can eat them. Apples, pears, stone fruits
etc or small portions of berries. If in doubt, berries are
better.

"Today, I had chinese noodel stir fry.  At 1 hour post meal,
I hit 8.3mmol per litre.  2 hours later, I dropped to 5.4
mmol per litre."

No surprises there. For US readers 8.3 is 150mg/dl, 5.4 is
just under 100. You also demonstrated why the one-hour test
is a far better indicator for us than the two-hour.

It was almost certainly the noodles, not the ingredients
unless there was sugar or cornflour/starch in the sauce.
Hopefully, you didn't have rice with them.

When I eat noodles or pasta these days, I double the
vege/meat/sauce component and halve the noodles/pasta.

Congratulations - nice to meet a newby who is prepared to
try testing and analysis of the results from day 1. You'll
be back here in six months teaching newbies yourself:-)

Cheers Alan, T2, Australia.
d&e, metformin 2x500mg

I have no medical qualifications beyond my own experience.
Choose your advisers carefully, because experience can be
an expensive teacher.

Everything in Moderation - Except Laughter.
JJ Jones - 06 Apr 2006 23:29 GMT
I'm a newly-diagnosed prediabetic.  I was very confused at first, but
now its been about 2 months and I've been reading a great deal about
Diabetes, so I'm not so confused anymore.  Based upon my own knowledge,
here is what I would advise.

1.  Talk to your doctor about getting all of the relevant blood tests.
Most important seems to be fasting blood glucose, A1C, and fats
(cholesterols).

2.  Bring your test results to a good hospital dietitian and have
him/her design a diet for you.  With all due respect to the people in
this group, I would not base my treatment plan on advice from
strangers.  The diet that you follow is of enormous importance in
determining whether your diabetes will get better or worse.

Sometimes dietary needs are non-obvious.  For example, my BG numbers
are pretty good but my HDL (good cholesterol) is low.  So my dietitian
has focused more on that problem than on the problem of keeping BG low.
There are other factors in diet besides just blood sugar control, and
that can be determined from your blood work and from consulting with
your doctor.

3.  If you are overweight, lose weight!!!  That's virtually priority
one.  A lot of authorities say that in some cases simply losing weight
is enough to stop the progress of the disease.  Losing weight will
almost certainly improve matters.

4.  Body mass index.  A person's body mass index is the ratio of their
height to their weight.  You have probably seen these tables that tell
you whether you are overweight for your height.  If you are, then lose
weight.

5.  Pot bellies.  Another risk factor for developing Diabetes are pot
bellies.  Men should have a waist no bigger than 40 inches and women no
bigger than 35 inches.  If you do, then get rid of it (easier said then
done).

6.  A book that I'm now reading says that prediabetes increases your
probability of heart disease by a factor of 4.  Consequently, it is
very important to control cholesterol.  My dietition put me on a diet
of 12 ounces of very low fat meat per day.  Very low fat means less
than 1 gram of fat per ounce.

7.  I test my blood 3 times a day:  Upon waking up and before and after
one of my meals.  I don't have much problem with spikes, but if you do,
then you need to deal with it as soon as possible.

8.  Exercise is extremely important.  I find that exercise
significantly reduces my BG.  Also, aerobic exercise is good for your
heart and cleans the cholesterol muck out of your arteries.  But if you
haven't exercised for a long time, check with your doctor first.
Alan S - 07 Apr 2006 00:46 GMT
>7.  I test my blood 3 times a day:  Upon waking up and before and after
>one of my meals.  I don't have much problem with spikes, but if you do,
>then you need to deal with it as soon as possible.

How long after?

Cheers, Alan, T2, Australia.
d&e, metformin 2x500mg
Signature

Everything in Moderation - Except Laughter.

Priscilla H. Ballou - 07 Apr 2006 17:55 GMT
> 2.  Bring your test results to a good hospital dietitian and have
> him/her design a diet for you.  With all due respect to the people in
> this group, I would not base my treatment plan on advice from
> strangers.  The diet that you follow is of enormous importance in
> determining whether your diabetes will get better or worse.

Hmmm.  The hospital dietition isn't a stranger?

Priscilla
systemswamper - 08 Apr 2006 00:24 GMT
Thak you very much for your advice.
Alan S - 05 Apr 2006 01:38 GMT
>Hi
>
[quoted text clipped - 14 lines]
>blood test as soon as I get up, before breakfast and after a shower. Am
>I missing something ?  Thanks again for your kind help.

Hi

First, to repeat the good advice Susan offered, read this:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

Then, after you've done that, give us some idea of your
daily menu and your lifestyle (active or sedentary).

You could also read this book by Gretchen Becker; it's the
best book I've seen on the subject:

The First Year Type 2 Diabetes: An Essential Guide for the
Newly Diagnosed

She has published a more relevant one for you, but I haven't
read it yet:
Prediabetes : What You Need to Know to Keep Diabetes Away

Try your local bookshops or library, or you can buy both on
Amazon.

Remember, we aren't doctors, just patients like yourself
looking for answers.

Cheers Alan, T2, Australia.
d&e, metformin 2x500mg
Signature

I have no medical qualifications beyond my own experience.
Choose your advisers carefully, because experience can be
an expensive teacher.

Everything in Moderation - Except Laughter.

kincherk - 05 Apr 2006 06:43 GMT
> >I am looking for advice - what can I do at this stage to increase my
> >chances of NOT crossing this threshold ?  Can this in fact, be
> >prevented ? The physician has already told me that my condition will
> >deteriorate over the years no matter what I do.  Is this true ?  Sorry
> >- I dont know much about diabetes.

I wouldn't give up hope.  There have been several studies that have
shown that diet and exercise can delay or prevent diabetes.  Try
searching google for diabetes prevention.  Here's one site I found:
http://www.ndep.nih.gov/diabetes/prev/prevention.htm

> You could also read this book by Gretchen Becker; it's the
> best book I've seen on the subject:
[quoted text clipped - 5 lines]
> read it yet:
> Prediabetes : What You Need to Know to Keep Diabetes Away

I highly recommend this book.  I'm in the same boat and have found her
advice very helpful.  It's a paperback and you can probably pick up a
used copy on Amazon for not much $$, if you can't find it locally.

kincherk
Hi_Therre - 05 Apr 2006 12:36 GMT
>Hi
>
[quoted text clipped - 14 lines]
>blood test as soon as I get up, before breakfast and after a shower. Am
>I missing something ?  Thanks again for your kind help.

To record those values see Sig.
Nicky - 05 Apr 2006 12:43 GMT
> I eat virtually nothing betwen supper and going to bed, and I do my
> blood test as soon as I get up, before breakfast and after a shower. Am
> I missing something ?  Thanks again for your kind help.

You've had the essential diet and testing advice, and you seem to be the
sort who'll do something about it. You also need to have a daily exercise
routine - do you exercise at the moment?

Nicky.

Signature

A1c 10.5/5.4/<6  T2 DX 05/2004
1g Metformin, 100ug Thyroxine
95/74/72Kg

Michelle - 06 Apr 2006 03:55 GMT
>To me, being on the borderline like this means that I can (and I
>probably do) go over the threshold often.

You are exactly right.  I'm in the same boat as you--normal FBS, but
spikes after meals containing certain foods.  If I eat bread, pasta,
potatoes, rice, and of course, sugar, my 1 hr BS will spike at 180.
But take heart.  If you use your meter to test what you eat and
eliminate or decrease the amount of the offending foods, you can keep
your BS within acceptable parameters: <140 at 1 hr and <120 at 2 hrs.
I've been at this for about 6 months and by eating what I know works
for me, my sugars are always within range.

You are to be congratulated for being proactive!

Michelle
T2 spectrum
systemswamper - 06 Apr 2006 19:01 GMT
HI,

Yep,I have my mountain bike on a trainer - I ride it for about 2-2.5
hours a week.  With the onset of summer, I shall again, ride it
outdoors more frequently (the snow is now gone !!!)
oldal4865 - 05 Apr 2006 21:19 GMT
systemswamper wrote in message
<1144191319.994790.39630@u72g2000cwu.googlegroups.com>...
>Hi
>
[quoted text clipped - 9 lines]
>prevented ? The physician has already told me that my condition will
>deteriorate over the years no matter what I do.

   There is a non-prescription therapy proven in formal medical clinical
trials to delay the Progression of Type 2 diabetes

(That's your problem,  by the way,  a "Progression".     You very likely
have been developing diabetes for several years.    The concept of
"pre-diabetes" is based on an arbitrary and almost capricious choice of
blood sugar targets.     Twenty years ago,  your sugars could have been
regarded as "harmless".    Twenty years from now,   those sugars could
easily be defined as "Full-Blown Diabetes".)

The therapy:

  1.  Lose fat lb,  especially abdominal fat
  2.  Gain muscle lb any way you can
 3.  Exercise every day,  the more vigorously the better
  4.  Limit your daily carbohydrate intake;   aim for slowly digesting
carbs;  spread your daily carb over several small meals.

In essence,  the therapy attempts to minimize the amount of insulin you
manufacture.    That somewhat protects your beta cells from a premature
death mechanism which,  sadly,  you inherited.     Items 1-3 reduce your
Insulin Resistance.   Item 4 reduces your absolute need for insulin.

More sad news:   FbG doesn't "catch" about 30% of diabetics.     Your
2-hour-after-eating bG is also very important.   Pay attention to both
numbers.

In any case,  keep coming back.    Diabetes is one of the odd diseases in
which the patient does all the work and most of the management.   The more y
ou know about the disease,  and the faster you learn about it,   the better
your chances for a long and trouble-free life.

Regards
   Old Al
Anil - 06 Apr 2006 19:35 GMT
Dear SystemSwamper,

OldAl has give you the best distilled advice to stay on the
"borderline". Most find it hard but a rigorous exercise of about 60-90
minutes a day is what it takes to stay close to "normal". You will be
surprised how much control you will get over your middle ground by
simply walking briskly.  You seem to suggest you can do better than
just walk the talk. That is even better but a routine that allows you
to stay fit no matter what the weather is will  increase your chances
of avoiding the free fall.

No matter what you eat and you will get plenty of conflicting advice
from this group, stay trim and watch your weight like a hawk. Keep
reducing your weight until you are mid to low range of your "normal"
BMI band. Depending on your preferred lifestyle choose a balanced diet
that works for you.

After being dxed for 9 months with T2 diabetes I am just getting a
grasp of the complexity of this beast. But what has always surprised me
is how a few simple guidlines one needs to follow to stay out of harm's
way.

OldAl has pretty much captured the essence of what you will need to
know at this stage! Do follow it!

Anil
LizardQueen - 05 Apr 2006 21:53 GMT
I wouldn't let your doctors pessimistic view get to you - you don't
know how much it will progress (or reverse) until you try to work on
it.

I'm in about your boat - not officially diagnosed though.  I caught my
fasting of 104 by screwing around with a home glucose meter trying to
figure out where some odd symptoms I had were coming from.

My bg goes up about to yours after meals but usually drops steeply at
the 30-40 minute mark rather than staying up for an hour.  Like yours,
my 2 hour is usually normal.

Old Al gives some excellent advice, definitely listen to him.

It doesn't look like you're much overweight (I am, and am working on
getting rid of it) but if you are try to get rid of any excess
poundage. Cut back on carbs, especially simple ones like noodles, and
exercise as much as you can.

Some people find that a protein snack before bed lowers their fasting
glucose number.  I myself haven't had too much luck there as I bottom
out in the middle of the night and then bounce back up again higher but
it's something you could try.

Good luck and welcome,
LQ
 
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