My husband gets a physical every 5 years and this time his results came back as ‘prediabetic’. The HGBA1C was 6%, and normal should be below 5.6%. This was shocking since he is very slim, eats well and runs about 5 miles per day. At the bottom of the report his doctor wrote “get more exercise and watch what you eat”. He also wants to sign my husband up for some sort of educational class. I’ve been searching for the best interventions and everything focuses on losing weight and exercising. We will try to shift to a more Mediterranean diet but there’s not much room for improvement in lifestyle. Anyone else had their blood sugar creep up despite maintaining a healthy weight? It is worth asking for a referral to an endocrinologist?
Some people lose the genetic lottery. Was there a rising trend visible in the previous HbA1c measurements?
Things to consider:
- Even at a healthy weight, has his body composition changed? If his body fat percentage increased, that can worsen blood glucose control. (A quick check -- has he needed to get larger-waist pants or loosen belts since five years ago?)
- What do you mean by "eat well"? If his diet is high in refined low-fiber carbohydrates, that may not be good for someone genetically prone to glucose control issues. That may indicate shifting to more fibrous carbohydrates and/or reducing carbohydrate intake.
Yes I am hypothyroid and my doc said there is a relationship between the two. When my glucose crept over 100 fasting in the early morning I started taking metformin 1x per day before I go to bed which keeps my morning level in a better range. My A1c is 5.4 down from 5.7 last year before metfirmin. I am high end of normal weight and work out regularly. I eat 1500 calories a day and it is extremely difficult for me to lose any weight so I am all about maintaining things now that I am 60. I do feel better in the morning so that high morning sugar must have been affecting me. My thin athletic H has had his glucose rise from the 80s to the 90s in the past decade. His doc attributed that to aging.
I think it’s worth repeating the test at the very least. I did some googling and found out that the test results can be off by +/- .5%. Found this in one article:
*Any test for diagnosis of diabetes requires confirmation with a second measurement unless there are clear symptoms of diabetes.
My husband has Type II diabetes and I wish I had found this ebook and website when he was prediabetic. Sometimes you just can’t beat genetics. It’s helpful to know what you can do to mitigate long term negative outcomes. My husband has managed to keep his A1C down on minimal medication for three years now. Not always fun but it works.
What do you do? It kind of sounds like the only thing your H CAN do is change his diet (cutting carbs) and maybe start taking metformin. If he’s already at a good weight and if he already exercises, much of the “standard” advice won’t be helpful.
I was eating well and exercising when I was diagnosed with diabetes 12 years ago. The doctor told me I was the healthiest diabetic patient she’d ever had. As ucb says, sometimes you lose the genetic lottery.
Good luck to your H!
There is a difference between subcutaneous fat, which is not necessarily bad for a person’s health. But the fat that is harmful is the unseen fat around your organs which is visceral fat. You can be slim, but have visceral fat, the fat around your organs.
As for eating well, it’s hard to tell what that really means, but anything with added sugar (and there are sugar substitutes, which I wouldn’t recommend either) should be eliminated from his diet. No sugar in the coffee, fruit juices, desserts, etc. Some fruits may be OK, but others may be no-no’s. I’d recommend seeing a professional dietician or nutritional expert and talk to them about his diet.
His fasting glucose was also high, at 111. He has virtually no extra body fat and has actually been losing abdominal fat, needing a smaller belt and pants waist size over the past few years. I attributed it to more aggressive running but perhaps something else is going on. I think he should be checked for late onset type 1 diabetes, which often is associated with normal weight. We do eat a lot of whole grain breads and cereal, I guess those still count as carbohydrates.
Ding, ding, ding.
Thanks for all of the tips! I am lamenting all of the baking I’m not going to do this holiday season…
If you follow a recommended diet for diabetes he should be able to manage just fine! Most of the seniors in my family lived long, long lives and were athletic, playing tennis, skiing etc. into their 80s. All were also hypothyroid (including the men). I want to beat those odds and never slide into “diabetes” from “pre-diabetes.” And yes, there is a strong genetic component especially in “normal weight” active middle agers. There is a fairly active body of research on prophylactic use of Metformin and most of it is positive. At minimum it could slow down the onset of clinical diabetes. I was not afraid to give it a try when my doctor suggested it. I already have taken Synthroid for almost 40 years, so the idea of taking another “pill” for the rest of my life didn’t really scare me. The biggest hurdle are other medical practitioners who when I tell them I take Metformin say “oh are you diabetic” and I say “no” and look at me quizically, the more open-minded ask me about it and I’m always happy to share my story. i must admit, though, that in the past 5 years, bread, pasta and starches are now a “treat” in my life as opposed to a staple food. So I have modified my diet as my metabolism continues to slow down and my body doesn’t process like it used to when I was younger.
My brother in law is diabetic. He is slim and active. Lots of diabetes in his family. Sometimes it just happens.
Thanks @momofthreeboys, I will ask about Metformin. Glad the outlook is so much better now for this disease than in years past.
My FIL died of complications from diabetes when he was 73. For years, he told my husband he had to watch what he ate and get a lot of exercise so he wouldn’t come down with the same disease. So DH is in great shape (runs 6 or 7 days a week), but he’s still on the verge of being prediabetic. His brother is very overweight and doesn’t exercise at all, and he’s fine! It’s a lottery, I guess. I will tell him about Metformin, thanks!
I second r/keto and would also recommend r/lowcarb.
I have PCOS and a family history of diabetes so I try to keep my carb consumption way down… It’s an adjustment, but it’s doable and you don’t really feel like you’re sacrificing anything.
There are also plenty of low-carb baking recipes and cookbooks; you should look some up! I’d be happy to recommend my favorites as well. I also believe that Bob’s Red Mill sells a low-carb baking mix that you can use in place of flour.
I am also very fit healthy and pre-diabetic. I test blood sugar level to come up with a right diet for me. What I noticed was that it’s not just what you eat. In my case blood sugar level depends heavily on when I eat. I now maintain a strict meal schedule and I manage below 120 most of the time.
As a type 2 diabetic for 11 years, it’s as much what you eat more of as well as what you limit. Make sure the carbs are “good” carbs. Fruits and grains that are high in fiber. Brown rice instead of white rice. Watch the sauces like soy and duck sauce. And have some form of lean protein at every meal - chicken breast, turkey, yogurt.
I was very heavy when I started, but I am down over 25 pounds and the numbers are getting better.
Cut carbs. Whole grains are still carbs. Fruits are high in carbs. Carrots, beets, potatoes, parsnips, etc are all high in carbs. Lactose is a carb. A “healthy” breakfast of yogurt, fruit, and granola is loaded with carbs. Beans and lentils and the like can only be consumed in small amounts, unfortunately, despite their healthy fiber. Brown rice is better than white rice, but it still has to be limited to about 1/3 of a cup of cooked rice. Only the minimum serving of pasta is okay: check the box. Fruit juices are out. Grapes and citrus fruits are loaded with sugar. A SMALL apple is your best bet: 15 gms of carb in a 100gm apple. Watery fruits like strawberries. You have to get a sense of how much of each thing you personally can eat by doing a lot of testing at first.
Get over the idea that natural fats are “bad” and whole grains are “good.” Think (mostly) lean meats, fish, eggs, green leafy vegetables as the core.
You can find breads that have about 12-13 gms of net carb per slice. Not the world’s greatest bread, perhaps, but it enables you to have a sandwich w/o busting the carb bank. There are also low-carb wraps. To my knowledge, Bob;s Red Mill does not have a low carb baking mix. They do have a gluten free mix, but that won’t help you.
Pairing protein and/or fat with a carb slows down the absorbtion, and thus keeps the blood sugar on a more even keel. Try to keep carb consumption at any one meal below 20gms most of the time.
Many people find that they need to avoid carbs most rigorously at breakfast, because the “dawn phenomenon” causes blood sugar to surge then anyway.
Metformin remains the gold standard. The newer drugs usually push the pancreas to produce more insulin, which burns out the insulin-producing cells faster and can cause T2s to have dangerous lows. The dose has to be increased gradually in order to minimize the side effects of gas and diarrhea. I find that if on 1500, it helps to take 500 in the morning and 1000 at night, rather than the reverse.
Agree with grapes. Not sure about citrus. I had grapefruits and measured blood sugar level. Eating grapefruits even sweet grapefruits didn’t affect me. Bananas on the other hand were bad.
That’s probably a good idea, @momsquad - it turned out that I have late-onset Type 1. If I’d known that earlier, i could have started insulin earlier (and saved myself all the grief of those ineffective oral meds I tried.) There are blood tests that indicate whether or not your body is still producing insulin, which can really help with your treatment regimen.
Citrus fruits are pretty carby - not as bad as bananas, but not great. (one small orange has about 12 cards whereas a banana - the worst fruit for carbs! - is about 25 grams.) But igloo raises a good point, in that it really depends on how your body reacts to/processes the carbs you eat.
Maybe Igloo has no problems with grapefruit, but I can’t even look at an orange without spiking my blood sugar. On the other hand, it turns out that I can eat all the dark chocolate I want without ever impacting my blood sugar. It makes no sense, but I’m not complaining. It’s a win for me!