Confused Type 2

For a number of years I was told I have pre-diabetes. Just watch your diet and exercise. I have a meter and was told to test my BS twice a day. My A1C's are usually 5.6 to 6.4. Doc says you're doing well. Last year I saw on my medical info that I am diabetic. I asked if that's true and how did it happen. He said there were 2 times my A1C were 6.8 so now I'm diabetic and no matter how good my numbers are in the future, I'll always be type 2. Nothing has changed as to what I'm to do. Still check BS 2x day, watch my diet and exercise. My morning BS is usually 95 to 115. 2 hrs after breakfast it is lower than fasting number. I definitely could lose about 70-80 lbs, but it is so hard to lose, no matter what I do. I'm always hungry and always craving sweets. I want to prevent complications in the future, but don't know if I should be doing more than I am right now. I'd welcome your comments.

First, a disclaimer.

I have a big problem with the term "pre-diabetic". IMHO there is no such thing; it's like the classic example "a little bit pregnant". Either my body can control my blood sugar without assistance, or it can't. Either I have the ability, or I've lost it. Sure there are differences of degree -- major differences -- but the basic fact remains. Either my body can take care of it, automatically, or it cannot. "Pre diabetic" in my opinion is a cop-out that doctors use to duck spending time on a patient, in the cynical belief that someone with a "mild" case doesn't deserve or need the same care and attention as someone else.

Now then. That being said, I would not lose any sleep over the label. There is an endless debate raging in the diabetes community (here included) over the meanings of the different "types" of diabetes. BUT: which category or labeling pigeonhole someone thinks you belong in is not the point. What matters is what you do about it! At the end of the day, I don't care whether I am "pre diabetic", type 1, type 2, or type 97. I care about normalizing my blood sugar by whatever means necessary. That's the only thing that's going to materially affect my life.

Of course we always want to do better than we are doing, that's just human nature. But an A1c of 5.6 is excellent. If you can stay in that general range, you're doing great.

Now about those carb cravings, I can only report on my own experience; I expect others will want to chime in too. When I switched to a low carb diet, the cravings were very strong for the first week or ten days, then faded dramatically. Not that I don't occasionally cheat, but the bulk of the time I have more than enough self discipline (now) to stay on the right path. The other thing that happened when I went low carb was that I dropped a bunch of weight, which has stayed off for nearly 2 years now, and my lipids dropped like a rock.

There are some very good books out there on this subject. Here are a couple of the best:

Jenny Ruhl, Diet 101: The Truth About Low Carb Diets (Turners Falls: Technion Books, 2008))

Richard K. Bernstein, Dr. Bernstein's Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)

Bernstein's book is my own personal bible. He is too strict for some people, but that's okay. You don't have to follow his advice right to the letter. As with advice from any expert, the rational course is to take what you can use and leave the rest.

Hope you find some of this useful. Please stay in touch and let us know how you're doing!

- David

Thanks, David for all the info. During the years I never lived as though this was very serious because I never showed any effects but after talking with a foot doctor about the possible consequences of the disease it made me rethink that this is real and I need to take better care. I've heard about Dr. Bernstein. I'll check out his book and the other, as well. I always felt better when I ate low carb.

I would second David's comments about the carb cravings, when you stop eating fast acting carbs the cravings disappear. Here's a link to the bloodsugar101 website which I found very useful when I decided to cut carbs.

Sorry to hear of your situation. I have some comparable gripes with my (past) doctors. With a T2 family history & some "prediabetic" numbers, the doctots neglected to test my blood glucose for several years . . . and suddenly I was a T2 with a 14.1 A1c!
To clarify, you're not taking any diabetes meds? If your A1C is creeping up, sounds like your pancreas is losing function. Time for you to take more action (because your doctor isn't!).
A few ideas:
Find out if there is a 'living with diabetes" class in your area--insurance should pay for it.
Rather than "watching your diet & exercise", try some new more intentional approaches. Ie, see a dietitian. Ban white foods from your regular diet. Or get yourself into a more intense fitness routine.
Try one serious change every couple of weeks.
Hang in!

BTW, that web site is operated by Jenny Ruhl, the author of one of the books recommended above. TONS of good info there!

All excellent ideas and not to horn on David(dns) and deborah; I would also check out mediteranean style diets, low carb choices and above all meter 2 hours after meals to get a feel how your body is doing and tune carbs back to enhance.

I would also suggest be sure you are getting regular exercise to help burn off excess glucose in skeletal muscles.

As was suggested you do not want to wait till the diet, liver, kidneys and flailing pancreas conspire to shove your a1c skyward to 8 and above. At the higher a1c numbers 14, and I was at 13.3 it becomes a real chore with diet, exercise and suitable meds to kick out all the excess glucose and get body pulled back to surface of the earth. You will get there but its tough work. As indicated a good pro-active doctor, dietitian, cde and excellent websites like this and researching web ( and there is a stack of crap out there as well as the gold)

best wishes and good luck with your health.