I'm confused

Last July my doctor told me I had pre-diabetes. My fasting blood sugar was 110 and mt A1C was 5.8. She sent me to a nutritionist. The nutritionist gave me a glucose meter and told me when to check my blood sugar. She told me that my readings shouldn't be over 140 at two hours. Sometimes they get around 155. I have been searching different sites and one said to check it at one hour, then again at two hours. I did that just to see what happened and at one hour it was 187 and then at two hours it was 92. Is that bad? I didn't think a non diabetic would get that high. I also had eaten a lot of carbs before that. This has happened twice now.I have talked to two different doctors about this and got two different responses. One doctor said not to worry about the one hour reading because it went down to normal at two hours. The other doctor said that is way too high and if that keeps up we need to talk about taking medication..... why would I take medication if I'm not diabetic?? Normally my blood sugar stays around 90-100. Since my doctor told me about pre-diabetes in July I have changed my diet and exercise plan and I have lost 22 pounds. It just doesn't seem like my blood sugar should be getting that high. Can any one help me with this? Thank you!

I think the best advice would be to go to an endocrinologist or someone who specializes in diabetes and have them run other blood tests to look at the big picture. I would assume that he thought you were pre-Type 2, but as many people on these forums have attested, Type 2 can be misdiagnosed and people actually have LADA Type 1.

Your numbers sound ok, and I know a lot of us would kill for an A1c like that, but it's different for everyone and A1c's aren't always good for giving the big picture.

If it were me, I would continue with the diet and exercise plan and avoid going on medication as long as possible. That is, presuming all other blood tests were in the normal range for a non-diabetic. Also (not saying this is entirely the case with your doctor), but you have to be aware that some doctor's are more inclined to push prescriptions on you. If your numbers are good after losing the weight and continuing with diet and exercise, why should you need medication?

Don't let any of this scare you! Find out all the facts, speak with a specialist, and do all the research you can before making the best decision for you.

When I was first diagnosed my path forward was heavily influenced by the bloodsugar101 website. It presents a whole page of studies that say that going over 140 will gradually destroy your beta cells and your diabetes will gradually get worse. So I decided to make it my goal never to go over 140. I realize this is a very conservative goal but my initial A1C was 13.1 and I have already have a severely damaged metabolism.

Many T1's think that this is too difficult to achieve but there are important differences between T1 and T2. First they have no beta cells to lose, so it may not be as important, and second I have found that I can tailor a diet that allows me to achieve this goal almost all of the time. Since I don't take insulin I am not trying to match my insulin dose to what I estimate the carbs in my meal are or how fast they will hit my blood stream. Instead I just have to avoid the foods that spike me.

The bloodsugar101 website explains how to implement such an "Eat to your Meter" approach. It involves trying meals without the usual suspects like grain, potatoes, fruit, sugar, legumes etc. and testing pre meal and 1 and 2 hour post. This will give you the information to tailor a diet that will allow you to meet your blood sugar targets. When you have achieved your goal you can try gradually adding back different food items one at a time, in reduced quantities, and note the effect on your blood sugar. After you have stable blood sugars you can cut back on the testing. For myself the whole list is still forbidden but you may well be different, especially since you are dealing with it before too much damage is done.

One final note, docs tend to eschew such early intervention and instead tell you to watch what you eat without advocating a testing program. This is flying blind and usually results in the progression of the disease and the requirement to escalate the treatment with more and more drugs. Educate yourself and set goals for yourself don't let anyone do it for you no matter how many letters they have after their name.

Finally if you find you need to restrict your carbs further the Bernstein Group here on tuD is a great resource. Many have found this is quite doable and that there are still plenty of tasty food items they can still eat. I have been eating this way for 2.75 years and have no trouble sticking to the diet. I applaud your proactive stance and wish you the best of luck going forward.

Hi Ann: I agree with KCCO; too often doctors will jump to the conclusion that pre-diabetes means pre-Type 2 diabetes, but as so many TuDiabetes members have found, pre-diabetes can mean you have just caught the onset of Type 1 autoimmune diabetes early. It is SO important to make the distinction between Type 1 and Type 2 diabetes, because the treatments are very different (especially in the early stages). I have written several blogs that may help (10 Tips and We Need a Detective in the House/Misdiagnosis). The tests to ask an endocrinologist for are the full autoantibody suite (glutamic acid decarboxylase antibodies (GADA), islet cell antibodies (ICA), and/or insulinoma-associated (IA-2) autoantibodies), and a c-peptide test is also useful. Also, going lower carb can help keep blood sugar spikes down.