Hi, I'm Suzanne and I've been officially pre-diabetic for a little over 3 months. A1C was 5.8 in February and 5.7 at the end of May. I've been eating relatively low-carb (75 grams per day), and I think it's working out well - I've lost about 7 pounds in 5 weeks and BG is mostly staying at reasonable levels - especially in the last 2 weeks since I stopped buying crackers, chocolate bars, etc. Still coming to terms with the fact that this is forever. Anyway, happy to be here. : )
Suzanne, we're happy to have you here - so glad you found us ;) It sounds as if you're doing a great job beginning to manage! You'll find loads of information and support here. Keep posting, ask whatever you wish. Stop in the chat room some time if you wish.
Hi Suzanne....cute cat! Welcome to our family. Have you had your Type confirmed? Feel free to ask questions; lots of knowledgeable people here!
Hi Zoe. Thanks for the welcome and on behalf of Simon (the kitty).
It's been assumed that I'm pre-Type 2. There's a strong family history - my father, uncle and both aunts had Type 2, as did their aunt and possibly their father...
Just worth checking out, especially if you are not overweight, have been losing weight and/or have another autoimmune condition. Many of us were misdiagnosed as type 2 due just to age. If there is any question, antibody testing and c-peptide will tell you which it is.
Hmmm...I had been 10-15 lbs overweight, although I'm almost at my goal now. But I didn't start losing til I cut the carbs. I was eating a LOT of carbs before getting that A1C result in March - probably several hundred grams a day. I don't have any autoimmune condition that I know of. I may ask for antibody testing at my next Drs appt, but I seriously doubt it's anything but pre-Type 2 in my case. Is there even a pre-Type 1?
Technically, there isn't any such thing as pre-Type 1. Type 1 generally comes on very quickly, and the only people I know who caught true T1 very early are families with more than one child with diabetes.
However, there is LADA, which is slow-onset T1. That one almost always gets misdiagnosed as T2 at first and then switched. As Zoe said, that's due to age (and a general ignorance about LADA).
I agree that it's worth getting checked out now, because it'll save you some trouble in the future.
Also, if you're seeing an internist for your diabetes care, please switch to an endocrinologist if you can. I recommend this because, even though you may not need it now, most of us find that an endocrinologist is much more educated about diabetes (as they should be!). Developing a relationship with an endocrinologist now, rather than later when you really, really need it, seems like a good option to me.
It can't hurt, Cacomistle, to know for sure. No, it isn't called "pre-Type 1" but there is a slow onset version of Type 1 called LADA. I was misdiagnosed as Type 2 due to age and did fine on oral meds for 15 months until my blood sugar started to rise and I figured out I was Type 1. You may, in fact, be Type 2, but it is important to get the testing and know for sure.
Thanks for the info and suggestions.
I'm not happy that you need to be here but I'm happy that you have found us. Next to your medical team this place is the best resource available.
Being pre-diabetic is unfortunately a forever thing but it doesn't necessarily mean that you will have complications or even that you will always have symptoms of diabetes. Most people with pre-diabetes can improve and forestall the progress of diabetes if not forever at least for a while.
Oh and I agree with Zoe, Simon is a cool looking cat.
In a real sense, there is a "pre-Type 1." The autoantibodies will usually be detectable before actual diabetes diagnosis (fasting BG greater than or equal to 126 mg/dl). Type 1 TrialNet has performed autoantibody testing on thousands of non-D relatives of Type 1s, and the researchers can predict with some degree of certainty the timing of overt diabetes. The autoimmune destruction of the beta cells can go on for a long time. Usually some trigger (often an illness, or in the case of autoimmune gestational diabetes, pregnancy) pushes a person over the edge to overt diabetes.
Thanks for the clarification, Melitta.
Welcome to the family Suzanne sorry you had to join us, but I am thrilled you found this group early in your life with D.
I recently read a great article by Riva Greenberg on the Huffington Post. Riva is a Type1 D and an author and advocate for PWD in this article she explains the misnomer of "pre-diabetes" . http://www.huffingtonpost.com/riva-greenberg/prediabetes_b_3023146.html
Congrats on already understanding the carb/blood sugar connection and also on your weight loss. I echo the other comments about finding and establishing a relationship with a good endocrinologist or a Certified Diabetes Educator (CDE) to help out should things change. I have had T1D for 38 years and count my CDE as a friend even more than a nurse/educator.
Suzanne - While I'm sorry that you have to deal with this lifetime metabolic challenge, I congratulate you on your perceptive and wise course of action. I think many people, if not most, when presented with the same facts would have made different and less appropriate choices.
Clare's citation of the Huffington Post Riva Greenberg article provides some context as to the social/medical "norm" for people given a diagnosis of "pre-diabetes." It seems that the "pre-diabetes" euphemism enables the patient to deny the reality of their situation.
I'm curious about your thought process. Did your diagnosing doctor explain that "pre-diabetes" is really a much more serious finding than it appears? Or did you conclude that a pre-diabetes diagnosis was indeed serious business? What led to your quick adoption of a restricted carb diet as an appropriate tool for your situation? Did you get persuasive advice from a friend or a particular source like a book or an internet blog?
You made, I think, an unusual yet very effective choice given your circumstances. I'm interested in the fuller context and who or what provided the essential influence for your healthy choice.
Thank you and good luck on your new journey!
A very thoughtful and perceptive set of questions, Terry. Suzanne, I too would be very interested in knowing what led you down this path. As Terry says, it's rare for a patient to take the "pre-diabetes" label as seriously as it deserves to be -- just how truly unusual it is, you will grow to appreciate.
Congratulations on your assertive, proactive approach to membership in "the club no one wants to join". You are on the right track and your long term prospect is very bright indeed. And as you'll also come to appreciate, connecting with this community was the right thing to do. It contains an unmatched wealth of shared experience as well as a place to discuss your experiences with others who truly get it. Please keep in touch and let us know how you're getting along!
David
P.S. We live with three felines. They send their best to Simon. ;-)
Thanks to everyone for the welcome messages and support!
Terry & David, to answer your questions about how I got on this path somewhat early in the game - this is kind of a long story, but I'll try and be concise so no eyes glaze over. : ) I had insisted on the A1C test at every physical because there was so much Type 2 in my family and because I knew I wasn't eating well - sugar and carbs were my life. Before this year, my doctor didn't really think it was necessary but did it because I asked. When the 5.8 result came back, she referred me to a nutritionist, who gave the apparently typical advice of 45g carbs per meal and 15g for snacks. This sounded incredibly restrictive and made me feel like my life was over. Then I stumbled onto another forum where most members eat under 100g per day (much less in some cases) but high levels of some fats. At first this depressed me more - I like to bake, I like to eat out, I like Starbucks, etc - but then I turned up some low carb, higher fat recipe sites. The idea that there was a way to still bake and have dessert kind of sustained me. I'm still struggling with how few carbs and how much fat I'm comfortable with. The nutritionist I saw was not in favor of this whole thing and said that carbs could be up to 50% of my calories. I'm seeing her again in a couple of days and she won't be happy I've been doing this...too bad. I've lost 7 pounds in the 5 weeks since I last saw her, which may dampen the objections.
As to how I came to take the whole thing seriously, it's partly a matter of having seen what my father, uncles and aunts went through with this - heart attacks, stroke, neuropathy and (for my father and one aunt) shortened lives. Also, I seem to need to make a project out of things in order to deal with them, so I've really gotten into researching and testing my blood sugar. The results don't always thrill me, but it's gotten better since I stopped buying sweets and cut back on bread. It's going to be an ongoing struggle - I'm working on ways to eat out (and enjoy it) and to walk into Starbucks without consuming 60g of carbs in a sitting.
My primary care provider is great, but I can tell her knowledge of diabetes is limited. She used the word "cure" in relation to getting this under control, and I understand from what I've read that my body will never handle carbs well. I know I will want to bring in an endocrinologist at some point.
Again, it's been a long story, but an amazingly long and convoluted thought process has taken place over 3+ months.
David, Simon says Hi to your kitties. : )
I agree there is definitely pre type 1 and I feel I was having symptoms on and off for years, starting out with hypoglycemia 10 years before I started to go into dka. But it never showed up in my bg tests, not even 6 months before I dkaed. I think if I had tested at the right times though it would have shown much higher bg.
I wonder if my doctor had done antibody testing then if it would have shown up.. my guess is yes and then I could have maybe prevented what happened with better management and treatment. Maybe I could have even prevented the full onset with all the new research available now.
Suzanne - Thanks for satisfying my curiosity. While I am a person with type 1 diabetes, I have done quite a bit of reading on type 2 diabetes as well. My take on the Riva Greenberg article in Huffpo is that if type 2 diabetes is detected and acted on early in the process, there exists a wonderful opportunity to slow down or even stop the process. Not cure, but possibly, to put T2D into permanent or long-term remission.
If I were a person like you, this is what would excite and empower me. Your personal interest in asking questions and "making a project" out of things all work in your favor.
I adopted a lowered carb way of eating a little over a year ago. I've been eating about 50-70 grams of carbs/day, with some days under 50. My protein consumption has not changed and remains normal. The fat in my diet, however, now makes up about 60% of my daily calories. This is the part that freaks out the traditional medicos, dietitians included. This way of eating led to a sustained 15% weight loss, a 50% reduction of total daily insulin, a significant drop in my A1c, and a marked drop in the number and severity of hypoglycemic episodes - a critical element of my personal safety.
The medical establishment has swallowed the idea, hook, line, and sinker, that "fat makes you fat," and that "fat causes heart disease." From my reading, research, and personal experience, I reject these assertions. In fact I think that this advice is dangerous and has contributed, in no small part, to the current epidemic of obesity and type 2 diabetes. And they've not put a dent into the rate of heart disease!
It is not difficult to sustain a low carb way of eating. I'm not on a diet; I've changed my entire way of eating. I've done it for a year and there are several TuD members that have done it for many more. I don't get the food cravings that characterized my low fat, high carb former way of eating. I'm not hungry between meals. I feel the same freedom from carbs that I felt from cigarettes when I quit smoking. Carbs do have an addictive quality.
You have not only discovered some important information but have also acted on it. Congrats on your weight loss! When I started my low-carb regimen, it was primarily to normalize blood glucose. When the weight started dropping off, I was surprised and very pleased. It has truly improved not only my diabetes regimen but also my health in general.
I salute your nutritional activism. Be aware that you may get some strong push back from the medical/nutritional community. Not all of them hold those beliefs, however. Check out the Low Carb Dietitian website.
By the way, I occasionally treat myself to a Starbucks coffee of the day along with a sausage and egg breakfast sandwich. The sandwich uses an English muffin. I throw out the larger of the two bread halves and eat it open face. That reduces my carb consumption to 21 grams, a less than optimal but acceptable amount.
I'm hoping that you will post a few diaries about your story as it unfolds. You represent an interesting and unusual case. Let's hope it's the wave of the future!
I'm not going to rehash what Terry says above since he says it so clearly and succintly. I do feel compelled to reinforce one point, however: what he refers to as "pushback" from the professional community. If you even mention the idea of low carb, you'll get that, all right — in spades. That dietitian who advised you to eat 50% of your diet as carbs (sheer insanity, in my book) is a perfect example
My diet, and the results it has produced, are nearly a carbon copy of Terry's — right down to the high fat diet and unanticipated weight loss. Oh, and one other thing resulted from my new diet: improved lipids. And when I say "improved", I mean drastically.
In my experience, the prevailing current of opinion in medical circles is years behind reality when it comes to nutrition. You need to be your own expert. After all, who knows more about your body than you? And who has more at stake?
Thanks to you both for the encouragement. I'm kind of dreading the nutritionist visit Tuesday - I know she'll try to talk me into not doing what I'm doing, and I don't enjoy confrontation. My doctor is pretty much OK with the dietary changes because my lipid profile has generally been great, although she does want to check my lipids in 6 months "if I'm going to be doing something crazy (said with a smile)."
I've read in other forums that low carb/higher fat has led not only to great blood sugar control but in many (though not all) cases to better lipids as well. That is a large part of what has made me want to at least try out this path.
As for Starbucks, I think I'm going have to sneak in my own low-carb baked goods and just get an acceptable coffee drink. : )