Pre Diabetes and high blood sugar

I was told two weeks ago I have all the right signs for pre diabetes. The doctor prescribed Metformin 500mg twice a day and diet/exerciser.

If my doctor had told me I had cancer and needed chemo I would have said yes sir. So I have been treating exercise like chemo and have stayed regular. I have cut all bad foods and processed sugars out of my diet.

The issue is my blood sugar is still hanging around 150 and when I exercise it jumps to 250. I don't get. Any suggestion of good books or next steps. I re visit my doctor in two weeks and although I feel better I am not seeing my sugar drop. Any help or feedback would be great.

When you exercise it goes up? Usually bg goes down when you exercise. But like we say YDMV (your diabetes may vary). I sometimes go high when I'm at practice. Are you drinking something sugary when you are working out? like gatorade or something of the sort?

Think Like a pancreas-Gary Sheiner (not sure if I spelled it right) but its a good book that's what I'm reading right now. Has a lot of tips in it. Since you aren't on insulin you can just *ignore* those parts but they are good tips too and good to keep in mind if you ever do go on insulin.

Tud is a GREAT site for information and resources. is also a good site for information as well. Hope this helps a bit.

Welcome to the club no one wanted to join! I'm sorry you've been put in this position, but this is a wonderful place to learn.

The first thing I have to say is that Metformin's effects are mostly cumulative--meaning that you won't see large improvements right away. It takes about six weeks for the medication to fully "kick in".

Next I want to say that it's good to see a pro-active doctor around here! Your doctor did the right thing dealing with it early.

Now I have some questions.

1 Did they draw an A1c? That's your average blood sugar over three months, and it helps to determine how high your blood sugar consistently runs.

2. Do you exercise in the morning or on an empty stomach? If you are, that could be causing the high blood sugars there. Also, how long are you staying up there? Another also, many people find that exercise--especially weight lifting--raises them.

3. Are you sure you aren't having a low blood sugar while you're exercising? Metformin doesn't cause lows, but the exercise, especially since you're new at it, may be dropping you. If it is, then the 250 could be what we call a rebound high, which is when your body does its best to bring you back to where you should be but it overshoots and makes you high instead.

4. When you say "hanging around 150", is that a fasting number or a post-meal number or a random number? The context of the number is important. For example, I'd be more concerned about a fasting number of 150 than a 2 hour post-meal number of 150.

I wish you lots of luck and feel free to ask any questions you want!

many discussions on this

The definition of "Bad Foods" for a T2 is a contentious issue. While processed sugar is an obvious no no many of us find the naturally occurring sugars in fruit to be just as problematic.

Most people are surprised to learn that starch is just a problematic as sugar for many T2's. The reason is that our bodies are equipped to convert starch quickly to glucose which is readily absorbed, the end result is that starch hits many of our bloodstreams like a ton of bricks.

The solution is to "Eat to Your Meter" which means you test extensively and determine what foods are causing you problems. Then you either eliminate them or restrict quantities until you get your meter readings down to a non dangerous range. A very concise explanation can be found at the bloodsugar101 website that AliciaM linked to. Pay particular attention to the "How to Control your Blood Sugar" link. The result is a customized diet tailored to your individual body.

Since you have been diagnosed a pre-diabetic it is probable that you can get by with a less restrictive diet as compared to someone who waits longer to get their blood sugar under control, like me. Many docs treat pre-diabetes as a minor concern, but they are wrong, don't be fooled.

Thanks for the feedback. You are right I am eating all sorts of fruits to curve my appetite. Saturday I was in Michigan eating Michigan sweet Cherries and it spiked me to 275. What would you consider bad fruits that I should stay away from?

275 is *extremely high*. Make sure your hands are clean when you test. If you see repeated numbers like this, I suggest you find a doctor who knows something about diabetes who can run the right it sounds more like you have full blown diabetes, not pre-diabetes.

Diabetes is diagnosed at the following levels, according to the National Insititutes of Health:

See here:

A random plasma glucose of over 200 along with
hunger, thirst, urinating a lot is also enough to diagnose diabetes.... (i.e. a person without diabetes should *never* see BG this high).

See diagnostic criteria here:


Personally about the only thing along those lines I can eat without an unacceptable spike are berries in small quantities. I almost always eat them with nuts and a few squares of dark chocolate (70% or better). The fat in the nuts and chocolate helps slow the carb absorption so that even my feeble pancreas can handle it without a spike. This is a nice treat, it's important to not feel deprived or you will stray from your diet.

Remember test extensively at first and make changes in your diet based on what your meter tells you. Some can tolerate small quantities of green apples for instance, the only way to find out if you can is to test. My personal goal is to never go over 140, any food that causes a spike over this is off my list. Fast acting carbs cause cravings for more in many people. For me eating carbs to curb hunger is a self defeating strategy. I have found a diet with high fat, moderate protein and low carbs mostly from vegetables to be extremely satisfying in a way my carbaholic diet pre diabetes never was.

Another website I would recommend is the Low Carb Dietician. Read her blog from the beginning. Lots of good info there. She is a RD and CDE and has blood sugar issues of her own, so she has a lot of credibility in my book.

I know that with your recent diagnosis this is lot to process, but this is all quite doable, as many around here have found.

Well, at my T2 house, all fruit except strawberries and blueberries raises my blood sugar higher than I want it.

Hey boyordy:

Reading all the posts I would agree that it is debatable whether you're pre-diabetic or have full blown diabetes. The good thing is that you're doing something about it.

It was only about a year ago that I was going through the same thing after my initial diagnosis. In retrospect I'm stunned how little I knew about nutrition at the time and how many foods I was eating that I thought were "healthy" but were actually shooting my BG through the roof. We've been told all our lives that fruit is healthy. For someone with impaired glucose control, it can be a disaster. Bananas, oranges, apples, pineapples, watermelon all rocket me into the 200's and 300's within minutes. The other one to be careful of is yoghurt, milk and cereal. Most commercial "low-fat" yoghurts are so fortified with sugar to make up for the flavor loss of removing fat that they contain more sugar than the equivalent portions of ice cream. Most processed foods are to be avoided. They have more hidden sugar than most people realize. Also, most artificial sweeteners in powdered form contain dextrose as a bulking agent, so if you pouring Splenda/Equal/Sweet and Low into your coffee, you'll see it raise your BG. They claim to be "Sugar Free," and technically they are if you use the strict definition of Sugar (Sucrose). However any substance ending in "ose" or "ol" will most likely raise your BG. Stevia in tablet form is the only sweetener I have found that won't.

There is so much deceptive labeling making you believe you're eating something healthy: "steel-cut, whole-grain, low-fat, net-carbs, etc." Ignore them all and only follow the real measure of truth - total carb content on labels (carbs=sugar) and your meter readings post eating these foods. I learned pretty quickly that the foods that caused the most gradual and manageable rise for me were the ones that are sold at the perimeter of the grocery store, not-processed, and usually not boxed or packaged: i.e., all non-starchy vegetables, avocados, almonds, pistachios, beef, pork, fish, chicken, sour cream, real butter, eggs, to name a few.

Regarding exercise: Different types of exercise have different effects on people. Cross training will shoot my BG from the 80's to 150's in no time. Running will bring me down about 10 points for every 30 minutes I run. Lifting weights will do the same. Mountain biking brings me up 30 points in an hour. Walking for an hour will bring me down 10 points. Everybody responds differently, so it is key to test and log what different effects different activities have and then tailor your specific exercise program accordingly. And for the ones that you love that raise your BG, you can manage with the right insulin dose. I take 1 unit of Regular Human insulin before I ride my mountain bike and keep my BG flat that way.

Regarding good books: The ones that had the greatest impact on me are: Dr. Bernstein's Diabetes Solution by Dr. Bernstein, Blood Sugar 101 and Diet 101 by Jenny Ruhl, Wheat Belly by William Davis, and Born to Run by Christopher McDougall.

All the best!


Being Pre-Diabetic is like being a little bit pregnant, you either are or you aren't. The term is just a play on words designed to get your attention and hopefully motivate you to do something now rather than later. The numbers that you are seeing to me indicate that you have T2 rather than Pre-Diabetes. It is just a matter of definition because after all you have had T2 all along it was just in its early stages.

I like the way you have attacked this disease, diet and exercise are the most important things for a T2. They are the best way to fight the insulin resistance that is so prevalent in T2.

Exercise causes strange BG levels at times. It can raise or lower you BG. It can lower levels because your muscles are consuming the glucose in your body. Exercise can also raise BG levels because it can cause your liver to release some of the glucose that it has stored.

You seem to be on the right track. Diabetes is a lifelong balancing act that some people call their personal science experiment.

Thanks. Its funny because I went from a bad diet to what I thought was a healthy diet fully of hidden sugars. I am eating all of those fruits and yogurt and stressing about why my BG keeps going up. Then I eat something that I would expect to spike me and it doesn't.

Thanks for all the information.

Thanks. I am running 2 miles a day and Stationary Biking in the evening another Five. My goal is to drop 30lbs and hope this helps me. Thanks again for the info this stuff can be confusing and scary.

It is amazing the feedback and advice I have gotten. Thank you for all the help. I hope in the months and years to follow I can provide the same help to others that all of you wonderful people have given me.

Thank You again :)

Lots and lots and lots of great advice here, I second all of it. You definitely want to read those books, especially the ones by Bernstein, Scheiner, and Ruhl. They are among the most basic foundation books for diabetics. All kinds of great information there.

And as you're now aware, all sorts of foods that you might have considered harmless, aren't. You're going to become an expert on nutrition -- every well controlled diabetic is. It's pretty much unavoidable.

I do have to get on one soapbox before subsiding: I reject the term "pre-diabetic". It's a word invented by someone (not sure whom) to downplay a mild case and make it sound less important. But there's no such thing as "a little bit pregnant"; by the same token, there's no such thing as "pre-diabetic". Either one's body can maintain normal blood sugar by itself, unassisted -- or it CAN'T. There is no gray area here.

Thanks David.

One thing that I learned when I was first diagnosed almost 30 years ago is that the ability to learn is the single best determinant of long term success. Of course that means putting into play the things you learn!

You've received a great deal of good advice here, in a very short space. It took me years to assimilate and employ what's written in this short list of responses.

Most of all, you have a great attitude. Accept the reality and learn how to incorporate some new habits that will improve your health. You're asking the right questions! Good luck to you.

One other thing I meant to say and didn't --

The sheer amount of information that's out there to be absorbed can sometimes seem overwhelming at first -- but don't be intimidated by it. Approach it gradually; learn one new thing at a time. Much less pressure that way. You can't assimilate it all at once, anyway, and in fact there's no need to. You're going to be at this for a long time, after all. ;-)

Personally, fruit, unless it's cooked, isn't an issue. But I also don't like many fruits. For some reason, mangoes and nectarines (my favorites) don't bother me. Neither do apples and pears...

I guess it's a good thing I like more vegetables than fruits!