# Pre Diabetes



## CXRAndy (29 Sep 2021)

I've just had a surprising test result for my long term glucose level!

My *haemoglobin A1C* result puts my glucose level where I should take proactive steps to reduce my weight, especially around my midriff. 

My recent doctors appointment basic health checks came back normal. I decided to test my glucose daily with a meter and my results came back within the normal range, so I wasn't overly concerned and since I began a weight loss program by going with low carbohydrates and high fat diet LC/HF.

However the gold standard for assessing blood glucose is to have the A1C test. This eliminates the daily photo shot test results from a standard glucose test. The basic idea behind the long term test is that when glucose is present in the blood stream, some of it sticks to the blood cells and doesn't get released. Blood cells last around 3-4 months before they die and are replaced by the body. So being able to read this level of (sticky) glucose is a perfect marker to gauge long term levels.

*Now the shocker, some 25% of adults don't know they have diabetes and 90% don't know they're pre-diabetic! *If you don't know you're pre-diabetic then then is a high probability you and I will develop full blown type 2 diabetes within 5 years.

I now will have to change my lifestyle long term to reverse my A1C glucose. I will test again in 4 months time to see if my level has began to drop. Its not a rapid process and can take quiet a long time, especially if the healthy diet isn't maintained.

I paid for my test online, via Lloyds pharmacy ( its the diabetes test ), but your GP should conduct the *A1C* test especially if you have a weight issue and raise your concerns about your health. The test involves a small blood sample from a pin prick in the skin to be sent to a laboratory. My result came back in less than 48 hours 

90% don't know- get checked


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## lazybloke (29 Sep 2021)

My GP offers the "over-40s health-check" every 5 years, and that includes the HbA1C test.
So for those of a certain age, there's no excuse not to have those glucose levels checked periodically. They also assess risk of heart disease and so on. Not sure if Covid has affected access to these checks, or even if all GPs offer it; worth investigating.


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## Ming the Merciless (29 Sep 2021)

lazybloke said:


> My GP offers the "over-40s health-check" every 5 years, and that includes the HbA1C test.
> So for those of a certain age, there's no excuse not to have those glucose levels checked periodically. They also assess risk of heart disease and so on. Not sure if Covid has affected access to these checks, or even if all GPs offer it; worth investigating.



Not all GPs offer the over 40s check every 5 years. I was invited for over 40s at 48 and haven’t been invited since. More than 5 years have passed.


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## winjim (29 Sep 2021)

Ming the Merciless said:


> Not all GPs offer the over 40s check every 5 years. I was invited for over 40s at 48 and haven’t been invited since. More than 5 years have passed.


Nobody's ever invited me for an over 40s check but I'm only 43. I guess I could do my HbA1c at work if I was worried - we have picked up diabetic members of staff before during training and analyser validation procedures.


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## Mo1959 (29 Sep 2021)

Never been invited for any health checks and now 62.

Haven't a clue what my cholesterol or blood sugars could be and the way things are going, I can't see routine health screening starting back for a long time.


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## vickster (29 Sep 2021)

Good luck getting blood tests done by NHS GP, my practice can’t do anything routine due to lack of blood tubes (I need a vitamin D check ideally before seeing rheumatologist).

If not had a health check and want one, just ask the practice and see what they say. I think mine got booked in when seeing either doctor or nurse for something else


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## CXRAndy (29 Sep 2021)

It seems pretty much what our family member who was a GP. The testing is patchy at best. 

She suggested that to over egg your health concerns and suggest that you want an HBA1C test, and anything else you can get them to do also


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## lazybloke (29 Sep 2021)

winjim said:


> Nobody's ever invited me for an over 40s check but I'm only 43. I guess I could do my HbA1c at work if I was worried - we have picked up diabetic members of staff before during training and analyser validation procedures.





Mo1959 said:


> Never been invited for any health checks and now 62.
> 
> Haven't a clue what my cholesterol or blood sugars could be and the way things are going, I can't see routine health screening starting back for a long time.





vickster said:


> Good luck getting blood tests done by NHS GP, my practice can’t do anything routine due to lack of blood tubes (I need a vitamin D check ideally before seeing rheumatologist).
> 
> If not had a health check and want one, just ask the practice and see what they say. I think mine got booked in when seeing either doctor or nurse for something else



Good advice, Vickster.
My GP never contacted me either - I enquired after hearing media stories about Health Checks.
They were only too pleased to book me in. So pleased, in fact, that I think they must get a bonus.

But the checks weren't a high priority, I had to wait several weeks even pre-Covid when supply chains were secure. I imagine the checks are a much lower priority today, but if you don't ask you don't get.


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## CXRAndy (29 Sep 2021)

lazybloke said:


> They were only too pleased to book me in. So pleased, in fact, that I think they must get a bonus.


They do get a payment for conducting tests. 

Financial incentive, you'd think GPs would be knocking down all their patients doors


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## Tenkaykev (29 Sep 2021)

Ming the Merciless said:


> Not all GPs offer the over 40s check every 5 years. I was invited for over 40s at 48 and haven’t been invited since. More than 5 years have passed.


There have been various health initiatives over the years where money is directed to one particular area and the GP surgeries get paid to implement them. Once the funds dry up the GP surgeries generally stop offering them.


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## Dogtrousers (29 Sep 2021)

I had a whole battery of tests last year when I had my TIA (mini stroke) and everything came out well, including diabetes tests. Although I don't know if they used that particular A1C test. Still I'm inside "normal" on the BMI (yes, I know, BMI blah blah) chart for the first time in decades, so weight is under control.


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## Ming the Merciless (29 Sep 2021)

Presume most have also seen this article which came out this week?

https://www.independent.co.uk/life-...eans-fat-diabetes-type-2-health-b1928467.html


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## carpiste (29 Sep 2021)

I`ve been getting blood pressure, blood tests regularly from my health centre for several years. They always contact me once a year without fail and I arrange an appointment to see the practice nurse with a follow up visit, or since covid, a telephone consultation with my GP. 
Keeping regular appointments and having these simple tests prevents a lot of long term issues and makes sense to any group practice so I am surprised when I hear the above comments. 
I actually had my latest blood tests last week and just waiting for the results.


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## carpiste (29 Sep 2021)

Ming the Merciless said:


> Presume most have also seen this article which came out this week?
> 
> https://www.independent.co.uk/life-...eans-fat-diabetes-type-2-health-b1928467.html


Thankfully all the jeans I wore when I was 21, some 40 years ago, have been long discarded to both the bin and memory


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## CXRAndy (29 Sep 2021)

carpiste said:


> I actually had my latest blood tests last week and just waiting for the results


It's good news to hear that someone is getting regularly tested.

It would be interesting to know which particular tests were carried out. 

My GPs just generally say everything is normal, I have to literally interrogate them to explain the results in detail.


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## CXRAndy (29 Sep 2021)

I did get down to my early 20s size a few years ago. Unfortunately I did it by calorie deficit, not really understanding the types of food, I should have been eating. I was always hungry

I'm now using LC/HF/Keto regime and whilst reducing in waist, I dont feel hungry between meals, which is a real bonus to fighting off cravings


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## vickster (29 Sep 2021)

carpiste said:


> I`ve been getting blood pressure, blood tests regularly from my health centre for several years. They always contact me once a year without fail and I arrange an appointment to see the practice nurse with a follow up visit, or since covid, a telephone consultation with my GP.
> Keeping regular appointments and having these simple tests prevents a lot of long term issues and makes sense to any group practice so I am surprised when I hear the above comments.
> I actually had my latest blood tests last week and just waiting for the results.


But do you have an actual diagnosis/cardiovascular/metabolic history. Take any medication for such? If so, it makes sense that you are monitored regularly for disease progression/effectiveness of any medication.

The comments of not having checks are more related to screening type checks rather than disease monitoring it seems?


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## carpiste (29 Sep 2021)

vickster said:


> But do you have an actual diagnosis/cardiovascular/metabolic history. Take any medication for such? If so, it makes sense that you are monitored regularly for disease progression/effectiveness of any medication.
> 
> The comments of not having checks are more related to screening type checks rather than disease monitoring it seems?


As it happens I do have a history, yes, but I was getting yearly checks prior to those coming to light. I am not alone as all my family, over 40, have also been getting regular checks at the same practice. My brother was recently diagnosed with cardiovascular disease as a direct result of the same screening. I suppose it could well be he and others are checked regularly as a result of my diagnoses and are checked in case there is a hereditary factor.
Either way, without going into politics, my point was that some group practices have different ideas when it comes to regular health checks and how far they go with the checks. I guess I`m one of the lucky ones. Oh ,and I hasten to add, it is a NHS practice.


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## Domus (29 Sep 2021)

I'm 67 and just had my annual Health Check at my GPs practice. I too am Pre Diabetic with an HBA1c reading of 43. Normal reading is 21 - 40.
42 - 47 is potentially higher risk of developing Type 2.

My diet is pretty good, no meat, no dairy, no alcohol however my downfall is cakes and biscuits. My exercise apart from cycling is very poor so it may spur me on to have a go at the Couch to 5K again. Started at the first lockdown then pulled my Achillies. New shoes needed methinks.

Signed up for NHS Diabetes Prevention Programme. Phone consultations to advise and encourage. First one is this Friday. I know what to do but doing it is another thing, group encouragement can't hurt.
Here


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## iluvmybike (29 Sep 2021)

I'm 68 and do not recall ever having been invited for a health check. Our GPs seem to be overhelmed dealing with ill people and doesn't see to have time for these things - even though knwing early means you can deal with certain conditions


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## Mo1959 (29 Sep 2021)

iluvmybike said:


> I'm 68 and do not recall ever having been invited for a health check. Our GPs seem to be overhelmed dealing with ill people and doesn't see to have time for these things - even though knwing early means you can deal with certain conditions


Yes. Seems common sense that prevention and/or early intervention would be an awful lot better than trying to treat an established condition.


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## Ming the Merciless (29 Sep 2021)

Dogtrousers said:


> Aged about 19 or 20, and very dissatisfied with university life, I noticed that all students wore jeans. I've not worn jeans since then. So I'm ok



One size fits all elasticated trousers?


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## winjim (29 Sep 2021)

How do you define a 'normal' patient?

Someone who hasn't had enough biochemical tests yet.


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## CXRAndy (29 Sep 2021)

Mo1959 said:


> Yes. Seems common sense that prevention and/or early intervention would be an awful lot better than trying to treat an established condition.


Thankfully diabetes can be reversed as well as being prediabetic for most. Diet and willingness is the key


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## carpiste (29 Sep 2021)

Domus said:


> I'm 67 and just had my annual Health Check at my GPs practice. I too am Pre Diabetic with an HBA1c reading of 43. Normal reading is 21 - 40.
> 42 - 47 is potentially higher risk of developing Type 2.
> 
> My diet is pretty good, no meat, no dairy, no alcohol however my downfall is cakes and biscuits. My exercise apart from cycling is very poor so it may spur me on to have a go at the Couch to 5K again. Started at the first lockdown then pulled my Achillies. New shoes needed methinks.
> ...


I was told I was pre-diabetic 2 years ago and didn`t realise the consequences of making big life changes....
Then, of course, I was diagnosed with type 2 and HAD to make changes or end up on medication (more than I`m already on!" 
Cake and biscuits were also my big issue but I have completely changed my diet, no sugar, carbs and more exercise.
I`ve lost close on 3 stone since May and feel far better than I have in years. I had blood tests last week and just waiting results but I`m sure my readings will be lower and hopefully I`ll be able to carry on drug free.
https://www.diabetes.org.uk/ is a very good place for info.


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## lazybloke (30 Sep 2021)

Found some more info; this link takes you to the NHS Health Check pages.
https://www.healthcheck.nhs.uk/

I don't think much of their website design, but search around and there is spme useful info, such as a list of conditions that qualify you for more frequent testing.

Otherwise it's every 5 years for a health check, once you've hit 40.
It should be by invitation but it only takes a phone call if you've not heard .


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## HLaB (30 Sep 2021)

In my late teens I ended up developing Pancreatitis during which I was getting blood tests daily for diabetes. (Lol at the end of the week my fingers were like leather and the automatic needle to draw blood bounced of them ). Fortunately as I was approaching the diabetic level it all cleared up and things reverted to normal. The docs could never figure out what caused it to come and go. Roll on 20 years I suddenly developed chronic fatigue and they tested for it again. Fortunately that was normal and something else in normal caused it and doubly fortunately that has been sorted now.


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## Ming the Merciless (30 Sep 2021)

Dogtrousers said:


> Aged about 19 or 20, and very dissatisfied with university life, I noticed that all students wore jeans. I've not worn jeans since then. So I'm ok



I am not sure walking round in just @Drago ’s cast off Y fronts is the way to go.


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## mustang1 (1 Oct 2021)

Forgive my ignorance, but is the way to prevent (or prolong?) T2D to these things:
1. Control food portion size
2. Cut the junk (I'm looking at you, sugar)
3. Exercise (muscle strengthening, cardio, HIIT).
(ps: this isn't sarcasm, it's what I read over and over again).

And medication is only taken once you are diagnosed with T2D right? Then some people choose not to take it and decide to change their lifestyle (eating and exercising habits mainly) and hope pre-T2D goes away.

If that's all you have to do, then why not do it? I don't do it because I'm lazy. Thanks for any tips!

EDIT: ps I'm refering to if you do not already have any medical conditions where you have no choice. I *do* have a choice (no underlying medical conditions that I know of, but I'm a lazy git as i mentioned above).


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## vickster (1 Oct 2021)

mustang1 said:


> Forgive my ignorance, but is the way to prevent (or prolong?) T2D to these things:
> 1. Control food portion size
> 2. Cut the junk (I'm looking at you, sugar)
> 3. Exercise (muscle strengthening, cardio, HIIT).
> (ps: this isn't sarcasm, it's what I read over and over again).


4. Keep weight/waist size in healthy range
5. Don't have any family history / genetic [including ethnicity] pre-disposition (not a lot you can do about this except minimise risks, and not the same as underlying conditions)
6. Don't use corticosteroids long term
7. Look after your pancreas (no heavy drinking)

All the required info can be found on diabetes UK *https://www.diabetes.org.uk/
https://www.diabetes.org.uk/preventing-type-2-diabetes *


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## CXRAndy (1 Oct 2021)

mustang1 said:


> 1. Control food portion size
> 2. Cut the junk (*I'm looking at you, sugar)*
> 3. Exercise (muscle strengthening, cardio, HIIT).
> (ps: this isn't sarcasm, it's what I read over and over again).



This is the problem with the readily available western diet, ( of which I was supremely adapted to) it's full of carbohydrates. Just about everything has carbs. Carbohydrates are converted to glucose. Excess glucose creates high levels of insulin, which leads to insulin resistance.

Insulin resistance reduces the body's ability to access the body fat (which is usually too much by the time you've got IR) to burn as fuel.

So to reduce IR, carbohydrates have to be almost eliminated from a person's diet until the body regains the equilibrium of insulin sensitivity. Thus allowing easy access to stored body fats.

IR makes losing weight extremely difficult, that's why so many fail because they dont see tangible results from altering their diet.

I went through a week or so cold turkey to almost eliminate carbohydrates from my diet. I dont feel hungry between meals by fuelling on mostly fats and protein. I employ intermittent fasting of 18/6 and only 2 meals a day. As of today, I've lost 13lb this month.

I've become fat adapted

I,know its sounds bizarre to eat more fats to lose weight. But it seems to be working, I dont crave food between meals.


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## grldtnr (1 Oct 2021)

CXRAndy said:


> Thankfully diabetes can be reversed as well as being prediabetic for most. Diet and willingness is the key


I have type 2 diabetes, I must correct you, whilst it's true you can be in remission, i.e. reverse diabetes, that's have normal glucose levels, unfortunately you will still be Diabectic, being in remission isn't a get out of jail card, so you will still have to maintain the LC/HF diet.
Best of British in remaining pre Diabectic, I am just hovering on the cusp myself.


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## grldtnr (1 Oct 2021)

CXRAndy said:


> This is the problem with the readily available western diet, ( of which I was supremely adapted to) it's full of carbohydrates. Just about everything has carbs. Carbohydrates are converted to glucose. Excess glucose creates high levels of insulin, which leads to insulin resistance.
> 
> Insulin resistance reduces the body's ability to access the body fat (which is usually too much by the time you've got IR) to burn as fuel.
> 
> ...


Ues it's counter intuitive, and it is hard to think what to eat to avoid Carbs, but as long as you don't eat more than 150 grms of carbs a day you are on the right yracks


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## mustang1 (1 Oct 2021)

CXRAndy said:


> This is the problem with the readily available western diet, ( of which I was supremely adapted to) it's full of carbohydrates. Just about everything has carbs. Carbohydrates are converted to glucose. Excess glucose creates high levels of insulin, which leads to insulin resistance.
> 
> Insulin resistance reduces the body's ability to access the body fat (which is usually too much by the time you've got IR) to burn as fuel.
> 
> ...


Is your diet akin to Low Carb/High Fat diet? I started that today. But I guess it wasn't too bad because its Friday which is a low-stress day for me. I hope I can continue the LCHF way and see where it leads.


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## grldtnr (1 Oct 2021)

mustang1 said:


> Is your diet akin to Low Carb/High Fat diet? I started that today. But I guess it wasn't too bad because its Friday which is a low-stress day for me. I hope I can continue the LCHF way and see where it leads.


Yes , I try to follow it, but a lifetime of eating a supposed healthy diet, takes a long time to unlock, but my sugar consumption is almost nil, I have cut out potatoes and all other starchy foods that we were told we should eat, pasta ,rice, and even porridge oats which I used to have a big bowl of every morning, tho' the jury is out on that one, it's carby but it releases it slowly, it was my wonder fuel for when working on the Post ,walking all day , but I became much more sedentary after being knocked of my bike, that's where it went wrong for me.
I believe , if you are active you can eat what you want, but become lazy that's when diabetes will get you


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## CXRAndy (1 Oct 2021)

mustang1 said:


> Is your diet akin to Low Carb/High Fat diet? I started that today. But I guess it wasn't too bad because its Friday which is a low-stress day for me. I hope I can continue the LCHF way and see where it leads.


Yes, I'm currently using LCHF. I'm hoping to progress into Keto. I've not counted my carb intake, as of yet. However I've cut out all bread, pasta, sweet stuff, sugar and low fat milk. No porridge or potatoes. 

I now drink full cream with tea or coffee and eat eggs, cheese, fresh vegetables, fish and meats. I cook in butter add extra virgin olive oil to every salad I eat. Nuts, avocado are daily foods too.


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## CXRAndy (1 Oct 2021)

Oh and no alcohol, which I've never been so keen to indulge in the last 15 years


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## grldtnr (1 Oct 2021)

CXRAndy said:


> Oh and no alcohol, which I've never been so keen to indulge in the last 15 years


I have found the Diabetes UK forum very useful & helpfull, if you have diabetes is worth a look.


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## lazybloke (1 Oct 2021)

The Michael Mosely TV shows demonstrate a wide variety of approaches as shortcuts to improving health. Reversing and eliminating the descent to T2D is a common theme. 
Diet and HiiT are the usual approach. Less strenuous forms of exercise are often demonstrated too.

This is usually demonstrated by a group of volunteers, plus another control group. Small groups, so a little unscientific and anecdotal, but interesting anyway.


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## CXRAndy (1 Oct 2021)

HIIT has big benefits in releasing growth hormones even for a couple of days after training.


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## Domus (2 Oct 2021)

Had my first phone group session yesterday. Too many people I think, took ages to take the register, ask if people just wanted to listen or answer questions. Many of the people on the call were not native speakers and needed translators, some could not, or would not mute their phones and so background noise was a problem. Some good information came from it but not enough to justify one hour and fifteen minutes.
It was everyone's first time so will see how the next session goes.


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## Spoked Wheels (2 Oct 2021)

grldtnr said:


> Ues it's counter intuitive, and it is hard to think what to eat to avoid Carbs, but as long as you don't eat more than 150 grms of carbs a day you are on the right yracks


150g is rather too much for somebody that is already diabetic. I keep my carbs under 20g a day and I notice how that helps me. 25g of carbs for a 2000 cal diet is advisable for a diabetic.... although some doctors would recommend you cut carbs to 30% - 40%, that is 600 - 800 cal or 150g - 200g on a 2000cal diet. For me it is impossible to control my glucose level, no medication and the 30%carbs the doctor recommended, although it can be done while taking medication. The bottom line is that you will never revert diabetes on 150g of carbs.



CXRAndy said:


> This is the problem with the readily available western diet, ( of which I was supremely adapted to) it's full of carbohydrates. Just about everything has carbs. Carbohydrates are converted to glucose. Excess glucose creates high levels of insulin, which leads to insulin resistance.
> 
> Insulin resistance reduces the body's ability to access the body fat (which is usually too much by the time you've got IR) to burn as fuel.
> 
> ...



Spot on....congratulations on your achievements.


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## CXRAndy (2 Oct 2021)

Thanks, I've got a long way to go.

Get my A1C glucose down, weight down, I anticipate 28lb more to go.


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## Ridgeway (2 Oct 2021)

Wasn't even aware of this long term A1C value, had naively thought low blood sugar was low blood sugar, seems not. Will look into this and see where i can get a test.

Thanks for the heads up


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## grldtnr (3 Oct 2021)

That's one of the things with Carb control with Diabectic's, what is tolebro for one is different for another, some have to be very strict, if they wish to be medication free, ,Type 1 sufferers have a slightly easier time of it,They have to monitor their bllod sugars and inject Insulin, for what they are about to eat , against a background base level, that's constant blood monitoring on waking ,testing before & after eating and fasting, but they can eat more or less what they want, but still have to control Carbs.
Type 2's don't have that,unless they become insulin dependent ,but that's not common.
It isn't one rule for every one,we are all different, some can eat more than others, the most insidious aspect of type 2, is that outwardly, symptoms don't readily represent them selves, the only sure way is finger prick tests ,which many Doctors , on the NHS, won't prescribe for ,saying it's uneccasary , so trying has to be at patients expense.
I perhaps have been ignorant of my personal carb count, all though I am just over the considerex Diabectic threshold, I know that I am , so eat a diet to try and mitigate it, a few more years then maybe I can come off medication, Metformin, which is my goal, but for now I am ok.


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## carpiste (3 Oct 2021)

For anyone who is just starting out on the diet route for T2 or pre diabetes let me tell you that the diet thing does get easier and you will discover lots of new foods you probably never considered in the past!
Cutting out carbs was my big fear but I replaced potatoes with butternut squash! They are fantastic roasted in the over, with skins on. They are fantastic in soups and are both full of fibre, vitamins and really do fill you up. Just like spuds but, to me, even tastier!
Rice and pasta I replaced with various beans, peas, seeds and, again, I haven`t missed them at all. 
I was gifted a soup maker and I now make soup every other day. I make 1.6 ltr of soup which is more than enough for me and MrsC for two days. The added bonus with soup is that it is incredibly cheap as most veg is almost thrown at you for pennies, and of course it is full of good stuff. All the vitamins you can ask for as well as being tasty. It takes about 10 minutes to roughly chop vegetables, add hot water to stock cubes and add spice. 30 minutes later it`s ready to eat!
The worst thing for me, being a cake and biscuit monster, was replacing sweet stuff. But once again I found there are some nice low fat, sugar free biscuits out there and best of all I discovered I really like yoghurt! I go for fat free, 0% fat, Greek yoghurt and I add a low fat regular yoghurt to it for the sweetness. My preferred choice is Morrisons date, fig and grain added to Fage Greek yoghurt. I have also just found Aldi do a Greek 0% fat yoghurt by Brooklea. They also do a Greek style coconut yoghurt I mix to it to add that sweetness I like.
It`s strange, but the thought of eating cake, chocolate or chips makes me feel quite ill nowadays!
Oh yes, alcohol!.....
Whilst it`s true there are a lot of carbs in beer you can still have the odd one if you are that way inclined or, better still, you can have the odd spirit.
I don`t drink very often but I have had a few glasses of Whisky when the SIL and daughter have been here for the evening.


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## grldtnr (3 Oct 2021)

carpiste said:


> For anyone who is just starting out on the diet route for T2 or pre diabetes let me tell you that the diet thing does get easier and you will discover lots of new foods you probably never considered in the past!
> Cutting out carbs was my big fear but I replaced potatoes with butternut squash! They are fantastic roasted in the over, with skins on. They are fantastic in soups and are both full of fibre, vitamins and really do fill you up. Just like spuds but, to me, even tastier!
> Rice and pasta I replaced with various beans, peas, seeds and, again, I haven`t missed them at all.
> I was gifted a soup maker and I now make soup every other day. I make 1.6 ltr of soup which is more than enough for me and MrsC for two days. The added bonus with soup is that it is incredibly cheap as most veg is almost thrown at you for pennies, and of course it is full of good stuff. All the vitamins you can ask for as well as being tasty. It takes about 10 minutes to roughly chop vegetables, add hot water to stock cubes and add spice. 30 minutes later it`s ready to eat!
> ...


 you would be better of not eating the 0% fat free yoghurt ,that goes for any low cal , fat free products , to make these products palatable they add Sugar or sweeteners, counter productive ! 
But if you like it ...Also I advise against eating too many Sugar free products like biscuits or cake ,they replace the sugar with a sweetner ' Sorbitol' I think, which is a known laxitive , I found out the difficult way.....on top of the Metformin, .......Sheesse!!!!!!
So keep of the biccies and sugar free sweets.


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## CXRAndy (3 Oct 2021)

I'm new to this very low carbohydrates diet, so are sticking to staples. I like the idea of a soup maker, I love soups.

Great way of getting vegetables without a daily salad. I can drop in butter to bump my fat intake


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## Spoked Wheels (3 Oct 2021)

grldtnr said:


> That's one of the things with Carb control with Diabectic's, what is tolebro for one is different for another, *some have to be very strict, if they wish to be medication free.*



I have to disagree with that statement.
If you truly want to control diabetes through diet only then you have to be very strick with carbs.
I have reverted diabetes twice, the first time round, 10 years ago, I cut carbs down a lot but not as much as now, however, I was doing huge amounts of exercise and that allowed me to eat more carbs but it just wasn't sustainable in the long run.

What is 20g of net carbs? 

8 cups of green leafy salad + 3 eggs + 4 spoons of double cream + half medium size avocado. From memory that's about 20g.... I eat a variation of these everyday, although probably the green salad is a permanente fixture.

I hear the same reports from a bunch of fellow diabetics.

Incidentally, I would not like to be a type 1 diabetic. Some type 2 that don't control their diabetes can actually get to the point that their pancreas can't any longer produce insulin so they become type 1.


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## sasquath (4 Oct 2021)

grldtnr said:


> I have type 2 diabetes, I must correct you, whilst it's true you can be in remission, i.e. reverse diabetes, that's have normal glucose levels, unfortunately you will still be Diabectic, being in remission isn't a get out of jail card, so you will still have to maintain the LC/HF diet.
> Best of British in remaining pre Diabectic, I am just hovering on the cusp myself.


My colleague at work have type 2 diabetes, currently on the tablets. His pancreas is not producing enough insulin. If he lost 5 of his 13 stones he would be in normal range. But being lazy git and fussy eater(likes maybe 5 meals all junk) he's headed for insulin injections. All he had to do 5 years ago when he was first warned was to cut the crap food and excercise a bit. We even got training room set up at work so he could do some HIT after work, used it for a week and stopped.
Now he's happy cause his prescription s are free - moron.

Sorry, had to vent.


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## Spoked Wheels (4 Oct 2021)

sasquath said:


> My colleague at work have type 2 diabetes, currently on the tablets. His pancreas is not producing enough insulin. If he lost 5 of his 13 stones he would be in normal range. But being lazy git and fussy eater(likes maybe 5 meals all junk) he's headed for insulin injections. All he had to do 5 years ago when he was first warned was to cut the crap food and excercise a bit. We even got training room set up at work so he could do some HIT after work, used it for a week and stopped.
> Now he's happy cause his prescription s are free - moron.
> 
> Sorry, had to vent.



I wouldn't be so quick to judge.

His pancreas probably needs to produce a great deal of insulin but it just can't so that's were tablets come in... but he will only get worse unless he understands what's happening to him and learns to control the condition. Doctor's adivese are probably 40 years out of date, they treat diabetes exactly the same as they did then but with more modern medicines.

It's not easy to lose nearly half of your body weight, specially when you are insulin resistant.... it's a battle and even harder when you don't understand why you can't lose weight.

He needed to cut processed food and the snacks between meals.

HIT might not be ideal for him when he's carrying all that extra weight, walking an hour or two a day would be far more beneficial to him than running..... running would cause his body to release too much cortisol and that would raise his glucose level, etc...walking is much more effective.

It's hard to exercise when you are a diabetic, you don't have the same energy than a normal person has, furthermore, if you do the wrong kind of exercise then you have to do an awful lot to make little difference. The most effective way to control diabetes is through a low carb diet and fasting.

I've been there, having said that, I have the support of my wonderful wife and she has helped me get better.


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## sasquath (4 Oct 2021)

Spoked Wheels said:


> I wouldn't be so quick to judge.
> 
> His pancreas probably needs to produce a great deal of insulin but it just can't so that's were tablets come in... but he will only get worse unless he understands what's happening to him and learns to control the condition. Doctor's adivese are probably 40 years out of date, they treat diabetes exactly the same as they did then but with more modern medicines.
> 
> ...


He was warned 8, 6, and 3 years ago about being pre diabetes. He insists he never had the for an hour of excercise a day, so doctors suggested hit as alternative, he even got 15 minutes off work to do it. He had 8 years warning, and changed nothing, still drinks 4-6 pints a week while stuffing his face on pub grub and McDonald's breakfasts.
Then he winges half a Monday how shitty he feels...while munching on white bread sarnies for lunch.

God give me strength, or deafen me so I won't hear that daffodil whining again.


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## Spoked Wheels (5 Oct 2021)

sasquath said:


> He was warned 8, 6, and 3 years ago about being pre diabetes. He insists he never had the for an hour of excercise a day, so doctors suggested hit as alternative, he even got 15 minutes off work to do it. He had 8 years warning, and changed nothing, still drinks 4-6 pints a week while stuffing his face on pub grub and McDonald's breakfasts.
> Then he winges half a Monday how shitty he feels...while munching on white bread sarnies for lunch.
> 
> God give me strength, or deafen me so I won't hear that daffodil whining again.



Lucky to have 3 warnings. I had none.

The first sign of trouble is when I was diagnosed with fatty liver, the doctor said 3/4 of the population have a fatty liver and suggested I did more exercise. I followed his instructions but years later I learnt I had developed type 2. I regret not looking for a second opinion or at least searching on Internet.... I'm not sure I would have found any useful information at the time but at least I would feel better now I think 
Now I know that asking me to do more exercise was pretty much useless advice, on the other hand, had he suggested intermittent fasting and stop snacking between meals I'm pretty sure I would not have developed type 2 diabetes and I would have reversed the fatty liver ( based on the information available to me know)
Bad food choices was not my problem, the problem was snacking on fruits.... I thought that snacking on fruits was OK but when it's done over many years it is not OK.... everytime I had a few grapes, an apple or a banana my pancreas produced more and more insulin until I became resistant to insulin.
I don't blame anybody, I did this to myself, having said that the food industry has a lot to answer for, since the 50s they have gradually and systematically have given consumers incorrect advice and they have done it purposely. They have modified products and introduced new products and ideas that have people craving for more food, foods that are designed that way so that when you eat them, you get a glucose spike but when the glucose level drops in a couple of hours you feel hungry again, just in time for a snack.
We have been brain washed into believing that all vegetables oils are good for us and that animal fats are bad for us when it's totally the opposite, with the exception of olive and coconut oils. Vegetables oils are in fact largely responsible for causing fatty liver.
Anyway.... just my 0.002


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## grldtnr (5 Oct 2021)

sasquath said:


> He was warned 8, 6, and 3 years ago about being pre diabetes. He insists he never had the for an hour of excercise a day, so doctors suggested hit as alternative, he even got 15 minutes off work to do it. He had 8 years warning, and changed nothing, still drinks 4-6 pints a week while stuffing his face on pub grub and McDonald's breakfasts.
> Then he winges half a Monday how shitty he feels...while munching on white bread sarnies for lunch.
> 
> God give me strength, or deafen me so I won't hear that daffodil whining again.


I would suggest he needs a 'buddy' to help him confront his issue with diabetes, has he a partner, having one for support is very helpfull in the battle, another thing , HIT exercise is counterproductive, better to have a low impact routine, a daily walk or amble along & around on a bike, is better long term, 'Spokey' upthread said increased physical exercise increases Glucose levels, which probably is true, I am not a medic ,so can't say.
Ian a singleton, but I let my friends know about my condition, they don't 'nag' me about it , but they understand that I can't or should not indulge in what I used to, so don't force things on me, but support me about it.
Your aqaintance needs friendly support, he won't get it unless you offer it, then it's up to him to make the change.
Diabetics don't always choose to be so, but some end up like him.


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## Spoked Wheels (5 Oct 2021)

grldtnr said:


> better to have a low impact routine, a daily walk or amble along & around on a bike, is better long term, 'Spokey' upthread said increased physical exercise increases Glucose levels, which probably is true, I am not a medic ,so can't say.


I'm not a doctor either but I've read so much about this condition over the last year and I have three cousins that are doctors but don't want to see me and my endless questions again lol

I would agree with you, walking and gentle cycling is an excellent exercise to tackle diabetes.... although I understand that exercise counts for 15% max in the battle for control of glucose levels.

As for Spokey's comment I think he refers to aerobic exercise, when the heart rate goes up to above 80% of max capacity....in that case the hormone cortisol goes up and that converts fats into glucose and in extreme cases even from protein. So the effect of exercise is actually undesirable..... for people that are pre diabetics, insulin resistants, diabetics.... normal people have nothing to worry about.


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## sasquath (5 Oct 2021)

How would you rate importance of getting out of severe obesity?
40%


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## BoldonLad (5 Oct 2021)

lazybloke said:


> The Michael Mosely TV shows demonstrate a wide variety of approaches as shortcuts to improving health. Reversing and eliminating the descent to T2D is a common theme.
> Diet and HiiT are the usual approach. Less strenuous forms of exercise are often demonstrated too.
> 
> This is usually demonstrated by a group of volunteers, plus another control group.* Small groups, so a little unscientific and anecdotal, but interesting anyway.*



My Sister-in-Law (77) has been T2 diabetic for as long as I have known her (30+ years). She is/was a notoriously inactive person (although not significantly overweight). Her GP recently convinced her to join a (gentle) exercise class. After two months, she was able to dispense with her medication (Metformin? of some such name). 

As you say, not scientific or statistically significant, but, interesting.


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## grldtnr (5 Oct 2021)

sasquath said:


> How would you rate importance of getting out of severe obesity?
> 40%


Very important,, I had been a chunk for most of my life, with little input or want to change , like many I wasn't overly concerned that I was losing weight, but I didn't think I was becoming Diabectic, for some, it is a symptom, what was the decider for me was increased thirst, and piddling, a classic symptom, but on the face of it, wasn't a red flag. 
Most Type 2 develop it through being obese, general medical advice is lose weight, best way is to diet, but that is a broken wheel.
The best way is to Change your diet to lose weight, not diet ,i.e cut back on this and that, the best way is eat LC/HF, / keto, eat the Mediterranean diet, eating proteins and fats is counter intuitive, but shun the sweet stuff and the bread & pasta, you feel fuller and less hungry.
Sugary ,carby food makes you content , but when the sugar has gone ,your hungry again, and so starts the cycle.


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## sasquath (5 Oct 2021)

grldtnr said:


> Very important,, I had been a chunk for most of my life, with little input or want to change , like many I wasn't overly concerned that I was losing weight, but I didn't think I was becoming Diabectic, for some, it is a symptom, what was the decider for me was increased thirst, and piddling, a classic symptom, but on the face of it, wasn't a red flag.
> Most Type 2 develop it through being obese, general medical advice is lose weight, best way is to diet, but that is a broken wheel.
> The best way is to Change your diet to lose weight, not diet ,i.e cut back on this and that, the best way is eat LC/HF, / keto, eat the Mediterranean diet, eating proteins and fats is counter intuitive, but shun the sweet stuff and the bread & pasta, you feel fuller and less hungry.
> Sugary ,carby food makes you content , but when the sugar has gone ,your hungry again, and so starts the cycle.


I would say the post carb hyper hunger thing is individual too.
I can't feel the hunger spikes after eating carbs, sweets yes but not carbs. Saying that I'm almost vegetarian, so unusual diet from what I can see. I'm a bit overweight(bmi 24.5) but that's my GF's fault, she started baking cakes every week in the lockdown.


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## Spoked Wheels (5 Oct 2021)

sasquath said:


> I would say the post carb hyper hunger thing is individual too.
> I can't feel the hunger spikes after eating carbs, sweets yes but not carbs. Saying that I'm almost vegetarian, so unusual diet from what I can see. I'm a bit overweight(bmi 24.5) but that's my GF's fault, she started baking cakes every week in the lockdown.



Indeed, the amount of glucose in the blood of a non diabetic person is about one tea spoon. For a diabetic, it can be as much as 3 and a half so the swing between a glucose spike and a drop, hence the cravings.
There's a gentleman at my local cycling club that eats everything I wouldn't eat, however, he is very disciplined with portions and 3 meals a day. He is very slim and no issues with food choices for him  on a Saturday club ride we stop for breakfast and he eats two large toats with honey  that would get me in trouble. 

Sweets are sugar and carbs are converted into glucose ( sugar in the blood) very quickly... I think it takes the body 15 min to convert a slice of bread into glucose.

Go easy on those cakes


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## CXRAndy (5 Oct 2021)

Anything that has sugar or starch carbohydrates can easily and quickly be converted into glucose by the body. That's the issue carbohydrates are in almost all processed foods in large amounts.


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## Domus (22 Oct 2021)

Cut down cakes and biscuits drastically since diagnosis. Cut portion size of pasta, rice and potatoes a little. Also tried the whole-wheat pasta, not keen so settled on 50-50 as a compromise. Completed couch to 5K week 2 this morning and weighed in this morning at 77.2 Kgs. 2 Kgs loss in a month. Just got to keep it going.


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## Ming the Merciless (22 Oct 2021)

CXRAndy said:


> Anything that has sugar or starch carbohydrates can easily and quickly be converted into glucose by the body. That's the issue carbohydrates are in almost all processed foods in large amounts.



and in many unprocessed foods as well. That where the carbs in processed come from. They are not added separate .


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## CXRAndy (22 Oct 2021)

Ming the Merciless said:


> and in many unprocessed foods as well. That where the carbs in processed come from. They are not added separate .



I was watching Dr Jason Fung on YT. He said that the carbs that are refined, also often have the satiety markers removed. Meaning you can easily overdo refined carb intake, exacerbating blood sugar issues

For those struggling to control glucose levels, all forms a carbs, whether natural or from refined sources need to be drastically reduced.


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## Ming the Merciless (22 Oct 2021)

CXRAndy said:


> I was watching Dr Jason Fung on YT. He said that the carbs that are refined, also often have the satiety markers removed. Meaning you can easily overdo refined carb intake, exacerbating blood sugar issues
> 
> For those struggling to control glucose levels, all forms a carbs, whether natural or from refined sources need to be drastically reduced.



Safety markers , what do you mean by that? The raw ingredients aren’t manufactured so what are you referring to?


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## CXRAndy (22 Oct 2021)

I've dropped 27lb in 6 weeks, transitioned to low carb, high fat diet, zero refined carbs and employ OMAD one meal a day eating pattern.


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## CXRAndy (22 Oct 2021)

Ming the Merciless said:


> Safety *Satiety* markers , what do you mean by that? The raw ingredients aren’t manufactured so what are you referring to?


For example flour, when processed from the grain, other natural nutrients are removed in processing which do influence peoples sense of being satisfied from eating said food.


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## grldtnr (22 Oct 2021)

Dogtrousers said:


> I read an article once about how important the satiety response is. Naturally I've forgotten it all now. I don't know why I bother. I think it went "blah blah leptins blah blah".


I am Diabectic , but only just, type 2, I do know if I do binge on something I shouldn't, it happens sometimes, then come meal times I don't feel like eating that meal, it's a vicious circle, the worst things are choco bars or a decadent slice of cake, If I do succumb, it buggers everything up food wise, so I don't buy it, can't eat it.
What mean is that, for some, a slice of cake ,a few biccies with the tea, i don't do, I get the sugar rush, I feel sayited, but It doesn't last, I would then over indulge, a fool to myself.
It's strange , if you don't go overboard with carbs then you don't feel hunger, do I try now to follow the low carb High fat diet.
Supper to night will be sardines on toast & a salad( brined, a good splash of vinegar, carb content about 30 gems, a daily allowance of less than 100.


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## CXRAndy (23 Oct 2021)

My instant glucose levels are beginning to look better, with them now back in the lower segment of normal range. 

I'm due a A1C retest around Christmas


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## Domus (12 Nov 2021)

Just started week 6 of Couch to 5 K this morning and weighed in at 75.8 Kgs.
My cake consumption is at almost zero and my carb portions are smaller. 
Very pleased with the weight, when diagnosed I was hovering around 80 Kgs


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## CXRAndy (12 Nov 2021)

Domus said:


> Just started week 6 of Couch to 5 K this morning and weighed in at 75.8 Kgs.
> My cake consumption is at almost zero and my carb portions are smaller.
> Very pleased with the weight, when diagnosed I was hovering around 80 Kgs



Did the GP conduct an hbA1C glucose test to diagnose your Prediabetes?


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## CXRAndy (12 Nov 2021)

I test my glucose a couple times a week, the levels are around 4.8-5.3 fasted. 

I have to take them later morning, as I have a natural glucose spike, known as 'dawn phenomenon' .

Most days I eat between 3pm to 6pm, but often just have one meal around 5pm. I just drink water, black tea and black coffee through my fasted period 

I try to keep my carbs very low, even zero most days I do have the odd cheat meal.


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## Domus (12 Nov 2021)

CXRAndy said:


> Did the GP conduct an hbA1C glucose test to diagnose your Prediabetes?


It was a routine health check, general lifestyle questions, weight, height, and bloods. Only concern was the hbA1C which was 43


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## CXRAndy (12 Nov 2021)

Domus said:


> It was a routine health check, general lifestyle questions, weight, height, and bloods. Only concern was the hbA1C which was 43



Good job you've caught it now and are taking corrective steps


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## Domus (12 Nov 2021)

Thats the plan


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## Mike Ayling (13 Nov 2021)

Recently saw a 3 part Michael Moseley show based in Australia.
Michael deliberately ate nothing but junk food for two weeks to make himself pre diabetic. He put on a lot of weight and then went onto a healthy diet which corrected it.
He also got a number of overweight Australians onto diet and exercise plans. Some succeeded, others did not.
I have been off alcohol for about six months and cakes, biscuits, chocolate, lollies etc for about two months. I still eat oatmeal for breakfast and a bit of wholegrain bread. The programme mentioned that some friuts, mango and banana have a lot of sugar and apples have the least. In the last two months I have dropped from 75 kg to 71kg and am still dropping about 100g a week. Still eating meat and dairy.

Mike


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## CXRAndy (13 Nov 2021)

Mike Ayling said:


> Recently saw a 3 part Michael Moseley show based in Australia.
> Michael deliberately ate nothing but junk food for two weeks to make himself pre diabetic. He put on a lot of weight and then went onto a healthy diet which corrected it.
> He also got a number of overweight Australians onto diet and exercise plans. Some succeeded, others did not.
> I have been off alcohol for about six months and cakes, biscuits, chocolate, lollies etc for about two months. I still eat oatmeal for breakfast and a bit of wholegrain bread.* The programme mentioned that some fruits, mango and banana have a lot of sugar and apples have the least.* In the last two months I have dropped from 75 kg to 71kg and am still dropping about 100g a week. Still eating meat and dairy.
> ...



That is the advice, steer clear of processed fruit juices. If you want fruit, have small amounts of the berries , raspberry, blackberry, blue berry, strawberry. These have much lower fructose contents than other fruits. But don't overdo fruits because they're loaded with carbs. if you want fruits, add full fat cream, this blunts the insulin spike in response to the carbohydrates from the fruits. 

You can do this with meals too, eat the low glycaemic index foods first then eat lets call them 'forbidden foods' after and these foods will have a blunted insulin response due to the lower GI meal. 

Also, a way to flatten the glucose spike/ insulin response after eating a meal is to do some light activity like going for a walk. This allows the body to utilise the glucose on moving the body.


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## Domus (4 Dec 2021)

Started week 9 of Couch to 5K this morning. 5 minute brisk walk a solid 30 minutes run/jog/shuffle, then 5 minute walk to warm down. Weight seems stable at 75.4 Kgs. Trousers now a little slacker around the waist, getting used to not snacking. Should finish week 9 on Wednesday and have signed up for Park Run which I shall try next Saturday. My 30 minutes run turned out to be 4.9 Kms according to RWGPS so should be on for the full 5 K by Wednesday.


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## Once a Wheeler (4 Dec 2021)

Some serious issues here that should be taken seriously; but if my doctor tells me I am pre-diabetic, I will remind him that I am also pre-dead.


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## Spoked Wheels (5 Dec 2021)

CXRAndy said:


> . if you want fruits, add full fat cream, this blunts the insulin spike in response to the carbohydrates from the fruits.


This doesn't make sense to me, full cream has almost no impact on insulin *** NOT NEGATIVE*** but fruit does so the spike in insulin it's just as bad as if you have the fruit by itself... a blood glucose meter will tell you.



CXRAndy said:


> You can do this with meals too, eat the low glycaemic index foods first then eat lets call them 'forbidden foods' after and these foods will have a blunted insulin response due to the lower GI meal.


I'm afraid such strategy will only end in full blown diabetes, believe me, avoid diabetes if you can.

A very important trick is missing here, every time food enters the mouth, insulin is released, even if you drink cream a small amount of insulin is released, therefore, cut out the snacks or at least have them with main meals.Even better, eat breakfast and lunch together or skip breakfast altogether.

Once pre diabetes is set then unless changes are really meant then you won't stop diabetes from developing. The only way is full commitment to reverse the damage and prevent extending what is already substantial damage to your health.


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## Domus (8 Dec 2021)

Wind and rain eased (a little) so went out and finished my Couch to 5K this morning. Now basking in the glory. 

Park run on Saturday then I think one weekday 5 K in-between should keep me on track with at least one bike ride and my pilates class on Mondays.


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## CXRAndy (8 Dec 2021)

Spoked Wheels said:


> This doesn't make sense to me, full cream has almost no impact on insulin *** NOT NEGATIVE*** but fruit does so the spike in insulin it's just as bad as if you have the fruit by itself... a blood glucose meter will tell you.
> 
> 
> I'm afraid such strategy will only end in full blown diabetes, believe me, avoid diabetes if you can.
> ...


It seems that eating lower glycemic foods first then a higher Gi foods as part of a meal has less of a peak on insulin response.

Im not advocating this instead of reducing carbs overall. Obviously the best strategy is to severely reduce all carbs. This with intermittent fasting can reverse IR/Prediabetes/diabetes.


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## Domus (11 Dec 2021)

Bolton Parkrun done this morning. 34.22 minutes. Quite slow downhill due to lots of slippery, muddy leaves. Even slower up hill 
Onwards


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## JhnBssll (14 Dec 2021)

I've got less than half a pancreas but my HbA1C levels are thankfully normal, I get tested every 12 months. I have to be careful though as I'm at risk of double diabetes in the long term, having been both secondary type 1 and type 2 in the past  Look after your organs folks


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## Domus (19 Dec 2021)

Bolton Parkrun number two 32. 24 minutes. Must be getting fitter, weight down to 75.1 Kg.
Going to be difficult over the Christmas period with all the temptations.


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