Friday, August 31, 2012



For the week or so when I was writing down everything I ate (without weighing or measuring anything except carbs, but jotting it all down anyway) and then testing my blood four times a day, my weight kept going down. Then I stopped writing it down or testing my blood, just counting carbs in my head. And my weight started to creep up again! A small gain on four days out of five. Yesterday I wrote things down again -- including a big lunch at a Chinese restaurant, where I had the tiniest scoop of rice to soak up the sauces but otherwise all meat and vegetables -- and my weight went down again ...

So what am I doing differently when I write things down?

I think one big difference is between-snack snacking. When I was testing my blood, I had to wait two hours after a meal before I could test. I couldn't eat in that period because it would throw off the results. Sometimes I wanted a little something an hour or so after a meal, but I couldn't have it. When I stopped testing my blood, that restriction was gone. If I felt like a piece of chocolate an hour after a meal, I had it. It's just a piece of chocolate, right? Today I had a spicy lunch, and a while afterwards I started craving something sweet. Chocolate, or an orange, or a cup of tea (I still have 3/4 tsp low-GI sugar in my tea). But I had wanted to check that the lunch was ok, I was having a noodle soup with only half the noodles and lots of bean sprouts and other vegetables instead. I was a bit worried about those noddles. Turned out it was fine, 6.7 mmol/L. But in those two hours I really noticed how much I wanted a little taste of something sweet. And if, in the past, I had given in to that craving regularly; it would all add up to quite a bit.

You would think three meals plus three snacks, eating up to every two hours, would be enough! I've gone back to writing everything down. I'm not testing my blood very often, just after things like the Chinese food or the noodles to make sure I am still going ok. But I'm writing it down to be fully conscious about what I am eating and when.

Another difference is I was making sure I was having at least six glasses of fluid a day, and writing that down too. When I stopped writing it, I think I stopped drinking as much. Yesterday I had my six glasses, spread evenly throughout the day. And got up at least four times in the night to pee. Sigh. My body seems to get used to the extra liquid pretty quickly, but then forgets again just as quickly. A couple of days of drinking enough and I'll be fine through the night again.

The moral of the story is I need to track.

Wednesday, August 29, 2012

Visiting the doctor


Finally I got to see my doctor and talk about my prediabetes.

She didn't really have anything to say that I haven't already read about and talked about here, but it was good to check with a professional (doctors know everything, right! But I do have a bad habit of self-diagnosis). I need to lose weight (10 kg would be good, 20 kg even better) and exercise for at least half an hour every day. To achieve the former she talked about maybe seeing a dietician, joining Weight Watchers, or getting meals home-delivered from one of the weight loss companies.

Something she didn't bring up was spreading carbohydrates out over the day and not eating too many carbs at once to avoid a blood sugar spike. The prediabetes book I read also didn't mention this, but it seems to be in all the diabetes literature including what I was given when I had gestational diabetes. That and eating low GI foods were an important part of managing it, and from my understanding it's the high blood sugar levels that do the damage to your body. So surely it is important for prediabetes too, if to a lesser extent? Anyway, I mentioned I'd been eating carefully and checking my blood sugar levels and the doctor seemed to think this was a good idea.

[I have actually stopped doing this, I'm now pretty clear on what my carbohydrate limits are so I don't see the need to check my blood four times a day at a cost of about 50 cents per test. I will continue to moderate my carbohydrates, and maybe check occasionally to make sure I'm still on track.]

I asked about my previous glucose tolerance test, I did have one two years ago as well as during and immediately after my last pregnancy. In 2010 my blood sugar two hours after the glucose was 5.8 mmol/L which is well within normal limits. It's good to know the prediabetes is only recent and hasn't been damaging my organs for several years.

The doctor weighed and measured me, which was a bit funny. Last visit the other doctor weighed me and got exactly the same as I'd been at home that morning. Today these scales put me at a kg heavier, which is always unpleasant, and then she measured my height at 154.5 cm when I would say I'm 152 at the absolute most! That is a whole inch difference. Very odd. I doubt very much that I am still growing at my age.

So, no new advice, but I now have a doctor telling me it is very important I lose weight, if I needed any further motivation.

Tuesday, August 28, 2012

Wednesday weigh-in: 77.7 kg


Down another half a kg this week which is good. My weight is actually up a little today compared to the last couple of days which annoyed me as we didn't even have the usual D&D supper last night! Oh well, fluctuations happen. The overall direction is down.

Starting weight 15/08/12: 79.1 kg
Week 1: 78.2 kg
Week 2: 77.7 kg

The gods of snot laughed at my recommittment to everyday exercise. I had been fighting off a cold for a few days; headache, runny nose, sore throat; and yesterday I woke up much worse. So I didn't even walk the kids to school. Feel a bit better today. Not sure how I'll go at the gym this afternoon -- but I will go. Even if just for a slow walk on the treadmill.

Speaking of which, I am getting my treadmill back. We got a really good one some years ago but I rarely used it and ended up giving it to a friend. I said she could keep it but she always treated it as a loan and now she is having her house renovated and needs to pack and store most of the stuff in the house so she is going to give it back. I'm not going to put it back in the loungeroom (where it dominated), it will go out in the "studio" which is a converted garage. There is no internal connection to the house so it is a junk room/guest bedroom with no heating or air con and I rarely go out there. I don't see the treadmill being used much out there, but we'll see. It weighs 112kg so even though it has two wheels at the front it is a bugger to move around. The original idea was that it would be in the loungeroom so I could watch TV while jogging, but it is huge and heavy and takes up too much space so I don't see that happening again. The studio is also pretty full. Our house isn't particularly small, but we have too much stuff! Twelve overflowing bookcases, for a start.

Monday, August 27, 2012

New exercise goals


After a very inactive weekend (my mother visited and entertained the kids by, of all things, teaching them both to knit; Tim and I took the opportunity to play lots of Rift together) I have recommitted to exercising every day. It is important, I just have to make the time. But I am done with the rowing machine, for now at least, and needed a new mountain to conquer.

I have chosen the cross-trainer (elliptical machine), a bit of a favourite from way back before I moved on to other things. This afternoon I kept up a brisk "jog" -- or whatever the correct name for the movement is -- for 30 mins. I managed 3.7 km in that time. I was suitably sweaty at the end, but I know I can go a fair bit quicker. I am setting a goal of 5 km. That will mean speeding up by a considerable amount, but I think I can build up to it in a month or so.

After that it should be warm enough for me to start jogging outside and try to tame the lake run.

I'm not really worried that I get sick of each type of exercise so quickly -- after all there are so many things to try! I just have to make sure I don't leave too big a gap between each thing. And I definitely need a goal to aim for each time. I've always been very bored by the thought of exercise just for the sake of exercise, I need a specific target to strive for to make it seem worthwhile and interesting.

Thursday, August 23, 2012

Food survey


Only a handful of people read this blog, and I've had about three comments ever. So to encourage people to comment, I'm going to ask YOU a question!

What food did you start off hating, or thought you would hate, but ended up liking?

And, bonus question, what did you try to train yourself to get used to, but still hate?

I've tried porridge several times. I know lots of people like it. It's supposed to be really healthy, too. But to me it is like a bowl of warm glue, and I was not one of those children who liked to eat the school Perkins Paste.

On the other hand, I love quinoa (pronounced keen-wa). I use it instead of rice, but it has much more protein and much less carbohydrate. And it tastes yummy, especially with a squeeze of lemon or whatever sauce you are having it with. And leftovers the next day, stir-fried with finely chopped mushrooms & stuff so it looks like fried rice. Unfortunately, the rest of my family don't like it and continue to demand Jasmine Rice (which has a higher GI than sugar, might as well just inject glucose straight to the bloodstream), so yesterday I bought a small rice cooker so I can cook my quinoa at the same time as I do the family's rice in the big one. I'd recommend anyone to try it -- although I will say I only like the white; the black & red taste a bit different.

Thor's day


I struggled a bit with PMS yesterday afternoon and today. With terrible timing, yesterday I decided to start counting calories again as well as carbs. Horrible. Having to weigh or estimate every single thing, no longer being able to think "this little cube of cheese is free", having to look at the whole day instead of just the level of carbs for that meal.

When I got to the end of the day, my score sheet looked pretty good. Lots of exercise, offsetting some of the calories. The recommended amount of fruit, vegetables, and dairy. Nearly enough water. But all that I could focus on was that I had gone over my planned 1500 calories. And OMG so many calories in that chicken breast. And that tiny spoonful of rice. I should have had one slice of chicken, two grains of rice. And who eats a whole banana! Do you know how many calories in that thing? You're disgusting!

I don't think I am ready to go back to calorie counting. As long as I am gradually losing weight, I will just stick with counting carbs for now.

I bought two Pandora charms today. A turtle, to celebrate my rowing victory. And a strawberry, to remind me to eat healthily. My bracelet is looking really nice, it started off a bit sparce but it has a respectable number of charms now.

Pouring rain today, the third Thursday in a row. I was explaining to the kids that it is really Thor's Day, named after the god of thunder. So maybe that is why. Thursday is usually our busy afternoon, but I gave the kids the option of just staying home and they took it. So I didn't exercise.

Wednesday, August 22, 2012

Rowing milestone

More Wednesday:

I went back to the gym this afternoon and got back on the rowing machine while the kids were doing their Gecko class. (I've decided they are going to keep doing Gecko for the moment, at least for the rest of this term while the weather is often too cold to play outside -- although today was lovely, almost Spring.) I felt like maybe today was the day to get that 5 km in the 30 mins.

I started strongly. The first five minutes I dealt with the usual little niggles; back feeling a bit stiff, knee giving a twinge. The second five minutes were hard, my muscles were protesting at the fast pace. I was on track though. The middle ten minutes, the middle third, was the worst; I had already worked so hard yet I still had such a long way to go! I was feeling at that point that I might not be able to keep up the pace, I was getting tired. I was dripping sweat, my bra was rubbing under my arm, my shoulder muscles were complaining ... and whenever I closed my eyes for a few moments to focus I unconsciously slowed down and had to go a bit faster for a while to compensate. But when I got to around the 25 minute mark I realised I was going to do it. I was still on pace, and I could do another five minutes. Five minutes is nothing. I tried to speed up at the end but had nothing left, I just kept pulling at the same steady pace I'd been maintaining pretty much the whole row. And I got to 5 km with 15 seconds to spare. I used those final seconds to slow right down, aware of my heart pounding and sweat pouring off me. At 30 minutes, I had gone 5.03 km.

I think I've been rowing for about a month, which seems about the right amount of time for me to work towards a specific goal. I have earned another charm! Yay! Finally!

After my gym session this morning I was thinking about how 30 mins of moderate intensity exercise was really quite pleasant. After this afternoon's session I can say that 30 mins of high intensity exercise is very unpleasant. I didn't enjoy it at all. My sense of achievement was more "thank God that is over". I had been pretty keen on rowing, now I have no immediate plans to do more. I might take a little break from it and do something else, and when I get back on the rowing machine I think I will put up the resistance but go more slowly and/or for a lesser time. I know that I don't have to enjoy something for it to be good for me, but it sure helps with motivation. That row was damn hard, and not fun.

Since writing this morning about spending more time exercising while work is slow, I won a job that I had quoted for last week. So I'm going to have less time again for a few weeks. Lucky I have Gecko in the afternoons to mind the kids while I work out!

Hmm, if not rowing, what am I going to do at the gym during that half hour? I did like the cross-trainer this morning.

Tuesday, August 21, 2012

Wednesday weigh in: 78.2 kg


I am, for the moment, using Wednesday as official weigh-in day because this day last week I had my glucose tolerance test and was able to start my diabetes-friendly diet; and also because it was my highest point for a long time after having those three days of carbohydrate loading.

Starting weight: 79.1 kg (174 pounds)
Week 1: 78.2 kg
Loss: 0.9 kg
Total loss: 0.9 kg
Goal: 58 kg

It's a nice loss, but it is slightly artificial as half of it was the temporary gain from the carbs. Still, I did lose it.

I don't know if my "spreading out the carbs" diet is going to be enough on its own. It is doing a dandy job of keeping my blood glucose levels steady, but I also need to lose weight to make a permanent improvement in my chances of avoiding diabetes. I need to do more.

Oh, I had a bit of a binge last night. It was D&D, with supper, as usual; I had a plan to eat a limited amount. A little of this, a little of that. I ended up having a huge amount of cheese & crackers and some licorice bullets and chips and strawberries. To many carbs, and way too many calories. A couple of the guys also feel we binge too much on Tuesdays, I am going to suggest we really cut back. Healthier food, and only eating at supper not all night at the games table. I feel a bit deprived just thinking about it but it's important.

Cutting back on refined carbs and overall calories is one side of the equation. Of course exercise is the other.

Lately I have been walking the kids to and from school every day, giving me two and a half hours a week of walking; half slower and half brisk. A nice start. I also row for 30 mins about three times a week, much more vigorous exercise. I am going to ramp up the exercise more, especially during quiet times at work. I went this morning -- I didn't make it to my BodyPump class (they had finished the warm-up and half of the squat track already) so I did 20 mins on the cross-trainer, a 5 min sprint on the rowing machine, and a few sets on the chest press and leg press machines. I will be back this afternoon with the kids for Gecko class.

Monday, August 20, 2012

What I have learned about Prediabetes


Over the past week I have been reading numerous websites like Diabetes Australia and the equivalent US and UK sites, World Health Organization (WHO), National Diabetes Information Clearinghouse (NDIC), various other health sites, books borrowed from the library, and the handouts I was given when I had gestational diabetes. I've got information from the sheet that had my blood test results and even from an obesity special of "Embarassing Bodies". What follows is my summary of all that information. I'm afraid it isn't referenced, and as figures varied slightly from source to source they might not always be what your favourite source gives. Also, most of the world measures blood sugar in mmol/L, any Americans reading will have to multiply by 18 to get mg/dl. Sorry if I've made any mistakes, but this is what I have learned about prediabetes.

What is Prediabetes?
Blood glucose (sugar) is managed by the pancreas. The human body likes a level of 4--6 mmol/L (millimoles per liter), and to achieve this the pancreas secretes several different hormones. When you haven't eaten for a while it secretes glucagon to increase your blood glucose level, when you eat it releases insulin which opens the cells of the body to let glucose in so you can use it. If you have type 2 diabetes, or to a lesser extent prediabetes; your muscles, fat, and liver don't respond properly to the insulin (insulin resistance). The pancreas releases more but eventually can't keep up, and excess glucose builds up in the blood and can do a lot of damage. The thirst and frequent urination that go with diabetes are caused by the kidneys trying to flush out all that extra glucose. (Type 1 diabetes is quite different, it occurs when the pancreas makes little or no insulin at all.)

A normal fasting level of glucose is less than 5.6 mmol/L. A reading of 5.6--6.9 is considered impaired fasting glucose. A reading of 7.0 of over is considered diabetes.

Two hours after drinking 75 grams of glucose, a normal reading is less than 7.8 mmol/L. A reading of 7.8--11.1 shows impaired glucose tolerance, a reading of over 11.1 is diabetes.

Both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are now called prediabetes. IGT carries a worse risk of developing into full-blown diabetes. People with prediabetes are ten times more likely to get diabetes, generally within ten years. One site suggested the average was three years. Prediabetes is almost completely preventable and reversable.

Who gets Prediabetes?
The risk assessment factors include:
# Age -- older people have a higher risk
# Gender -- men are more likely to get it
# BMI (body mass index) -- fatter people have a higher risk, in particular visceral fat* is a major contributor.
# Family history -- it has a genetic factor
# Heart rate -- high is bad
# Blood pressure -- high is bad
# A history of gestational diabetes or having given birth to a large baby
# A history of polycystic ovary syndrome

Obviously not all of these are preventable, but a lifestyle that includes a healthy diet and exercise can have a huge effect of BMI, heart rate, and blood pressure.

Visceral fat
Visceral fat is the fat that surrounds the abdominal organs, as opposed to subcutaneous fat which sits under the skin all over the body. An apple-shaped body is a good indicator of too much visceral fat. Visceral fat is associated with a much higher risk of prediabetes, diabetes, heart disease, metabolic syndrome, breast cancer, high blood pressure, gall bladder disease, and cancer of the colon and rectum. It causes a decrease in blood flow, and releases hormones into the blood that contribute to insulin resistance. Visceral fat is very, very bad; but fortunately it is the first to go when you lose weight. Even exercise without a restricted diet will reduce visceral fat.

What is so bad about Prediabetes?
Not only does it quickly lead to diabetes, if not treated, but risk factors for various problems are already increasing.
# Heart attack and stroke -- risk is double for prediabetic, double that again for a diabetic
# Damage to the blood vessels in the eyes can lead to blindness
# Alzheimer's risk doubles with diabetes
# Diabetes leads to kidney disease and possible kidney failure
# Nerve disease can lead to foot amputation
# A diabetic can expect a lot more sick days
# Sexual disfunction is common
# I have seen mentions of links to shoulder problems and periodontal disease as well

How do you prevent/reverse Prediabetes?
A weight reduction of only 5-7% can cause a 60% reduction in the incidence of diabetes. Compare this to a 31% reduced risk given by the diabetes drug metformin. A healthy weight, or even a healthier weight, is extremely important.

Exercise is vital, not only because it helps you to lose weight, but because exercise makes your cells more sensitive to insulin -- opposing insulin resistance. It also helps reduce some of the other diabetic risk factors like high blood pressure.

Frequent high glucose levels are doing damage to your pancreas and your vascular (blood) system, which is very dangerous. Damage to blood vessels in the brain can lead to a stroke, damage to blood vessels in the eyes can lead to blindness etc. Limit your intake of sugar and highly processed carbohydrates, and check your blood glucose levels to make sure they are within acceptable limits.

The Glucose Index is a way of measuring how quickly carbohydrates in food are converted to glucose in the blood. For diabetics and prediabetics, low GI foods are better because their blood glucose level rises more slowly and over a longer period rather than a quick spike.

# Lose weight
# Exercise
# Manage your carbohydrate intake, spreading them throughout the day. Aim for low GI foods.

Other issues
I have discussed topics that have seemed important to me in my particular circumstances. I haven't talked about medication or bariatric surgery for instance. So you might want to do some more research if you think you needhelp getting your prediabetes under control.

Rowing races


I continued my rowing machine adventures this afternoon. My favourite two machines used to be one behind the other, beside windows overlooking the pool. But today the back one had been moved up to beside the other. The pool-view machine was taken, and I figured the second one was still better than the pair downstairs behind the treamills.

The older guy next to me was doing about my speed but we weren't synchronised and I found that vaguely uncomfortable, like trying to dance out of time with music. I tried to ignore him. He soon got off, anyway. I started my row with lots of little niggles that made me think I might stop sooner than 30 mins; my lower back ached almost at once, then a knee felt a bit sore, then one foot ... but after a while I felt better so I just kept going. I was rowing at a decent pace for me, between 30 and 33 spins per minute.

Then another guy got onto the machine next to me and instantly set off on a cracking pace. I sped up to match, I almost couldn't help it. 38 spins per minute, far above my comfort zone! I couldn't keep it up for long, though, I had to drop back to my usual pace. I felt a bit silly trying to keep up, but I kept surreptitiously glacing over at his screen wishing I could go that fast. Then he stopped! He was only doing a 5 min sprint. So maybe he couldn't go that fast for 30 mins either.

That little effort to keep up with him had used up most of my energy stores and the rest of the row was a real struggle. I wanted to sprint at the end but just didn't have anything left. Nevertheless, in my 30 mins I went 4.74 km -- 0.5 km further than last time! A huge improvement. So maybe that little race, which the other guy probably wasn't even aware of, helped me. Or maybe not, without that I would have sprinted at the end instead of in the middle, and I was going at a better pace than previously for the whole row. Anyway, I feel like I am getting close to my goal of 5 km.

photo by CircaSassy

Sunday, August 19, 2012

Lying labels and weekend away


When I was shopping on Friday I picked up some Rice Stick Noodles to have with a stir-fry that night. I knew that both rice and pasta were high carb, but the packet said that 100g of noodles when prepared as directed (ie cooked in boiling water) was only 9.8g of carbohydrate -- easy to fit into my new plan of aiming for around 30g of carbs each meal. There were some fairly starchy vegetables in the stir-fry (carrot, baby corn, snow peas) and I had one square of chocolate for dessert; in all I estimated about 25g of carbs.

Two hours later my blood sugar was at an unacceptable 8.3 mmol/L.

I looked up Rice Stick Noodles on my app. It estimated 43g of carbohydrate for 100g! 43 is a little bit more than 9.8 -- not really within a reasonable error margin! So I think the packet lied, or was in error. It's imported from Thailand, so I'm not sure if Australian authorities are responsible or not. I am seriously considering contacting someone to complain/inform. It wasn't really a problem for me, but imagine the results if someone with real diabetes, maybe reliant on medication, trusted that label!

In a way it's good it happened, I learned a couple of things. Firstly, if something looks to good to be true, it probably is! I should have realised that that label was way off, considering it was pure high GI carbohydrate. Secondly, I know that around 58g of carbohydrate -- 4 serves -- is too much for me. This is important to know as at least one website suggested I have up to 55g of carbs with a meal. Further experimentation will show what I can have and remain below the magic number of 7.8 mmol/L. The rest of the time I have kept it under 7.0. Finally it shows me, if I needed further confirmation, that I definitely prediabetic; my body can't cope with large doses of carbohydrate. A "normal" person's blood sugars wouldn't have gone that high after a little handful of noodles.

I continued to carefully regulate my carbohydrate intake over the weekend, even though we were away from home. I had a banana on the road trip, modified McDonald's for lunch with nuggets and a salad and half a small fries, one micro-mini cupcake at afternoon tea and two biscuits at the second afternoon tea at another house, and only half a cup of rice at the Thai restaurant for dinner -- the rest meat and vegetables with nothing starchy or fried. My blood sugars were great all day.

I didn't take my testing kit with me today as it would have been too much to carry walking around the city, so I'm not as sure about today. I had bacon & eggs for breakfast with some toast, a cup of milk for afternoon tea, and two mini fajitas for dinner. All good levels of carbs. But then there was lunch ... I had chicken and spinach and a little bit of potato, good there. A fruity cocktail, not too bad. Then a big chocolate-filled eclair. Probably pretty bad, especially since it was at the same time as the other things. At least I did a bit of walking around the city and up & down the picturesque paths in the Chinese Gardens at Darling Harbour. In fact, I was walking while I was eating my eclair -- that cancels out, right?

We had a lovely weekend away. I got to see my cousins' babies; Kimberley had little girl Harper (10 weeks) and her brother Jamie (and his wife, of course) had twin boys Ryder and Jesse (about 4 months). I hadn't seen them yet. Then we saw my brother-in-law Nick and his wife, they are newly pregnant. A very baby day! Then dinner with my father-in-law, night at a lovely hotel with ocean views, and the next day wandering around the city. It snowed here in Canberra on Friday, but only 3 1/2 hours drive away in coastal Sydney it was warm and sunny. I ended up carrying around my coat, the kids' jumpers, and Tim's long-sleeve shirt (he kept his T-shirt on!). Tim had his hands full with the eleven books we bought at our favourite fantasy & sci-fi bookstore Galaxy that we hardly ever get to now that we don't live Sydney. The kids had the fun of riding in a train (we don't have trains in Canberra) and they slept most of the drive home in the car so they got to skip all the boring bit. All in all, a really nice weekend for everyone.

Thursday, August 16, 2012

It's prediabetes


When I originally booked my glucose tolerance test the receptionist said the results would take 3-4 days so I booked a doctor appointment accordingly. But when I was getting the test done the nurse (or whatever her designation was) at the collection centre said it would take about 2 days. So this afternoon I went into my doctor's clinic and asked. Sure enough, they were there. I had been a bit paranoid about whether they would give them to me, I thought they might insist I wait until I saw a doctor. The receptionist checked her computer and said the doctor (the one who referred me for the test when I saw him about something else, not my usual doctor who is very hard to get in to see) had seen them and there was no further action. Sounded good. She asked if I would like a copy, and of course I said yes. She printed it out but then hesitated and went to check with the doctor first. Bad? Had she noticed something? I could hear him riffling through the pages (he had the first room down the corridor, and the door was ajar) but couldn't hear what he said to her. She came back, and handed the papers over with a reassuring smile.

"Fasting 4.1 (normal range 3.4 -- 6.0)
1 Hour 10.1
2 Hours 10.0 H (normal range 3.4 -- 7.7)

"The two hour glucose value is in the impaired range (7.8 -- 11.0 mmol/L). Guidelines suggest that the one hour value has the least importance in interpretation. Current criteria are based on the fasting and two hour values.
There is no evidence of diabetes mellitus.
Periodic retesting of undiagnosed diabetes mellitus is recommended by measuring fasting serum glucose each year in patients with impaired glucose tolerance."

So, I have prediabetes but they don't have any specific recommendations other than to recheck every year. Of course my doctor may have something more to say. I have cancelled my appt with the random doctor next Wednesday and booked in with my own doctor the following week, when she is available. I decided that this is a long term thing that I need a long term doctor-patient relationship for.

I fully expected this result. I've been reading a book about prediabetes that I got from the library and the more I read the more I was convinced that I had it. My home blood test figures while on the high-carb diet were pretty clear. But unlike the pathology lab recommendation, I don't intend to just wait until it turns into diabetes. There seems to be plenty I can do.

As I have been doing the past couple of days, I can manage my blood sugar levels to avoid further harm to my pancreas and other parts of my body. I can lose weight so that I don't have as much dangerous visceral fat (fat around my internal organs, different to subcutaneous fat that sits under the skin). I can exercise regularly; not just to lose weight but because it helps my body deal with glucose.

As I said, I've been reading a lot; but I obviously haven't been taking it in properly. In that last paragraph, I wasn't able to remember exactly why visceral fat is so bad for diabetes or what exercise does that is so good.  I guess up until now I was reading for interest without knowing for sure that it was actually important. And I can lose weight and exercise without knowing the technical reasons why. But I'll be reading over everything again until I could give a lecture on it if I wanted to.

There are other figures in the lab results, all my numbers are normal except for cholesterol which was 5.6; normal range is 3.5 -- 5.5. Only 0.1 over normal! That is awsome for me! Last reading I remember getting was 7.1, so it is great to get it so low. Hopefully next time it should be down in the normal range.

My weight on the morning of the gtt, after three days of overeating carbs, was up to 79.1 kg. Not a nice number. But I am confident I can get it down again.

I don't feel stressed or upset about this diagnosis at all. Maybe because I was expecting it. But also it seems to be very managable and reversable. I am in control of my own destiny!

I have some challenges this weekend involving eating out several times. It will my first test of dealing with temptations and restaurant food. I have an app on my phone that tells me the carbs in things, I will probably have to guess a bit. I will also away from the gym. But that is life, I just have to deal with it and find a way.

To Gecko or not to Gecko?


I felt a bit sluggish on the rower today, I assume due to my slight cold (feeling a lot better today already), but I still beat my previous best distance. 4.24 km in 30 mins today.

The kids are starting to get a bit resistant to going to Gecko fitness, although they loved it at first. We get home from school then have afternoon tea and change and go straight out again, three days a week. They don't get much time just to play. Or do their chores or homework. They already do gymnastics and violin lessons. Also, there are a couple of very disruptive little girls in the Gecko class who fight with each other and chew gum & eat lollies the whole time (while exercising!) and don't do as they are told. My kids find that a bit hard to deal with. I was going to cancel today but the gym gave me a number to call and now I am reconsidering. It has its downsides, but it is good exercise. And it gets me to the gym even when I don't want to go. I will think about it some more.

I've been carefully moderating my carbohydrate intake and testing my blood glucose levels and they have been excellent all day. Whatever "impaired glucose tolerance" I have is clearly controllable with diet and exercise. And should be reversable.

Wednesday, August 15, 2012

Staying away from medication


My dietician friend told me that if I do have diabetes it could be months before I am able to see an endocrinologist or whatever specialist I need to see, so the doctor could put me on medication straight away without waiting for a specialist opinion. I don't think my doctor would, but I am not seeing my regular doctor. Of course I want to avoid hopefully-unnecessary medication; so for next six days, until I see the doctor, I will be managing my diet and taking regular blood glucose tests. That way, when I see the doctor next week I can prove that I can manage diabetes without medication. Or if I can't, at least I will know. And of course if I don't have diabetes (fingers crossed), managing my diet will help me avoid getting it in the future.

A "diabetes" diet is in most ways just a basic healthy diet: a balance of protein, carbs, fibre, dairy etc, not too much fat. But I need to spread my carbs out evenly throughout the day. I am currently using the handouts I got when I had gestational diabetes, and I am going to pick up some books from the library today. I am aiming for 1-2 serves of carbohydrate for each snack and 2-3 serves at each meal. One serve is 15g of carbohydrate: one slice of bread, a small apple, half a potato. Non-starchy vegetables have very little carbohydrate; meat and cheese have none.

I am also going to exercise regularly; both to stabilise blood sugar (it helps) and to lose weight.

Getting rid of my dangerous belly fat is a long-term goal.

This kind of sounds like I think I have diabetes; I don't really. I am expecting pre-diabetes or nothing. But I am in a fairly high risk category and I need to take action now to avoid getting it in five or ten years. I am using this as a motivator.

Tuesday, August 14, 2012

Glucose tolerance test


I had my glucose tolerance test for diabetes this morning. I don't see the doctor until next Wednesday, which is frustrating. I couldn't even see my usual doctor then, I would have had to wait even longer, so I'm just seeing some random doctor in the same clinic. The results might be ready on Friday, maybe I can get a look at them early. My nutritionist friend can translate them for me, she asked me to get a copy but I forgot.

By yesterday afternoon I was starting to feel a bit unwell. I don't know if it was the cold I've caught from my son, or the high levels of carbohydrates. Or both. My blood sugars were 9.8 two hours after lunch and 9.0 two hours after dinner, both pretty high. The clinic said I can still do the test while I have a cold so presumably it also wouldn't affect these figures.

I started fasting at 9.30pm. I didn't sleep well at all and felt a bit nauseated in the morning after I got up. At the clinic I gave them a wee sample then rested for a while, then they took the vial of fasting blood before I drank the horrible horrible glucose drink -- 75g of glucose in 300mL of water, that is equivalent to 15 teaspoons of sugar. I felt extremely nauseated afterwards and was quite worried about vomiting. I would have loved to lie down somewhere. I also felt very cold, and a bit weak and dizzy. But I got through it and they took blood at one hour and two hours, then I could go.

They didn't do a fingerprick test at the same time (they have in the past, when I did the test at the hospital) so I have no idea what sort of blood sugar level I had. I did think about taking my own testing kit with me, to use in the toilets if they wouldn't show me the fingerprick figures, but decided against it. I wish I had. I hate not knowing stuff.

 I went and had part of a Subway sandwich on the way back to my car but still felt quite nauseated for another hour or so. I'm a lot better now (2.30pm) but still not great; but that could be more about my cold. Runny nose and headache etc.

Now I just have to wait and see. I hate waiting.

Monday, August 13, 2012

Starting to panic just a little bit


I have nearly finished day two of carbo loading for my glucose tolerance test on Wednesday. I am starting to get quite worried about what the result will be. I had my old testing kit from when I had gestational diabetes, so I've done a few blood tests at different times of day, both before and after I started the carb loading. At first I thought the results were ok, mostly. A bit high one hour after eating; but that is ok, right, because they generally tell you to test two hours after eating when your blood sugars have stabilised a bit. Now I'm not sure if it is ok or not.

Worse, I also now think that what I was reading as "acceptable" was actually only "acceptable for a diabetic". Not "normal". I've read a lot of web-sites (yes, yes, a very dangerous thing to do. Damn you, easily accessable internet!) and I've found all the information a bit confusing. They generally only give a fasting figure for non-diabetics (mine is ok) but don't talk much about what it should be later in the day.

I haven't been keeping very comprehensive records yet, just a few tests here and there, but for my own records here is what I have so far (btw for Americans multiply everything by 18 to get mg/dL):

Fri 10 Aug
3.50 pm (more than two hours after a high-carb lunch) -- 6.7 mmol/L
5.00 pm (one hour after 35g carbs) -- 10.2, this is very high
6.00 pm (two hours after 35g carbs) -- 5.5

Sat 11 Aug
7.30 am (fasting) -- 4.3 mmol/L, this is normal
2.00 pm (after very high-lunch, about 60g) -- 8.4
3.00 pm (two hours after lunch) -- 6.5

Mon 13 Aug
3.20 pm (more than two hours after super-high-carb lunch, about 100g) -- 7.6 mmol/L
5.30 pm (two hours after low-carb afternoon tea* and half an hour exercise) -- 4.7
8.30 pm (two hours after pasta for dinner) -- 7.4

* I ate some of my afternoon-tea carbs at lunch, so afternoon tea was just strawberries; I probably shouldn't have done it that way.

So. If normal non-diabetic blood sugar is supposed to be 4--6 mmol/L all the time, then I am stuffed. Definitely diabetic. If it is allowed to go up to 7.8 two hours after eating and never get above 10, then I only need be a tiny bit worried. Still need to take action for my health, but not an immediate problem. If it is allowed to go up to 7.8 two hours after eating and the one hour after eating mark doesn't matter at all, then I am just fine and dandy.

I've been feeling bloated and a bit headachy and a bit sick today. I though it was all the carbs, but this evening I have a bit of a sore throat, so maybe I'm just sick. Aiden has a runny nose.

At the gym today I did my first 30 min row. I didn't go fast, just steadily, and got to 4.22 km. I didn't really have any problems rowing for that long so maybe the carbo loading is good for something.

Friday, August 10, 2012

Not waiting for "rock bottom"


My diabetes test is scheduled for next Wednesday. I have to get checked every couple of years because I had gestational diabetes, but I don't think I have it. I have no symptoms, and I've done a couple of finger-prick blood tests at home which have been normal.

Nevertheless, I am in a pretty high risk category for getting diabetes at some point. The gestational diabetes is a big warning indicator, plus I am overweight with lots of stomach fat and my dad has pre-diabetes. I have very high cholesterol, and I have always been prone to episodes of hypoglycemia (I don't know if this last is relevant, but I know that is can be a problem for diabetics).

Diabetes doesn't just mean having to inject yourself with insulin or avoiding donuts; it increases your risk of heart disease, stroke and depression, and can cause blindness and nasty circulation problems.

Why am I waiting to be diagnosed with some horrible disease to take action about my health? It isn't just about getting thin.

When I had gestational diabetes I had no difficulty managing it with careful diet, but that was for the health of my baby. I can't seem to consistently do it for myself.

I can't take action for the next few days. From tomorrow morning I will be on a three-day carb-laden diet to prepare for the glucose tolerance test. But after that, regardless of the results, I need to start looking after myself.

The best way to avoid diabetes is to act like you already have it. Regular exercise, achieving a healthy weight, a healthy diet of normal food. The only real difference is the carb counting. Carbohydrate-rich foods have to be spread out through the day in careful portions -- not too much but not too little.

I'm feeling fat and stressed and sad today. Like I need to fix my health but won't be able to. I've failed at this before.

Monday, August 6, 2012

Long and faster


Today I did 24 mins on the rowing machine again, but with the much improved distance of 3.56 km. I may not be losing any weight (yesterday I was back up to 78.5 kg) but my body seems to be liking my relaxed approach to exercise -- my rowing is improving by leaps and bounds.

I'm afraid I did very little else today; watched the Olympic highlights and did the grocery shopping. I have a new, very short, editing job to do. I read it through today and will edit tomorrow. I like to think about things a bit. Let concepts and problems percolate. For instance, I've realised that this author really needs to think about who his audience is so he doesn't alienate the very people he is trying to convince.

Sunday, August 5, 2012

Long and slow


On Thursday I did a longer slower row, 24 mins -- twice as long as usual -- but only about 3/4 of my best speed. A little over 3 km.

Today I went to a writing workshop where I nutted out the details of a novel I want to write. I already have a WIP (work in progress) but I have agonised over it so long and written so little that I have decided to set it aside for a while and start a new project. I will come back to that one later.

So much Olympics to watch!

Wednesday, August 1, 2012

Personal Best


A PB on the rowing machine today -- 2.035 km in my 12 mins! Yay, I did it! I had to go a bit harder right from the beginning, and I was buggered by the end. Did it though.

Then I got on the treadmill and watched the Olympics.