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.

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